SENATE FILE 2103

BY  JOCHUM

A BILL FOR

An Act relating to services provided by assisted living programs.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 231C.1, subsection 2, paragraph b, Code 2011, is amended to read as follows:
   b.  To establish standards for assisted living programs that allow flexibility in design which promotes a social model of service delivery by focusing on independence, individual needs and desires, and consumer-driven quality of service, and that provide consumer protections to ensure program transparency, oversight, and accountability.
    Sec. 2.  Section 231C.1, subsection 3, Code 2011, is amended to read as follows:
   3.  It is the intent of the general assembly that the department promote a social model for assisted living programs, provide consistent standards and oversight to ensure protection of consumers, and
 
utilize a consultative process to assist with compliance by assisted living programs.
    Sec. 3.  Section 231C.2, subsection 2, Code Supplement 2011, is amended to read as follows:
   2.
  a.  “Assisted living” means
 
the provision
 
to three or more tenants of
 
a social model of housing with
 
in a physical structure which provides a homelike environment and balances individual privacy with the benefits of social interaction and provides associated services which may.
   b.  The social model shall provide an environment that supports each tenant in maximizing the tenant’s highest practicable level of well-being through individualized, stimulating, and purposeful activities, connections to and interaction with the outside community, and other interventions that assist a tenant in maintaining optimal independence while delaying further decline from any existing health, cognitive, mental health, or functional condition.
   c.  The services offered shall
 
include but are not limited to health-related
 
the following:
   (1)  Health-related
 
care,
 
or personal care, and assistance with instrumental activities of daily living to three or more tenants in a physical structure which provides a homelike environment.
   (2)  “Assisted living” also includes
 
The encouragement of family involvement, tenant self-direction, and tenant participation in decisions that emphasize choice, dignity, privacy, individuality, shared risk, and independence
 
in a manner commensurate with the tenant’s health, cognitive, mental health, and functional status. “Assisted living” includes the provision of housing and assistance with instrumental activities of daily living only if personal care or health-related care is also included. “Assisted living” includes
   (3)  Access to awake staff
 
twenty-four hours per day response staff to meet
 
a tenant’s scheduled and unscheduled or unpredictable needs
 
commensurate with the tenant’s health, cognitive, mental health, and functional status, in a manner that promotes maximum dignity and independence and provides supervision, safety, and security.
   d.  Services may include assistance with instrumental activities of daily living.
    Sec. 4.  Section 231C.5, subsection 2, paragraph a, Code Supplement 2011, is amended to read as follows:
   a.  A description of all fees, charges, and rates describing tenancy and basic services covered, and any additional and optional services and their related costs. 
 
The occupancy agreement shall also include the circumstances under which fees, charges, or rates are subject to change, and the process by which such change is made including but not limited to a provision of timely notice of such change.
    Sec. 5.  Section 231C.5, subsection 2, Code Supplement 2011, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  q.  The specific type and level of services the program provides and the specific health, cognitive, mental health, or functional condition that, by law, prohibit initial occupancy or may necessitate subsequent transfer or involuntary transfer.
    Sec. 6.  RULES.  The department of inspections and appeals shall adopt rules to implement the provisions of this Act.
EXPLANATION
   This bill amends Code sections related to assisted living programs. The bill adds that the purpose of establishing an assisted living program includes providing consumer protections to ensure program transparency, oversight, and accountability. The bill provides that it is the intent of the general assembly that the department of inspections and appeals provide consistent standards and oversight to ensure protection of consumers of assisted living programs.
   The bill amends the definition of “assisted living” to mean the provision of a social model of housing in a physical structure with services to three or more tenants. The physical structure must balance individual privacy with the benefits of social interaction. The bill provides that the social model must create an environment that supports the tenant in maximizing the highest practicable level of well-being that assists the tenant in maintaining optimal independence and delaying further decline in any existing health, cognitive, mental health, or functional condition.
   The bill amends the definition of “assisted living” to include as required assisted living services, health-related care, the encouragement of family involvement, tenant self-direction, and tenant participation in a manner commensurate with the tenant’s health, cognitive, mental health, and functional status, and access to awake staff 24 hours per day to meet the tenant’s needs commensurate with the tenant’s health, cognitive, mental health, and functional status. The bill provides that assisted living services may include assistance with instrumental activities of daily living.
   The bill provides that a written occupancy agreement shall include the circumstances under which fees, charges, or rates are subject to change and the process for making the changes including a provision for timely notice. The bill also requires a written occupancy agreement to include the specific type and level of services the program provides and the specific health, cognitive, mental health, or functional conditions that prohibit initial occupancy or may necessitate subsequent transfer.