135C.2 - PURPOSE -- RULES -- SPECIAL CLASSIFICATIONS -- PROTECTION AND ADVOCACY AGENCY.
135C.2 PURPOSE -- RULES -- SPECIAL CLASSIFICATIONS --
PROTECTION AND ADVOCACY AGENCY.
1. The purpose of this chapter is to promote and encourage
adequate and safe care and housing for individuals who are aged or
who, regardless of age, are infirm, convalescent, or mentally or
physically dependent, by both public and private agencies by
providing for the adoption and enforcement of rules and standards:
a. For the housing, care, and treatment of individuals in
health care facilities, and
b. For the location, construction, maintenance, renovation,
and sanitary operation of such health care facilities which will
promote safe and adequate care of individuals in such homes so as to
further the health, welfare, and safety of such individuals.
2. Rules and standards prescribed, promulgated, and enforced
under this chapter shall not be arbitrary, unreasonable, or
confiscatory and the department or agency prescribing, promulgating,
or enforcing such rules or standards shall have the burden of proof
to establish that such rules or standards meet such requirements and
are consistent with the economic problems and conditions involved in
the care and housing of persons in health care facilities.
3. a. The department shall establish by administrative rule
the following special classifications:
(1) Within the residential care facility category, a special
license classification for residential facilities intended to serve
persons with mental illness.
(2) Within the nursing facility category, a special license
classification for nursing facilities which designate and dedicate
the facility or a special unit within the facility to provide care
for persons who suffer from chronic confusion or a dementing illness.
A nursing facility which designates and dedicates the facility or a
special unit within the facility for the care of persons who suffer
from chronic confusion or a dementing illness shall be specially
licensed. For the purposes of this subsection, "designate" means
to identify by a distinctive title or label and "dedicate" means
to set apart for a definite use or purpose and to promote that
purpose.
b. The department may also establish by administrative rule
special classifications within the residential care facility,
intermediate care facility for persons with mental illness,
intermediate care facility for persons with mental retardation, or
nursing facility categories, for facilities intended to serve
individuals who have special health care problems or conditions in
common. Rules establishing a special classification shall define the
problem or condition to which the special classification is relevant
and establish requirements for an approved program of care
commensurate with the problem or condition. The rules may grant
special variances or considerations to facilities licensed within the
special classification.
c. The rules adopted for intermediate care facilities for
persons with mental retardation shall be consistent with, but no more
restrictive than, the federal standards for intermediate care
facilities for persons with mental retardation established pursuant
to the federal Social Security Act, § 1905(c)(d), as codified in 42
U.S.C. § 1396d, in effect on January 1, 1989. However, in order for
an intermediate care facility for persons with mental retardation to
be licensed, the state fire marshal must certify to the department
that the facility meets the applicable provisions of the rules
adopted for such facilities by the state fire marshal. The state
fire marshal's rules shall be based upon such a facility's compliance
with either the provisions applicable to health care occupancies or
residential board and care occupancies of the life safety code of the
national fire protection association, 2000 edition. The department
shall adopt additional rules for intermediate care facilities for
persons with mental retardation pursuant to section 135C.14,
subsection 8.
d. Notwithstanding the limitations set out in this subsection
regarding rules for intermediate care facilities for persons with
mental retardation, the department shall consider the federal
interpretive guidelines issued by the federal centers for Medicare
and Medicaid services when interpreting the department's rules for
intermediate care facilities for persons with mental retardation.
This use of the guidelines is not subject to the rulemaking
provisions of sections 17A.4 and 17A.5, but the guidelines shall be
published in the Iowa administrative bulletin and the Iowa
administrative code.
4. The protection and advocacy agency designated in the state,
under Pub. L. No. 98-527, the Developmental Disabilities Act of 1984,
Pub. L. No. 99-319, the Protection and Advocacy for Mentally Ill
Individuals Act of 1986, and Pub. L. No. 100-146, the federal
Developmental Disabilities Assistance and Bill of Rights Act
Amendments of 1987, is recognized as an agency legally authorized and
constituted to ensure the implementation of the purposes of this
chapter for populations under its authority and in the manner
designated by Pub. L. No. 98-527, Pub. L. No. 99- 319, and Pub. L.
No. 100-146 and in the assurances of the governor of the state.
5. The department shall establish a special classification within
the residential care facility category in order to foster the
development of residential care facilities which serve persons with
mental retardation, chronic mental illness, a developmental
disability, or brain injury, as described under section 225C.26, and
which contain five or fewer residents. A facility within the special
classification established pursuant to this subsection is exempt from
the requirements of section 135.63. The department shall adopt rules
which are consistent with rules previously developed for the waiver
demonstration project pursuant to 1986 Iowa Acts, chapter 1246,
section 206, and which include all of the following provisions:
a. A facility provider under the special classification must
comply with rules adopted by the department for the special
classification. However, a facility provider which has been
accredited by the accreditation council for services to persons with
mental retardation and other developmental disabilities shall be
deemed to be in compliance with the rules adopted by the department.
b. A facility must be located in an area zoned for single or
multiple-family housing or in an unincorporated area and must be
constructed in compliance with applicable local requirements and the
rules adopted for the special classification by the state fire
marshal in accordance with the concept of the least restrictive
environment for the facility residents. Local requirements shall not
be more restrictive than the rules adopted for the special
classification by the state fire marshal and the state building code
requirements for single or multiple-family housing, under section
103A.7.
c. Facility provider plans for the facility's accessibility
to residents must be in place.
d. A written plan must be in place which documents that a
facility meets the needs of the facility's residents pursuant to
individual program plans developed according to age appropriate and
least restrictive program requirements.
e. A written plan must be in place which documents that a
facility's residents have reasonable access to employment or
employment-related training, education, generic community resources,
and integrated opportunities to promote interaction with the
community.
f. The facilities licensed under this subsection shall be
eligible for funding utilized by other licensed residential care
facilities for persons with mental retardation, or licensed
residential care facilities for persons with mental illness,
including but not limited to funding under or from the federal social
services block grant, the state supplementary assistance program,
state mental health and developmental disabilities services funds,
and county funding provisions.
6. a. This chapter shall not apply to adult day services
provided in a health care facility. However, adult day services
shall not be provided by a health care facility to persons requiring
a level of care which is higher than the level of care the facility
is licensed to provide.
b. The level of care certification provisions pursuant to
sections 135C.3 and 135C.4, the license application and fee
provisions pursuant to section 135C.7, and the involuntary discharge
provisions pursuant to section 135C.14, subsection 8, shall not apply
to respite care services provided in a health care facility.
However, respite care services shall not be provided by a health care
facility to persons requiring a level of care which is higher than
the level of care the facility is licensed to provide.
c. The department shall adopt rules to implement this
subsection.
7. The rules adopted by the department regarding nursing
facilities shall provide that a nursing facility may choose to be
inspected either by the department or by the joint commission on
accreditation of health care organizations. The rules regarding
acceptance of inspection by the joint commission on accreditation of
health care organizations shall include recognition, in lieu of
inspection by the department, of comparable inspections and
inspection findings of the joint commission on accreditation of
health care organizations, if the department is provided with copies
of all requested materials relating to the inspection process. Section History: Early Form
[C50, 54, § 135C.5; C58, 62, 66, 71, 73, 75, 77, 79, 81, § 135C.2]
Section History: Recent Form
85 Acts, ch 114, § 1; 87 Acts, ch 234, § 426; 88 Acts, ch 1249, §
3; 89 Acts, ch 115, § 1; 89 Acts, ch 269, § 1; 90 Acts, ch 1039, § 6;
90 Acts, ch 1267, § 27; 91 Acts, ch 267, § 139; 92 Acts, ch 1241, §
48; 94 Acts, ch 1151, § 2, 3; 94 Acts, ch 1170, §7, 22; 95 Acts, ch
67, § 11; 96 Acts, ch 1053, § 1; 96 Acts, ch 1129, § 25, 26, 113; 98
Acts, ch 1119, §12; 99 Acts, ch 141, §11; 2001 Acts, ch 64, §3; 2002
Acts, ch 1050, §17; 2003 Acts, ch 44, §114; 2003 Acts, ch 101, §1, 4
Referred to in § 135B.9, 135C.37, 135C.38, 155.1, 235A.15, 235B.6
Rules requiring special license classification for facility or
unit designated and dedicated to caring for persons with chronic
confusion or a dementing illness; applicability; existing facilities;
90 Acts, ch 1016, § 1 Footnotes
Subsection 7 is effective contingent upon passage of federal
legislation; see 96 Acts, ch 1053, § 3