Senate File 2103 - Introduced SENATE FILE 2103 BY JOCHUM A BILL FOR An Act relating to services provided by assisted living 1 programs. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 5585XS (2) 84 ad/rj

S.F. 2103 Section 1. Section 231C.1, subsection 2, paragraph b, Code 1 2011, is amended to read as follows: 2 b. To establish standards for assisted living programs that 3 allow flexibility in design which promotes a social model of 4 service delivery by focusing on independence, individual needs 5 and desires, and consumer-driven quality of service , and that 6 provide consumer protections to ensure program transparency, 7 oversight, and accountability . 8 Sec. 2. Section 231C.1, subsection 3, Code 2011, is amended 9 to read as follows: 10 3. It is the intent of the general assembly that the 11 department promote a social model for assisted living programs , 12 provide consistent standards and oversight to ensure protection 13 of consumers, and utilize a consultative process to assist with 14 compliance by assisted living programs. 15 Sec. 3. Section 231C.2, subsection 2, Code Supplement 2011, 16 is amended to read as follows: 17 2. a. “Assisted living” means the provision to three or 18 more tenants of a social model of housing with in a physical 19 structure which provides a homelike environment and balances 20 individual privacy with the benefits of social interaction and 21 provides associated services which may . 22 b. The social model shall provide an environment that 23 supports each tenant in maximizing the tenant’s highest 24 practicable level of well-being through individualized, 25 stimulating, and purposeful activities, connections to and 26 interaction with the outside community, and other interventions 27 that assist a tenant in maintaining optimal independence while 28 delaying further decline from any existing health, cognitive, 29 mental health, or functional condition. 30 c. The services offered shall include but are not limited to 31 health-related the following: 32 (1) Health-related care , or personal care , and assistance 33 with instrumental activities of daily living to three or more 34 tenants in a physical structure which provides a homelike 35 -1- LSB 5585XS (2) 84 ad/rj 1/ 4

S.F. 2103 environment . 1 (2) “Assisted living” also includes The encouragement 2 of family involvement, tenant self-direction, and tenant 3 participation in decisions that emphasize choice, dignity, 4 privacy, individuality, shared risk, and independence in a 5 manner commensurate with the tenant’s health, cognitive, 6 mental health, and functional status . “Assisted living” 7 includes the provision of housing and assistance with 8 instrumental activities of daily living only if personal care 9 or health-related care is also included. “Assisted living” 10 includes 11 (3) Access to awake staff twenty-four hours per day 12 response staff to meet a tenant’s scheduled and unscheduled 13 or unpredictable needs commensurate with the tenant’s health, 14 cognitive, mental health, and functional status, in a manner 15 that promotes maximum dignity and independence and provides 16 supervision, safety, and security. 17 d. Services may include assistance with instrumental 18 activities of daily living. 19 Sec. 4. Section 231C.5, subsection 2, paragraph a, Code 20 Supplement 2011, is amended to read as follows: 21 a. A description of all fees, charges, and rates describing 22 tenancy and basic services covered, and any additional and 23 optional services and their related costs. The occupancy 24 agreement shall also include the circumstances under which 25 fees, charges, or rates are subject to change, and the process 26 by which such change is made including but not limited to a 27 provision of timely notice of such change. 28 Sec. 5. Section 231C.5, subsection 2, Code Supplement 2011, 29 is amended by adding the following new paragraph: 30 NEW PARAGRAPH . q. The specific type and level of services 31 the program provides and the specific health, cognitive, mental 32 health, or functional condition that, by law, prohibit initial 33 occupancy or may necessitate subsequent transfer or involuntary 34 transfer. 35 -2- LSB 5585XS (2) 84 ad/rj 2/ 4

S.F. 2103 Sec. 6. RULES. The department of inspections and appeals 1 shall adopt rules to implement the provisions of this Act. 2 EXPLANATION 3 This bill amends Code sections related to assisted living 4 programs. The bill adds that the purpose of establishing an 5 assisted living program includes providing consumer protections 6 to ensure program transparency, oversight, and accountability. 7 The bill provides that it is the intent of the general assembly 8 that the department of inspections and appeals provide 9 consistent standards and oversight to ensure protection of 10 consumers of assisted living programs. 11 The bill amends the definition of “assisted living” to 12 mean the provision of a social model of housing in a physical 13 structure with services to three or more tenants. The physical 14 structure must balance individual privacy with the benefits 15 of social interaction. The bill provides that the social 16 model must create an environment that supports the tenant in 17 maximizing the highest practicable level of well-being that 18 assists the tenant in maintaining optimal independence and 19 delaying further decline in any existing health, cognitive, 20 mental health, or functional condition. 21 The bill amends the definition of “assisted living” to 22 include as required assisted living services, health-related 23 care, the encouragement of family involvement, tenant 24 self-direction, and tenant participation in a manner 25 commensurate with the tenant’s health, cognitive, mental 26 health, and functional status, and access to awake staff 24 27 hours per day to meet the tenant’s needs commensurate with 28 the tenant’s health, cognitive, mental health, and functional 29 status. The bill provides that assisted living services may 30 include assistance with instrumental activities of daily 31 living. 32 The bill provides that a written occupancy agreement 33 shall include the circumstances under which fees, charges, or 34 rates are subject to change and the process for making the 35 -3- LSB 5585XS (2) 84 ad/rj 3/ 4

S.F. 2103 changes including a provision for timely notice. The bill 1 also requires a written occupancy agreement to include the 2 specific type and level of services the program provides and 3 the specific health, cognitive, mental health, or functional 4 conditions that prohibit initial occupancy or may necessitate 5 subsequent transfer. 6 -4- LSB 5585XS (2) 84 ad/rj 4/ 4