General Assembly: 80 (2003 Regular GA) - Chapter 166 - Regulation of elder family homes, elder group homes, and assisted living programs — fire and safety standards


Published: 2003-05-30

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488LAWS OF THE EIGHTIETH G.A., 2003 SESSIONCH. 165

Sec. 18. Section 135C.1, subsection 1, Code 2003, is amended to read as follows: 1. “Adult day services” means adult day services as defined in section 231.61 231D.1 that

are provided in a licensed health care facility.

Sec. 19. Section 231C.2, Code 2003, is amended by adding the following new subsection: NEW SUBSECTION. 0A. “Adult day services” means adult day services as defined in sec-

tion 231D.1.

Sec. 20. Section 231.61, Code 2003, is repealed.

Sec. 21. DEPARTMENTAL REPORT. The department of inspections and appeals, in con- sultationwith the department of elder affairs and the department of public safety, shall submit a written report to the general assembly by December 31, 2004, with copies to the joint appro- priations subcommittee on health and human services that provides details regarding the im- plementation of this Act, including fees collected annually, and expenses incurred by the af- fected state agencies for administration, certification issuance, inspection, and other costs related to this Act. The department of inspections and appeals shall also include information in the report regarding its projections as to whether the fees imposed under this Act are suffi- cient to cover future expenses of affected state agencies under this Act.

Sec. 22. ADULTDAY SERVICES—PERSONSWITHMENTAL RETARDATION. For the period beginning July 1, 2003, and ending June 30, 2004, if an adult day services program serv- ing persons withmental retardation is voluntarily accredited by the commission on accredita- tion of rehabilitation facilities (CARF) for personal and social services or by the council on quality and leadership in supports for persons with disabilities, prior to July 1, 2003, the de- partment of inspections and appeals shall accept voluntary accreditation as the basis for certi- fication as an adult day services program by the department.

Sec. 23. EFFECTIVE DATE. The section of this Act relating to adult day services serving persons with mental retardation, being deemed of immediate importance, takes effect upon enactment.

Approved May 30, 2003

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CH. 166CH. 166

CHAPTER 166

REGULATION OF ELDER FAMILY HOMES, ELDER GROUP HOMES, AND ASSISTED LIVING PROGRAMS — FIRE AND SAFETY STANDARDS

H.F. 675

AN ACT relating to the regulation of elder family homes, elder group homes, and assisted liv- ing programs, providing for fees, and providing penalties.

Be It Enacted by the General Assembly of the State of Iowa:

Section 1. Section 100.1, subsection 6, Code 2003, is amended to read as follows: 6. To adopt rules designating a fee to be assessed to each building, structure, or facility for

which a fire safety inspection or plan review by the state firemarshal is required as a condition of licensure by law. The fee designated by rule shall be set in an amount that is reasonably

489 LAWS OF THE EIGHTIETH G.A., 2003 SESSION CH. 166

related to the costs of conducting the applicable inspection or plan review. The fees collected by the state fire marshal shall be deposited in the general fund of the state.

Sec. 2. Section 135C.33, subsection 5, paragraph e, Code 2003, is amended to read as fol- lows: e. An employee of an assisted living facility program certified or voluntarily accredited un-

der chapter 231C, if the employee provides direct services to consumers.

Sec. 3. Section 231B.1, subsection 4, Code 2003, is amended to read as follows: 4. “Elder group home” means a single-family residence that is a residence of operated by

a personwho is providing room, board, and personal care to three through five elders who are not related to the person providing the service within the third degree of consanguinity or af- finity.

Sec. 4. Section 231B.2, subsection 2, paragraph c, Code 2003, is amended to read as fol- lows: c. An elder group home shall be owner-occupied, or owned by a nonprofit corporation and

occupied by a resident manager staffed by an on-site manager twenty-four hours per day, seven days perweek. A residentmanager shall reside in and provide services for nomore than one elder group home.

Sec. 5. Section 231B.2, subsections 3 and 5, Code 2003, are amended to read as follows: 3. An elder group home established pursuant to this chapter shall be certified by the depart-

ment of inspections and appeals. 5. Inspections and certification services shall be provided by the department of inspections

and appeals. However, beginning July 1, 1994, the department may enter into contracts with the area agencies on aging to provide these services.

Sec. 6. Section 231B.3, subsection 2, Code 2003, is amended to read as follows: 2. A person who has knowledge that an elder group home is operating without certification

shall report the name and address of the home to the department of inspections and appeals. The department of inspections and appeals shall investigate a report made pursuant to this section.

Sec. 7. Section 231C.1, Code 2003, is amended to read as follows: 231C.1 FINDINGS, AND PURPOSE, AND INTENT. 1. The general assembly finds that assisted living is an important part of the long-term care

system in this state. Assisted living emphasizes the independence anddignity of the individual while providing services in a cost-effective manner. 2. The purposes of establishing an assisted living program include all of the following: a. To encourage the establishment and maintenance of a safe and homelike environment

for individuals of all income levels who require assistance to live independently but who do not require health-related care on a continuous twenty-four hour per day basis. b. To establish standards for assisted living programs that allow flexibility in design which

promotes a social model of service delivery by focusing on individual independence, individu- al needs and desires, and consumer-driven quality of service. c. To encourage general public participation in the development of assisted living programs

for individuals of all income levels. 3. It is the intent of the general assembly that the department of elder affairs establish policy

for assisted living programs and that the department of inspections and appeals enforce this chapter.

Sec. 8. Section 231C.2, subsections 1 and 6, Code 2003, are amended to read as follows: 1. “Assisted living”means provision of housingwith serviceswhichmay include but are not

490LAWS OF THE EIGHTIETH G.A., 2003 SESSIONCH. 166

limited to health-related care, personal care, and assistance with instrumental activities of daily living to six three ormore tenants in a physical structurewhich provides a homelike envi- ronment. “Assisted living” also includes encouragement of family involvement, tenant self- direction, and tenant participation in decisions that emphasize choice, dignity, privacy, indi- viduality, shared risk, and independence. “Assisted living” includes the provision of housing and assistance with instrumental activities of daily living only if personal care or health- related care is also included. 6. “Tenant” means an individual who receives assisted living services through a certified or

accredited assisted living program.

Sec. 9. Section 231C.2, Code 2003, is amended by adding the following new subsections: NEWSUBSECTION. 2A. “Governmental unit” means the state, or any county, municipali-

ty, or other political subdivision or any department, division, board, or other agency of any of these entities. NEW SUBSECTION. 4A. “Legal representative” means a person appointed by the court to

act on behalf of the tenant, or a person acting pursuant to a power of attorney. NEWSUBSECTION. 4B. “Occupancy agreement”means awritten agreement entered into

between an assisted living programand a tenant that clearly describes the rights and responsi- bilities of the assisted living program and a tenant, and other information required by rule. “Occupancy agreement” may include a separate signed lease and signed service agreement. NEW SUBSECTION. 5A. “Recognized accrediting entity” means a nationally recognized

accrediting entity that the department recognizes as having specific assisted living program standards equivalent to the standards established by the department for assisted living pro- grams. NEW SUBSECTION. 6A. “Tenant advocate” means the office of long-term care resident’s

advocate established in section 231.42. NEWSUBSECTION. 7. “Tenant’s representative” means a tenant’s legal representative or

any representative authorized by the tenant to act on behalf of the tenant.

Sec. 10. Section 231C.3, Code 2003, is amended by striking the section and inserting in lieu thereof the following: 231C.3 CERTIFICATION OF ASSISTED LIVING PROGRAMS. 1. Thedepartment shall establishby rule in accordancewith chapter 17A, aprogram for cer-

tification andmonitoring of assisted living programs. Thedepartmentmay adopt by reference with orwithout amendment, nationally recognized standards and rules for assisted living pro- grams. The rules shall include specification of recognized accrediting entities and provisions related to dementia-specific programs. The standards and rules shall be formulated in con- sultation with the department of inspections and appeals, and affected industry, professional, and consumer groups and shall be designed to accomplish the purposes of this chapter and shall include but are not limited to rules relating to all of the following: a. Provisions to ensure, to thegreatest extent possible, thehealth, safety, andwell-beingand

appropriate treatment of tenants. b. Requirements that assisted living programs furnish the department of elder affairs and

the department of inspections and appeals with specified information necessary to administer this chapter. c. Standards for tenant evaluation or assessment, which may vary in accordance with the

nature of the services provided or the status of the tenant. d. Provisions for granting short-term waivers for tenants who exceed occupancy criteria. 2. In addition to the adoption of standards and rules for assisted livingprograms, thedepart-

ment in consultation with the department of inspections and appeals and affected industry, professional, and consumer groups, shall issue interpretive guidelines, including the expecta- tions of program certification monitors, to provide direction to assisted living programs in complying with certification requirements. 3. Each assisted living program operating in this state shall be certified by the department

491 LAWS OF THE EIGHTIETH G.A., 2003 SESSION CH. 166

of inspections and appeals. If an assisted living program is voluntarily accredited by a recog- nized accrediting entity, the department of inspections and appeals shall certify the assisted living program on the basis of the voluntary accreditation. An assisted living program that is certified by the department of inspections and appeals on the basis of voluntary accreditation shall not be subject to payment of the certification fee prescribed in section 231C.18, but shall be subject to an administrative fee as prescribed by rule. An assisted living program certified under this section is exempt from the requirements of section 135.63 relating to certificate of need requirements. 4. The owner or manager of a certified assisted living program shall comply with the rules

adopted by the department for an assisted living program. A person including a governmental unit shall not represent an assisted living program to the public as an assisted living program or as a certified assisted living program unless and until the program is certified pursuant to this chapter. 5. a. Services provided by a certified assisted living program may be provided directly by

staff of the assisted livingprogram, by individuals contractingwith the assisted living program to provide services, or by individuals employed by the tenant or with whom the tenant con- tracts if the tenant agrees to assume the responsibility and risk of the employment or the con- tractual relationship. b. If a tenant is terminally ill and has elected to receive hospice services under the federal

Medicare program from a Medicare-certified hospice program, the assisted living program and theMedicare-certified hospice program shall enter into a written agreement under which the hospice program retains professional management responsibility for those services. 6. The department of inspections and appeals may enter into contracts to provide certifica-

tion and monitoring of assisted living programs. The department of inspections and appeals shall: a. Have full access at reasonable times to all records,materials, and common areas pertain-

ing to the provision of services and care to the tenants of a programduring certification,moni- toring, and complaint investigations of programs seeking certification, currently certified, or alleged to be uncertified. b. With the consent of the tenant, visit the tenant’s unit. c. Require that the recognized accrediting entity providing accreditation for a programpro-

vide copies to the department of all materials related to the accreditation, monitoring, and complaint process. 7. The departmentmay also establish by rule in accordancewith chapter 17A a special clas-

sification for affordable assisted living programs. The rules shall be formulated in consulta- tion with the department of inspections and appeals and affected industry, professional, and consumer groups. 8. A department, agency, or officer of this state or of any governmental unit shall not pay

or approve for payment from public funds any amount to an assisted living program for an ac- tual or prospective tenant, unless the program holds a current certificate issued by the depart- ment of inspections and appeals and meets all current requirements for certification. 9. The department shall adopt rules regarding the conducting or operating of another busi-

ness or activity in thedistinct part of thephysical structure inwhich theassisted livingprogram is provided, if the business or activity serves nontenants. The rules shall be developed in con- sultation with the department of inspections and appeals and affected industry, professional, and consumer groups. 10. An assisted living program shall comply with section 135C.33.

Sec. 11. Section 231C.4, Code 2003, is amended to read as follows: 231C.4 FIRE AND SAFETY STANDARDS. The state fire marshal shall adopt rules, in coordination with the department of elder affairs

and the department of inspections and appeals, relating to the certification or voluntary ac- creditation and monitoring of the fire and safety standards of certified or voluntarily accred- ited assisted living programs.

492LAWS OF THE EIGHTIETH G.A., 2003 SESSIONCH. 166

Sec. 12. Section 231C.5, Code 2003, is amended by striking the section and inserting in lieu thereof the following: 231C.5 WRITTEN OCCUPANCY AGREEMENT REQUIRED. 1. An assisted living program shall not operate in this state unless a written occupancy

agreement, as prescribed in subsection 2, is executed between the assisted living programand each tenant or tenant’s representative, prior to the tenant’s occupancy, and unless the assisted living program operates in accordance with the terms of the occupancy agreement. The as- sisted living program shall deliver to the tenant or tenant’s representative a complete copy of the occupancy agreement and all supporting documents and attachments and shall deliver, at least thirty days prior to any changes, awritten copy of changes to the occupancy agreement if any changes to the copy originally delivered are subsequently made. 2. An assisted living program occupancy agreement shall clearly describe the rights and re-

sponsibilities of the tenant and the program. The occupancy agreement shall also include but is not limited to inclusion of all of the following information in the body of the agreement or in the supporting documents and attachments: a. A description of all fees, charges, and rates describing tenancy and basic services cov-

ered, and any additional and optional services and their related costs. b. A statement regarding the impact of the fee structure on third-party payments, and

whether third-party payments and resources are accepted by the assisted living program. c. The procedure followed for nonpayment of fees. d. Identification of the party responsible for payment of fees and identification of the ten-

ant’s representative, if any. e. The term of the occupancy agreement. f. A statement that the assisted living program shall notify the tenant or the tenant’s repre-

sentative, as applicable, in writing at least thirty days prior to any change being made in the occupancy agreement with the following exceptions: (1) When the tenant’s health status or behavior constitutes a substantial threat to the health

or safety of the tenant, other tenants, or others, including when the tenant refuses to consent to relocation. (2) When an emergency or a significant change in the tenant’s condition results in the need

for the provision of services that exceed the type or level of services included in the occupancy agreement and the necessary services cannot be safely provided by the assisted living pro- gram. g. A statement that all tenant information shall be maintained in a confidential manner to

the extent required under state and federal law. h. Occupancy, involuntary transfer, and transfer criteria and procedures, which ensure a

safe and orderly transfer. The internal appeals process provided relative to an involuntary transfer. i. The program’s policies and procedures for addressing grievances between the assisted

living program and the tenants, including grievances relating to transfer and occupancy. j. A statement of the prohibition against retaliation as prescribed in section 231C.13. k. The emergency response policy. l. The staffing policy which specifies if the staff is available twenty-four hours per day, if

nurse delegationwill be used, and howstaffingwill be adapted tomeet changing tenant needs. m. In dementia-specific assisted livingprograms, a description of the services andprogram-

ming provided to meet the life skills and social activities of tenants. n. The refund policy. o. A statement regarding billing and payment procedures. 3. Occupancy agreements and related documents executed by each tenant or tenant’s rep-

resentative shall be maintained by the assisted living program in program files from the date of execution until three years from the date the occupancy agreement is terminated. A copy of themost current occupancy agreement shall be provided tomembers of the general public, upon request. Occupancy agreements and related documents shall be made available for on- site inspection to the department of inspections and appeals upon request and at reasonable times.

493 LAWS OF THE EIGHTIETH G.A., 2003 SESSION CH. 166

Sec. 13. Section 231C.6, Code 2003, is amended by striking the section and inserting in lieu thereof the following: 231C.6 INVOLUNTARY TRANSFER. 1. If an assisted living program initiates the involuntary transfer of a tenant and the action

is not a result of a monitoring evaluation or complaint investigation by the department of in- spections and appeals, and if the tenant or tenant’s representative contests the transfer, the following procedure shall apply: a. The assisted living program shall notify the tenant or tenant’s representative, in accor-

dance with the occupancy agreement, of the need to transfer, the reason for the transfer, and the contact information of the tenant advocate. b. The assisted living program shall provide the tenant advocate with a copy of the notifica-

tion to the tenant. c. The tenant advocate shall offer the notified tenant or tenant’s representative assistance

with the program’s internal appeals process. The tenant is not required to accept the assis- tance of the tenant advocate. d. If, following the internal appeals process, the assisted living program upholds the trans-

fer decision, the tenant may utilize other remedies authorized by law to contest the transfer. 2. The department, in consultation with the department of inspections and appeals and af-

fected industry, professional, and consumergroups, shall establish, by rule in accordancewith chapter 17A, procedures to be followed, including the opportunity for hearing,when the trans- fer of a tenant results from a monitoring evaluation or complaint investigation conducted by the department of inspections and appeals.

Sec. 14. NEW SECTION. 231C.7 COMPLAINTS. 1. Any person with concerns regarding the operations or service delivery of an assisted liv-

ing programmay file a complaint with the department of inspections and appeals. The name of the person who files a complaint with the department of inspections and appeals and any personal identifying information of the person or any tenant identified in the complaint shall be kept confidential and shall not be subject to discovery, subpoena, or other means of legal compulsion for its release to a person other than department of inspections and appeals’ em- ployees involved with the complaint. 2. The department, in cooperationwith the department of inspections and appeals, shall es-

tablish procedures for the disposition of complaints received in accordance with this section.

Sec. 15. NEW SECTION. 231C.8 INFORMAL REVIEW. If an assisted living program contests the regulatory insufficiencies of a monitoring evalua-

tion or complaint investigation, the program shall submit written information, demonstrating that the program was in compliance with the applicable requirement at the time of the moni- toring evaluation or complaint investigation, in support of the contesting of the regulatory in- sufficiencies, to the department of inspections and appeals for review. The department of in- spections and appeals shall review thewritten information submittedwithin tenworking days of the receipt of the information. At the conclusion of the review, the department of inspec- tions and appeals may affirm, modify, or dismiss the regulatory insufficiencies. The depart- ment of inspections and appeals shall notify the program in writing of the decision to affirm, modify, or dismiss the regulatory insufficiencies, and the reasons for the decision. In the case of a complaint investigation, the department of inspections and appeals shall also notify the complainant, if known, of the decision and the reasons for the decision.

Sec. 16. NEW SECTION. 231C.9 PUBLIC DISCLOSURE OF FINDINGS. Following a monitoring evaluation or complaint investigation of an assisted living program

by the department of inspections and appeals pursuant to this chapter, the department of inspections and appeals’ final findings with respect to compliance by the assisted living program with requirements for certification shall be made available to the public in a readily available form and place. Other information relating to an assisted living program that is ob- tained by the department of inspections and appealswhich does not constitute the department

494LAWS OF THE EIGHTIETH G.A., 2003 SESSIONCH. 166

of inspections andappeals’ final findings fromamonitoring evaluation or complaint investiga- tion of the assisted living program shall not bemade available to the public except in proceed- ings involving the denial, suspension, or revocation of a certificate under this chapter.

Sec. 17. NEW SECTION. 231C.10 DENIAL, SUSPENSION, OR REVOCATION — CON- DITIONAL OPERATION. 1. The department of inspections and appeals may deny, suspend, or revoke a certificate in

any casewhere the department of inspections and appeals finds that there has been a substan- tial or repeated failure on the part of the assisted living program to comply with this chapter or the rules, orminimum standards adopted under this chapter, or for any of the following rea- sons: a. Cruelty or indifference to assisted living program tenants. b. Appropriation or conversion of the property of an assisted living program tenant without

the tenant’s written consent or the written consent of the tenant’s legal guardian. c. Permitting, aiding, or abetting the commission of any illegal act in the assisted living pro-

gram. d. Obtaining or attempting to obtain or retain a certificate by fraudulent means, misrepre-

sentation, or by submitting false information. e. Habitual intoxication or addiction to the use of drugs by the applicant, administrator,

executive director, manager, or supervisor of the assisted living program. f. Securing the devise or bequest of the property of a tenant of an assisted living program

by undue influence. g. Founded dependent adult abuse as defined in section 235B.2. h. In the case of any officer,member of the board of directors, trustee, or designatedmanag-

er of the programor any stockholder, partner, or individualwhohas greater than a ten percent equity interest in the program, who has or has had an ownership interest in an assisted living program, home health agency, residential care facility, or licensed nursing facility in any state which has been closed due to removal of program, agency, or facility licensure or certification or involuntary termination from participation in either the medical assistance or Medicare programs, or who has been found to have failed to provide adequate protection or services for tenants to prevent abuse or neglect. i. In the case of a certificate applicant or an existing certified owner or operator who is an

entity other than an individual, the person is in a position of control or is an officer of the entity and engages in any act or omission proscribed by this chapter. j. For any other reason as provided by law or administrative rule. 2. The department of inspections and appeals may as an alternative to denial, suspension,

or revocation conditionally issue or continue a certificate dependent upon the performance by the assisted living program of reasonable conditions within a reasonable period of time as set by thedepartment of inspections andappeals so as topermit theprogram to commence or con- tinue the operation of the program pending full compliance with this chapter or the rules adopted pursuant to this chapter. If the assisted living program does not make diligent efforts to comply with the conditions prescribed, the department of inspections and appealsmay, un- der the proceedings prescribed by this chapter, suspend, or revoke the certificate. An assisted living program shall not be operated on a conditional certificate for more than one year.

Sec. 18. NEW SECTION. 231C.11 NOTICE — APPEAL — EMERGENCY PROVISIONS. 1. The denial, suspension, or revocation of a certificate shall be effected by delivering to the

applicant or certificateholderby restricted certifiedmail or bypersonal service anotice setting forth the particular reasons for such action. Such denial, suspension, or revocation shall be- come effective thirty days after themailing or service of the notice, unless the applicant or cer- tificate holder, within such thirty-day period, requests a hearing, in writing, of the department of inspections and appeals, in which case the notice shall be deemed to be suspended. 2. The denial, suspension, or revocation of a certificatemay be appealed in accordancewith

rules adopted by the department of inspections and appeals in accordance with chapter 17A.

495 LAWS OF THE EIGHTIETH G.A., 2003 SESSION CH. 166

3. When the department of inspections and appeals finds that an imminent danger to the health or safety of tenants of an assisted living program exists which requires action on an emergency basis, the department of inspections and appealsmay direct removal of all tenants of an assisted living program and suspend the certificate prior to a hearing.

Sec. 19. NEW SECTION. 231C.12 DEPARTMENT NOTIFIED OF CASUALTIES. Thedepartment of inspections andappeals shall be notifiedwithin twenty-fourhours, by the

most expeditiousmeans available, of any accident causing substantial injury or death, andany substantial fire or natural or other disaster occurring at or near an assisted living program.

Sec. 20. NEW SECTION. 231C.13 RETALIATION BY ASSISTED LIVING PROGRAM PROHIBITED. An assisted living program shall not discriminate or retaliate in any way against a tenant,

tenant’s family, or an employee of the program who has initiated or participated in any pro- ceeding authorized by this chapter. An assisted living program that violates this section is sub- ject to a penalty as established by administrative rule in accordance with chapter 17A and to be assessed and collected by the department of inspections and appeals and paid into the state treasury to be credited to the general fund of the state.

Sec. 21. NEW SECTION. 231C.14 CIVIL PENALTIES. The department may establish by rule, in accordance with chapter 17A, civil penalties for

the following violations by an assisted living program: 1. Noncompliance with any regulatory requirements which presents an imminent danger

or a substantial probability of resultant death or physical harm to a tenant. 2. Following receipt of notice from the department of inspections and appeals, continued

failure or refusal to comply within a prescribed time frame with regulatory requirements that have a direct relationship to the health, safety, or security of program tenants.

Sec. 22. NEW SECTION. 231C.15 CRIMINAL PENALTIES AND INJUNCTIVE RELIEF. 1. A person establishing, conducting, managing, or operating any assisted living program

without a certificate is guilty of a seriousmisdemeanor. Each day of continuing violation after conviction or notice from the department of inspections and appeals by certified mail of a violation shall be considered a separate offense or chargeable offense. A person establishing, conducting, managing, or operating an assisted living program without a certificate may be temporarily or permanently restrained by a court of competent jurisdiction from such activity in an action brought by the state. 2. A person who prevents or interferes with or attempts to impede in any way any duly au-

thorized representative of the department of inspections and appeals in the lawful enforce- ment of this chapter or of the rules adopted pursuant to this chapter is guilty of a simplemisde- meanor. As used in this subsection, lawful enforcement includes but is not limited to: a. Contacting or interviewing any tenant of an assisted living program in private at any rea-

sonable hour and without advance notice. b. Examining any relevant records of an assisted living program. c. Preserving evidence of any violation of this chapter or of the rules adopted pursuant to

this chapter.

Sec. 23. NEW SECTION. 231C.16 NURSING ASSISTANT AND MEDICATION AIDE — CERTIFICATION. The department of inspections and appeals, in cooperationwith other appropriate agencies,

shall establish a procedure to allow nursing assistants ormedication aides to claimworkwith- in an assisted living program as credit toward sustaining the nursing assistant’s ormedication aide’s certification.

496LAWS OF THE EIGHTIETH G.A., 2003 SESSIONCH. 166

Sec. 24. NEW SECTION. 231C.17 COORDINATION OF THE LONG-TERM CARE SYS- TEM — TRANSITIONAL PROVISIONS. 1. A hospital licensed pursuant to chapter 135B or a health care facility licensed pursuant

to chapter 135Cmayoperate anassisted livingprogram, located in adistinct part of or separate structure under the control of the hospital or health care facility, if certified pursuant to this chapter. 2. This chapter shall not be construed to require that a facility licensed as a different type

of facility also comply with the requirements of this chapter, unless the facility is represented to the public as a certified assisted living program. 3. A certified assisted living program that complies with the requirements of this chapter

shall not be required to be licensed as a health care facility pursuant to chapter 135C, unless the facility is represented to the public as a licensed health care facility. 4. A continuing care retirement community that is in compliance with chapter 523D shall

not be held in violation of this chapter if the continuing care retirement community provides services to its independent living residents.1

Sec. 25. NEW SECTION. 231C.18 IOWA ASSISTED LIVING FEES. 1. The department of inspections and appeals shall collect assisted living programcertifica-

tion and related fees. An assisted living program that is certified by the department of inspec- tions and appeals on the basis of voluntary accreditation by a recognized accrediting entity shall not be subject to payment of the certification fee, but shall be subject to an administrative fee as prescribed by rule. Fees collected and retained pursuant to this section shall be depos- ited in the general fund of the state. 2. The following certification and related fees shall apply to assisted living programs: a. For a two-year initial certification, seven hundred fifty dollars. b. For a two-year recertification, one thousand dollars. c. For a blueprint plan review, nine hundred dollars. d. For an optional preliminary plan review, five hundred dollars.

Sec. 26. NEW SECTION. 231C.19 APPLICATION OF LANDLORD AND TENANT ACT. Chapter 562A, the uniform residential landlord and tenant Act, shall apply to assisted living

programs under this chapter.

Sec. 27. Section 235B.3, subsection 2, paragraph d, Code 2003, is amended to read as fol- lows: d. A person who performs inspections of elder group homes for the department of elder af-

fairs inspections and appeals and a resident advocate committeemember assigned to an elder group home pursuant to chapter 231B.

Sec. 28. Chapter 231A, Code 2003, is repealed.

Sec. 29. TRANSITION OF STAFF. All employees of the department of elder affairs per- forming functions related to certification and monitoring of or complaint investigations re- lated to assisted living programs as of June 30, 2003, shall become employees of the depart- ment of inspections and appeals without loss of classification, pay, or benefits, effective July 1, 2003. All employees of the department of elder affairs performing functions related to af- fordable assisted living as of June 30, 2003, shall become employees of the Iowa finance au- thority without loss of classification, pay, or benefits, effective July 1, 2003.

Approved May 30, 2003

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1 See 2003 Iowa Acts, First Extraordinary Session, chapter 2, §17 herein