H.F. 2451 Section 1. Section 231.3, subsections 2, 3, and 4, Code 1 2018, are amended to read as follows: 2 2. Access to physical and mental health care and long-term 3 living and community support services without regard to 4 economic status. 5 3. Suitable and affordable housing that reflects the needs 6 of older people individuals . 7 4. Full restorative services for those who require 8 institutional care, and a comprehensive array of home and 9 community-based, long-term care living and community support 10 services adequate to sustain older people in their communities 11 and, whenever possible, in their homes, including support for 12 caregivers. 13 Sec. 2. Section 231.3, Code 2018, is amended by adding the 14 following new subsection: 15 NEW SUBSECTION . 3A. Access to comprehensive information 16 and a community navigation system providing all available 17 options related to long-term living and community support 18 services that assist older individuals in the preservation 19 of personal assets and the ability to entirely avoid or 20 significantly delay reliance on entitlement programs. 21 Sec. 3. Section 231.4, subsection 1, paragraphs j, k, and o, 22 Code 2018, are amended to read as follows: 23 j. “Home and community-based services” means a continua 24 of services available in an individual’s home or community 25 which include but are not limited to case management services , 26 options counseling, family caregiving, homemaker services , 27 home health aide, personal care services , adult day services , 28 respite services , congregate and home delivered meals, 29 nutrition counseling, nutrition education, and other medical 30 and social services which contribute to the health and 31 well-being of individuals and their ability to reside in a home 32 or community-based care setting. 33 k. “Legal representative” means a tenant’s legal 34 representative as defined in section 231B.1 or 231C.2 , or 35 -1- LSB 5225HV (3) 87 pf/rh 1/ 9

H.F. 2451 a resident’s guardian, conservator, or attorney in fact of 1 a resident representative payee, or agent under a power of 2 attorney . 3 o. “Options counseling” means a service involving an 4 interactive process, which may include a needs assessment, 5 directed by the recipient individual and which may include 6 other participants of the individual’s choosing and the 7 individual’s legal representative, in which the individual 8 receives guidance to make informed choices about long-term 9 living and community support services and supports in order to 10 sustain independent living. 11 Sec. 4. Section 231.14, subsection 1, paragraph g, Code 12 2018, is amended to read as follows: 13 g. Adopt a formula method for the distribution of federal 14 Act and state funds taking into account, to the maximum 15 extent feasible, the best available data on the geographic 16 distribution of older individuals in the state, and publish the 17 formula method for review and comment. 18 Sec. 5. Section 231.23, subsection 8, Code 2018, is amended 19 to read as follows: 20 8. Assist the commission in adopting a formula method for 21 the distribution of funds available from the federal Act and 22 state appropriations and allocations. 23 Sec. 6. Section 231.23A, Code 2018, is amended to read as 24 follows: 25 231.23A Programs and services. 26 The department on aging shall provide or administer, but is 27 not limited to providing or administering, all of the following 28 programs and services: 29 1. Services for older individuals including but not limited 30 to home and community-based services such as adult day, 31 assessment and intervention, transportation, chore, counseling, 32 homemaker, material aid, personal care, reassurance, 33 respite, visitation, caregiver support, emergency response 34 system, mental health outreach, and home repair , persons 35 -2- LSB 5225HV (3) 87 pf/rh 2/ 9

H.F. 2451 with disabilities eighteen years of age and older, family 1 caregivers, and veterans as defined by the department in the 2 most current version of the department’s reporting manual and 3 pursuant to the federal Act and regulations. 4 2. The older American community service employment program. 5 3. The case Case management program for frail elders 6 services . 7 4. The aging and disability resource center. 8 5. The legal assistance development program. 9 6. The nutrition and health promotion program. 10 7. Administration relating to the area agencies on aging The 11 Iowa family caregiver program . 12 8. Elder abuse prevention, detection, intervention, and 13 awareness including neglect and exploitation. 14 9. Other programs and services authorized by law. 15 Sec. 7. Section 231.32, subsection 1, Code 2018, is amended 16 to read as follows: 17 1. The commission shall designate an area agency on 18 aging for each planning and service area. The commission 19 shall continue the designation until an area agency on 20 aging’s designation is removed for cause as determined by the 21 commission, until the time of renewal or the annual update of 22 an area plan, until the agency voluntarily withdraws as an 23 area agency on aging, or until a change in the designation 24 of planning and service areas or area agencies on aging 25 is required by state or federal law. In that event, the 26 commission shall proceed in accordance with subsections 2, 3, 27 and 4 . Designated area agencies on aging shall comply with the 28 requirements of the federal Act. 29 Sec. 8. Section 231.32, subsection 2, paragraph d, Code 30 2018, is amended to read as follows: 31 d. Any public or nonprofit private agency in a planning 32 and service area or any separate organizational unit within 33 such agency which is under the supervision or direction for 34 this purpose of the department on aging and which can and will 35 -3- LSB 5225HV (3) 87 pf/rh 3/ 9

H.F. 2451 engage only in the planning or provision of a broad range of 1 supportive long-term living and community support services or 2 nutrition services within the planning and service area. 3 Sec. 9. Section 231.33, subsections 1 and 3, Code 2018, are 4 amended to read as follows: 5 1. Develop and administer an area plan on aging approved by 6 the commission . 7 3. Enter into subgrants or contracts to provide services 8 under the plan. 9 Sec. 10. Section 231.33, Code 2018, is amended by adding the 10 following new subsection: 11 NEW SUBSECTION . 22. Encourage the development of public 12 and private partnerships, entrepreneurial activities, and other 13 mutually collaborative efforts. 14 Sec. 11. Section 231.42, subsection 4, paragraph a, Code 15 2018, is amended to read as follows: 16 a. If abuse, neglect, or exploitation of a resident or 17 tenant is suspected, the state or a local long-term care 18 ombudsman shall, with the permission of the resident or tenant 19 as applicable under federal law, make an immediate referral to 20 the department of inspections and appeals, the department of 21 human services, the department on aging, or the appropriate 22 law enforcement agency, as applicable. The state or a local 23 long-term care ombudsman shall cooperate, if requested, with 24 the department of inspections and appeals, department of human 25 services, department on aging, or any law enforcement agency 26 pursuant to any investigation of such abuse, neglect, or 27 exploitation. 28 Sec. 12. Section 231.42, subsection 6, paragraph a, 29 unnumbered paragraph 1, Code 2018, is amended to read as 30 follows: 31 The state or a local long-term care ombudsman or certified 32 volunteer long-term care ombudsman shall have access to the 33 medical and social records of a resident or tenant, if any of 34 the following applies: 35 -4- LSB 5225HV (3) 87 pf/rh 4/ 9

H.F. 2451 Sec. 13. Section 231.42, subsection 6, paragraph b, Code 1 2018, is amended to read as follows: 2 b. Records may be reproduced by the state or a local 3 long-term care ombudsman or by a certified volunteer long-term 4 care ombudsman . 5 Sec. 14. Section 231.53, Code 2018, is amended to read as 6 follows: 7 231.53 Coordination with Workforce Investment Innovation and 8 Opportunity Act. 9 The older American community service employment program 10 shall be coordinated with the federal Workforce Investment 11 Innovation and Opportunity Act administered by the department 12 of workforce development. 13 Sec. 15. Section 231.56, Code 2018, is amended to read as 14 follows: 15 231.56 Services and programs. 16 The department shall administer long-term living and 17 community support services and programs that allow older 18 individuals to secure and maintain maximum independence and 19 dignity in a home environment that provides for self-care with 20 appropriate supportive services, assist in removing individual 21 and social barriers to economic and personal independence for 22 older individuals, and provide a continuum of care for older 23 individuals and individuals with disabilities , and secure 24 the opportunity for older individuals to receive managed 25 in-home and community-based long-term care services . Funds 26 appropriated for this purpose shall be allocated based on 27 administrative rules adopted by the commission. The department 28 shall require such records as needed to administer this 29 section . 30 Sec. 16. Section 231.56A, subsection 1, Code 2018, is 31 amended to read as follows: 32 1. The department shall administer the prevention of elder 33 abuse, neglect, and exploitation program in accordance with the 34 requirements of the federal Act. The purpose of the program 35 -5- LSB 5225HV (3) 87 pf/rh 5/ 9

H.F. 2451 is to carry out activities for intervention in , investigation 1 of, and response to elder abuse, neglect, and exploitation 2 including financial exploitation. 3 Sec. 17. Section 231.64, Code 2018, is amended to read as 4 follows: 5 231.64 Aging and disability resource center. 6 1. The aging and disability resource center shall be 7 administered by the department consistent with the federal 8 Act. The department shall designate area agencies on aging to 9 establish, in consultation with other stakeholders including 10 organizations representing the disability community, a 11 coordinated system for providing all of the following: 12 a. Comprehensive information, referral, and assistance 13 regarding the full range of available public and private 14 long-term care programs living and community support services , 15 options, service providers, and resources within a community, 16 including information on the availability of integrated 17 long-term care. 18 b. Options counseling to assist individuals in assessing 19 their existing or anticipated long-term care needs and 20 developing and implementing a plan for long-term care designed 21 to meet their specific needs and circumstances. The plan 22 for long-term care living and community support services may 23 include support with person-centered care transitions to assist 24 consumers and family caregivers with transitions between home 25 and care settings. 26 c. Consumer access to the range of publicly-supported 27 long-term care programs living and community support services 28 for which consumers may be eligible, by serving as a convenient 29 point of entry for such programs services . The aging and 30 disability resource center shall offer information online and 31 be available via a toll-free telephone number, electronic 32 communications, and in person. 33 2. The aging and disability resource center shall assist 34 older individuals, persons with disabilities age eighteen or 35 -6- LSB 5225HV (3) 87 pf/rh 6/ 9

H.F. 2451 older, family caregivers, and people who inquire about or 1 request assistance on behalf of members of these groups, as 2 they seek long-term care living and community support services 3 and community supports . 4 Sec. 18. REPEAL. Section 231.2, Code 2018, is repealed. 5 EXPLANATION 6 The inclusion of this explanation does not constitute agreement with 7 the explanation’s substance by the members of the general assembly. 8 This bill amends provisions in Code chapter 231 (department 9 on aging —— older Iowans) relating to programs and activities 10 under the purview of the department on aging. 11 The bill amends provisions relating to the state policy and 12 objectives for the department on aging by including statements 13 that it is the policy of the state to work toward the 14 objectives of attaining: access to physical and mental health 15 care and long-term living and community support services for 16 older individuals without regard to economic status; suitable 17 and affordable housing that reflects the needs of older 18 individuals; and access to comprehensive information and a 19 community navigation system that provides all available options 20 related to long-term living and community support services 21 that assist older individuals in the preservation of personal 22 assets and the ability to entirely avoid or significantly delay 23 reliance on entitlement programs. 24 The bill amends the definitions used in Code chapter 25 231 including “home and community-based services”, “legal 26 representative”, and “options counseling”. The bill also 27 changes various references throughout the Code chapter relating 28 to “services” to instead refer to “long-term living and 29 community support services”. 30 The bill directs the commission on aging to adopt a “method” 31 rather than a “formula” for distribution of funds available 32 under the federal Older Americans Act. 33 The bill clarifies that the department on aging shall 34 provide or administer: programs and services for older 35 -7- LSB 5225HV (3) 87 pf/rh 7/ 9

H.F. 2451 individuals, persons with disabilities 18 years of age and 1 older, family caregivers, and veterans; case management 2 services; and the Iowa family caregiver program. The bill 3 eliminates from the programs and services to be provided or 4 administered by the department administration relating to the 5 area agencies on aging. 6 The bill provides that in addition to other bases, the 7 commission on aging shall continue a designation of an area 8 agency on aging until the time of a renewal or the annual 9 update of the area plan. 10 The bill clarifies that the area plan developed and 11 administered by an area agency on aging must be approved by 12 the commission on aging. The bill eliminates the authority 13 of area agencies on aging to enter into subgrants to provide 14 services under the agency plan, but retains their authority to 15 enter into contracts to do so. The bill directs area agencies 16 on aging to encourage the development of public and private 17 partnerships, entrepreneurial activities, and other mutually 18 collaborative efforts. 19 The bill eliminates the provision that directed the 20 state or a local long-term care ombudsman, if requested, to 21 cooperate with the department of inspections and appeals, the 22 department of human services, the department on aging, or any 23 law enforcement agency pursuant to any investigation of abuse, 24 neglect, or exploitation. The bill also provides that in 25 addition to the state or a local long-term care ombudsman, a 26 certified volunteer long-term care ombudsman is authorized to 27 have access to the medical and social records of a resident 28 or tenant under specific circumstances and to reproduce such 29 records. 30 The bill updates a reference by replacing the reference to 31 the federal Workforce Investment Act with the federal Workforce 32 Innovation and Opportunity Act. 33 The bill directs the department to administer long-term 34 living and community support services and programs but 35 -8- LSB 5225HV (3) 87 pf/rh 8/ 9

H.F. 2451 eliminates the directive to the department to secure the 1 opportunity for older individuals to receive managed in-home 2 and community-based long-term care services. 3 The bill eliminates the requirement that, as part of 4 carrying out the prevention of elder abuse, neglect, and 5 exploitation program, the department carry out activities 6 for investigation of elder abuse, neglect, and exploitation 7 including financial exploitation, but retains the directive to 8 the department to carry out activities for intervention in and 9 response to elder abuse, neglect, and exploitation including 10 financial exploitation. 11 The bill specifically provides that an aging and disability 12 resource center is to provide consumer access to information 13 about long-term living and community support services online, 14 and be available via a toll-free telephone number, electronic 15 communications, and in person. 16 The bill repeals Code section 231.2 relating to legislative 17 findings and declarations. 18 -9- LSB 5225HV (3) 87 pf/rh 9/ 9