H.F. _____ Section 1. NEW SECTION . 714I.1 Definitions. 1 As used in this chapter, unless the context otherwise 2 requires: 3 1. “Individual with a disability” means an individual 4 with a physical, mental, or developmental disability that 5 substantially impairs the individual’s ability to provide 6 adequately for the individual’s own care or protection. 7 2. “Nursing facility” means as defined in section 135C.1. 8 3. “Older individual” means a person who is sixty years of 9 age or older. 10 4. “Resident” means an older individual or an individual 11 with a disability who resides in a nursing facility. 12 5. “Spenddown obligation” means the amount by which an 13 individual’s countable income exceeds the applicable income 14 standard or nonexempt resources exceed the applicable resource 15 disregard in order for the individual to be eligible for the 16 Medicaid program. 17 Sec. 2. NEW SECTION . 714I.2 Financial exploitation of an 18 older individual or individual with a disability —— penalties. 19 1. A person commits financial exploitation of an older 20 individual or an individual with a disability when the person 21 knowingly obtains control over the income or assets of an older 22 individual or an individual with a disability with the intent 23 to permanently deprive the older individual or individual with 24 a disability of the use, benefit, or possession of the income, 25 assets, or property of the older individual or individual 26 with a disability, thereby benefitting such other person or 27 detrimentally affecting the older individual or individual with 28 a disability. 29 2. A person who commits financial exploitation of an older 30 individual or an individual with a disability is guilty of the 31 following: 32 a. A simple misdemeanor if the value of the income, assets, 33 or property is less than fifty dollars. 34 b. A serious misdemeanor if the value of the income, assets, 35 -1- LSB 2342YC (6) 87 pf/nh 1/ 7

H.F. _____ or property is at least fifty dollars but less than five 1 hundred dollars. 2 c. An aggravated misdemeanor if the value of the income, 3 assets, or property is at least five hundred dollars but less 4 than one thousand dollars. 5 d. A class “D” felony if the value of the income, assets, or 6 property is at least one thousand dollars but less than fifty 7 thousand dollars. 8 e. A class “C” felony if the value of the income, assets, or 9 property is at least fifty thousand dollars or more. 10 Sec. 3. NEW SECTION . 714I.3 Conversion or misappropriation 11 of assets —— nonpayment of Medicaid services —— liability. 12 1. A person who assumes the responsibility of managing the 13 financial affairs of an older individual or an individual with 14 a disability and who willfully converts or misappropriates 15 the income or assets belonging to the older individual or an 16 individual with a disability which constitute the spenddown 17 obligation of the individual for the purposes of meeting 18 eligibility requirements under the Medicaid program, resulting 19 in nonpayment of costs incurred by the individual for care 20 provided by a health care provider, shall be liable to the 21 health care provider for any outstanding payment of such costs. 22 If such liability is established against such person by the 23 health care provider, the health care provider may recover any 24 reasonable attorney fees incurred. 25 2. A person who assumes the responsibility of managing 26 the financial affairs of a resident and who fails to pay a 27 nursing facility for the care provided to the resident from 28 such income or assets which constitute the spenddown obligation 29 of the resident for the purposes of meeting eligibility 30 requirements under the Medicaid program shall be liable to the 31 nursing facility for any outstanding payment of such costs. 32 If such liability is established against such person, the 33 nursing facility may also recover any reasonable attorney fees 34 incurred. 35 -2- LSB 2342YC (6) 87 pf/nh 2/ 7

H.F. _____ 3. For the purposes of this section, a person assumes the 1 responsibility of managing the financial affairs of an older 2 individual, an individual with a disability, or a resident 3 when the person receives, has access to, handles, or controls 4 the income or assets of the older individual, individual 5 with a disability, or resident including income from any 6 source including but not limited to social security, railroad 7 retirement, or other sources disclosed as income contained 8 in the records of the department of human services or other 9 appropriate state agency. 10 4. a. The department of human services, or other 11 appropriate agency, may release information from the agency’s 12 records containing information regarding the income and assets 13 of an older individual, individual with a disability, or a 14 resident to the attorney general or any county attorney in 15 the state for purposes of investigating or prosecuting any 16 suspected violation of this section. 17 b. The attorney general or the county attorney of any county 18 in which an affected provider or nursing facility is located, 19 who successfully prosecutes a violation of this section, may 20 request of the sentencing court as a condition of the sentence 21 that restitution of all amounts unlawfully withheld from the 22 affected provider or nursing facility be made by the offender. 23 c. Any order of restitution entered by the court or by 24 agreement shall provide that ten percent of any restitution 25 installment or payment paid by or on behalf of the offender 26 shall be paid to the county attorney successfully prosecuting 27 the violation to compensate for the cost of prosecution, and 28 any remaining amount shall be paid to the affected provider or 29 nursing facility up to the amount owed. 30 Sec. 4. NEW SECTION . 714I.4 Application and construction. 31 1. Nothing in this chapter shall be construed to limit 32 the remedies otherwise available to an older individual or 33 individual with a disability pursuant to any state law. 34 2. Nothing in this chapter shall be construed to impose 35 -3- LSB 2342YC (6) 87 pf/nh 3/ 7

H.F. _____ criminal liability on a person who has made a good-faith effort 1 to assist an older individual or individual with a disability 2 in the management of the property of the older individual or 3 individual with a disability, who through no fault of such 4 person is unable to provide assistance to the older individual 5 or individual with a disability. 6 3. Nothing in this chapter shall limit the ability of an 7 older individual or an individual with a disability to engage 8 in bona fide estate planning, to transfer property, and to 9 otherwise seek to reduce estate and inheritance taxes provided 10 that such actions do not adversely impact the standard of 11 living to which the older individual or individual with a 12 disability has become accustomed at the time of such actions. 13 4. It shall not be a defense under this chapter that 14 a person alleged to have violated this chapter reasonably 15 believed the victim was not an older individual or an 16 individual with a disability. 17 EXPLANATION 18 The inclusion of this explanation does not constitute agreement with 19 the explanation’s substance by the members of the general assembly. 20 This bill relates to financial exploitation, conversion 21 and misappropriation of funds, and other violations relative 22 to older individuals and individuals with a disability. The 23 bill includes definitions of “individual with a disability”, 24 “nursing facility”, “older individual”, “resident”, and 25 “spenddown obligation” for the purposes of the bill. 26 The bill provides criminal penalties applicable when a 27 person commits financial exploitation as described in the bill 28 based upon the value of the property ranging from less than $50 29 (a simple misdemeanor which is punishable by confinement for no 30 more than 30 days or a fine of at least $65 but not more than 31 $625 or by both) to at least $50,000 (a class “C” felony which 32 is punishable by confinement for no more than 10 years and a 33 fine of at least $1,000 but not more than $10,000). 34 The bill provides that a person who assumes the 35 -4- LSB 2342YC (6) 87 pf/nh 4/ 7

H.F. _____ responsibility of managing the financial affairs of an older 1 individual or an individual with a disability and who willfully 2 converts or misappropriates the income or assets belonging to 3 the older individual or individual with a disability which 4 constitute the spenddown obligation of the individual for 5 the purposes of meeting eligibility requirements under the 6 Medicaid program, resulting in nonpayment of costs incurred by 7 the individual for care provided by a health care provider, 8 shall be liable to the health care provider for any outstanding 9 payment of such costs. If such liability is established, the 10 provider may recover any reasonable attorney fees incurred. 11 The bill also provides that a person who assumes the 12 responsibility of managing the financial affairs of a resident 13 of a nursing facility and who fails to pay a nursing facility 14 for the care provided to the resident from such income or 15 assets which constitute the spenddown obligation of the 16 resident for the purposes of meeting eligibility requirements 17 under the Medicaid program shall be liable to the nursing 18 facility for any outstanding payment of such costs. If such 19 liability is established, the nursing facility may also recover 20 any reasonable attorney fees incurred. 21 Under the bill, a person assumes the responsibility of 22 managing the financial affairs of an older individual, an 23 individual with a disability, or a resident when the person 24 receives, has access to, handles, or controls the income or 25 assets of the older individual, individual with a disability, 26 or resident including income from any source including but 27 not limited to social security, railroad retirement, or other 28 sources disclosed as income contained in the records of the 29 department of human services (DHS) or other appropriate state 30 agency. 31 The bill authorizes DHS or other appropriate agency to 32 release information from the agency’s records containing 33 information regarding the income and assets of the older 34 individual or individual with a disability to the attorney 35 -5- LSB 2342YC (6) 87 pf/nh 5/ 7

H.F. _____ general or any county attorney in the state for purposes of 1 investigating or prosecuting any suspected violation related 2 to managing the financial affairs of an individual who is a 3 recipient of Medicaid resulting in nonpayment of costs of a 4 health care provider or nursing facility. 5 The attorney general or the county attorney of any county 6 in which an affected provider or nursing facility is located, 7 who successfully prosecutes a violation of the bill, may 8 request of the sentencing court as a condition of the sentence, 9 that restitution of all amounts unlawfully withheld from the 10 affected provider or nursing facility be made by the offender. 11 Any order of restitution entered by the court or by agreement 12 shall provide that 10 percent of any restitution installment 13 or payment paid by or on behalf of the offender shall be paid 14 to the county attorney successfully prosecuting the violation 15 to compensate for the cost of prosecution, and any remaining 16 amount shall be paid to the affected provider or nursing 17 facility up to the amount owed. 18 Nothing in the bill is to be construed to limit the remedies 19 otherwise available to the older individual or individual with 20 a disability pursuant to any state law; or to impose criminal 21 liability on a person who has made a good-faith effort to 22 assist the older individual or individual with a disability 23 in the management of the property of the older individual or 24 individual with a disability, who through no fault of such 25 person is unable to provide assistance to the older individual 26 or individual with a disability. 27 Nothing in the bill is to limit the ability of an older 28 individual or an individual with a disability to engage in bona 29 fide estate planning, to transfer property, and to otherwise 30 seek to reduce estate and inheritance taxes provided that such 31 actions do not adversely impact the standard of living to which 32 the older individual or individual with a disability has become 33 accustomed at the time of such actions. 34 Under the bill, it is not a defense that a person alleged to 35 -6- LSB 2342YC (6) 87 pf/nh 6/ 7