Senate Study Bill 3221 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON HUMAN RESOURCES BILL BY CHAIRPERSON RAGAN) A BILL FOR An Act relating to criteria for exemptions from admission or 1 discharge requirements for assisted living programs which 2 exceed their occupancy criteria. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 6209SC (2) 83 pf/nh

S.F. _____ Section 1. Section 231C.3, subsection 1, Code Supplement 1 2009, is amended to read as follows: 2 1. The department shall establish by rule in accordance with 3 chapter 17A minimum standards for certification and monitoring 4 of assisted living programs. The department may adopt by 5 reference with or without amendment, nationally recognized 6 standards and rules for assisted living programs. The rules 7 shall include specification of recognized accrediting entities 8 and provisions related to dementia-specific programs. The 9 standards and rules shall be formulated in consultation with 10 affected state agencies and affected industry, professional, 11 and consumer groups; shall be designed to accomplish the 12 purposes of this chapter; and shall include but are not limited 13 to rules relating to all of the following: 14 a. Provisions to ensure, to the greatest extent possible, 15 the health, safety, and well-being and appropriate treatment 16 of tenants. 17 b. Requirements that assisted living programs furnish 18 the department with specified information necessary to 19 administer this chapter. All information related to a provider 20 application for an assisted living program submitted to the 21 department shall be considered a public record pursuant to 22 chapter 22. 23 c. Standards for tenant evaluation or assessment, and 24 service plans, which may vary in accordance with the nature 25 of the services provided or the status of the tenant. When a 26 tenant needs personal care or health-related care, the service 27 plan shall be updated within thirty days of occupancy and as 28 needed with significant change, but not less than annually. 29 d. (1) Provisions allowing an exemption for admission of 30 a tenant to, or an exemption from discharge of a tenant from, 31 an assisted living program, who otherwise exceeds occupancy 32 criteria, if all of the following criteria are met: 33 (a) The tenant, the tenant’s legal representative, the 34 tenant’s physician, and the program consent to the tenant’s 35 -1- LSB 6209SC (2) 83 pf/nh 1/ 3

S.F. _____ admission or continued tenancy. 1 (b) The assisted living program has the capacity to provide, 2 obtain, or arrange for the provision of necessary services for 3 the tenant, including but not limited to certified home health 4 care or licensed hospice program care. 5 (c) The assisted living program is in substantial 6 compliance. 7 (d) Admission or retention of the tenant does not compromise 8 the safety of the tenant, any other tenant, or assisted living 9 program staff. 10 (2) If a tenant granted admission or exemption from 11 discharge under subparagraph (1) subsequently requires 12 health-related care beyond the capacity of the program as 13 specified in subparagraph (1), subparagraph divison (b), 14 becomes medically unstable, or requires maximum assistance with 15 activities of daily living, the tenant shall be discharged from 16 the program and the program shall initiate proceedings for 17 involuntary transfer of the tenant in accordance with section 18 231C.6, or the program may seek a short-term waiver as provided 19 in paragraph “e” . 20 d. e. Provisions for granting short-term waivers for 21 tenants who exceed occupancy criteria. 22 EXPLANATION 23 This bill provides for adoption of rules by the department of 24 inspections and appeals to allow an exemption for admission of 25 a tenant to, or an exemption from discharge of a tenant from, 26 an assisted living program, who otherwise exceeds occupancy 27 criteria, if specified conditions are met. The conditions 28 include: the tenant, the tenant’s legal representative, the 29 tenant’s physician, and the program consent to the tenant’s 30 admission or continued tenancy; the program has the capacity 31 to provide, obtain, or arrange for the provision of necessary 32 services for the tenant, including but not limited to certified 33 home health care or licensed hospice program care; the program 34 is in substantial compliance; and admission or retention of the 35 -2- LSB 6209SC (2) 83 pf/nh 2/ 3

S.F. _____ tenant does not compromise the safety of the tenant, any other 1 tenant, or program staff. 2 If the tenant granted admission or exemption from discharge 3 subsequently requires health-related care beyond the capacity 4 of the program, becomes medically unstable, or requires maximum 5 assistance with activities of daily living, the tenant must be 6 discharged from the program and transfer pursuant to existing 7 involuntary transfer proceedings, or the program may seek a 8 short-term waiver from the department for tenants who exceed 9 occupancy criteria. 10 -3- LSB 6209SC (2) 83 pf/nh 3/ 3