House File 710 - Reprinted



                                      HOUSE FILE       
                                      BY  COMMITTEE ON HUMAN RESOURCES

                                      (SUCCESSOR TO HSB 101)


    Passed House, Date               Passed Senate,  Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act relating to the regulation of elder group homes and
  2    providing penalties.
  3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  4 TLSB 1267HV 81
  5 pf/gg/14

PAG LIN



  1  1    Section 1.  Section 231B.1, Code 2005, is amended by
  1  2 striking the section and inserting in lieu thereof the
  1  3 following:
  1  4    231B.1  DEFINITIONS.
  1  5    1.  "Department" means the department of elder affairs or
  1  6 the department's designee.
  1  7    2.  "Elder" means a person sixty years of age or older.
  1  8    3.  "Elder group home" means a single=family residence that
  1  9 is operated by a person who is providing room, board, and
  1 10 personal care and may provide health=related services to three
  1 11 through five elders who are not related to the person
  1 12 providing the service within the third degree of consanguinity
  1 13 or affinity, and which is staffed by an on=site manager
  1 14 twenty=four hours per day, seven days per week.
  1 15    4.  "Governmental unit" means the state, or any county,
  1 16 municipality, or other political subdivision or any
  1 17 department, division, board, or other agency of any of these
  1 18 entities.
  1 19    5.  "Health=related care" means services provided by a
  1 20 registered nurse or a licensed practical nurse, on a part=time
  1 21 or intermittent basis, and services provided by other licensed
  1 22 health care professionals, on a part=time or intermittent
  1 23 basis.
  1 24    6.  "Medication setup" means assistance with various steps
  1 25 of medication administration to support a tenant's autonomy,
  1 26 which may include but is not limited to routine prompting,
  1 27 cueing and reminding, opening containers or packaging at the
  1 28 direction of the tenant, reading instructions or other label
  1 29 information, or transferring medications from the original
  1 30 container into suitable medication dispensing containers,
  1 31 reminder containers, or medication cups.
  1 32    7.  "Occupancy agreement" means a written agreement entered
  1 33 into between an elder group home and a tenant that clearly
  1 34 describes the rights and responsibilities of the elder group
  1 35 home and the tenant, and other information required by rule.
  2  1 "Occupancy agreement" may include a separate signed lease and
  2  2 signed service agreement.
  2  3    8.  "Personal care" means assistance with the essential
  2  4 activities of daily living which may include but are not
  2  5 limited to transferring, bathing, personal hygiene, dressing,
  2  6 grooming, and housekeeping that are essential to the health
  2  7 and welfare of a tenant.
  2  8    9.  "Tenant" means an individual who receives elder group
  2  9 home services through a certified elder group home.
  2 10    10.  "Tenant advocate" means the office of the long=term
  2 11 care resident's advocate established in section 231.42.
  2 12    11.  "Tenant's legal representative" means a person
  2 13 appointed by the court to act on behalf of a tenant, or a
  2 14 person acting pursuant to a power of attorney.
  2 15    Sec. 2.  NEW SECTION.  231B.1A  FINDINGS, PURPOSE, AND
  2 16 INTENT.
  2 17    1.  The general assembly finds that elder group homes are
  2 18 an important part of the long=term care continua in this
  2 19 state.  Elder group homes emphasize the independence and
  2 20 dignity of the individual while providing housing in a cost=
  2 21 effective manner.
  2 22    2.  The purposes of establishing and regulating elder group
  2 23 homes include all of the following:
  2 24    a.  To encourage the establishment and maintenance of a
  2 25 safe and homelike environment for individuals of all income
  2 26 levels who require assistance with personal care to live
  2 27 independently but who require health=related care only on a
  2 28 part=time or intermittent basis.
  2 29    b.  To establish standards for elder group homes that allow
  2 30 flexibility in design, which promotes a model of service
  2 31 delivery by focusing on individual independence, needs and
  2 32 desires, and consumer=driven quality of service.
  2 33    c.  To encourage public participation in the development of
  2 34 elder group home programs for individuals of all income
  2 35 levels.
  3  1    3.  It is the intent of the general assembly that the
  3  2 department of elder affairs establish policy for elder group
  3  3 homes and that the department of inspections and appeals
  3  4 enforce this chapter.
  3  5    Sec. 3.  Section 231B.2, Code 2005, is amended by striking
  3  6 the section and inserting in lieu thereof the following:
  3  7    231B.2  CERTIFICATION OF ELDER GROUP HOMES == RULES.
  3  8    1.  The department shall establish by rule, in accordance
  3  9 with chapter 17A, minimum standards for certification and
  3 10 monitoring of elder group homes.  The department may adopt by
  3 11 reference, with or without amendment, nationally recognized
  3 12 standards and rules for elder group homes.  The standards and
  3 13 rules shall be formulated in consultation with the department
  3 14 of inspections and appeals and affected industry,
  3 15 professional, and consumer groups and shall be designed to
  3 16 accomplish the purposes of this chapter and shall include but
  3 17 not be limited to rules relating to all of the following:
  3 18    a.  Provisions to ensure, to the greatest extent possible,
  3 19 the health, safety, well=being, and appropriate treatment of
  3 20 tenants.
  3 21    b.  Requirements that elder group homes furnish the
  3 22 department of elder affairs and the department of inspections
  3 23 and appeals with specified information necessary to administer
  3 24 this chapter.  All information related to the provider
  3 25 application for an elder group home presented to either the
  3 26 department of inspections and appeals or the department of
  3 27 elder affairs shall be considered a public record pursuant to
  3 28 chapter 22.
  3 29    c.  Standards for tenant evaluation or assessment, which
  3 30 may vary in accordance with the nature of the services
  3 31 provided or the status of the tenant.
  3 32    d.  Provisions for granting short=term waivers for tenants
  3 33 who exceed occupancy criteria.
  3 34    2.  Each elder group home operating in this state shall be
  3 35 certified by the department of inspections and appeals.
  4  1    3.  The owner or manager of a certified elder group home
  4  2 shall comply with the rules adopted by the department for an
  4  3 elder group home.  A person, including a governmental unit,
  4  4 shall not represent an elder group home to the public as an
  4  5 elder group home or as a certified elder group home unless and
  4  6 until the program is certified pursuant to this chapter.
  4  7    4.  a.  Services provided by a certified elder group home
  4  8 may be provided directly by staff of the elder group home, by
  4  9 individuals contracting with the elder group home to provide
  4 10 services, or by individuals employed by the tenant or with
  4 11 whom the tenant contracts if the tenant agrees to assume the
  4 12 responsibility and risk of the employment or the contractual
  4 13 relationship.
  4 14    b.  If a tenant is terminally ill and has elected to
  4 15 receive hospice services under the federal Medicare program
  4 16 from a Medicare=certified hospice program, the elder group
  4 17 home and the Medicare=certified hospice program shall enter
  4 18 into a written agreement under which the hospice program
  4 19 retains professional management responsibility for those
  4 20 services.
  4 21    5.  The department of inspections and appeals may enter
  4 22 into contracts to provide certification and monitoring of
  4 23 elder group homes.  The department of inspections and appeals
  4 24 shall:
  4 25    a.  Have full access at reasonable times to all records,
  4 26 materials, and common areas pertaining to the provision of
  4 27 services and care to the tenants of a program during
  4 28 certification, monitoring, and complaint investigations of
  4 29 programs seeking certification, currently certified, or
  4 30 alleged to be uncertified.
  4 31    b.  With the consent of the tenant, visit the tenant's
  4 32 unit.
  4 33    6.  A department, agency, or officer of this state or of
  4 34 any governmental unit shall not pay or approve for payment
  4 35 from public funds any amount to an elder group home for an
  5  1 actual or prospective tenant, unless the program holds a
  5  2 current certificate issued by the department of inspections
  5  3 and appeals and meets all current requirements for
  5  4 certification.
  5  5    7.  The department shall adopt rules regarding the
  5  6 conducting or operating of another business or activity in the
  5  7 distinct part of the physical structure in which the elder
  5  8 group home is operated, if the business or activity serves
  5  9 persons who are not tenants.  The rules shall be developed in
  5 10 consultation with the department of inspections and appeals
  5 11 and affected industry, professional, and consumer groups.
  5 12    8.  An elder group home shall comply with section 135C.33.
  5 13    9.  The department of elder affairs and the department of
  5 14 inspections and appeals shall conduct joint training sessions
  5 15 for personnel responsible for conducting monitoring
  5 16 evaluations and complaint investigations of elder group homes.
  5 17    10.  Certification shall be for two years unless revoked
  5 18 for good cause by the department of inspections and appeals.
  5 19    Sec. 4.  Section 231B.4, Code 2005, is amended by striking
  5 20 the section and inserting in lieu thereof the following:
  5 21    231B.4  ZONING == FIRE AND SAFETY STANDARDS.
  5 22    An elder group home shall be located in an area zoned for
  5 23 single=family or multiple=family housing or in an
  5 24 unincorporated area and shall be constructed in compliance
  5 25 with applicable local housing codes and the rules adopted for
  5 26 the special classification by the state fire marshal.  In the
  5 27 absence of local building codes, the facility shall comply
  5 28 with the state plumbing code established pursuant to section
  5 29 135.11 and the state building code established pursuant to
  5 30 section 103A.7 and the rules adopted for the special
  5 31 classification by the state fire marshal.
  5 32    Sec. 5.  NEW SECTION.  231B.5  WRITTEN OCCUPANCY AGREEMENT
  5 33 REQUIRED.
  5 34    1.  An elder group home shall not operate in this state
  5 35 unless a written occupancy agreement, as prescribed in
  6  1 subsection 2, is executed between the elder group home and
  6  2 each tenant or the tenant's legal representative prior to the
  6  3 tenant's occupancy, and unless the elder group home operates
  6  4 in accordance with the terms of the occupancy agreement.  The
  6  5 elder group home shall deliver to the tenant or the tenant's
  6  6 legal representative a complete copy of the occupancy
  6  7 agreement and all supporting documents and attachments and
  6  8 shall deliver at least thirty days prior to any changes, a
  6  9 written copy of changes to the occupancy agreement if any
  6 10 changes to the copy originally delivered are subsequently
  6 11 made, unless otherwise provided in this section.
  6 12    2.  An elder group home occupancy agreement shall clearly
  6 13 describe the rights and responsibilities of the tenant and the
  6 14 elder group home.  The occupancy agreement shall also include
  6 15 but is not limited to inclusion of all of the following
  6 16 information in the body of the agreement or in the supporting
  6 17 documents and attachments:
  6 18    a.  A description of all fees, charges, and rates
  6 19 describing tenancy and basic services covered, and any
  6 20 additional and optional services and their related costs.
  6 21    b.  A statement regarding the impact of the fee structure
  6 22 on third=party payments, and whether third=party payments and
  6 23 resources are accepted by the elder group home.
  6 24    c.  The procedure followed for nonpayment of fees.
  6 25    d.  Identification of the party responsible for payment of
  6 26 fees and identification of the tenant's legal representative,
  6 27 if any.
  6 28    e.  The term of the occupancy agreement.
  6 29    f.  A statement that the elder group home shall notify the
  6 30 tenant or the tenant's legal representative, as applicable, in
  6 31 writing at least thirty days prior to any change being made in
  6 32 the occupancy agreement with the following exceptions:
  6 33    (1)  When the tenant's health status or behavior
  6 34 constitutes a substantial threat to the health or safety of
  6 35 the tenant, other tenants, or others, including when the
  7  1 tenant refuses to consent to relocation.
  7  2    (2)  When an emergency or a significant change in the
  7  3 tenant's condition results in the need for the provision of
  7  4 services that exceed the type or level of services included in
  7  5 the occupancy agreement and the necessary services cannot be
  7  6 safely provided by the elder group home.
  7  7    g.  A statement that all tenant information shall be
  7  8 maintained in a confidential manner to the extent required
  7  9 under state and federal law.
  7 10    h.  Occupancy, involuntary transfer, and transfer criteria
  7 11 and procedures, which ensure a safe and orderly transfer.
  7 12    i.  The internal appeals process provided relative to an
  7 13 involuntary transfer.
  7 14    j.  The program's policies and procedures for addressing
  7 15 grievances between the elder group home and the tenants,
  7 16 including grievances relating to transfer and occupancy.
  7 17    k.  A statement of the prohibition against retaliation as
  7 18 prescribed in section 231B.13.
  7 19    l.  The emergency response policy.
  7 20    m.  The staffing policy which specifies if nurse delegation
  7 21 will be used, and how staffing will be adapted to meet
  7 22 changing tenant needs.
  7 23    n.  The refund policy.
  7 24    o.  A statement regarding billing and payment procedures.
  7 25    3.  Occupancy agreements and related documents executed by
  7 26 each tenant or tenant's legal representative shall be
  7 27 maintained by the elder group home from the date of execution
  7 28 until three years from the date the occupancy agreement is
  7 29 terminated.  A copy of the most current occupancy agreement
  7 30 shall be provided to members of the general public, upon
  7 31 request.  Occupancy agreements and related documents shall be
  7 32 made available for on=site inspection to the department of
  7 33 inspections and appeals upon request and at reasonable times.
  7 34    Sec. 6.  NEW SECTION.  231B.6  INVOLUNTARY TRANSFER.
  7 35    1.  If an elder group home initiates the involuntary
  8  1 transfer of a tenant and the action is not a result of a
  8  2 monitoring evaluation or complaint investigation by the
  8  3 department of inspections and appeals, and if the tenant or
  8  4 tenant's legal representative contests the transfer, the
  8  5 following procedure shall apply:
  8  6    a.  The elder group home shall notify the tenant or
  8  7 tenant's legal representative, in accordance with the
  8  8 occupancy agreement, of the need to transfer, the reason for
  8  9 the transfer, and the contact information of the tenant
  8 10 advocate.
  8 11    b.  The elder group home shall provide the tenant advocate
  8 12 with a copy of the notification to the tenant.
  8 13    c.  The tenant advocate shall offer the notified tenant or
  8 14 tenant's legal representative assistance with the program's
  8 15 internal appeals process.  The tenant is not required to
  8 16 accept the assistance of the tenant advocate.
  8 17    d.  If, following the internal appeals process, the elder
  8 18 group home upholds the transfer decision, the tenant or the
  8 19 tenant's legal representative may utilize other remedies
  8 20 authorized by law to contest the transfer.
  8 21    2.  The department, in consultation with the department of
  8 22 inspections and appeals and affected industry, professional,
  8 23 and consumer groups, shall establish by rule, in accordance
  8 24 with chapter 17A, procedures to be followed, including the
  8 25 opportunity for hearing, when the transfer of a tenant results
  8 26 from a monitoring evaluation or complaint investigation
  8 27 conducted by the department of inspections and appeals.
  8 28    Sec. 7.  NEW SECTION.  231B.7  COMPLAINTS.
  8 29    1.  Any person with concerns regarding the operations or
  8 30 service delivery of an elder group home may file a complaint
  8 31 with the department of inspections and appeals.  The name of
  8 32 the person who files a complaint with the department of
  8 33 inspections and appeals and any personal identifying
  8 34 information of the person or any tenant identified in the
  8 35 complaint shall be kept confidential and shall not be subject
  9  1 to discovery, subpoena, or other means of legal compulsion for
  9  2 its release to a person other than department of inspections
  9  3 and appeals' employees involved with the complaint.
  9  4    2.  The department, in cooperation with the department of
  9  5 inspections and appeals, shall establish procedures for the
  9  6 disposition of complaints received in accordance with this
  9  7 section.
  9  8    Sec. 8.  NEW SECTION.  231B.8  INFORMAL REVIEW.
  9  9    1.  If an elder group home contests the findings of
  9 10 regulatory insufficiencies of a monitoring evaluation or
  9 11 complaint investigation, the program shall submit written
  9 12 information, demonstrating that the program was in compliance
  9 13 with the applicable requirement at the time of the monitoring
  9 14 evaluation or complaint investigation of the regulatory
  9 15 insufficiencies, to the department of inspections and appeals
  9 16 for review.
  9 17    2.  The department of inspections and appeals shall review
  9 18 the written information submitted within ten working days of
  9 19 the receipt of the information.  At the conclusion of the
  9 20 review, the department of inspections and appeals may affirm,
  9 21 modify, or dismiss the regulatory insufficiencies.  The
  9 22 department of inspections and appeals shall notify the program
  9 23 in writing of the decision to affirm, modify, or dismiss the
  9 24 regulatory insufficiencies, and the reasons for the decision.
  9 25    3.  In the case of a complaint investigation, the
  9 26 department of inspections and appeals shall also notify the
  9 27 complainant, if known, of the decision and the reasons for the
  9 28 decision.
  9 29    Sec. 9.  NEW SECTION.  231B.9  PUBLIC DISCLOSURE OF
  9 30 FINDINGS.
  9 31    Upon completion of a monitoring evaluation or complaint
  9 32 investigation of an elder group home by the department of
  9 33 inspections and appeals pursuant to this chapter, including
  9 34 the conclusion of all administrative appeals processes, the
  9 35 department of inspections and appeals' final findings with
 10  1 respect to compliance by the elder group home with
 10  2 requirements for certification shall be made available to the
 10  3 public in a readily available form and place.  Other
 10  4 information relating to an elder group home that is obtained
 10  5 by the department of inspections and appeals which does not
 10  6 constitute the department of inspections and appeals' final
 10  7 findings from a monitoring evaluation or complaint
 10  8 investigation of the elder group home shall be made available
 10  9 to the department of elder affairs upon request to facilitate
 10 10 policy decisions, but shall not be made available to the
 10 11 public except in proceedings involving the denial, suspension,
 10 12 or revocation of a certificate under this chapter.
 10 13    Sec. 10.  NEW SECTION.  231B.10  DENIAL, SUSPENSION, OR
 10 14 REVOCATION == CONDITIONAL OPERATION.
 10 15    1.  The department of inspections and appeals may deny,
 10 16 suspend, or revoke a certificate in any case where the
 10 17 department of inspections and appeals finds that there has
 10 18 been a substantial or repeated failure on the part of the
 10 19 elder group home to comply with this chapter or minimum
 10 20 standards adopted under this chapter or for any of the
 10 21 following reasons:
 10 22    a.  Appropriation or conversion of the property of an elder
 10 23 group home tenant without the tenant's written consent or the
 10 24 written consent of the tenant's legal representative.
 10 25    b.  Permitting, aiding, or abetting the commission of any
 10 26 illegal act in the elder group home.
 10 27    c.  Obtaining or attempting to obtain or retain a
 10 28 certificate by fraudulent means, misrepresentation, or by
 10 29 submitting false information.
 10 30    d.  Habitual intoxication or addiction to the use of drugs
 10 31 by the applicant, administrator, executive director, manager,
 10 32 or supervisor of the elder group home.
 10 33    e.  Securing the devise or bequest of the property of a
 10 34 tenant of an elder group home by undue influence.
 10 35    f.  Founded dependent adult abuse as defined in section
 11  1 235B.2.
 11  2    g.  In the case of any officer, member of the board of
 11  3 directors, trustee, or designated manager of the elder group
 11  4 home or any stockholder, partner, or individual who has
 11  5 greater than a five percent equity interest in the elder group
 11  6 home, who has or has had an ownership interest in an elder
 11  7 group home, assisted living or adult day services program,
 11  8 home health agency, residential care facility, or licensed
 11  9 nursing facility in this or any state which has been closed
 11 10 due to removal of program, agency, or facility licensure or
 11 11 certification or involuntary termination from participation in
 11 12 either the medical assistance or Medicare programs, or who has
 11 13 been found to have failed to provide adequate protection or
 11 14 services for tenants to prevent abuse or neglect.
 11 15    h.  In the case of a certificate applicant or an existing
 11 16 certified owner or operator who is an entity other than an
 11 17 individual, the person is in a position of control or is an
 11 18 officer of the entity and engages in any act or omission
 11 19 proscribed by this chapter.
 11 20    i.  For any other reason as provided by law or
 11 21 administrative rule.
 11 22    2.  The department of inspections and appeals may as an
 11 23 alternative to denial, suspension, or revocation conditionally
 11 24 issue or continue a certificate dependent upon the performance
 11 25 by the elder group home of reasonable conditions within a
 11 26 reasonable period of time as set by the department of
 11 27 inspections and appeals so as to permit the program to
 11 28 commence or continue the operation of the elder group home
 11 29 pending full compliance with this chapter or the rules adopted
 11 30 pursuant to this chapter.  If the elder group home does not
 11 31 make diligent efforts to comply with the conditions
 11 32 prescribed, the department of inspections and appeals may,
 11 33 under the proceedings prescribed by this chapter, deny,
 11 34 suspend, or revoke the certificate.  An elder group home shall
 11 35 not be operated on a conditional certificate for more than one
 12  1 year.
 12  2    Sec. 11.  NEW SECTION.  231B.11  NOTICE == APPEAL ==
 12  3 EMERGENCY PROVISIONS.
 12  4    1.  The denial, suspension, or revocation of a certificate
 12  5 shall be effected by delivering to the applicant or
 12  6 certificate holder by restricted certified mail or by personal
 12  7 service a notice setting forth the particular reasons for such
 12  8 action.  Such denial, suspension, or revocation shall become
 12  9 effective thirty days after the mailing or service of the
 12 10 notice, unless the applicant or certificate holder, within
 12 11 such thirty=day period, requests a hearing, in writing, of the
 12 12 department of inspections and appeals, in which case the
 12 13 notice shall be deemed to be suspended.
 12 14    2.  The denial, suspension, or revocation of a certificate
 12 15 may be appealed in accordance with rules adopted by the
 12 16 department of inspections and appeals in accordance with
 12 17 chapter 17A.
 12 18    3.  When the department of inspections and appeals finds
 12 19 that an imminent danger to the health or safety of a tenant of
 12 20 an elder group home exists which requires action on an
 12 21 emergency basis, the department of inspections and appeals may
 12 22 direct removal of all tenants of the elder group home and
 12 23 suspend the certificate prior to a hearing.
 12 24    Sec. 12.  NEW SECTION.  231B.12  DEPARTMENT NOTIFIED OF
 12 25 CASUALTIES.
 12 26    The department of inspections and appeals shall be notified
 12 27 within twenty=four hours, by the most expeditious means
 12 28 available, of any accident causing substantial injury or death
 12 29 to a tenant, and any substantial fire or natural or other
 12 30 disaster occurring at or near an elder group home.
 12 31    Sec. 13.  NEW SECTION.  231B.13  RETALIATION BY ELDER GROUP
 12 32 HOME PROHIBITED.
 12 33    An elder group home shall not discriminate or retaliate in
 12 34 any way against a tenant, a tenant's family, or an employee of
 12 35 the elder group home who has initiated or participated in any
 13  1 proceeding authorized by this chapter.  An elder group home
 13  2 that violates this section is subject to a penalty as
 13  3 established by administrative rule in accordance with chapter
 13  4 17A and to be assessed and collected by the department of
 13  5 inspections and appeals and paid into the state treasury to be
 13  6 credited to the general fund of the state.
 13  7    Sec. 14.  NEW SECTION.  231B.14  CIVIL PENALTIES.
 13  8    The department may establish by rule, in accordance with
 13  9 chapter 17A, civil penalties for the following violations by
 13 10 an elder group home:
 13 11    1.  Noncompliance with any regulatory requirements which
 13 12 presents an imminent danger or a substantial probability of
 13 13 resultant death or physical harm to a tenant.
 13 14    2.  Following receipt of notice from the department of
 13 15 inspections and appeals, continued failure or refusal to
 13 16 comply within a prescribed time frame with regulatory
 13 17 requirements that have a direct relationship to the health,
 13 18 safety, or security of elder group home tenants.
 13 19    3.  Preventing or interfering with or attempting to impede
 13 20 in any way any duly authorized representative of the
 13 21 department of inspections and appeals in the lawful
 13 22 enforcement of this chapter or of the rules adopted pursuant
 13 23 to this chapter.  As used in this subsection, "lawful
 13 24 enforcement" includes but is not limited to:
 13 25    a.  Contacting or interviewing any tenant of an elder group
 13 26 home in private at any reasonable hour and without advance
 13 27 notice.
 13 28    b.  Examining any relevant records of an elder group home.
 13 29    c.  Preserving evidence of any violation of this chapter or
 13 30 of the rules adopted pursuant to this chapter.
 13 31    Sec. 15.  NEW SECTION.  231B.15  CRIMINAL PENALTIES AND
 13 32 INJUNCTIVE RELIEF.
 13 33    A person establishing, conducting, managing, or operating
 13 34 an elder group home without a certificate is guilty of a
 13 35 serious misdemeanor.  Each day of continuing violation after
 14  1 conviction or notice from the department of inspections and
 14  2 appeals by certified mail of a violation shall be considered a
 14  3 separate offense.  A person establishing, conducting,
 14  4 managing, or operating an elder group home without a
 14  5 certificate may be temporarily or permanently restrained by a
 14  6 court of competent jurisdiction from such activity in an
 14  7 action brought by the state.
 14  8    Sec. 16.  NEW SECTION.  231B.16  COORDINATION OF THE LONG=
 14  9 TERM CARE SYSTEM == TRANSITIONAL PROVISIONS.
 14 10    1.  A hospital licensed pursuant to chapter 135B, a health
 14 11 care facility licensed pursuant to chapter 135C, an assisted
 14 12 living program certified pursuant to chapter 231C, or an adult
 14 13 day services program certified pursuant to chapter 231D may
 14 14 operate an elder group home, if the elder group home is
 14 15 certified pursuant to this chapter.
 14 16    2.  This chapter shall not be construed to require that a
 14 17 facility licensed as a different type of facility also comply
 14 18 with the requirements of this chapter, unless the facility is
 14 19 represented to the public as an elder group home.
 14 20    3.  A certified elder group home that complies with the
 14 21 requirements of this chapter shall not be required to be
 14 22 licensed or certified as a different type of facility, unless
 14 23 the elder group home is represented to the public as another
 14 24 type of facility.
 14 25    Sec. 17.  NEW SECTION.  231B.17  IOWA ELDER GROUP HOME
 14 26 FEES.
 14 27    1.  The department of inspections and appeals shall collect
 14 28 elder group home certification and related fees.  Fees
 14 29 collected and retained pursuant to this section shall be
 14 30 deposited in the general fund of the state.
 14 31    2.  The following certification and related fees shall
 14 32 apply to elder group homes:
 14 33    a.  For a two=year initial certification, seven hundred
 14 34 fifty dollars.
 14 35    b.  For a two=year recertification, one thousand dollars.
 15  1    c.  For a blueprint plan review, nine hundred dollars.
 15  2    d.  For an optional preliminary plan review, five hundred
 15  3 dollars.
 15  4    Sec. 18.  NEW SECTION.  231B.18  APPLICATION OF LANDLORD
 15  5 AND TENANT ACT.
 15  6    Chapter 562A, the uniform residential landlord and tenant
 15  7 Act, shall apply to elder group homes under this chapter.
 15  8    Sec. 19.  NEW SECTION.  231B.19  RESIDENT ADVOCATE
 15  9 COMMITTEES.
 15 10    The commission of elder affairs shall adopt by rule
 15 11 procedures for appointing members of resident advocate
 15 12 committees for elder group homes.
 15 13    Sec. 20.  NEW SECTION.  231B.20  NURSING ASSISTANT AND
 15 14 MEDICATION AIDE == CERTIFICATION.
 15 15    The department of inspections and appeals, in cooperation
 15 16 with other appropriate agencies, shall establish a procedure
 15 17 to allow nursing assistants or medication aides to claim work
 15 18 within an elder group home as credit toward sustaining the
 15 19 nursing assistant's or medication aide's certification.
 15 20    Sec. 21.  NEW SECTION.  231B.21  MEDICATION SETUP ==
 15 21 ADMINISTRATION AND STORAGE OF MEDICATIONS.
 15 22    1.  An elder group home may provide for medication setup if
 15 23 requested by a tenant or the tenant's legal representative.
 15 24 If medication setup is provided following such request, the
 15 25 elder group home shall be responsible for the specific task
 15 26 requested and the tenant shall retain responsibility for those
 15 27 tasks not requested to be provided.
 15 28    2.  If medications are administered or stored by an elder
 15 29 group home, or if the elder group home provides for medication
 15 30 setup, all of the following shall apply:
 15 31    a.  If administration of medications is delegated to the
 15 32 elder group home by the tenant or tenant's legal
 15 33 representative, the medications shall be administered by a
 15 34 registered nurse, licensed practical nurse, or advanced
 15 35 registered nurse practitioner licensed or registered in Iowa
 16  1 or by the individual to whom such licensed or registered
 16  2 individuals may properly delegate administration of
 16  3 medications.
 16  4    b.  Medications, other than those self=administered by the
 16  5 tenant or provided through medication setup, shall be stored
 16  6 in locked storage that is not accessible to persons other than
 16  7 employees responsible for administration or storage of
 16  8 medications.
 16  9    c.  Medications shall be labeled and maintained in
 16 10 compliance with label instructions and state and federal law.
 16 11    d.  A person other than a dispensing pharmacist shall not
 16 12 alter the prescription.
 16 13    e.  Medications shall be stored in their originally
 16 14 received containers.
 16 15    f.  If medication setup is provided by the elder group home
 16 16 at the request of the tenant or tenant's legal representative,
 16 17 or if medication administration is delegated to the elder
 16 18 group home by the tenant or tenant's legal representative,
 16 19 appropriate staff of the elder group home may transfer the
 16 20 medications in the tenant's presence from the original
 16 21 prescription container to medication dispensing containers,
 16 22 reminder containers, or medication cups.
 16 23    g.  Elder group home assistance with medication
 16 24 administration as specified in the occupancy agreement shall
 16 25 not require the elder group home to provide assistance with
 16 26 the storage of medications.
 16 27    Sec. 22.  Section 335.33, Code 2005, is amended to read as
 16 28 follows:
 16 29    335.33  ELDER GROUP HOMES.
 16 30    A county board of supervisors or county zoning commission
 16 31 shall consider an elder group home a family home, as defined
 16 32 in section 335.25, for purposes of zoning, in accordance with
 16 33 section 231B.2 231B.4, and may establish limitations regarding
 16 34 the proximity of one proposed elder group home to another.
 16 35    Sec. 23.  Section 414.31, Code 2005, is amended to read as
 17  1 follows:
 17  2    414.31  ELDER GROUP HOMES.
 17  3    A city council or city zoning commission shall consider an
 17  4 elder family group home a family home, as defined in section
 17  5 414.22, for purposes of zoning, in accordance with section
 17  6 231B.2 231B.4, and may establish limitations regarding the
 17  7 proximity of one proposed elder group home to another.
 17  8 HF 710
 17  9 pf:nh/es/25