House Study Bill 46 - Introduced SENATE/HOUSE FILE _____ BY (PROPOSED DEPARTMENT ON AGING BILL) A BILL FOR An Act relating to programs and services under the purview of 1 the department on aging. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 1225XD (8) 85 pf/nh

S.F. _____ H.F. _____ Section 1. Section 10A.402, subsection 5, Code 2013, is 1 amended by striking the subsection. 2 Sec. 2. Section 22.7, subsection 62, Code 2013, is amended 3 to read as follows: 4 62. Records of , information, applications, and files 5 maintained by the department on aging or office of long-term 6 care ombudsman pertaining to clients served assistance provided 7 by the prevention of elder abuse, neglect, and exploitation 8 program department or office, including information relating to 9 complaints made to or investigations by the department on aging 10 or the office of long-term care ombudsman, unless disclosure 11 is otherwise allowed under section 231.42, subsection 12, 12 paragraph “b” . 13 Sec. 3. Section 135C.1, Code 2013, is amended by adding the 14 following new subsections: 15 NEW SUBSECTION . 1A. “Certified volunteer long-term care 16 ombudsman” means a volunteer long-term care ombudsman certified 17 pursuant to section 231.45. 18 NEW SUBSECTION . 13A. “Office of long-term care ombudsman” 19 means the office of long-term care ombudsman established 20 pursuant to section 231.42. 21 NEW SUBSECTION . 20A. “State long-term care ombudsman” 22 means the state long-term care ombudsman appointed pursuant to 23 section 231.42. 24 Sec. 4. Section 135C.11, subsection 2, Code 2013, is amended 25 to read as follows: 26 2. The procedure governing hearings authorized by this 27 section shall be in accordance with the rules promulgated by 28 the department. A full and complete record shall be kept 29 of all proceedings, and all testimony shall be reported but 30 need not be transcribed unless judicial review is sought 31 pursuant to section 135C.13 . Copies of the transcript may be 32 obtained by an interested party upon payment of the cost of 33 preparing the copies. Witnesses may be subpoenaed by either 34 party and shall be allowed fees at a rate prescribed by the 35 -1- LSB 1225XD (8) 85 pf/nh 1/ 23

S.F. _____ H.F. _____ department’s rules. The director may, after advising the 1 resident advocate committee established pursuant to section 2 135C.25 certified volunteer long-term care ombudsman , either 3 proceed in accordance with section 135C.30 , or remove all 4 residents and suspend the license or licenses of any health 5 care facility, prior to a hearing, when the director finds that 6 the health or safety of residents of the health care facility 7 requires such action on an emergency basis. The fact that no 8 resident advocate committee a certified volunteer long-term 9 care ombudsman has not been appointed for a particular facility 10 shall not bar the director from exercising the emergency powers 11 granted by this subsection with respect to that facility. 12 Sec. 5. Section 135C.13, Code 2013, is amended to read as 13 follows: 14 135C.13 Judicial review. 15 Judicial review of any action of the director may be sought 16 in accordance with the terms of the Iowa administrative 17 procedure Act, chapter 17A . Notwithstanding the terms of said 18 Act chapter 17A , petitions for judicial review may be filed in 19 the district court of the county where the facility or proposed 20 facility is located, and pending final disposition of the 21 matter the status quo of the applicant or licensee shall be 22 preserved except when the director, with the advice and consent 23 of the resident advocate committee established pursuant to 24 section 135C.25 certified volunteer long-term care ombudsman , 25 determines that the health, safety or welfare of the residents 26 of the facility is in immediate danger, in which case the 27 director may order the immediate removal of such residents. 28 The fact that no resident advocate committee a certified 29 volunteer long-term care ombudsman has not been appointed for a 30 particular facility shall not bar the director from exercising 31 the emergency powers granted by this subsection section with 32 respect to that facility. 33 Sec. 6. Section 135C.14, subsection 8, paragraph d, Code 34 2013, is amended to read as follows: 35 -2- LSB 1225XD (8) 85 pf/nh 2/ 23

S.F. _____ H.F. _____ d. The notification of resident advocate committees 1 certified volunteer long-term care ombudsmen by the department 2 of all complaints relating to health care facilities and the 3 involvement of the resident advocate committees certified 4 volunteer long-term care ombudsmen in resolution of the 5 complaints. 6 Sec. 7. Section 135C.20A, subsection 2, Code 2013, is 7 amended to read as follows: 8 2. The report card form shall be developed by the department 9 in cooperation with representatives of the department on 10 aging, the state long-term care resident’s advocate ombudsman , 11 representatives of resident advocate committees certified 12 volunteer long-term care ombudsmen , representatives of 13 protection and advocacy entities, consumers, and other 14 interested persons. 15 Sec. 8. Section 135C.20B, subsection 2, paragraph c, Code 16 2013, is amended to read as follows: 17 c. Any information submitted by care review committee 18 members or residents with regard to the quality of care of the 19 facility. 20 Sec. 9. Section 135C.37, Code 2013, is amended to read as 21 follows: 22 135C.37 Complaints alleging violations —— confidentiality. 23 A person may request an inspection of a health care facility 24 by filing with the department, resident advocate committee of 25 the facility certified volunteer long-term care ombudsman , or 26 the office of long-term care resident’s advocate as established 27 pursuant to section 231.42 ombudsman , a complaint of an alleged 28 violation of applicable requirements of this chapter or the 29 rules adopted pursuant to this chapter . A person alleging 30 abuse or neglect of a resident with a developmental disability 31 or with mental illness may also file a complaint with the 32 protection and advocacy agency designated pursuant to section 33 135B.9 or section 135C.2 . A copy of a complaint filed with the 34 resident advocate committee a certified volunteer long-term 35 -3- LSB 1225XD (8) 85 pf/nh 3/ 23

S.F. _____ H.F. _____ care ombudsman or the office of long-term care resident’s 1 advocate ombudsman shall be forwarded to the department. The 2 complaint shall state in a reasonably specific manner the 3 basis of the complaint, and a statement of the nature of the 4 complaint shall be delivered to the facility involved at the 5 time of the inspection. The name of the person who files a 6 complaint with the department, resident advocate committee 7 certified volunteer long-term care ombudsman , or the office 8 of long-term care resident’s advocate ombudsman shall be kept 9 confidential and shall not be subject to discovery, subpoena, 10 or other means of legal compulsion for its release to a person 11 other than department employees involved in the investigation 12 of the complaint. 13 Sec. 10. Section 135C.38, subsection 1, paragraphs a and c, 14 Code 2013, are amended to read as follows: 15 a. Upon receipt of a complaint made in accordance with 16 section 135C.37 , the department or resident advocate committee 17 certified volunteer long-term care ombudsman shall make a 18 preliminary review of the complaint. Unless the department 19 or committee certified volunteer long-term care ombudsman 20 concludes that the complaint is intended to harass a facility 21 or a licensee or is without reasonable basis, the department or 22 committee certified volunteer long-term care ombudsman shall 23 make or cause to be made an on-site inspection of the health 24 care facility which is the subject of the complaint within the 25 time period determined pursuant to the following guidelines, 26 which period shall commence on the date of receipt of the 27 complaint: 28 (1) For nursing facilities, an on-site inspection shall be 29 initiated as follows: 30 (a) Within two working days for a complaint determined by 31 the department or committee certified volunteer long-term care 32 ombudsman to be an alleged immediate jeopardy situation. 33 (b) Within ten working days for a complaint determined by 34 the department or committee certified volunteer long-term care 35 -4- LSB 1225XD (8) 85 pf/nh 4/ 23

S.F. _____ H.F. _____ ombudsman to be an alleged high-level, nonimmediate jeopardy 1 situation. 2 (c) Within forty-five calendar days for a complaint 3 determined by the department or committee certified volunteer 4 long-term care ombudsman to be an alleged nonimmediate jeopardy 5 situation, other than a high-level situation. 6 (2) For all other types of health care facilities, an 7 on-site inspection shall be initiated as follows: 8 (a) Within two working days for a complaint determined by 9 the department or committee certified volunteer long-term care 10 ombudsman to be an alleged immediate jeopardy situation. 11 (b) Within twenty working days for a complaint determined by 12 the department or committee certified volunteer long-term care 13 ombudsman to be an alleged high-level, nonimmediate jeopardy 14 situation. 15 (c) Within forty-five calendar days for a complaint 16 determined by the department or committee certified volunteer 17 long-term care ombudsman to be an alleged nonimmediate jeopardy 18 situation, other than a high-level situation. 19 c. The department may refer to the resident advocate 20 committee certified volunteer long-term care ombudsman of a 21 facility any complaint received by the department regarding 22 that facility, for initial evaluation and appropriate action by 23 the committee certified volunteer long-term care ombudsman . 24 Sec. 11. Section 135C.38, subsection 2, paragraphs a and d, 25 Code 2013, are amended to read as follows: 26 a. The complainant shall be promptly informed of the 27 result of any action taken by the department or committee 28 certified volunteer long-term care ombudsman in the matter. 29 The complainant shall also be notified of the name, address, 30 and telephone number of the designated protection and advocacy 31 agency if the alleged violation involves a facility with one 32 or more residents with developmental disabilities or mental 33 illness. 34 d. A person who is dissatisfied with any aspect of the 35 -5- LSB 1225XD (8) 85 pf/nh 5/ 23

S.F. _____ H.F. _____ department’s handling of the complaint may contact the office 1 of long-term care resident’s advocate, established pursuant to 2 section 231.42 ombudsman , or may contact the protection and 3 advocacy agency designated pursuant to section 135C.2 if the 4 complaint relates to a resident with a developmental disability 5 or a mental illness. 6 Sec. 12. Section 135C.38, subsections 3 and 4, Code 2013, 7 are amended to read as follows: 8 3. An inspection made pursuant to a complaint filed under 9 section 135C.37 need not be limited to the matter or matters 10 included in the complaint. However, the inspection shall 11 not be a general inspection unless the complaint inspection 12 coincides with a scheduled general inspection or unless in the 13 course of the complaint investigation a violation is evident to 14 the inspector. Upon arrival at the facility to be inspected, 15 the inspector shall show identification to the person in charge 16 of the facility and state that an inspection is to be made, 17 before beginning the inspection. Upon request of either the 18 complainant or the department or committee certified volunteer 19 long-term care ombudsman , the complainant or the complainant’s 20 representative or both may be allowed the privilege of 21 accompanying the inspector during any on-site inspection 22 made pursuant to this section . The inspector may cancel the 23 privilege at any time if the inspector determines that the 24 privacy of any resident of the facility to be inspected would 25 otherwise be violated. The protection and dignity of the 26 resident shall be given first priority by the inspector and 27 others. 28 4. If upon an inspection of a facility by its resident 29 advocate committee certified volunteer long-term care ombudsman 30 pursuant to this section , the committee certified volunteer 31 long-term care ombudsman advises the department of any 32 circumstance believed to constitute a violation of this chapter 33 or of any rule adopted pursuant to it, the committee certified 34 volunteer long-term care ombudsman shall similarly advise the 35 -6- LSB 1225XD (8) 85 pf/nh 6/ 23

S.F. _____ H.F. _____ facility at the same time. If the facility’s licensee or 1 administrator disagrees with the conclusion of the committee 2 certified volunteer long-term care ombudsman regarding the 3 supposed violation, an informal conference may be requested and 4 if requested shall be arranged by the department as provided in 5 section 135C.42 before a citation is issued. If the department 6 thereafter issues a citation pursuant to the committee’s 7 certified volunteer long-term care ombudsman’s finding, the 8 facility shall not be entitled to a second informal conference 9 on the same violation and the citation shall be considered 10 affirmed. The facility cited may proceed under section 135C.43 11 if it so desires. 12 Sec. 13. Section 225C.4, subsection 1, paragraph m, Code 13 2013, is amended to read as follows: 14 m. Provide consultation and technical assistance to 15 patients’ advocates appointed pursuant to section 229.19 , in 16 cooperation with the judicial branch and the resident advocate 17 committees appointed for health care facilities certified 18 volunteer long-term care ombudsmen certified pursuant to 19 section 135C.25 231.45 . 20 Sec. 14. Section 227.2, subsection 2, Code 2013, is amended 21 to read as follows: 22 2. A copy of the written report prescribed by subsection 1 23 shall be furnished to the county board of supervisors, to the 24 county mental health and intellectual disability coordinating 25 board or to its advisory board if the county board of 26 supervisors constitutes ex officio the coordinating board, to 27 the administrator of the county care facility inspected and to 28 its resident advocate committee certified volunteer long-term 29 care ombudsman , and to the department on aging. 30 Sec. 15. Section 227.4, Code 2013, is amended to read as 31 follows: 32 227.4 Standards for care of persons with mental illness or an 33 intellectual disability in county care facilities. 34 The administrator, in cooperation with the department of 35 -7- LSB 1225XD (8) 85 pf/nh 7/ 23

S.F. _____ H.F. _____ inspections and appeals, shall recommend and the mental health 1 and disability services commission created in section 225C.5 2 shall adopt standards for the care of and services to persons 3 with mental illness or an intellectual disability residing in 4 county care facilities. The standards shall be enforced by 5 the department of inspections and appeals as a part of the 6 licensure inspection conducted pursuant to chapter 135C . The 7 objective of the standards is to ensure that persons with 8 mental illness or an intellectual disability who are residents 9 of county care facilities are not only adequately fed, clothed, 10 and housed, but are also offered reasonable opportunities for 11 productive work and recreational activities suited to their 12 physical and mental abilities and offering both a constructive 13 outlet for their energies and, if possible, therapeutic 14 benefit. When recommending standards under this section , 15 the administrator shall designate an advisory committee 16 representing administrators of county care facilities, county 17 mental health and developmental disabilities regional planning 18 councils, and county care facility resident advocate committees 19 certified volunteer long-term care ombudsmen to assist in the 20 establishment of standards. 21 Sec. 16. Section 231.4, subsection 1, Code 2013, is amended 22 to read as follows: 23 1. For purposes of this chapter , unless the context 24 otherwise requires: 25 a. “Administrative action” means an action or decision made 26 by an owner, employee, or agent of a long-term care facility, 27 assisted living program, elder group home, or by a governmental 28 agency, which affects the service provided to residents or 29 tenants covered in this chapter . 30 b. “Assisted living program” means a program which provides 31 assisted living as defined pursuant to section 231C.2 and which 32 is certified under chapter 231C . 33 c. “Certified volunteer long-term care ombudsman” or 34 “certified volunteer” means a volunteer long-term care ombudsman 35 -8- LSB 1225XD (8) 85 pf/nh 8/ 23

S.F. _____ H.F. _____ certified pursuant to section 231.45. 1 c. d. “Commission” means the commission on aging. 2 d. e. “Department” means the department on aging. 3 e. f. “Director” means the director of the department on 4 aging. 5 f. g. “Elder group home” means elder group home as defined 6 in section 231B.1 which is certified under chapter 231B . 7 g. h. “Equivalent support” means in-kind contributions 8 of services, goods, volunteer support time, administrative 9 support, or other support reasonably determined by the 10 department as equivalent to a dollar amount. 11 h. i. “Federal Act” means the Older Americans Act of 1965, 12 42 U.S.C. § 3001 et seq., as amended. 13 i. j. “Home and community-based services” means a continua 14 of services available in an individual’s home or community 15 which include but are not limited to case management, 16 homemaker, home health aide, personal care, adult day, 17 respite, home delivered meals, nutrition counseling, and other 18 medical and social services which contribute to the health and 19 well-being of individuals and their ability to reside in a home 20 or community-based care setting. 21 j. k. “Legal representative” means a tenant’s legal 22 representative as defined in section 231B.1 or 231C.2 , or a 23 guardian, conservator, or attorney in fact of a resident. 24 k. l. “Long-term care facility” means a long-term care 25 unit of a hospital or a facility licensed under section 135C.1 26 whether the facility is public or private. 27 m. “Long-term care ombudsman” means an advocate for 28 residents and tenants of long-term care facilities, assisted 29 living programs, and elder group homes who carries out duties 30 as specified in this chapter. 31 l. n. “Older individual” means an individual who is sixty 32 years of age or older. 33 o. “Options counseling” means a service involving an 34 interactive process, which may include a needs assessment, 35 -9- LSB 1225XD (8) 85 pf/nh 9/ 23

S.F. _____ H.F. _____ directed by the recipient individual and which may include 1 other participants of the individual’s choosing and the 2 individual’s legal representative, in which the individual 3 receives guidance to make informed choices about long-term 4 living services and supports in order to sustain independent 5 living. 6 m. p. “Resident” means a resident or tenant of an 7 individual residing in a long-term care facility, assisted 8 living program, or elder group home, excluding facilities 9 licensed primarily to serve persons with an intellectual 10 disability or mental illness. 11 q. “Tenant” means an individual who receives assisted living 12 services through an assisted living program or an individual 13 who receives elder group home services through an elder group 14 home. 15 n. r. “Unit of general purpose local government” means the 16 governing body of a city, county, township, metropolitan area, 17 or region within the state that has a population of one hundred 18 thousand or more, that is recognized for areawide planning, and 19 that functions as a political subdivision of the state whose 20 authority is general and not limited to only one function or 21 combination of related functions, or a tribal organization. 22 Sec. 17. Section 231.23A, subsection 2, Code 2013, is 23 amended to read as follows: 24 2. The senior internship older American community service 25 employment program. 26 Sec. 18. Section 231.23A, subsection 7, Code 2013, is 27 amended by striking the subsection. 28 Sec. 19. Section 231.32, Code 2013, is amended by adding the 29 following new subsection: 30 NEW SUBSECTION . 5. Upon designation, an area agency on 31 aging shall be considered an instrumentality of the state and 32 shall adhere to all state and federal mandates applicable to an 33 instrumentality of the state. 34 Sec. 20. Section 231.33, Code 2013, is amended by adding the 35 -10- LSB 1225XD (8) 85 pf/nh 10/ 23

S.F. _____ H.F. _____ following new subsection: 1 NEW SUBSECTION . 21. Comply with all applicable 2 requirements of the Iowa public employees’ retirement system 3 established pursuant to chapter 97B. 4 Sec. 21. Section 231.41, Code 2013, is amended to read as 5 follows: 6 231.41 Purpose. 7 The purpose of this subchapter is to establish and provide 8 for the operation of the office of long-term care resident’s 9 advocate ombudsman; to carry out, through the office, a state 10 long-term care ombudsman program within the department in 11 accordance with the requirements of the federal Act , ; and to 12 adopt the supporting federal regulations and guidelines for its 13 operation. 14 Sec. 22. Section 231.42, Code 2013, is amended to read as 15 follows: 16 231.42 Office of long-term care resident’s advocate ombudsman 17 —— duties —— penalties for violations. 18 1. Office established. The office of long-term care 19 resident’s advocate ombudsman is established within the 20 department, in accordance with section 712 of the federal 21 Act, as codified at 42 U.S.C. § 3058g and state law . The 22 office shall consist of the state long-term care resident’s 23 advocate and ombudsman, any local long-term care resident’s 24 advocates ombudsmen, and any certified volunteer long-term care 25 ombudsmen . 26 2. State long-term care resident’s advocate ombudsman . The 27 director of the department shall appoint the state long-term 28 care resident’s advocate ombudsman who shall do all of the 29 following: 30 a. Establish and implement a statewide confidential 31 uniform reporting system for receiving, analyzing, referring, 32 investigating, and resolving complaints about administrative 33 actions and the health, safety, welfare, and rights of 34 residents or tenants of long-term care facilities, assisted 35 -11- LSB 1225XD (8) 85 pf/nh 11/ 23

S.F. _____ H.F. _____ living programs, and elder group homes, excluding facilities 1 licensed primarily to serve persons with an intellectual 2 disability or mental illness . 3 b. Publicize the office of long-term care resident’s 4 advocate ombudsman and provide information and education to 5 consumers, the public, and other agencies about issues related 6 to long-term care in Iowa. 7 c. Monitor the development and implementation of federal, 8 state, and local laws, regulations, and policies that relate to 9 long-term care in Iowa. 10 d. Annually report to the governor and general assembly 11 on the activities of the office and make recommendations for 12 improving the health, safety, welfare, and rights of residents 13 and tenants of long-term care facilities, assisted living 14 programs, and elder group homes . 15 e. Cooperate with persons and public or private agencies 16 with regard to, and participate in, inquiries, meetings, 17 or studies that may lead to improvements in the health, 18 safety, welfare, and rights of residents and tenants and the 19 functioning of long-term care facilities, assisted living 20 programs, and elder group homes . 21 f. Recruit, train, educate, support, and monitor volunteers 22 associated with the office. 23 3. Local long-term care resident’s advocates ombudsmen . The 24 local long-term care resident’s advocates ombudsmen established 25 pursuant to this section shall do all of the following: 26 a. Accept, investigate, verify, and work to resolve 27 complaints , whether reported to or initiated by a long-term 28 care resident’s advocate, relating to any action or inaction 29 that may adversely affect the health, safety, welfare, or 30 rights of residents or tenants of a long-term care facility, 31 assisted living program, or elder group home . 32 b. Provide information about long-term care, the rights of 33 residents and tenants, payment sources for care, and selection 34 of a long-term care facility, assisted living program, or elder 35 -12- LSB 1225XD (8) 85 pf/nh 12/ 23

S.F. _____ H.F. _____ group home to providers, consumers, family members, volunteers, 1 and the public. 2 c. Make referrals to appropriate licensing, certifying, and 3 enforcement agencies to assure appropriate investigation of 4 abuse complaints and corrective actions. 5 d. Assist in the recruitment, training , and education , 6 support, and monitoring of certified volunteers associated with 7 the office of the long-term care resident’s advocate ombudsman . 8 e. Make noncomplaint-related visits to long-term care 9 facilities, assisted living programs, and elder group homes 10 to observe daily routines, meals, and activities, and work to 11 resolve complaints if any are identified during these visits. 12 4. Referrals of abuse, neglect, or exploitation. 13 a. If abuse, neglect, or exploitation of a resident 14 or tenant of a long-term care facility, assisted living 15 program, or elder group home is suspected, the state or a 16 local long-term care resident’s advocate ombudsman shall, with 17 the permission of the resident or tenant as applicable under 18 federal law, make an immediate referral to the department of 19 inspections and appeals , or the department of human services as 20 applicable, and to , the department on aging, or the appropriate 21 law enforcement agency , as applicable . The state or a local 22 long-term care resident’s advocate ombudsman shall cooperate, 23 if requested, with the department of inspections and appeals, 24 department of human services, department on aging, or any law 25 enforcement agency pursuant to any investigation of such abuse, 26 neglect, or exploitation. 27 b. If the department of inspections and appeals responds 28 to a complaint referred by the state or a local long-term 29 care resident’s advocate ombudsman against a long-term care 30 facility, assisted living program, elder group home, or 31 an employee of such entity, copies of related inspection 32 reports, plans of correction, and notice of any citations and 33 sanctions levied against the facility, program, or home shall 34 be forwarded to the office of the long-term care resident’s 35 -13- LSB 1225XD (8) 85 pf/nh 13/ 23

S.F. _____ H.F. _____ advocate ombudsman . 1 5. Access to long-term care facility, assisted living 2 program, or elder group home and residents and tenants . The 3 state or a local long-term care resident’s advocate ombudsman 4 or a trained certified volunteer may enter any long-term care 5 facility, assisted living program, or elder group home at any 6 time with or without prior notice or complaint and shall be 7 granted access to residents and tenants at all times for the 8 purpose of carrying out the duties specified in this section . 9 As used in this section , “access” means the right to do all of 10 the following: 11 a. Enter any long-term care facility, assisted living 12 program, or elder group home and provide identification. 13 b. Seek consent from the resident, tenant, or legal 14 representative to communicate privately and without restriction 15 with any resident , or tenant , or legal representative . 16 c. Communicate privately and without restriction with 17 any resident, tenant, or legal representative , or other 18 representative who consents to communication . 19 d. Review the clinical medical, social, or other records of 20 a resident or tenant. 21 e. Observe all resident or tenant areas of a long-term care 22 facility, assisted living program, or housing establishment 23 elder group home except the living area of any resident or 24 tenant who protests the observation. 25 6. Access to medical and personal social records. 26 a. The state or a local long-term care resident’s advocate 27 ombudsman shall have access to the medical and personal social 28 records of an individual who is a resident or tenant of a 29 long-term care facility, assisted living program, or elder 30 group home retained by the facility, program, or home. , if any 31 of the following applies: 32 (1) The state or local long-term care ombudsman or certified 33 volunteer long-term care ombudsman has the permission of the 34 resident or tenant, or the legal representative of the resident 35 -14- LSB 1225XD (8) 85 pf/nh 14/ 23

S.F. _____ H.F. _____ or tenant. 1 (2) The resident or tenant is unable to consent to the 2 access and has no legal representative. 3 (3) Access to the records is necessary to investigate a 4 complaint if all of the following apply: 5 (a) A legal representative of the resident or tenant refuses 6 to give the permission. 7 (b) The state or local long-term care ombudsman or a 8 certified volunteer long-term care ombudsman has reasonable 9 cause to believe that the legal representative is not acting in 10 the best interest of the resident or tenant. 11 (c) The local long-term care ombudsman or a certified 12 volunteer long-term care ombudsman obtains the approval of the 13 state long-term care ombudsman. 14 b. Records may be reproduced by the state or a local 15 long-term care resident’s advocate ombudsman . 16 c. Upon request of the state or a local long-term care 17 resident’s advocate ombudsman , a long-term care facility, 18 assisted living program, or elder group home shall provide the 19 name, address, and telephone number of the legal representative 20 or next of kin of any resident or tenant. 21 d. A long-term care facility, assisted living program, or 22 elder group home or personnel of such a facility, program, or 23 home who discloses records in compliance with this section and 24 the procedures adopted pursuant to this section shall not be 25 liable for such disclosure. 26 7. Access to administrative records. 27 a. Pursuant to the federal Act, the state or a local 28 long-term care ombudsman or a certified volunteer shall have 29 access to the administrative records, policies, and documents 30 of the long-term care facility, assisted living program, or 31 elder group home, which are accessible to residents, tenants, 32 or the general public. 33 b. Pursuant to the federal Act, the state or a local 34 long-term care ombudsman or a certified volunteer shall have 35 -15- LSB 1225XD (8) 85 pf/nh 15/ 23

S.F. _____ H.F. _____ access to, and upon request, copies of, all licensing and 1 certification records maintained by the state with respect to 2 a long-term care facility, assisted living program, or elder 3 group home. 4 7. 8. Interference prohibited —— penalties. 5 a. An officer, owner, director, or employee of a long-term 6 care facility, assisted living program, or elder group home who 7 intentionally prevents, interferes with, or attempts to impede 8 the work of the state or a local long-term care resident’s 9 advocate ombudsman or a certified volunteer is subject to a 10 penalty imposed by the director of not more than one thousand 11 five hundred dollars for each violation. If the director 12 imposes a penalty for a violation under this paragraph, 13 no other state agency shall impose a penalty for the same 14 interference violation. Any moneys collected pursuant to this 15 subsection shall be deposited in the general fund of the state. 16 b. The office of the long-term care resident’s advocate 17 ombudsman shall adopt rules specifying procedures for notice 18 and appeal of penalties imposed pursuant to this subsection . 19 c. The director, in consultation with the office of the 20 long-term care resident’s advocate ombudsman , shall notify 21 the county attorney of the county in which the long-term care 22 facility, assisted living program, or elder group home is 23 located, or the attorney general, of any violation of this 24 subsection . 25 8. 9. Retaliation prohibited —— penalties. An officer, 26 owner, director, or employee of a long-term care facility, 27 assisted living program, or elder group home shall not 28 retaliate against any person for having filed a complaint with, 29 or provided information to, the state or a local long-term 30 care resident’s advocate ombudsman or a certified volunteer . 31 A person who retaliates or discriminates in violation of this 32 subsection is guilty of a simple misdemeanor. 33 9. 10. Change in operations. A long-term care facility, 34 assisted living program, or elder group home shall inform the 35 -16- LSB 1225XD (8) 85 pf/nh 16/ 23

S.F. _____ H.F. _____ office of the long-term care resident’s advocate ombudsman 1 in writing at least thirty days prior to any change in 2 operations, programs, services, licensure, or certification 3 that affects residents or tenants, including but not limited 4 to the intention to close, decertify, or change ownership. In 5 an emergency situation, or when a long-term care facility, 6 assisted living program, or elder group home is evacuated, the 7 department of inspections and appeals shall notify the office 8 of the state long-term care resident’s advocate ombudsman . 9 10. 11. Immunity. The state or a local long-term care 10 resident’s advocate ombudsman, certified volunteer, or any 11 representative of the office participating in the good faith 12 performance of their official duties shall have immunity from 13 any civil or criminal liability that otherwise might result by 14 reason of taking, investigating, or pursuing a complaint under 15 this section . 16 11. 12. Confidentiality. 17 a. Information relating to any complaint made to or 18 investigation by the state or a local long-term care resident’s 19 advocate that discloses the identity of a complainant, 20 resident, or tenant, or ombudsman or certified volunteer, 21 information related to a resident’s or tenant’s personal social 22 or medical records, or files maintained by the state long-term 23 care ombudsman program shall remain confidential except as 24 follows: and shall be disclosed only at the discretion of the 25 state long-term care ombudsman. 26 a. If permission is granted by the director in consultation 27 with the state long-term care resident’s advocate. 28 b. If disclosure is authorized in writing by the complainant 29 and the resident, tenant, or the individual’s guardian or legal 30 representative. 31 c. If disclosure is necessary for the provision of services 32 to a resident or tenant, or the resident or tenant is unable to 33 express written or oral consent. 34 d. If ordered by a court. 35 -17- LSB 1225XD (8) 85 pf/nh 17/ 23

S.F. _____ H.F. _____ b. Information identifying a complainant, resident, or 1 tenant shall remain confidential and shall not be disclosed 2 unless any of the following applies: 3 (1) The complainant, resident, tenant, or a legal 4 representative consents to the disclosure and the consent is 5 given in writing. 6 (2) The complainant, resident, or tenant gives consent 7 orally and the consent is documented contemporaneously in a 8 writing made by the state long-term care ombudsman or a local 9 long-term care ombudsman. 10 (3) The disclosure is required by a court order. 11 c. The department shall adopt rules pursuant to chapter 17A 12 to administer this subsection. 13 12. 13. Posting of state long-term care resident’s advocate 14 ombudsman information. Every long-term care facility, assisted 15 living program, and elder group home shall post information 16 in a prominent location that includes the name, address, and 17 telephone number, and a brief description of the services 18 provided by the office of the long-term care resident’s 19 advocate ombudsman . The information posted shall be approved 20 or provided by the office of the long-term care resident’s 21 advocate ombudsman . 22 Sec. 23. Section 231.45, Code 2013, is amended to read as 23 follows: 24 231.45 Certified volunteer long-term care resident’s advocate 25 ombudsman program. 26 1. The department shall establish a certified volunteer 27 long-term care resident’s advocate ombudsman program in 28 accordance with the federal Act to provide assistance to the 29 state and local long-term care resident’s advocates ombudsmen . 30 2. The department shall develop and implement a 31 certification process for volunteer long-term care resident’s 32 advocates ombudsmen including but not limited to an application 33 process, provision for background checks, classroom or on-site 34 training, orientation, and continuing education. 35 -18- LSB 1225XD (8) 85 pf/nh 18/ 23