House File 53 - Introduced HOUSE FILE 53 BY FRY and HUNTER A BILL FOR An Act relating to notification of the placement of sex 1 offenders in nursing facilities, residential care 2 facilities, and assisted living programs, and the 3 prohibition of certain placements of sexually violent 4 predators in such facilities and programs, and providing 5 penalties, and including effective date provisions. 6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 7 TLSB 1370YH (3) 85 ad/rj

H.F. 53 Section 1. NEW SECTION . 135C.23A Sex offender notification. 1 1. Upon commitment of a person required to register as 2 a sex offender as provided in section 692A.103 to a nursing 3 facility, residential care facility, or assisted living program 4 as defined in section 231C.2, the clerk of the committing court 5 shall notify the department of inspections and appeals and the 6 admitting facility or program. 7 2. Prior to admission of a resident or tenant to a nursing 8 facility, residential care facility, or assisted living 9 program, the facility or program shall access and search the 10 sex offender registry established in chapter 692A to determine 11 whether the resident or tenant is a person required to register 12 as a sex offender, as provided in section 692A.103. 13 3. Upon the admission of a person required to register as a 14 sex offender, a nursing facility, residential care facility, or 15 assisted living program shall provide notice of the admission, 16 in accordance with the federal Health Insurance Portability and 17 Accountability Act of 1996, Pub. L. No. 104-191, other state 18 and federal regulations, and rules adopted by the department, 19 to all of the following persons: 20 a. Residents or tenants of the facility or program. 21 b. The emergency contact person or next of kin for residents 22 or tenants of the facility or program. 23 c. Operators, owners, managers, or employees of the facility 24 or program. 25 d. Visitors to the facility or program. 26 e. The sheriff for the county in which the facility or 27 program is located. The sheriff shall notify local law 28 enforcement agencies. 29 4. Upon the admission of a person required to register as a 30 sex offender, a nursing facility, residential care facility, or 31 assisted living program shall develop and implement a written 32 safety plan for each such person in accordance with rules 33 adopted by the department. 34 5. The department shall establish by rule, all of the 35 -1- LSB 1370YH (3) 85 ad/rj 1/ 14

H.F. 53 following: 1 a. The requirements of the notice required under this 2 section. The rules shall include but are not limited to 3 provisions for the method of notice and time of notice to each 4 of the persons enumerated in subsection 3. 5 b. The requirements of a safety plan for persons required 6 to register as a sex offender who are admitted by a nursing 7 facility, residential care facility, or assisted living 8 program. The rules shall include but are not limited to all of 9 the following: 10 (1) A plan for the safety of residents, tenants, and staff 11 of the facility or program. 12 (2) A plan for the safety of others when community functions 13 are held at a facility or program and when a person required to 14 register as a sex offender is not on the premises of a facility 15 or program but the person remains within the care, custody, and 16 control of the facility or program. 17 (3) A provision to establish the responsibilities of a 18 nursing facility, residential care facility, and assisted 19 living program and the operators, owners, managers, and 20 employees of facilities and programs in implementing a safety 21 plan. 22 (4) A provision for the timely development and 23 implementation of a safety plan. 24 6. The department shall work with interested stakeholders 25 in developing the proposed rules under this section. 26 7. A violation of this section is subject to the imposition 27 of a civil penalty in accordance with rules adopted by the 28 department pursuant to this section. 29 Sec. 2. Section 229A.8A, subsection 5, Code 2013, is amended 30 to read as follows: 31 5. Committed Except as provided in subsection 6A, committed 32 persons in the transitional release program are not necessarily 33 required to be segregated from other persons. 34 Sec. 3. Section 229A.8A, Code 2013, is amended by adding the 35 -2- LSB 1370YH (3) 85 ad/rj 2/ 14

H.F. 53 following new subsection: 1 NEW SUBSECTION . 6A. Persons in the transitional release 2 program shall not be released to a health care facility as 3 defined in section 135C.1. 4 Sec. 4. Section 229A.9A, Code 2013, is amended by adding the 5 following new subsection: 6 NEW SUBSECTION . 3A. If a release with or without 7 supervision is ordered, the committed person shall not be 8 released to a health care facility as defined in section 9 135C.1. 10 Sec. 5. Section 231C.3, subsection 9, Code 2013, is amended 11 to read as follows: 12 9. An assisted living program shall comply with section 13 sections 135C.23A and 135C.33 . 14 Sec. 6. Section 231C.5A, Code 2013, is amended to read as 15 follows: 16 231C.5A Assessment Admission and assessment of tenants —— 17 program eligibility. 18 1. An assisted living program receiving reimbursement 19 through the medical assistance program under chapter 249A shall 20 assist the department of veterans affairs in identifying, upon 21 admission of a tenant, the tenant’s eligibility for benefits 22 through the United States department of veterans affairs. The 23 assisted living program shall also assist the commission of 24 veterans affairs in determining such eligibility for tenants 25 residing in the program on July 1, 2009. The department of 26 inspections and appeals, in cooperation with the department of 27 human services, shall adopt rules to administer this section , 28 including a provision that ensures that if a tenant is eligible 29 for benefits through the United States department of veterans 30 affairs or other third-party payor, the payor of last resort 31 for reimbursement to the assisted living program is the medical 32 assistance program. The rules shall also require the assisted 33 living program to request information from a tenant or tenant’s 34 personal representative regarding the tenant’s veteran status 35 -3- LSB 1370YH (3) 85 ad/rj 3/ 14

H.F. 53 and to report to the department of veterans affairs only the 1 names of tenants identified as potential veterans along with 2 the names of their spouses and any dependents. Information 3 reported by the assisted living program shall be verified by 4 the department of veterans affairs. 5 2. An assisted living program is not required to enter 6 into a lease or occupancy agreement with an individual through 7 court order, referral, or other means without the express prior 8 approval of the manager of the assisted living program. 9 Sec. 7. Section 231C.14, subsection 1, Code 2013, is amended 10 by adding the following new paragraph: 11 NEW PARAGRAPH . d. Noncompliance with section 135C.23A. 12 Sec. 8. Section 602.8102, Code 2013, is amended by adding 13 the following new subsection: 14 NEW SUBSECTION . 152. Notify the department of inspections 15 and appeals and the admitting entity upon commitment of a 16 person required to register as a sex offender as provided in 17 section 692A.103 to a nursing facility or residential care 18 facility as defined in section 135C.1, or an assisted living 19 program as defined in section 231C.2. 20 Sec. 9. PLACEMENT OF PERSONS REQUIRED TO REGISTER. 21 1. For purposes of this section, “adequate placement” means 22 a placement that will provide the level of care necessary for 23 a person including the level of care provided by a nursing 24 facility or residential care facility. 25 2. For the period beginning July 1, 2013, through June 26 30, 2014, the department of human services, in compliance 27 with federal and state law, shall secure adequate placements 28 for persons required to register as a sex offender pursuant 29 to chapter 692A who are being released from the custody of 30 the department of corrections and require the type of medical 31 and personal care provided by a nursing facility, residential 32 care facility, or assisted living program; who are being 33 discharged or transferred from nursing facilities, residential 34 care facilities, or assisted living programs pursuant to a 35 -4- LSB 1370YH (3) 85 ad/rj 4/ 14

H.F. 53 provision of this Act; or who require the type of medical and 1 personal care provided by nursing facilities, residential care 2 facilities, or assisted living programs when the persons are 3 unable to gain access to a facility or program because the 4 persons are required to register on the sex offender registry. 5 3. The department of human services may use a state facility 6 to provide care for such persons or may conduct a request for 7 proposal process to contract with a private facility to care 8 for such persons. A request for proposals shall identify the 9 reimbursement rate and the necessary training for staff in the 10 facility or program. 11 4. The department of human services shall secure an adequate 12 placement for such a person within ten business days of being 13 notified by the department of corrections, the department of 14 inspections and appeals, or a nursing facility, residential 15 care facility, or assisted living program that placement is 16 needed for such person, provided that such period shall not 17 commence until the department of public safety receives and 18 approves registration data and makes such data available on 19 the sex offender registry internet site pursuant to section 20 692A.121, subsection 12. 21 Sec. 10. WORKFORCE DEVELOPMENT WORKGROUP. 22 1. The department of human services shall convene and 23 provide support to a health and mental health services for 24 sexual offender workforce development workgroup to address 25 issues connected with ensuring that an adequate workforce is 26 available in the state to provide health and mental health 27 services to persons who have a history of committing sexual 28 offenses and have been determined to be likely to reoffend. 29 The workgroup shall report at least annually to the governor 30 and general assembly providing findings, recommendations, 31 and financing information concerning the findings and 32 recommendations. 33 2. The membership of the workgroup shall include all of the 34 following: 35 -5- LSB 1370YH (3) 85 ad/rj 5/ 14

H.F. 53 a. The director of the department of aging or the director’s 1 designee. 2 b. The director of the department of corrections or the 3 director’s designee. 4 c. The director of the department of education or the 5 director’s designee. 6 d. The director of human services or the director’s 7 designee. 8 e. The director of the department of public health or the 9 director’s designee. 10 f. The director of the department of workforce development 11 or the director’s designee. 12 g. At least three individuals who have a history of 13 committing sexual offenses and have been determined likely to 14 reoffend who are receiving mental health or health services or 15 involved relatives of such individuals. 16 h. At least three providers of mental health or health 17 services for individuals who have a history of committing 18 sexual offenses and have been determined likely to reoffend. 19 i. Other persons identified by the workgroup. 20 3. In addition to the members identified in subsection 21 2, the membership of the workgroup shall include four 22 members of the general assembly serving in a ex officio, 23 nonvoting capacity. One member shall be designated by each 24 of the following: the majority leader of the senate, the 25 minority leader of the senate, the speaker of the house of 26 representatives, and the minority leader of the house of 27 representatives. A legislative member serves for a term as 28 provided in section 69.16B. 29 4. Except as provided in subsection 3 for legislative 30 appointments, the workgroup shall determine its own rules of 31 procedure, membership terms, and operating provisions. 32 Sec. 11. FACILITY FOR SEXUAL OFFENDERS COMMITTEE AND 33 REPORT. 34 1. The department of inspections and appeals, in 35 -6- LSB 1370YH (3) 85 ad/rj 6/ 14

H.F. 53 conjunction with the department of human services, shall 1 establish and facilitate the activities of a committee of 2 stakeholders to examine options for designating a facility 3 to provide care for persons in this state who have a history 4 of committing sexual offenses and have been determined to be 5 likely to reoffend. 6 2. The membership of the committee shall include but is not 7 limited to the following: 8 a. Representatives of the departments of inspections 9 and appeals, human services, public health, corrections, and 10 aging, the office of the state public defender, the office of 11 the citizens’ aide, the office of the state long-term care 12 resident’s advocate, and the judicial branch. 13 b. Consumers of services provided by health care facilities 14 and family members of consumers. 15 c. Representatives of the health care industry and industry 16 associations. 17 d. Direct care workers employed by health care facilities. 18 e. Representatives from the Iowa legal aid. 19 f. Representatives from AARP Iowa. 20 g. Representatives from the Iowa civil liberties union. 21 h. Other stakeholders as the department of inspections and 22 appeals and the department of human services deem necessary. 23 i. Four ex officio, nonvoting members from the general 24 assembly with not more than one member from each chamber being 25 from the same political party. The two senators shall be 26 appointed, one each, by the majority leader of the senate and 27 the minority leader of the senate. The two representatives 28 shall be appointed, one each, by the speaker of the house 29 of representatives and the minority leader of the house of 30 representatives. 31 3. The committee shall discuss and make recommendations on 32 all of the following: 33 a. Options to create a new facility or assist an existing 34 facility to expand services to provide care for elderly persons 35 -7- LSB 1370YH (3) 85 ad/rj 7/ 14

H.F. 53 who are no longer under judicial control, but have a history 1 of committing sexual offenses and have been determined to 2 be likely to reoffend. The committee shall identify the 3 characteristics of a client for such a facility, the need for 4 such a facility, options for creating a new facility to house 5 such persons, options for the expansion of an existing facility 6 to house such persons, options for using any alternative 7 facilities for such purposes, options for a public-private 8 partnership for such a facility, options for using part of 9 a mental health institute to house such persons, options to 10 qualify a facility for Medicaid reimbursement, cost projections 11 for any recommendations, regulatory challenges, and other 12 information deemed relevant by the department of inspections 13 and appeals and the department of human services. 14 b. The responsibility of the court, the clerk of the 15 district court, the department of corrections, or any other 16 entity, department, or person to inform a nursing facility, 17 residential care facility, or an assisted living program of the 18 admission of a person who has a history of committing sexual 19 offenses. 20 c. The responsibility of the court, clerk of the district 21 court, department of corrections, a facility, or any other 22 entity, department, or person to notify persons of the 23 discharge of a person who has a history of committing sexual 24 offenses from a nursing facility, residential care facility, or 25 assisted living program. 26 d. The requirements of a treatment safety plan for a person 27 admitted to a nursing facility, residential care facility, 28 or assisted living program who has a history of committing 29 sexual offenses. The treatment safety plan shall address the 30 procedure for notifying other residents of the residency of a 31 person required to register as a sex offender. 32 e. The establishment of a formal process for the department 33 of inspections and appeals to follow when completing facility 34 or assisted living program inspections or surveys. 35 -8- LSB 1370YH (3) 85 ad/rj 8/ 14

H.F. 53 f. The establishment of a system for the judicial branch to 1 identify facilities with the capacity to provide an appropriate 2 placement for a person requiring commitment when the person 3 also has a history of committing sexual offenses. 4 4. The committee shall provide a report detailing its 5 findings and recommendations to the governor and the general 6 assembly by December 15, 2013. 7 Sec. 12. EMERGENCY RULES. If specifically authorized by 8 a provision of this Act, the department of inspections and 9 appeals may adopt administrative rules under section 17A.4, 10 subsection 3, and section 17A.5, subsection 2, paragraph 11 “b”, to implement the provisions and the rules shall become 12 effective immediately upon filing or on a later effective date 13 specified in the rules, unless the effective date is delayed by 14 the administrative rules review committee. Any rules adopted 15 in accordance with this section shall not take effect before 16 the rules are reviewed by the administrative rules review 17 committee. The delay authority provided to the administrative 18 rules review committee under section 17A.4, subsection 7, and 19 section 17A.8, subsection 9, shall be applicable to a delay 20 imposed under this section, notwithstanding a provision in 21 those sections making them inapplicable to section 17A.5, 22 subsection 2, paragraph “b”. Any rules adopted in accordance 23 with the provisions of this section shall also be published as 24 a notice of intended action as provided in section 17A.4. 25 Sec. 13. CURRENT RESIDENTS AND TENANTS —— ACCESS AND SEARCH 26 OF SEX OFFENDER REGISTRY AND NOTIFICATION. A nursing facility, 27 residential care facility, or assisted living program, within 28 three months of the adoption of the rules by the department of 29 inspections and appeals regarding notification of the admission 30 of persons required to register as a sex offender to a facility 31 or program and development and implementation of safety plans 32 relating to such admitted persons, shall access and search the 33 sex offender registry established in chapter 692A for persons 34 who were residents or tenants of a facility or program prior to 35 -9- LSB 1370YH (3) 85 ad/rj 9/ 14

H.F. 53 the adoption of the rules and who remain residents or tenants 1 of the facility or program after the adoption of the rules. 2 Upon determining that a resident or tenant is a person required 3 to register as a sex offender, the facility or program shall, 4 within three months of the adoption of the rules, work with 5 the department of inspections and appeals and the department 6 of human services to transfer a sex offender living in the 7 facility or program to a state facility, based on the sex 8 offender status as an endangerment to the safety of individuals 9 in the facility or program, or notify persons as required by 10 section 135C.23A and the rules adopted pursuant to that section 11 and develop and implement a safety plan as required by section 12 135C.23A and the rules adopted pursuant to that section. The 13 rules shall provide that, for purposes of this section, a 14 nursing facility, residential care facility, or assisted living 15 program has the right to discharge a current resident or tenant 16 based solely on the person’s status as a sex offender as an 17 endangerment to the safety of individuals in the facility or 18 program. 19 Sec. 14. EFFECTIVE UPON ENACTMENT. This Act, being deemed 20 of immediate importance, takes effect upon enactment. 21 EXPLANATION 22 This bill addresses the placement of elderly sex offenders 23 in certain health or group living facilities. 24 The bill requires the clerk of the committing court to notify 25 the department of inspections and appeals and the admitting 26 facility or program, upon commitment of a person required to 27 register as a sex offender to a nursing facility, residential 28 care facility, or assisted living program. 29 Before admitting a person required to register as a sex 30 offender, a nursing facility, residential care facility, or 31 assisted living program must access and search the sex offender 32 registry to determine whether that person is required to 33 register as a sex offender. 34 If admitting a person required to register as a sex 35 -10- LSB 1370YH (3) 85 ad/rj 10/ 14

H.F. 53 offender, a nursing facility, residential care facility, or 1 assisted living program must provide notice of the admission 2 to residents or tenants; the emergency contact person or next 3 of kin of residents or tenants; operators, owners, managers, 4 employees, and visitors of the facility or program; and 5 the sheriff for the county in which the facility or program 6 is located. The sheriff must provide notice to local law 7 enforcement agencies. The nursing facility, residential care 8 facility, or assisted living program must also develop and 9 implement a written safety plan, in accordance with rules 10 adopted by the department of inspections and appeals, for the 11 person required to register as a sex offender. A violation of 12 these requirements may subject the facility or program to a 13 civil penalty. 14 The department of inspections and appeals is required to 15 establish the requirements of the notice provided by the 16 facility or program and the requirements of the safety plan. 17 The notice requirements must include but are not limited to 18 provisions for the method of the notice and the time of the 19 notice. The requirements of the safety plan must include 20 but are not limited to a plan for the safety of residents, 21 tenants, and staff; a plan for the safety of others when 22 community functions are held at the facility or program or when 23 a person required to register as a sex offender is not on the 24 premises of the facility or program, but remains in the care 25 and custody of the facility or program; the responsibilities of 26 the facility or program and its operators, owners, managers, 27 and employees; and the timely development and implementation 28 of a safety plan. 29 The bill provides that persons committed as sexually violent 30 predators that are in the transitional release program governed 31 by Code chapter 229A shall not be released to a health care 32 facility as defined in Code section 135C.1. The bill further 33 provides that a person committed as a sexually violent predator 34 shall not be released to a health care facility when a release 35 -11- LSB 1370YH (3) 85 ad/rj 11/ 14

H.F. 53 with or without supervision is ordered. The bill makes 1 conforming amendments. 2 The bill provides that an assisted living program is 3 not required to enter into an occupancy agreement with an 4 individual through court order, referral, or other means 5 without the express prior approval of the manager of the 6 assisted living program. 7 The bill also address placement of persons required to 8 register as a sex offender pursuant to Code chapter 692A. The 9 bill requires that by July 1, 2013, through June 30, 2014, the 10 department of human services must secure adequate placement 11 for certain persons required to register as a sex offender. 12 The department of human services must secure placement for the 13 following: a sex offender being released from the custody of 14 the department of corrections when that person needs medical 15 and personal care provided by a nursing facility, residential 16 care facility, or assisted living program; a sex offender who 17 is being discharged or transferred from a nursing facility, 18 residential care facility, or assisted living program pursuant 19 to a provision of the bill; or a person who requires the type 20 of medical and personal care provided by a nursing facility, 21 residential care facility, or assisted living program who is 22 unable to gain access to a facility or program because the 23 person is required to register on the sex offender registry. 24 The bill allows the department of human services to use a 25 state facility or to conduct a request for proposal process 26 to provide care for such persons. The bill requires the 27 department of human services to secure adequate placement for 28 such a person as described above within 10 business days of 29 being notified that placement is needed. 30 The bill requires the department of human services to 31 establish a workforce development workgroup to address problems 32 in ensuring that an adequate workforce is available in the 33 state to provide health and mental health services to persons 34 who have a history of committing sexual offenses and have been 35 -12- LSB 1370YH (3) 85 ad/rj 12/ 14

H.F. 53 determined likely to reoffend. The group is required to report 1 its findings, recommendations, and financing information for 2 those findings and recommendations annually to the governor and 3 the general assembly. 4 The bill directs the department of inspections and appeals, 5 in conjunction with the department of human services, to 6 establish and facilitate a committee to examine options for a 7 facility for sexual offenders. The committee must consider 8 options for a facility which would provide care for persons 9 who have a history of committing sexual offenses and have been 10 determined likely to reoffend. The committee shall identify 11 the residents to be served by the facility; the need for such 12 a facility; options for creating a new facility, expanding an 13 existing facility, or using any alternative facility for the 14 purpose of housing identified persons; options to qualify a 15 facility for Medicaid reimbursement; cost projections for the 16 recommendations; and other information deemed relevant by the 17 department of inspections and appeals. 18 The committee must also address the responsibility of the 19 court or the clerk of court, the department of corrections, 20 or any other entity to inform a nursing facility, residential 21 care facility, or assisted living program of the admission 22 of a person who has a history of committing sexual offenses 23 and to notify persons of the discharge of a person who has a 24 history of committing sexual offenses from a nursing facility, 25 residential care facility, or assisted living program. The 26 committee must consider and make recommendations on the 27 requirements of a treatment safety plan for a person who has 28 a history of committing sexual offenses when that person is 29 admitted to a nursing facility, residential care facility, 30 or assisted living program. The committee must consider 31 the establishment of a formal process for the department of 32 inspections and appeals to follow when completing facility 33 or assisted living program inspections or surveys. The 34 committee must also consider the establishment of a system for 35 -13- LSB 1370YH (3) 85 ad/rj 13/ 14

H.F. 53 the judicial branch to identify facilities with the capacity 1 to provide an appropriate placement for a person requiring 2 commitment when the person also has a history of committing 3 sexual offenses. 4 The bill requires the committee to provide a report of its 5 findings and recommendations to the governor and the general 6 assembly by December 15, 2013. 7 The bill allows the department of inspections and appeals to 8 adopt emergency rules. These rules are not effective unless 9 reviewed by the administrative rules review committee. 10 Within three months after the adoption of rules by the 11 department of inspections and appeals, the bill requires a 12 nursing facility, residential care facility, or assisted living 13 program to access and search the sex offender registry for 14 persons who were residents or tenants of a facility or program 15 prior to the adoption of the rules and who remain residents of 16 the facility or program. If the facility or program determines 17 that a resident or tenant is required to register as a sex 18 offender, the facility or program either must work with the 19 department of inspections and appeals and the department of 20 human services to either transfer a sex offender living in 21 the facility or program to a state facility or must notify 22 persons as required by the bill and the rules adopted pursuant 23 to the bill and develop and implement a safety plan. The 24 bill requires that rules provide that a nursing facility, 25 residential care facility, or assisted living program has the 26 right to discharge a current resident or tenant based only on 27 that person’s status as a sex offender as an endangerment to 28 the safety of individuals in the facility or program. 29 The bill is effective upon enactment. 30 -14- LSB 1370YH (3) 85 ad/rj 14/ 14