H.F. 2422 Section 1. Section 135C.3, subsection 1, Code 2011, is 1 amended to read as follows: 2 1. a. A licensed nursing facility shall provide an 3 organized twenty-four-hour program of services commensurate 4 with the needs of its residents and under the immediate 5 direction of a licensed nurse. Medical and nursing services 6 must be provided under the direction of either a house 7 physician or an individually selected physician. Surgery or 8 obstetrical care shall not be provided within the facility. 9 An admission to the nursing facility must be based on a 10 physician’s written order certifying that the individual being 11 admitted requires no greater degree of nursing care than the 12 facility to which the admission is made is licensed to provide 13 and is capable of providing. 14 b. A nursing facility is not required to admit an individual 15 through court order, referral, or other means without the 16 express prior approval of the administrator or owner of the 17 nursing facility. 18 Sec. 2. Section 135C.4, Code 2011, is amended to read as 19 follows: 20 135C.4 Residential care facilities. 21 1. Each facility licensed as a residential care facility 22 shall provide an organized continuous twenty-four-hour program 23 of care commensurate with the needs of the residents of the 24 home and under the immediate direction of a person approved 25 and certified by the department whose combined training 26 and supervised experience is such as to ensure adequate and 27 competent care. 28 2. All admissions to residential care facilities shall be 29 based on an order written by a physician certifying that the 30 individual being admitted does not require nursing services or 31 that the individual’s need for nursing services can be avoided 32 if home and community-based services, other than nursing care, 33 as defined by this chapter and departmental rule, are provided. 34 3. For the purposes of this section , the home and 35 -1- HF 2422 (5) 84 ad/rj 1/ 11

H.F. 2422 community-based services to be provided shall be limited to the 1 type included under the medical assistance program provided 2 pursuant to chapter 249A , shall be subject to cost limitations 3 established by the department of human services under the 4 medical assistance program, and except as otherwise provided by 5 the department of inspections and appeals with the concurrence 6 of the department of human services, shall be limited in 7 capacity to the number of licensed residential care facilities 8 and the number of licensed residential care facility beds in 9 the state as of December 1, 2003. 10 4. A residential care facility is not required to admit 11 an individual through court order, referral, or other means 12 without the express prior approval of the administrator or 13 owner of the residential care facility. 14 Sec. 3. NEW SECTION . 135C.23A Sex offender notification. 15 1. Upon commitment of a person required to register as 16 a sex offender as provided in section 692A.103 to a nursing 17 facility, residential care facility, or assisted living program 18 as defined in section 231C.2, the clerk of the committing court 19 shall notify the department of inspections and appeals and the 20 admitting facility or program. 21 2. Prior to admission of a resident or tenant to a nursing 22 facility, residential care facility, or assisted living 23 program, the facility or program shall access and search the 24 sex offender registry established in chapter 692A to determine 25 whether the resident or tenant is a person required to register 26 as a sex offender, as provided in section 692A.103. 27 3. Upon the admission of a person required to register as a 28 sex offender, a nursing facility, residential care facility, or 29 assisted living program shall provide notice of the admission, 30 in accordance with the federal Health Insurance Portability and 31 Accountability Act of 1996, Pub. L. No. 104-191, other state 32 and federal regulations, and rules adopted by the department, 33 to all of the following persons: 34 a. Residents or tenants of the facility or program. 35 -2- HF 2422 (5) 84 ad/rj 2/ 11

H.F. 2422 b. The emergency contact person or next of kin for residents 1 or tenants of the facility or program. 2 c. Operators, owners, managers, or employees of the facility 3 or program. 4 d. Visitors to the facility or program. 5 e. The sheriff for the county in which the facility or 6 program is located. The sheriff shall notify local law 7 enforcement agencies. 8 4. Upon the admission of a person required to register as a 9 sex offender, a nursing facility, residential care facility, or 10 assisted living program shall develop and implement a written 11 safety plan for each such person in accordance with rules 12 adopted by the department. 13 5. The department shall establish by rule, all of the 14 following: 15 a. The requirements of the notice required under this 16 section. The rules shall include but are not limited to 17 provisions for the method of notice and time of notice to each 18 of the persons enumerated in subsection 3. 19 b. The requirements of a safety plan for persons required 20 to register as a sex offender who are admitted by a nursing 21 facility, residential care facility, or assisted living 22 program. The rules shall include but are not limited to all of 23 the following: 24 (1) A plan for the safety of residents, tenants, and staff 25 of the facility or program. 26 (2) A plan for the safety of others when community functions 27 are held at a facility or program and when a person required to 28 register as a sex offender is not on the premises of a facility 29 or program but the person remains within the care, custody, and 30 control of the facility or program. 31 (3) A provision to establish the responsibilities of a 32 nursing facility, residential care facility, and assisted 33 living program and the operators, owners, managers, and 34 employees of facilities and programs in implementing a safety 35 -3- HF 2422 (5) 84 ad/rj 3/ 11

H.F. 2422 plan. 1 (4) A provision for the timely development and 2 implementation of a safety plan. 3 6. The department shall work with interested stakeholders 4 in developing the proposed rules under this section. 5 7. A violation of this section is subject to the imposition 6 of a civil penalty in accordance with rules adopted by the 7 department pursuant to this section. 8 Sec. 4. Section 231C.3, subsection 9, Code 2011, is amended 9 to read as follows: 10 9. An assisted living program shall comply with section 11 sections 135C.23A and 135C.33 . 12 Sec. 5. Section 231C.5A, Code 2011, is amended to read as 13 follows: 14 231C.5A Assessment of tenants —— program eligibility. 15 1. An assisted living program receiving reimbursement 16 through the medical assistance program under chapter 249A shall 17 assist the department of veterans affairs in identifying, upon 18 admission of a tenant, the tenant’s eligibility for benefits 19 through the United States department of veterans affairs. The 20 assisted living program shall also assist the commission of 21 veterans affairs in determining such eligibility for tenants 22 residing in the program on July 1, 2009. The department of 23 inspections and appeals, in cooperation with the department of 24 human services, shall adopt rules to administer this section , 25 including a provision that ensures that if a tenant is eligible 26 for benefits through the United States department of veterans 27 affairs or other third-party payor, the payor of last resort 28 for reimbursement to the assisted living program is the medical 29 assistance program. The rules shall also require the assisted 30 living program to request information from a tenant or tenant’s 31 personal representative regarding the tenant’s veteran status 32 and to report to the department of veterans affairs only the 33 names of tenants identified as potential veterans along with 34 the names of their spouses and any dependents. Information 35 -4- HF 2422 (5) 84 ad/rj 4/ 11

H.F. 2422 reported by the assisted living program shall be verified by 1 the department of veterans affairs. 2 2. An assisted living program is not required to enter 3 into a lease or occupancy agreement with an individual through 4 court order, referral, or other means without the express 5 prior approval of the manager or owner of the assisted living 6 program. 7 Sec. 6. Section 231C.14, subsection 1, Code 2011, is amended 8 by adding the following new paragraph: 9 NEW PARAGRAPH . d. Noncompliance with section 135C.23A. 10 Sec. 7. Section 602.8102, Code 2011, is amended by adding 11 the following new subsection: 12 NEW SUBSECTION . 152. Notify the department of inspections 13 and appeals and the admitting entity upon commitment of a 14 person required to register as a sex offender as provided in 15 section 692A.103 to a nursing facility or residential care 16 facility as defined in section 135C.1, or assisted living 17 program as defined in section 231C.2. 18 Sec. 8. PLACEMENT OF PERSONS REQUIRED TO REGISTER. 19 1. For purposes of this section, “adequate placement” means 20 a placement that will provide the level of care necessary for 21 a person including the level of care provided by a nursing 22 facility or residential care facility. 23 2. For the period beginning July 1, 2012, through June 24 30, 2013, the department of human services, in compliance 25 with federal and state law, shall secure adequate placements 26 for persons required to register as a sex offender pursuant 27 to chapter 692A who are being released from the custody of 28 the department of corrections and require the type of medical 29 and personal care provided by a nursing facility, residential 30 care facility, or assisted living program; who are being 31 discharged or transferred from nursing facilities, residential 32 care facilities, or assisted living programs pursuant to a 33 provision of this Act; or who require the type of medical and 34 personal care provided by nursing facilities, residential care 35 -5- HF 2422 (5) 84 ad/rj 5/ 11

H.F. 2422 facilities, or assisted living programs when the persons are 1 unable to gain access to a facility or program because the 2 persons are required to register on the sex offender registry. 3 3. The department of human services may use a state facility 4 to provide care for such persons or may conduct a request for 5 proposal process to contract with a private facility to care 6 for such persons. A request for proposals shall identify the 7 reimbursement rate and the necessary training for staff in the 8 facility or program. 9 4. The department of human services shall secure an adequate 10 placement for such a person within ten business days of being 11 notified by the department of corrections, the department of 12 inspections and appeals, or a nursing facility, residential 13 care facility, or assisted living program that placement is 14 needed for such person, provided that such period shall not 15 commence until the department of public safety receives and 16 approves registration data and makes such data available on 17 the sex offender registry internet site pursuant to section 18 692A.121, subsection 12. 19 Sec. 9. WORKFORCE DEVELOPMENT WORKGROUP. 20 1. If a workgroup to address issues connected with workforce 21 development related to mental health and disability services 22 is established by or as a result of legislation enacted by the 23 2012 regular session of the Eighty-fourth General Assembly, the 24 workgroup shall also address issues connected with ensuring 25 that an adequate workforce is available in the state to provide 26 services to persons who have a history of committing sexual 27 offenses and have been determined to be likely to reoffend. 28 2. a. If a workgroup to address issues connected with 29 workforce development for mental health and disability services 30 is not established by or as a result of legislation enacted by 31 the 2012 regular session of the Eighty-fourth General Assembly, 32 the department of human services shall convene and provide 33 support to a health and mental health services for sexual 34 offender workforce development workgroup to address issues 35 -6- HF 2422 (5) 84 ad/rj 6/ 11

H.F. 2422 connected with ensuring that an adequate workforce is available 1 in the state to provide health and mental health services to 2 persons who have a history of committing sexual offenses and 3 have been determined to be likely to reoffend. The workgroup 4 shall report at least annually to the governor and general 5 assembly providing findings, recommendations, and financing 6 information concerning the findings and recommendations. 7 b. The membership of the workgroup shall include all of the 8 following: 9 (1) The director of the department of aging or the 10 director’s designee. 11 (2) The director of the department of corrections or the 12 director’s designee. 13 (3) The director of the department of education or the 14 director’s designee. 15 (4) The director of human services or the director’s 16 designee. 17 (5) The director of the department of public health or the 18 director’s designee. 19 (6) The director of the department of workforce development 20 or the director’s designee. 21 (7) At least three individuals who have a history of 22 committing sexual offenses and have been determined likely to 23 reoffend who are receiving mental health or health services or 24 involved relatives of such individuals. 25 (8) At least three providers of mental health or health 26 services for individuals who have a history of committing 27 sexual offenses and have been determined likely to reoffend. 28 (9) Other persons identified by the workgroup. 29 c. In addition to the members identified in paragraph 30 “b”, the membership of the workgroup shall include four 31 members of the general assembly serving in a ex officio, 32 nonvoting capacity. One member shall be designated by each 33 of the following: the majority leader of the senate, the 34 minority leader of the senate, the speaker of the house of 35 -7- HF 2422 (5) 84 ad/rj 7/ 11

H.F. 2422 representatives, and the minority leader of the house of 1 representatives. A legislative member serves for a term as 2 provided in section 69.16B. 3 d. Except as provided in paragraph “c” for legislative 4 appointments, the workgroup shall determine its own rules of 5 procedure, membership terms, and operating provisions. 6 Sec. 10. FACILITY FOR SEXUAL OFFENDERS COMMITTEE AND 7 REPORT. 8 1. The department of inspections and appeals shall 9 establish and facilitate the activities of a committee of 10 stakeholders to examine options for designating a facility 11 to provide care for persons in this state who have a history 12 of committing sexual offenses and have been determined to be 13 likely to reoffend. 14 2. The membership of the committee shall include but is not 15 limited to the following: 16 a. Representatives of the departments of inspections 17 and appeals, human services, public health, corrections, and 18 aging, the office of the state public defender, the office of 19 the citizens’ aide, the office of the state long-term care 20 ombudsman, and the judicial branch. 21 b. Consumers of services provided by health care facilities 22 and family members of consumers. 23 c. Representatives of the health care industry and industry 24 associations. 25 d. Direct care workers employed by health care facilities. 26 e. Representatives from the Iowa legal aid. 27 f. Representatives from AARP Iowa. 28 g. Representatives from the Iowa civil liberties union. 29 h. Other stakeholders as the department of inspections and 30 appeals deems necessary. 31 i. Four ex officio, nonvoting members from the general 32 assembly with not more than one member from each chamber being 33 from the same political party. The two senators shall be 34 appointed, one each, by the majority leader of the senate and 35 -8- HF 2422 (5) 84 ad/rj 8/ 11

H.F. 2422 the minority leader of the senate. The two representatives 1 shall be appointed, one each, by the speaker of the house 2 of representatives and the minority leader of the house of 3 representatives. 4 3. The committee shall discuss and make recommendations on 5 all of the following: 6 a. Options to create a new facility or assist an existing 7 facility to expand services to provide care for elderly persons 8 who are no longer under judicial control, but have a history 9 of committing sexual offenses and have been determined to 10 be likely to reoffend. The committee shall identify the 11 characteristics of a client for such a facility, the need for 12 such a facility, options for creating a new facility to house 13 such persons, options for the expansion of an existing facility 14 to house such persons, options for using any alternative 15 facilities for such purposes, options for a public-private 16 partnership for such a facility, options for using part of 17 a mental health institute to house such persons, options to 18 qualify a facility for Medicaid reimbursement, cost projections 19 for any recommendations, regulatory challenges, and other 20 information deemed relevant by the department of inspections 21 and appeals. 22 b. The responsibility of the court, the clerk of the 23 district court, the department of corrections, or any other 24 entity, department, or person to inform a nursing facility, 25 residential care facility, or an assisted living program of the 26 admission of a person who has a history of committing sexual 27 offenses. 28 c. The responsibility of the court, clerk of the district 29 court, department of corrections, a facility, or any other 30 entity, department, or person to notify persons of the 31 discharge of a person who has a history of committing sexual 32 offenses from a nursing facility, residential care facility, or 33 assisted living program. 34 d. The requirements of a treatment safety plan for a person 35 -9- HF 2422 (5) 84 ad/rj 9/ 11

H.F. 2422 admitted to a nursing facility, residential care facility, 1 or assisted living program who has a history of committing 2 sexual offenses. The treatment safety plan shall address the 3 procedure for notifying other residents of the residency of a 4 person required to register as a sex offender. 5 e. The establishment of a formal process for the department 6 of inspections and appeals to follow when completing facility 7 or assisted living program inspections or surveys. 8 f. The establishment of a system for the judicial branch to 9 identify facilities with the capacity to provide an appropriate 10 placement for a person requiring commitment when the person 11 also has a history of committing sexual offenses. 12 4. The committee shall provide a report detailing its 13 findings and recommendations to the governor and the general 14 assembly by December 14, 2012. 15 Sec. 11. RULES. The department of inspections and appeals 16 shall adopt rules to administer the provisions of this Act. 17 Sec. 12. CURRENT RESIDENTS AND TENANTS —— ACCESS AND SEARCH 18 OF SEX OFFENDER REGISTRY AND NOTIFICATION. A nursing facility, 19 residential care facility, or assisted living program, within 20 three months of the adoption of the rules by the department of 21 inspections and appeals regarding notification of the admission 22 of persons required to register as a sex offender to a facility 23 or program and development and implementation of safety plans 24 relating to such admitted persons, shall access and search the 25 sex offender registry established in chapter 692A for persons 26 who were residents or tenants of a facility or program prior to 27 the adoption of the rules and who remain residents or tenants 28 of the facility or program after the adoption of the rules. 29 Upon determining that a resident or tenant is a person required 30 to register as a sex offender, the facility or program shall, 31 within three months of the adoption of the rules, work with 32 the department of inspections and appeals and the department 33 of human services to transfer a sex offender living in the 34 facility or program to a state facility, based on the sex 35 -10- HF 2422 (5) 84 ad/rj 10/ 11

H.F. 2422 offender status as an endangerment to the safety of individuals 1 in the facility or program, or notify persons as required by 2 section 135C.23A and the rules adopted pursuant to that section 3 and develop and implement a safety plan as required by section 4 135C.23A and the rules adopted pursuant to that section. The 5 rules shall provide that, for purposes of this section, a 6 nursing facility, residential care facility, or assisted living 7 program has the right to discharge a current resident or tenant 8 based solely on the person’s status as a sex offender as an 9 endangerment to the safety of individuals in the facility or 10 program. 11 Sec. 13. EFFECTIVE UPON ENACTMENT. This Act, being deemed 12 of immediate importance, takes effect upon enactment. 13 -11- HF 2422 (5) 84 ad/rj 11/ 11