S.F. _____ H.F. _____ Section 1. Section 135C.37, Code 2009, is amended to read 1 as follows: 2 135C.37 Complaints alleging violations —— confidentiality. 3 A person may request an inspection of a health care facility 4 by filing with the department, resident advocate committee 5 of the facility, or the office of long-term care resident’s 6 advocate as established pursuant to section 231.42, a complaint 7 of an alleged violation of applicable requirements of this 8 chapter or the rules adopted pursuant to this chapter. A 9 person alleging abuse or neglect of a resident with a 10 developmental disability or with mental illness may also file a 11 complaint with the protection and advocacy agency designated 12 pursuant to section 135B.9 or section 135C.2. A copy of a 13 complaint filed with the resident advocate committee or the 14 office of long-term care resident’s advocate shall be forwarded 15 to the department. The complaint shall state in a reasonably 16 specific manner the basis of the complaint, and a statement 17 of the nature of the complaint shall be delivered to the 18 facility involved at the time of the inspection. The name of 19 the person who files a complaint with the department, resident 20 advocate committee, or the office of long-term care resident’s 21 advocate shall be kept confidential and shall not be subject to 22 discovery, subpoena, or other means of legal compulsion for its 23 release to a person other than department employees involved in 24 the investigation of the complaint. 25 Sec. 2. Section 135C.38, subsection 2, paragraph d, Code 26 2009, is amended to read as follows: 27 d. A person who is dissatisfied with any aspect of the 28 department’s handling of the complaint may contact the office 29 of long-term care resident’s advocate, established pursuant 30 to section 231.42, or may contact the protection and advocacy 31 agency designated pursuant to section 135C.2 if the complaint 32 relates to a resident with a developmental disability or a 33 mental illness. 34 Sec. 3. Section 231.4, Code Supplement 2009, is amended by 1 -1- LSB 5280XD (6) 83 pf/nh 1/ 9

S.F. _____ H.F. _____ adding the following new subsections: 2 NEW SUBSECTION . 1A. “Assisted living program” means a 3 program which provides assisted living as defined pursuant to 4 section 231C.2 and which is certified under chapter 231C. 5 NEW SUBSECTION . 4A. “Elder group home” means elder group 6 home as defined in section 231B.1 which is certified under 7 chapter 231B. 8 NEW SUBSECTION . 9A. “Resident” means a resident or tenant 9 of a long-term care facility, assisted living program, or elder 10 group home, excluding facilities licensed primarily to serve 11 persons with mental retardation or mental illness. 12 Sec. 4. Section 231.4, subsection 10, Code Supplement 2009, 13 is amended by striking the subsection. 14 Sec. 5. Section 231.23A, subsection 7, Code Supplement 15 2009, is amended to read as follows: 16 7. Administration relating to the office of long-term care 17 resident’s advocate program and training for resident advocate 18 committees. 19 Sec. 6. Section 231.41, Code Supplement 2009, is amended to 20 read as follows: 21 231.41 Purpose. 22 The purpose of this subchapter is to establish the office 23 of long-term care resident’s advocate program operated 24 by within the Iowa commission on aging department in accordance 25 with the requirements of the federal Act, and to adopt 26 the supporting federal regulations and guidelines for its 27 implementation operation . In accordance with chapter 17A , 28 the commission on aging shall adopt and enforce rules for the 29 implementation of this subchapter . 30 Sec. 7. Section 231.42, Code Supplement 2009, is amended 31 by striking the section and inserting in lieu thereof the 32 following: 33 231.42 Office of long-term care resident’s advocate —— duties 34 —— penalties for violations. 35 1. Office established. The office of long-term care 1 -2- LSB 5280XD (6) 83 pf/nh 2/ 9

S.F. _____ H.F. _____ resident’s advocate is established within the department, in 2 accordance with section 712 of the federal Act, as codified 3 at 42 U.S.C. § 3058g. The office shall consist of the state 4 long-term care resident’s advocate and any local long-term care 5 resident’s advocates. 6 2. State long-term care resident’s advocate. The director 7 of the department shall appoint the state long-term care 8 resident’s advocate who shall do all of the following: 9 a. Establish and implement a statewide confidential 10 uniform reporting system for receiving, analyzing, referring, 11 investigating, and resolving complaints about the health, 12 safety, welfare, and rights of residents or tenants of 13 long-term care facilities, assisted living programs, and elder 14 group homes, excluding facilities licensed primarily to serve 15 persons with mental retardation or mental illness. 16 b. Publicize the office of long-term care resident’s 17 advocate and provide information and education to consumers, 18 the public, and other agencies about issues related to 19 long-term care in Iowa. 20 c. Monitor the development and implementation of federal, 21 state, and local laws, regulations, and policies that relate to 22 long-term care in Iowa. 23 d. Annually report to the governor and general assembly 24 on the activities of the office and make recommendations for 25 improving the health, safety, welfare, and rights of residents 26 and tenants of long-term care facilities, assisted living 27 programs, and elder group homes. 28 e. Cooperate with persons and public or private agencies 29 with regard to, and participate in, inquiries, meetings, 30 or studies that may lead to improvements in the health, 31 safety, welfare, and rights of residents and tenants and the 32 functioning of long-term care facilities, assisted living 33 programs, and elder group homes. 34 f. Recruit, train, educate, support, and monitor volunteers 35 associated with the office. 1 -3- LSB 5280XD (6) 83 pf/nh 3/ 9

S.F. _____ H.F. _____ 3. Local long-term care resident’s advocates. The local 2 long-term care resident’s advocates established pursuant to 3 this section shall do all of the following: 4 a. Accept, investigate, verify, and work to resolve 5 complaints, whether reported to or initiated by a long-term 6 care resident’s advocate, relating to any action or inaction 7 that may adversely affect the health, safety, welfare, or 8 rights of residents or tenants of a long-term care facility, 9 assisted living program, or elder group home. 10 b. Provide information about long-term care, the rights of 11 residents and tenants, payment sources for care, and selection 12 of a long-term care facility, assisted living program, or elder 13 group home to providers, consumers, family members, volunteers, 14 and the public. 15 c. Make referrals to appropriate licensing and enforcement 16 agencies to assure appropriate investigation of abuse 17 complaints and corrective actions. 18 d. Assist in the recruitment, training, education, support, 19 and monitoring of volunteers associated with the office of the 20 long-term care resident’s advocate. 21 e. Make noncomplaint-related visits to long-term care 22 facilities, assisted living programs, and elder group homes 23 to observe daily routines, meals, and activities, and work to 24 resolve complaints if any are identified during these visits. 25 4. Referrals of abuse, neglect, or exploitation. 26 a. If abuse, neglect, or exploitation of a resident or 27 tenant of a long-term care facility, assisted living program, 28 or elder group home is suspected, the state or a local 29 long-term care resident’s advocate shall, with the permission 30 of the resident or tenant as applicable under federal law, 31 make an immediate referral to the department of inspections 32 and appeals or the department of human services as applicable, 33 and to the appropriate law enforcement agency. The state or 34 a local long-term care resident’s advocate shall cooperate, 35 if requested, with the department of inspections and appeals, 1 -4- LSB 5280XD (6) 83 pf/nh 4/ 9

S.F. _____ H.F. _____ department of human services, or any law enforcement agency 2 pursuant to any investigation of such abuse, neglect, or 3 exploitation. 4 b. If the department of inspections and appeals responds 5 to a complaint referred by the state or a local long-term 6 care resident’s advocate against a long-term care facility, 7 assisted living program, elder group home, or an employee of 8 such entity, copies of related inspection reports, plans of 9 correction, and notice of any citations and sanctions levied 10 against the facility, program, or home shall be forwarded to 11 the office of the long-term care resident’s advocate. 12 5. Access to facility, program, or home. The state or a 13 local long-term care resident’s advocate or a trained volunteer 14 may enter any long-term care facility, assisted living program, 15 or elder group home at any time with or without prior notice 16 or complaint and shall be granted access to residents and 17 tenants at all times for the purpose of carrying out the duties 18 specified in this section. As used in this section, “access” 19 means the right to do all of the following: 20 a. Enter any long-term care facility, assisted living 21 program, or elder group home and provide identification. 22 b. Seek consent to communicate privately and without 23 restriction with any resident or tenant. 24 c. Communicate privately and without restriction with any 25 resident or tenant who consents to communication. 26 d. Review the clinical or other records of a resident or 27 tenant. 28 e. Observe all resident or tenant areas of a facility, 29 program, or housing establishment except the living area of any 30 resident or tenant who protests the observation. 31 6. Access to medical and personal records. 32 a. The state or a local long-term care resident’s advocate 33 shall have access to the medical and personal records of an 34 individual who is a resident or tenant of a long-term care 35 facility, assisted living program, or elder group home retained 1 -5- LSB 5280XD (6) 83 pf/nh 5/ 9

S.F. _____ H.F. _____ by the facility, program, or home. 2 b. Records may be reproduced by the state or a local 3 long-term care resident’s advocate. 4 c. Upon request of the state or a local long-term care 5 resident’s advocate, a long-term care facility, assisted living 6 program, or elder group home shall provide the name, address, 7 and telephone number of the guardian, conservator, attorney in 8 fact, legal representative, or next of kin of any resident or 9 tenant. 10 d. A long-term care facility, assisted living program, or 11 elder group home or personnel of such a facility, program, or 12 home who discloses records in compliance with this section and 13 the procedures adopted pursuant to this section shall not be 14 liable for such disclosure. 15 7. Interference prohibited —— penalties. 16 a. A person who intentionally prevents, interferes with, or 17 attempts to impede the work of the state or a local long-term 18 care resident’s advocate is subject to a penalty imposed by the 19 director of not more than one thousand five hundred dollars 20 for each violation. Any moneys collected pursuant to this 21 subsection shall be deposited in the general fund of the state. 22 b. The office of the long-term care resident’s advocate 23 shall adopt rules specifying procedures for notice and appeal 24 of penalties imposed pursuant to this subsection. 25 c. The director, in consultation with the office of the 26 long-term care resident’s advocate, shall notify the county 27 attorney of the county in which the long-term care facility, 28 assisted living program, or elder group home is located, or the 29 attorney general, of any violation of this subsection. 30 8. Retaliation prohibited —— penalties. An officer, 31 director, or employee of a long-term care facility, assisted 32 living program, or elder group home shall not retaliate against 33 any person for having filed a complaint with, or provided 34 information to, the state or a local long-term care resident’s 35 advocate. A person who retaliates or discriminates in 1 -6- LSB 5280XD (6) 83 pf/nh 6/ 9

S.F. _____ H.F. _____ violation of this subsection is guilty of a simple misdemeanor. 2 9. Change in operations. A long-term care facility, 3 assisted living program, or elder group home shall inform the 4 office of the long-term care resident’s advocate in writing at 5 least thirty days prior to any change in operations, programs, 6 services, licensure, or certification that affects residents or 7 tenants, including but not limited to any emergency situation, 8 evacuation, facility closure, program decertification, or 9 change of ownership. 10 10. Immunity. The state or a local long-term care 11 resident’s advocate or any representative of the office 12 participating in the good faith performance of their official 13 duties shall have immunity from any civil or criminal liability 14 that otherwise might result by reason of taking, investigating, 15 or pursuing a complaint under this section. 16 11. Confidentiality. Information relating to any complaint 17 made to or investigation by the state or a local long-term 18 care resident’s advocate that discloses the identity of a 19 complainant, resident, or tenant, or information related to 20 a resident’s or tenant’s personal or medical records, shall 21 remain confidential except as follows: 22 a. If permission is granted by the director in consultation 23 with the state long-term care resident’s advocate. 24 b. If disclosure is authorized in writing by the complainant 25 and the resident, tenant, or the individual’s guardian or legal 26 representative. 27 c. If disclosure is necessary for the provision of services 28 to a resident or tenant, or the resident or tenant is unable to 29 express written or oral consent. 30 d. If ordered by a court. 31 12. Posting of state long-term care resident’s advocate 32 information. Every long-term care facility, assisted living 33 program, and elder group home shall post information in 34 a prominent location that includes the name, address, and 35 telephone number, and a brief description of the services 1 -7- LSB 5280XD (6) 83 pf/nh 7/ 9

S.F. _____ H.F. _____ provided by the office of the long-term care resident’s 2 advocate. The information posted shall be approved or provided 3 by the office of the long-term care resident’s advocate. 4 Sec. 8. Section 231.44, subsections 1 and 3, Code Supplement 5 2009, are amended to read as follows: 6 1. The resident advocate committee volunteer program is 7 administered by the office of the long-term care resident’s 8 advocate program . The state and any local long-term care 9 resident’s advocate shall provide information, assistance, 10 and support to resident advocate committee program volunteers 11 to the extent possible. If funding becomes insufficient to 12 process applications and new appointments to resident advocate 13 committees can no longer be made, the director shall notify 14 the director of the department of inspections and appeals. A 15 health care facility shall not be found in violation of section 16 135C.25 for not having a resident advocate committee if new 17 appointments cannot be made as documented in accordance with 18 this subsection. 19 3. A An elder group home or long-term care facility 20 shall disclose the names, addresses, and phone numbers of a 21 resident’s family members, if requested, to a resident advocate 22 committee member, unless permission for this disclosure is 23 refused in writing by a family member. 24 Sec. 9. Section 235B.6, subsection 2, paragraph e, 25 subparagraph (10), Code Supplement 2009, is amended to read as 26 follows: 27 (10) The state or a local long-term care resident’s 28 advocate if the victim resides in a long-term care facility 29 or the alleged perpetrator is an employee of a long-term care 30 facility. 31 Sec. 10. REPEAL. Section 231.43, Code Supplement 2009, is 32 repealed. 33 EXPLANATION 34 This bill provides for the establishment of the office of 35 long-term care resident’s advocate which consists of the state 1 -8- LSB 5280XD (6) 83 pf/nh 8/ 9

S.F. _____ H.F. _____ long-term care resident’s advocate and any local long-term care 2 resident’s advocates. The bill provides that the director 3 of the department on aging is to appoint the state long-term 4 care resident’s advocate and specifies the duties of the state 5 and local long-term care resident’s advocates. In addition to 6 residents of long-term care facilities, the duties of the state 7 and local long-term care resident’s advocates under the bill 8 also extend to tenants of elder group homes and assisted living 9 programs. 10 The bill also provides for referrals of reports of 11 suspected abuse, neglect, or exploitation of a resident 12 or tenant by the state or local long-term care resident’s 13 advocate to the department of inspections and appeals or the 14 department of human services, as applicable, and to local 15 law enforcement; provides for access to certain areas of 16 a facility, assisted living program, or elder group home 17 under certain circumstances; provides for access to medical 18 and personal records of residents and tenants and provides 19 protection of confidentiality for information relating to a 20 complaint; establishes penalties for interference with the work 21 of the state or a local long-term care resident’s advocate 22 and for retaliation against a person who assists a resident’s 23 advocate; requires the reporting by a facility, assisted living 24 program, or elder group home to the office of the long-term 25 care resident’s advocate at least 30 days prior to any change 26 in operations, programs, services, licensure, or certification 27 that affects residents or tenants; provides immunity and 28 confidentiality provisions relating to the duties of the 29 resident’s advocates; provides for the posting of information 30 about the state long-term care resident’s advocate at each 31 facility, program, or home; and makes other conforming changes. 32 -9- LSB 5280XD (6) 83 pf/nh 9/ 9