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S1365aaH..............................................by HEALTH AND WELFARE RESIDENTIAL/ASSISTED LIVING FACILITIES - Amends and adds to existing law to update terminology related to various types of services provided to individuals, including changing references from "residential care homes" to "residential or assisted living facilities"; to change references from "adult foster care home" to "certified family home"; to govern the frequency of inspection requirements and to make them consistent for all types of facilities; to govern the conditions when waivers to certain licensing and certification requirements for these facilities may be granted; to define "authorized provider" and include authorized providers within provisions governing care providers; to create a personal assistance oversight committee and to specify membership; and to make other corrections to terminology for purposes of consistency. 02/03 Senate intro - 1st rdg - to printing 02/04 Rpt prt - to Health/Wel 02/09 Rpt out - rec d/p - to 2nd rdg 02/10 2nd rdg - to 3rd rdg 02/16 3rd rdg - PASSED - 30-1-4 AYES--Andreason, Boatright, Bunderson, Burtenshaw, Cameron, Crow, Danielson, Darrington, Davis, Deide, Dunklin, Frasure, Geddes, Ipsen, Keough, King-Barrutia, Lee, McLaughlin, Noh, Parry, Richardson, Riggs, Risch, Sandy, Schroeder, Stegner, Stennett, Thorne, Wheeler, Williams NAYS--Hawkins Absent and excused--Branch, Ingram, Sorensen, Whitworth Floor Sponsor - Ipsen Title apvd - to House 02/17 House intro - 1st rdg - to Health/Wel 03/23 Rpt out - to Gen Ord 03/27 Rpt out amen - to 1st rdg as amen 03/28 1st rdg - to 2nd rdg as amen 03/29 2nd rdg - to 3rd rdg as amen 03/30 3rd rdg as amen - PASSED - 61-0-9 AYES -- Alltus, Barraclough, Bell, Bieter, Black, Boe, Callister, Campbell, Chase, Cheirrett, Clark, Cuddy, Deal, Denney, Ellsworth, Field(13), Field(20), Gagner, Gould, Hadley, Hammond, Hansen(23), Hansen(29), Henbest, Hornbeck, Jaquet, Jones(Jones), Judd, Kempton, Kendell, Kunz, Lake, Linford, Loertscher, Mader, Marley, McKague, Meyer, Montgomery, Mortensen, Moss, Pearce, Pischner, Pomeroy, Reynolds, Ringo, Robison, Sali, Schaefer, Sellman, Shepherd, Smith, Smylie, Stevenson, Stoicheff, Stone, Tilman, Trail, Wheeler, Wood, Mr Speaker NAYS -- None Absent and excused -- Barrett, Bruneel, Crow, Geddes, Kellogg, Moyle, Ridinger, Taylor, Zimmermann Floor Sponsors - Sali, Loertscher Title apvd - to Senate Senate intro - to 10th Ord 03/31 Senate concurred in House amens - to engros 04/03 Rpt engros - 1st rdg - to 2nd rdg as amen 04/04 2nd rdg - to 3rd rdg as amen 04/05 3rd rdg as amen - PASSED - 25-9-1 AYES--Andreason, Boatright, Bunderson, Burtenshaw, Davis, Deide, Dunklin, Frasure, Geddes, Hawkins, Ingram, Ipsen, Lee, McLaughlin, Parry, Richardson, Riggs, Risch, Sandy, Sorensen, Thorne, Walton, Wheeler, Whitworth, Williams NAYS--Cameron, Crow, Danielson, Darrington, Keough, King-Barrutia, Noh, Schroeder, Stegner Absent and excused--Stennett Floor Sponsor - Ipsen Title apvd - to enrol Rpt enrol - Pres signed - Sp signed 04/06 To Governor 04/14 Governor signed Session Law Chapter 274 Effective: 07/01/00
S1365|||| LEGISLATURE OF THE STATE OF IDAHO |||| Fifty-fifth Legislature Second Regular Session - 2000IN THE SENATE SENATE BILL NO. 1365, As Amended in the House BY HEALTH AND WELFARE COMMITTEE 1 AN ACT 2 RELATING TO GOVERNANCE OF RESIDENTIAL OR ASSISTED LIVING FACILITIES AND SER- 3 VICES; AMENDING SECTION 15-2-616, IDAHO CODE, TO PROVIDE CORRECT TERMINOL- 4 OGY; AMENDING SECTION 31-3502, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY 5 AND TO MAKE A TECHNICAL CORRECTION; AMENDING SECTION 31-3503, IDAHO CODE, 6 TO PROVIDE CORRECT TERMINOLOGY AND TO MAKE TECHNICAL CORRECTIONS; AMENDING 7 SECTION 31-3513, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY AND TO MAKE A 8 TECHNICAL CORRECTION; AMENDING SECTION 39-1301, IDAHO CODE, TO FURTHER 9 DEFINE TERMS; AMENDING SECTION 39-1301a, IDAHO CODE, TO REDESIGNATE THE 10 SECTION AND TO DEFINE CONDITIONS FOR A WAIVER; AMENDING CHAPTER 13, TITLE 11 39, IDAHO CODE, BY THE ADDITION OF A NEW SECTION 39-1301B, IDAHO CODE, TO 12 AUTHORIZE AND GOVERN NURSING FACILITY CONVERSIONS; AMENDING SECTION 13 39-2411, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 14 39-3301, IDAHO CODE, TO CLARIFY LEGISLATIVE INTENT; AMENDING SECTION 15 39-3302, IDAHO CODE, TO FURTHER DEFINE TERMS, TO PROVIDE CORRECT TERMINOL- 16 OGY AND TO MAKE A TECHNICAL CORRECTION; AMENDING SECTION 39-3303, IDAHO 17 CODE, TO PROVIDE CORRECT TERMINOLOGY AND TO MAKE TECHNICAL CORRECTIONS; 18 AMENDING SECTIONS 39-3304, 39-3305, 39-3306 AND 39-3307, IDAHO CODE, TO 19 PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 39-3310, IDAHO CODE, TO 20 SPECIFY CONDITIONS FOR REVIEW; AMENDING SECTION 39-3311, IDAHO CODE, TO 21 INCLUDE REFERENCE TO AUTHORIZED PROVIDER; AMENDING SECTION 39-3313, IDAHO 22 CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 39-3314, IDAHO 23 CODE, TO STRIKE OBSOLETE LANGUAGE; AMENDING SECTION 39-3315, IDAHO CODE, 24 TO INCLUDE REFERENCE TO AUTHORIZED PROVIDER AND TO MAKE A TECHNICAL COR- 25 RECTION; AMENDING SECTION 39-3316, IDAHO CODE, TO PROVIDE CORRECT TERMI- 26 NOLOGY AND TO MAKE TECHNICAL CORRECTIONS; AMENDING SECTIONS 39-3318, 27 39-3319 AND 39-3320, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING 28 SECTION 39-3321, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY AND TO GOVERN 29 QUALIFICATIONS OF ADMINISTRATOR OR OPERATOR; AMENDING SECTION 39-3322, 30 IDAHO CODE, TO GOVERN REQUIREMENTS FOR FACILITY STAFF; AMENDING SECTIONS 31 39-3324 AND 39-3325, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING 32 SECTION 39-3330, IDAHO CODE, TO PROVIDE MEMBERSHIP OF THE BOARD AND CARE 33 COUNCIL AND TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTIONS 39-3331, 34 39-3340, 39-3341, 39-3342, 39-3345, 39-3348, 39-3349, 39-3350, 39-3352, 35 39-3353 AND 39-3354A, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING 36 SECTION 39-3355, IDAHO CODE, TO GOVERN INSPECTIONS AND TO PROVIDE CORRECT 37 TERMINOLOGY; AMENDING SECTIONS 39-3357, 39-3358 AND 39-3359, IDAHO CODE, 38 TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 39-3370, IDAHO CODE, TO 39 PROVIDE THE PURPOSE OF CERTIFIED FAMILY HOMES AND TO GOVERN WAIVERS; 40 AMENDING SECTION 39-3371, IDAHO CODE, TO PROVIDE AUTHORITY TO GOVERN CER- 41 TIFIED FAMILY HOMES, TO AUTHORIZE WAIVERS AND TO MAKE A TECHNICAL CORREC- 42 TION; AMENDING SECTIONS 39-3372, 39-3373, 39-3374, 39-3375 AND 39-3378, 43 IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 39-3379, 44 IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY AND TO GOVERN INSPECTIONS; 45 AMENDING SECTIONS 39-3380, 39-3381 AND 39-3382, IDAHO CODE, TO PROVIDE 46 CORRECT TERMINOLOGY; AMENDING SECTION 39-3383, IDAHO CODE, TO PROVIDE COR- 2 1 RECT TERMINOLOGY AND TO PROVIDE A CORRECT CODE REFERENCE; AMENDING SECTION 2 39-3384, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 3 39-3385, IDAHO CODE, TO GOVERN CONDITIONS OF A SERVICE PLAN; AMENDING SEC- 4 TIONS 39-3386, 39-3387, 39-3388 AND 39-3389, IDAHO CODE, TO PROVIDE COR- 5 RECT TERMINOLOGY; AMENDING SECTION 39-3393, IDAHO CODE, TO PROVIDE COR- 6 RECT TERMINOLOGY AND TO PROVIDE A CORRECT CODE REFERENCE; AMENDING SECTION 7 39-3501, IDAHO CODE, TO REVISE LEGISLATIVE INTENT, TO PROVIDE CORRECT TER- 8 MINOLOGY AND TO MAKE A TECHNICAL CORRECTION; AMENDING SECTION 39-3502, 9 IDAHO CODE, TO FURTHER DEFINE TERMS; AMENDING SECTIONS 39-3503, 39-3505, 10 39-3506 AND 39-3507, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING 11 SECTION 39-3510, IDAHO CODE, TO GOVERN REQUIREMENTS FOR PERIODIC REVIEW; 12 AMENDING SECTION 39-3511, IDAHO CODE, TO INCLUDE REFERENCE TO AUTHORIZED 13 PROVIDER; AMENDING SECTION 39-3513, IDAHO CODE, TO PROVIDE CORRECT TERMI- 14 NOLOGY; AMENDING SECTION 39-3515, IDAHO CODE, TO INCLUDE REFERENCE TO 15 AUTHORIZED PROVIDER AND TO MAKE A TECHNICAL CORRECTION; AMENDING SECTIONS 16 39-3516, 39-3518, 39-3519 AND 39-3520, IDAHO CODE, TO PROVIDE CORRECT TER- 17 MINOLOGY; AMENDING SECTION 39-3521, IDAHO CODE, TO PROVIDE CORRECT TERMI- 18 NOLOGY AND TO GOVERN QUALIFICATIONS OF ADMINISTRATOR OR OPERATOR; AMENDING 19 SECTIONS 39-3522, 39-3524 AND 39-3525, IDAHO CODE, TO PROVIDE CORRECT TER- 20 MINOLOGY; AMENDING SECTION 39-3530, IDAHO CODE, TO INCREASE THE SIZE OF 21 THE RESIDENTIAL OR ASSISTED LIVING COUNCIL FOR THE ELDERLY AND TO PROVIDE 22 CORRECT TERMINOLOGY; AMENDING SECTIONS 39-3531, 39-3532, 39-3533, 39-3540, 23 39-3541, 39-3542, 39-3545, 39-3548, 39-3549, 39-3550, 39-3552, 39-3553 AND 24 39-3554A, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 25 39-3555, IDAHO CODE, TO GOVERN REQUIREMENTS FOR INSPECTIONS; AMENDING SEC- 26 TIONS 39-3557, 39-3558 AND 39-3559, IDAHO CODE, TO PROVIDE CORRECT TERMI- 27 NOLOGY; AMENDING SECTION 39-3560, IDAHO CODE, TO SPECIFY PURPOSES OF CER- 28 TIFIED FAMILY HOMES AND TO AUTHORIZE A WAIVER; AMENDING SECTION 39-3561, 29 IDAHO CODE, TO AUTHORIZE A WAIVER OF CERTAIN PROHIBITIONS AND TO PROVIDE 30 CORRECT TERMINOLOGY; AMENDING SECTIONS 39-3562, 39-3563, 39-3564 AND 31 39-3568, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 32 39-3569, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY AND TO GOVERN INSPEC- 33 TION INTERVALS; AMENDING SECTIONS 39-3570, 39-3571 AND 39-3572, IDAHO 34 CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 39-3573, IDAHO 35 CODE, TO PROVIDE CORRECT TERMINOLOGY AND TO PROVIDE A CORRECT CODE REFER- 36 ENCE; AMENDING CHAPTER 35, TITLE 39, IDAHO CODE, BY THE ADDITION OF A NEW 37 SECTION 39-3573A, IDAHO CODE, TO GOVERN PHYSICIAN'S ORDERS FOR CERTIFIED 38 FAMILY HOMES; AMENDING SECTION 39-3574, IDAHO CODE, TO PROVIDE CORRECT 39 TERMINOLOGY AND TO PROVIDE A CORRECT CODE REFERENCE; AMENDING SECTIONS 40 39-3575, 39-3576, 39-3577 AND 39-3578, IDAHO CODE, TO PROVIDE CORRECT TER- 41 MINOLOGY; AMENDING SECTION 39-3580, IDAHO CODE, TO PROVIDE A CORRECT REF- 42 ERENCE AND TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 39-4803, IDAHO 43 CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 39-5303, IDAHO 44 CODE, TO PROVIDE CORRECT TERMINOLOGY AND TO MAKE TECHNICAL CORRECTIONS; 45 AMENDING SECTIONS 39-5304 AND 39-5308, IDAHO CODE, TO PROVIDE CORRECT TER- 46 MINOLOGY; AMENDING SECTION 39-5601, IDAHO CODE, TO PROVIDE A STATEMENT OF 47 LEGISLATIVE INTENT; AMENDING SECTION 39-5602, IDAHO CODE, TO FURTHER 48 DEFINE TERMS; AMENDING SECTION 39-5603, IDAHO CODE, TO PROVIDE CORRECT 49 TERMINOLOGY AND TO FURTHER DEFINE CONDITIONS RELATED TO PROVISION OF PER- 50 SONAL ASSISTANCE SERVICES; AMENDING SECTION 39-5604, IDAHO CODE, TO 51 REQUIRE HEALTH AND BACKGROUND CHECKS; AMENDING SECTION 39-5605, IDAHO 52 CODE, TO GOVERN TRAINING OF PERSONAL ASSISTANTS AND TO MAKE A TECHNICAL 53 CORRECTION; AMENDING SECTION 39-5606, IDAHO CODE, TO CLARIFY PAYMENT PRO- 54 VISIONS; AMENDING CHAPTER 56, TITLE 39, IDAHO CODE, BY THE ADDITION OF A 55 NEW SECTION 39-5607, IDAHO CODE, TO SPECIFY THE EFFECT OF PERSONAL ASSIS- 3 1 TANCE AGENCY RATES; AMENDING SECTION 39-5608, IDAHO CODE, TO PROVIDE COR- 2 RECT TERMINOLOGY AND TO PROVIDE CORRECT CODE REFERENCES; AMENDING CHAPTER 3 56, TITLE 39, IDAHO CODE, BY THE ADDITION OF A NEW SECTION 39-5609, IDAHO 4 CODE, TO PROVIDE CREATION AND MEMBERSHIP OF THE PERSONAL ASSISTANCE OVER- 5 SIGHT COMMITTEE; AMENDING SECTION 54-1601, IDAHO CODE, TO PROVIDE CORRECT 6 TERMINOLOGY; AMENDING SECTION 54-1705, IDAHO CODE, TO PROVIDE CORRECT TER- 7 MINOLOGY AND TO MAKE A TECHNICAL CORRECTION; AMENDING SECTIONS 54-4201, 8 54-4202, 54-4203, 54-4204, 54-4205, 54-4206, 54-4207 AND 54-4208, IDAHO 9 CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 54-4209, IDAHO 10 CODE, TO PROVIDE CORRECT TERMINOLOGY AND TO MAKE A TECHNICAL CORRECTION; 11 AMENDING SECTIONS 54-4210, 54-4211, 54-4212 AND 54-4213, IDAHO CODE, TO 12 PROVIDE CORRECT TERMINOLOGY; AMENDING SECTION 56-101, IDAHO CODE, TO PRO- 13 VIDE CORRECT TERMINOLOGY AND TO MAKE A TECHNICAL CORRECTION; AMENDING SEC- 14 TION 56-120, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY; AMENDING SECTIONS 15 56-201, 63-701, 63-3022K, 66-402, 67-2601 AND 67-2602, IDAHO CODE, TO PRO- 16 VIDE CORRECT TERMINOLOGY AND TO MAKE TECHNICAL CORRECTIONS; AND AMENDING 17 SECTION 67-6532, IDAHO CODE, TO PROVIDE CORRECT TERMINOLOGY. 18 Be It Enacted by the Legislature of the State of Idaho: 19 SECTION 1. That Section 15-2-616, Idaho Code, be, and the same is hereby 20 amended to read as follows: 21 15-2-616. RESTRICTION ON DEVISES TO NURSING HOME OR RESIDENTIALCARE HOME22 OR ASSISTED LIVING FACILITY OPERATORS. A devise or bequest involving either 23 real or personal property, directly or indirectly, to any person who owns, 24 operates or is employed at a nursing home, residentialcare homeor assisted 25 living facility or any home, including the testator's home, whether or not 26 licensed, in which the testator was a resident within one (1) year of his 27 death shall be presumed to have been the result of undue influence, rebuttable 28 by clear and convincing evidence. This section shall apply to all property 29 passing by testate succession after July 1, 1983, regardless of when the will 30 was written; provided, this section shall in no way limit or affect the 31 rights of a beneficiary who is related to the testator, or who is a charitable 32 or benevolent society or corporation; provided further that the foregoing lim- 33 itations shall not apply to wills of persons whose death is caused by acciden- 34 tal means and whose wills are executed prior to the accident which results in 35 death. 36 SECTION 2. That Section 31-3502, Idaho Code, be, and the same is hereby 37 amended to read as follows: 38 31-3502. DEFINITIONS. As used in this chapter, the terms defined in this 39 section shall have the following meaning, unless the context clearly indicates 40 another meaning: 41 (1) "Medically indigent" means any person who is in need of necessary 42 medical services and who, if an adult, together with his or her spouse, or 43 whose parents or guardian if a minor, does not have income and other resources 44 available to him from whatever source sufficient to pay for necessary medical 45 services. Nothing in this definition shall prevent the board of county commis- 46 sioners and administrator from requiring the applicant and obligated persons 47 to reimburse the county and the catastrophic health care costs program, where 48 appropriate, for all or a portion of their medical expenses, when investiga- 49 tion of their application pursuant to this chapter, determines their ability 50 to do so. 4 1 (2) "Hospital" means a facility licensed and regulated pursuant to sec- 2 tions 39-1301 through 39-1314, Idaho Code, excluding state institutions. 3 (3) "Dependent" means any person whom a taxpayer could claim as a depend- 4 ent under the income tax laws of the state of Idaho. 5 (4) "Applicant" means any person who is or may be requesting financial 6 assistance under this chapter. 7 (5) "Reimbursement rates" means the unadjusted medicaid rate of reim- 8 bursement for medical charges allowed pursuant to title XIX of the social 9 security act, as amended. For long-term care facilities, maximum 10 "reimbursement rates" means the unadjusted medicaid rate of reimbursement 11 allowed pursuant to the medical assistance program as determined by chapter 1, 12 title 56, Idaho Code, or the unadjusted medicare rate of reimbursement estab- 13 lished under title XVIII of the social security act, as amended, whichever is 14 greater. 15 (6) "Board" means the board of county commissioners. 16 (7) "Obligated persons" means those persons who are legally responsible 17 for an applicant. 18 (8) "County hospital" means any county approved institution or facility 19 for the care of sick persons. 20 (9) "Administrator" means the board of the catastrophic health care cost 21 program, as provided in section 31-3517, Idaho Code. 22 (10) "Catastrophic health care costs" means all necessary medical expenses 23 for services which are incurred by a recipient for which the reimbursement 24 rate exceeds in aggregate the sum of ten thousand dollars ($10,000) in any 25 twelve (12) consecutive month period. 26 (11) "Recipient" means an individual determined eligible for necessary 27 medical services under this chapter. 28 (12) "Resident" means a person with a home, house, place of abode, place 29 of habitation, dwelling or place where he or she actually lived for a consecu- 30 tive period of thirty (30) days or more. A resident does not include a person 31 who comes into this state for temporary purposes, including, but not limited 32 to, education, vacation, or seasonal labor. Entry into active military duty 33 shall not change a person's residence for the purposes of this chapter. Those 34 physically present within the following facilities and institutions shall be 35 residents of the county where they were residents prior to entering the facil- 36 ity or institution: 37 (a) Correctional facilities; 38 (b) Nursing homes or residentialcareor assisted living facilities; 39 (c) Other medical facility or institution. 40 (13) "Emergency service" means a service provided for a medical condition 41 in which sudden, serious and unexpected symptoms of illness or injury are suf- 42 ficiently severe to necessitate or call for immediate medical care. 43 (14) "Provider" means any person, firm, or corporation certified or 44 licensed by the state of Idaho or holding an equivalent license or certifica- 45 tion in another state, that provides necessary medical services as it appears 46 on an application for assistance pursuant to this chapter. 47 (15) "Third party applicant" means a person other than an obligated person 48 who completes, signs and files an application on behalf of a patient. 49 (16) "Clerk" means the clerk of the board or his or her designee. 50 (17) "Resources" means all property, whether tangible or intangible, real 51 or personal, liquid or nonliquid, including, but not limited to, all forms of 52 public assistance, crime victim's compensation, worker's compensation, vet- 53 erans benefits, medicaid, medicare and any other property from any source for 54 which an applicant and/or an obligated person may be eligible or in which he 55 or she may have an interest. Resources shall include the ability of an appli- 5 1 cant and obligated persons to pay for necessary medical services over a period 2 of up to three (3) years. For purposes of determining approval for medical 3 indigency only, resources shall not include the value of the homestead on the 4 applicant or obligated persons' residence, a burial plot, exemptions for per- 5 sonal property allowed in section 11-605(1) through (3), Idaho Code, and addi- 6 tional exemptions allowed by county resolution. 7 (18) A. "Necessary medical services" means a requested or provided medi- 8 cal service required in order to identify or treat a medically indigent 9 person's health condition, illness or injury and is: 10 (a) Consistent with the symptoms, diagnosis or treatment of the med- 11 ical indigent's condition, illness or injury; 12 (b) In accordance with generally accepted standards of medical or 13 surgical practice then prevailing in the community where the services 14 were provided; 15 (c) Furnished on an outpatient basis whenever it is safe, efficient 16 and reasonable to do so; 17 (d) Not provided primarily for the convenience of the medically 18 indigent person or the provider; 19 (e) The standard, most economical service or item that can safely, 20 reasonably and ethically be provided. 21 B. Necessary medical services shall not include the following: 22 (a) Bone marrow transplants; 23 (b) Organ transplants; 24 (c) Elective, cosmetic and/or experimental procedures; 25 (d) Services related to, or provided by, residential and/or shelter 26 care facilities; 27 (e) Normal, uncomplicated pregnancies, excluding caesarean section, 28 and childbirth well-baby care; 29 (f) Medicare copayments and deductibles; and 30 (g) Services provided by, or available to an applicant from state, 31 federal and local health programs. 32 Provided however, each board may determine, by ordinance or resolution 33 duly adopted in its county, to include as necessary medical services addi- 34 tional services not covered in this section. Necessary medical services pro- 35 vided by this option shall not be paid by the catastrophic health care costs 36 program, and shall remain the liability of the respective county. 37 SECTION 3. That Section 31-3503, Idaho Code, be, and the same is hereby 38 amended to read as follows: 39 31-3503. POWERS AND DUTIES OF BOARDS OF COUNTY COMMISSIONERS. The boards 40 of county commissioners in their respective counties shall, under such limita- 41 tions and restrictions as are prescribed by law: 42 (1) Care for and maintain the medically indigent residents of their coun- 43 ties as provided in this chapter up to ten thousand dollars ($10,000) per 44 claim in the aggregate over a twelve (12) month period with the remainder 45 being paid by the state catastrophic health care cost program pursuant to sec- 46 tion 31-3519, Idaho Code. 47 (2) Have the right to contract, transfer patients, negotiate provider 48 agreements, and all other powers incident to the duties created by this chap- 49 ter. 50 (3) From July 1, 1997, through June 30, 1998, pay for emergency services 51 for a nonresident to the point of stabilization as set forth in section 52 31-3507, Idaho Code, and when necessary, for costs of transfer to the 53 nonresident's place of residence, up to five thousand dollars ($5,000) per 6 1 claim in the aggregate over a twelve (12) month period with the remainder 2 being paid by the state catastrophic health care cost program pursuant to sec- 3 tion 31-3519, Idaho Code, unless such nonresident is from a state which has a 4 reciprocal agreement pursuant to section 31-3503B, Idaho Code, and qualifies 5 for necessary medical services under that agreement. 6 (4) Have the jurisdiction and power to provide county hospitals and pub- 7 lic general hospitals for the county and others who are sick, injured, maimed, 8 aged and infirm and to erect, enlarge, purchase, lease, or otherwise acquire, 9 and to officer, maintain and improve hospitals, hospital grounds, nurses' 10 homes, shelter care facilities and residentialcare homesor assisted living 11 facilities as defined in section 39-3301, Idaho Code, superintendent's quar- 12 ters, medical clinics, as that term is defined in section 39-1319, Idaho Code, 13 medical clinic grounds or any other necessary buildings, and to equip the 14 same, and to replace equipment, and for this purpose said boards may levy an 15 additional tax of not to exceed six hundredths percent (.06%) of the market 16 value for assessment purposes on all taxable property within the county. The 17 term "public general hospitals" as used in this subsection shall be construed 18 to include nursing homes. 19 SECTION 4. That Section 31-3513, Idaho Code, be, and the same is hereby 20 amended to read as follows: 21 31-3513. ELECTION FOR ISSUANCE OF BONDS. The county commissioners may, 22 when they deem the welfare of their counties require it, or when petitioned 23 thereto by a number of resident taxpayers of their respective counties equal 24 to fiveper centpercent (5%) of the number of persons voting for the secre- 25 tary of state of the state of Idaho, at the election next preceding the date 26 of such petition, submit to the qualified electors of said county at any elec- 27 tion held as provided in section 34-106, Idaho Code, the proposition whether 28 negotiable coupon bonds of the county to the amount stated in such proposition 29 shall be issued and sold for the purpose of providing such hospital, hospital 30 grounds, nurses' homes, nursing homes, residentialcare homesor assisted liv- 31 ing facilities, shelter care facilities, medical clinics, superintendent's 32 quarters, or any other necessary buildings, and equipment, and may on their 33 own initiative submit to the qualified electors of the county at any general 34 election the proposition whether negotiable coupon bonds of the county to the 35 amount stated in such proposition shall be issued and sold for the purpose of 36 providing for the extension and enlargement of existing hospital, hospital 37 grounds, nurses' homes, nursing homes, residentialcare homesor assisted liv- 38 ing facilities, shelter care facilities, medical clinics or grounds, 39 superintendent's quarters, or any other necessary buildings, and equipment, 40 and when authorized thereto by two-thirds (2/3) vote at such election, shall 41 issue and sell such coupon bonds and use the proceeds therefrom for the pur- 42 poses authorized by such election. Said proposition may be submitted to the 43 qualified electors at an election held subject to the provisions of section 44 34-106, Idaho Code, if the board of county commissioners shall by resolution 45 so determine. No person shall be qualified to vote at any election held under 46 the provisions of this section unless he shall possess all the qualifications 47 required of electors under the general laws of this state. 48 The board shall be governed in calling and holding such election and in 49 the issuance and sale of such bonds, and in the providing for the payment of 50 the principal and interest thereon by the provisions of sections 31-1901 51 through 31-1909, Idaho Code, and by the provisions of chapter 2, title 57, 52 Idaho Code; provided, however, that when such bonds have been issued and sold 53 and a period of two (2) years or more has elapsed from the date of sale of 7 1 said bonds and for any reason the proceeds from the sale of said bonds or 2 other moneys appropriated for the purpose for which said bonds were issued, 3 have not been used for the purpose for which they were appropriated or said 4 bond issue made, the board may, with the written consent of all of the bond- 5 holders first having been obtained, submit to the qualified electors, as 6 herein defined, the question of spending such moneys for a definite purpose. 7 The purpose for which it is decided to spend such moneys shall be clearly and 8 plainly stated on the ballot. If a majority of the qualified electors shall 9 vote in favor of spending such moneys for the purpose stated, the board of 10 county commissioners shall proceed in the same manner as if such different 11 purpose had been the original purpose for such bond issue or appropriation. 12 Provided, further that if less than a majority of the qualified electors shall 13 vote in favor of spending such moneys for such different purpose, or if no 14 such election should be had, when all of the bonds shall have been retired, 15 such excess moneys shall be placed in the general fund. 16 SECTION 5. That Section 39-1301, Idaho Code, be, and the same is hereby 17 amended to read as follows: 18 39-1301. DEFINITIONS. For purposes of this chapter the following defini- 19 tions will apply: 20 (a) "Hospital" means a facility which: 21 (1) Is primarily engaged in providing, by or under the supervision of 22 physicians, 23 (a) concentrated medical and nursing care on a twenty-four (24) hour 24 basis to inpatients experiencing acute illness; and 25 (b) diagnostic and therapeutic services for medical diagnosis and 26 treatment, psychiatric diagnosis and treatment, and care of injured, 27 disabled, or sick persons; and 28 (c) rehabilitation services for injured, disabled, or sick persons; 29 and 30 (d) obstetrical care. 31 (2) Provides for care of two (2) or more individuals for twenty-four (24) 32 or more consecutive hours. 33 (3) Is staffed to provide professional nursing care on a twenty-four (24) 34 hour basis. 35 (b) "Skilled nNursing facility" (nursing home) means a facility whose 36 design and function shall provide area, space and equipment to meet the health 37 needs of two (2) or more individuals who, at a minimum, require inpatient care 38 and services for twenty-four (24) or more consecutive hours for unstable 39 chronic health problems requiring daily professional nursing supervision and 40 licensed nursing care on a twenty-four (24) hour basis, restorative, rehabili- 41 tative care, and assistance in meeting daily living needs. Medical supervi- 42 sion is necessary on a regular, but not daily, basis. 43 (c)"Intermediate care facility" (nursing home) means a facility:44(1) Whose design and function shall provide area, space and equipment to45meet the restorative, rehabilitative, recreational, intermittent health46needs, and daily living needs of two (2) or more individuals who require47in-residence care and services for twenty-four (24) or more consecutive48hours;49(2) Whose design and function will provide for regular but less than50daily medical and skilled nursing care.51(d)"Intermediate care facility for the mentally retarded (ICFMR)" means 52 a nonnursing home facility, designed and operated to meet the unique educa- 53 tional, training, habilitative and medical needs of the developmentally dis- 8 1 abled through the provision of active treatment. 2 (ed) "Person" means any individual, firm, partnership, corporation, com- 3 pany, association, or joint stock association, and the legal successor 4 thereof. 5 (fe) "Government unit" means the state, or any county, municipality, or 6 other political subdivision, or any department, division, board or other 7 agency thereof. 8 (gf) "Licensing agency" means the department of health and welfare. 9 (hg) "Board" means the board of health and welfare. 10 (ih) "Physician" means an individual licensed to practice medicine and 11 surgery by the Idaho state board of medicine or the Idaho state board of podi- 12 atry. 13 (i) "Authorized provider" means an individual who is a nurse practitioner 14 or clinical nurse specialist, licensed to practice in Idaho in accordance with 15 the Idaho nurse practice act; or a physician's assistant, licensed by the 16 Idaho state board of medicine. 17 SECTION 6. That Section 39-1301a, Idaho Code, be, and the same is hereby 18 amended to read as follows: 19 39-1301aA. WAIVERS FORPERSONAL CARE SERVICESCERTIFIED FAMILY HOMESFROM20NURSING FACILITY AND INTERMEDIATE CARE FACILITY-- DEFINITIONS.The Idaho21department of health and welfare shall have the authority to grant personal22care services homes that have been approved pursuant to IDAPA2316.03.09.146.06.f.ix, a waiver from sections 39-1301(b) and (c) (1), Idaho24Code, to permit no more than two (2) persons, both of whom meet the level of25care defined in those sections, to reside in the same personal care services26home, regardless of payor source. Before granting a waiver under this section,27the department shall require, when feasible, written statements from each of28the two (2) persons or their legal representatives evidencing their desire to29reside in the same personal care services home(1) Chapter 13, title 39, 30 Idaho Code, shall not have the effect of preventing two (2) persons in need of 31 the care described in section 39-1301(b), Idaho Code, from residing in a cer- 32 tified family home when: 33 (a) Each of the persons has given a written statement to the department 34 requesting the arrangement and each person making the request is informed, 35 not coerced, and competent; and 36 (b) The department finds the arrangement safe and effective; and 37 (c) The department issues a written waiver permitting the arrangement. 38 (2) The department shall use negotiated rulemaking when promulgating 39 rules to carry out the provisions of this section to ensure a person's ability 40 to choose services and service provider is considered. 41 (3) The department shall revoke any waiver granted pursuant to this sec- 42 tion where it is determined there is a threat to the life or safety of either 43 person or where one (1) of the persons leaves thepersonal care services home44 living arrangement permanently or notifies the department in writing thatthey45dohe does not wish to reside in thepersonal care services homesetting with 46 the other individual. Any waiver granted under this section shall be reviewed 47 annually. 48 SECTION 7. That Chapter 13, Title 39, Idaho Code, be, and the same is 49 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 50 ignated as Section 39-1301B, Idaho Code, and to read as follows: 51 39-1301B. NURSING FACILITY CONVERSIONS. (1) A nursing facility that vol- 9 1 untarily reduces the number of its licensed beds to provide residential and 2 assisted living services, certified family home services, adult day health 3 services, respite care, hospice, outpatient therapy services, congregate 4 meals, home health, senior wellness clinic, or other services provided under a 5 medicaid home and community-based services waiver for the aged or disabled may 6 convert the original facility or portion of the facility back, and thereby 7 increase the number of nursing home beds to no more than the previously 8 licensed number of nursing home beds provided the facility has been in contin- 9 uous operation and has not been purchased or leased. Any conversion to the 10 original licensed bed capacity, or to any portion thereof, shall comply with 11 the same life safety code requirements as existed at the time the nursing 12 facility voluntarily reduced its licensed beds. 13 (2) To convert beds back to nursing facility beds under this section, the 14 nursing home must: 15 (a) Give notice of its intent to preserve conversion options to the 16 department no later than thirty (30) days after the effective date of the 17 license reduction; and 18 (b) Give notice to the department and any affected participant of the 19 intent to convert beds back. If construction is required for the conver- 20 sion of beds back, the notice of intent to convert beds back must be 21 given, at a minimum, one (1) year prior to the effective date of license 22 modification reflecting the restored beds; otherwise, the notice must be 23 given a minimum of ninety (90) days prior to the effective date of license 24 modification reflecting the restored beds. 25 (3) Conversion of beds back to nursing facility use under this section 26 must be completed no later than four (4) years after the effective date of the 27 license reduction. However, for good cause shown, the four (4) year period for 28 conversion may be extended by the department for an additional four (4) year 29 period. 30 SECTION 8. That Section 39-2411, Idaho Code, be, and the same is hereby 31 amended to read as follows: 32 39-2411. PERSONS, ACTIVITIES OR ENTITIES NOT SUBJECT TO REGULATION UNDER 33 THIS CHAPTER. The following are not subject to regulation for the purposes of 34 this chapter: 35 (1) A family member; 36 (2) An organization that provides only meal service in a person's resi- 37 dence; 38 (3) Entities furnishing durable medical equipment that does not involve 39 the delivery of professional services beyond those necessary to set up and 40 monitor the proper functioning of the equipment and educate the user on its 41 proper use; 42 (4) A professional licensed person who independently provides services in 43 the home; 44 (5) An employee or volunteer of an agency who provides nonprofessional 45 services only as an employee or volunteer; 46 (6) Facilities and institutions including, but not limited to, nursing 47 homes, hospitals, boarding homes, developmental disability residential pro- 48 grams, or other facilities and institutions, only when providing services to 49 persons residing within the facility or institution if the delivery of the 50 services is regulated by the state; 51 (7) Nursing homes, hospitals, or other institutions, agencies, organiza- 52 tions, or persons that contract with licensed home health, hospice, or home 53 care agencies for the delivery of services; 10 1 (8) In-home assessments by licensed professionals of an ill, disabled, or 2 infirm person's ability to adapt to the home environment that does not result 3 in regular ongoing care at home by that licensed professional; 4 (9) Services conducted by and for the adherents of a church or religious 5 denomination that rely upon spiritual means alone through prayer for healing 6 in accordance with the tenets' beliefs genuinely held by such adherents; 7 (10) A medicare approved dialysis center operating a medicare approved 8 home dialysis program; 9 (11) Case management services which do not include the direct delivery of 10 home health, hospice, or home care services; 11 (12) A medicare certified hospice agency; and 12 (13) A state authorized personalcare service providerassistance agency 13 or personal assistant as defined in chapter 56, title 39, Idaho Code. 14 SECTION 9. That Section 39-3301, Idaho Code, be, and the same is hereby 15 amended to read as follows: 16 39-3301. LEGISLATIVE INTENT AND DECLARATION. The purpose of aboard and17careresidential or assisted living facility in Idaho is to provide a humane, 18 safe, and home-like living arrangement for persons who are mentally ill, 19 developmentally disabled or physically disabled who need some assistance with 20 activities of daily living and personal care but do not require thelevel of21 careprovided by nursing facilities or other institutionsidentified under 22 section 39-1301(b), Idaho Code, other than for short exceptional stays. 23 The state will encourage the development of facilities tailored to the 24 needs of individual populations which operate in integrated settings in commu- 25 nities where sufficient supportive services exist to provide the resident, if 26 appropriate, an opportunity to work and be involved in recreation and educa- 27 tion opportunities alongside people who are not mentally ill, developmentally 28 disabled or physically disabled. Additional services can be made available in 29 the facility to meet the resident's identified needs. 30 The facilities shall be operated and staffed by individuals who have the 31 knowledge and experience required to provide safe and appropriate services to 32 all residents of the facility. The operators shall protect the rights and pro- 33 vide appropriate services to meet the needs of the individual residents. 34 The department will be responsible for monitoring and enforcing the provi- 35 sions of this chapter. This responsibility includes, but is not limited to, 36 monitoring the condition of the facility, the individualized, written plan of 37 care including activities of daily living and support services to be provided, 38 and the development of enforcement procedures when violations occur. 39 Nothing in this chapter is intended to reduce or eliminate any duty of the 40 department or any other public or private entity for provision of services for 41 any resident. 42 SECTION 10. That Section 39-3302, Idaho Code, be, and the same is hereby 43 amended to read as follows: 44 39-3302. DEFINITIONS. As used in this chapter: 45 (1) "Activities of daily living" means the performance of basic self-care 46 activities in meeting an individual's needs to sustain him in a daily living 47 environment. 48 (2) "Administrator/operator" means any person who has responsibility for 49 day-to-day administration or operation of a licensed residentialcareor 50 assisted living facility which provides services to individuals who are men- 51 tally ill, developmentally disabled or physically disabled. 11 1 (3) "Adult" means a person who has attained the age of eighteen (18) 2 years. 3 (4)"Adult foster care family" means all individuals related by blood or4marriage, other than residents, residing in the adult foster care home.5(5) "Adult foster care home" means a family home in which two (2) or less6adults are placed to live who are not able to reside in their own home and who7require family care, help in daily living, protection, security, and encour-8agement toward independence (may be referred to as a "home").9(6)"Advocate" means an authorized or designated representative of a pro- 10 gram or organization operating under federal or state mandate to represent the 11 interests of mentally ill, developmentally disabled, or elderly residents. 12 (75) "Assessment" means the conclusion reached using uniform criteria 13 developed by the department and relevant councils for determining a person's 14 need for care and services. 15 (86) "Board" means the board of health and welfare. 16 (97) "Board and care council" means the interdisciplinary group appointed 17 by the director to advise the agency on matters of policy relating toboard18and careresidential or assisted living facilities and certified family homes. 19 (8) "Care provider" means an adult member of the home family responsible 20 for maintaining the certified family home. The care provider and the legal 21 owner may not necessarily be the same person. 22 (109) "Certificate" means a one (1) year certificate issued by the certi- 23 fying agent of the department toadult foster carecertified family homes com- 24 plying with this chapter. 25 (10) "Certified family home" means a family home in which two (2) or fewer 26 adults are placed to live who are not able to reside in their own home and who 27 require family care, help in daily living, protection, security, and encour- 28 agement toward independence (may be referred to as a "home"). Notwithstanding 29 the foregoing, upon application by the owner the department may authorize not 30 more than four (4) adults to be placed in a certified family home which is 31 owner-occupied. 32 (11) "Certifying agent" means a personrepresenting the areas of social33services, mental health or developmental disabilities,acting under the 34 authority of the department to participate in the certification, inspection, 35 and regulation of an adult foster carecertified family home. 36 (12) "Client" means any person who receives financial aid and/or services 37 from an organized program of the department. 38 (13) "Continuing" means personal assistance services required over an 39 extended period of time. 40 (14) "Department" means the Idaho department of health and welfare. 41 (15) "Director" means the director of the Idaho department of health and 42 welfare. 43 (16) "Facility" means a licensed residentialcareor assisted living 44 facilitywhich provides services to individuals who are mentally ill, develop-45mentally disabled or physically disabledor an adult foster carecertified 46 family home. 47 (17)"Foster care provider" means an adult member of the foster care fam-48ily responsible for maintaining the adult foster care home. The foster care49provider and the legal owner may not necessarily be the same person.50(18)"Governmental unit" means the state, any county, any city, other 51 political subdivision, or any department, division, board, or other agency 52 thereof. 53 (18) "Home family" means all individuals related by blood or marriage, 54 other than residents, residing in the certified family home. 55 (19)"Him or his" means him or her.12 1(20)"License" means a basic permit to operate a licensed residentialcare2 or assisted living facility which provides services to individuals who are 3 mentally ill, developmentally disabled or physically disabled. 4 (210) "Licensee" means the holder of a license to operate a licensed resi- 5 dentialcareor assisted living facility under this chapter. 6 (221) "Licensing agency" means the unit of the department of health and 7 welfare that conducts inspections and surveys and issues licenses based on 8 compliance with this chapter. 9 (232) "Negotiated service agreement" means the agreement reached by the 10 resident and/or their representative and the facility, based on the assess- 11 ment, physician's orders if any, admission records if any, and desires of the 12 clients, and which outlines services to be provided and the obligations of 13 facility and resident. 14 (23) "Authorized provider" means an individual who is a nurse practitioner 15 or clinical nurse specialist, licensed by the Idaho state board of nursing, or 16 a physician assistant, licensed by the Idaho state board of medicine. 17 (24) "Person" means any individual, firm, partnership, corporation, com- 18 pany, association or joint stock association, and the legal successor thereof. 19 (25) "Personal assistance" means the provision by the staff of the facil- 20 ity of one (1) or more of the following services: 21 (a) Assisting the resident with activities of daily living. 22 (b) Arranging for supportive services. 23 (c) Being aware of the resident's general whereabouts. 24 (d) Monitoring the activities of the resident while on the premises of 25 the facility to ensure the resident's health, safety and well-being. 26 (26) "Political subdivision" means a city or county. 27 (27) "Representative of the department" means an employee of the depart- 28 ment. 29 (28) "Resident" means an adult whoresideslives in a licensed residential 30careor assisted living facility or an adult foster carecertified family home 31who may be mentally ill, developmentally disabled, physically disabled and/or32elderly and for whom appropriate care is givenand who requires personal 33 assistance or supervision. 34 (29) "Residentialcareor assisted living facility" means a facility or 35 residence, however named, operated on either a profit or nonprofit basis for 36 the purpose of providing necessary supervision, personal assistance, meals and 37 lodging to three (3) or more developmentally disabled, physically disabled 38and/or mentally ill adults not related to the owner. 39 (30) "Room and board" means lodging and meals. 40 (31) "Qualified mental health professional" means a person who is quali- 41 fied, by training and experience as defined by rules promulgated by the board, 42 to provide services to the mentally ill. 43 (32) "Qualified mental retardation professional" means a person who is 44 qualified, by training and experience as defined by rules promulgated by the 45 board, to provide services to the mentally retarded. 46 (33) "Substantial compliance" means there are no deficiencies whichwould47 endanger the health, safety, or welfare of the residents. It also means defi- 48 ciencies affecting resident welfare including resident rights, resident prop- 49 erty, and the opportunity, where appropriate, to work and be involved in rec- 50 reation and education opportunities in the community. 51 (34) "Supervision" means administrative activity which provides the fol- 52 lowing: protection, guidance, knowledge of the resident's whereabouts, and 53 assistance with activities of daily living. The operator is responsible for 54 providing appropriate supervision based on each resident's negotiated service 55 agreement. 13 1 (35) "Supportive services" means the specific services that are provided 2 to the resident in the community and that are required by the negotiated ser- 3 vice agreement or reasonably requested by the resident. 4 SECTION 11. That Section 39-3303, Idaho Code, be, and the same is hereby 5 amended to read as follows: 6 39-3303. PAYMENT LEVELS. Clients of the department who are mentally ill, 7 developmentally disabled or physically disabled and are receiving financial 8 aid as set out in sections 56-207, 56-208 and 56-209a, Idaho Code, seeking 9 placement in a licensed residentialcareor assisted living facility or certi- 10 fied family home will be assessed byathe department. Based upon the assessed 11 need, the specific types of services and supports required will determine the 12 level of payment to be received by the resident according to the following 13 criteria: 14 (1) Level I. The client requires room, board, and supervision and may 15 require one (1) or more of the following: 16 (a) Minimal assistance with activities of daily living and nonmedical 17 personal assistance. 18 (b) Minimal assistance with mobility, i.e., client is independently 19 mobile. 20 (c) Minimal assistance in an emergency, i.e., client is capable of self- 21 preservation in an emergency. 22 (d) Minimal assistance with medications, i.e., client does not require 23 medication management or supervision. 24 (e) Minimal behavior management substantiated by the client's history. 25 (2) Level II. The client requires room, board, and supervision and may 26 require one (1) or more of the following: 27 (a) Moderate assistance with activities of daily living and nonmedical 28 personal assistance. 29 (b) Moderate assistance with mobility, but easily mobile with assistance. 30 (c) Moderate assistance in an emergency, but client is capable of self- 31 preservation with assistance. 32 (d) Moderate assistance with medications. 33 (e) Moderate assistance with behavior management. 34 (3) Level III. The client requires room, board, and staff up and awake 35 on a twenty-four (24) hour basis and may require one (1) or more of the fol- 36 lowing: 37 (a) Extensive assistance with activities of daily living. 38 (b) Extensive personal assistance. 39 (c) Extensive assistance with mobility and may be immobile without exten- 40 sive assistance. 41 (d) Extensive assistance in an emergency and may be incapable of self- 42 preservation without assistance. 43 (e) Extensive assistance with and monitoring of medications. 44 (f) Extensive assistance with training and/or behavior management. 45 (4) Other levels and amounts as determined by the department pursuant to 46 negotiated rulemaking as defined in chapter 52, title 67, Idaho Code. 47 SECTION 12. That Section 39-3304, Idaho Code, be, and the same is hereby 48 amended to read as follows: 49 39-3304. TYPES OF FACILITIES. The state will foster the development of, 50 and provide incentives for, licensed residentialcareor assisted living 51 facilities serving specific mentally ill and developmentally or physically 14 1 disabled populations which are small in size to provide for family and home- 2 like arrangements. Small facilities of eight (8) beds or less for the develop- 3 mentally or physically disabled population and fifteen (15) beds or less for 4 the mentally ill population will provide residents with the opportunity for 5 normalized and integrated living in typical homes in neighborhoods and commu- 6 nities. 7 SECTION 13. That Section 39-3305, Idaho Code, be, and the same is hereby 8 amended to read as follows: 9 39-3305. RULES. The board shall have the authority to adopt, amend, 10 repeal and enforce such reasonable rules as may be necessary or proper to 11 carry out the purpose and intent of this chapter which are designed to protect 12 the health, safety and individual rights of residents in licensed residential 13careor assisted living facilities and provide adequate nutrition, supervi- 14 sion, and therapeutic recreational activities and to enable the department to 15 exercise the powers and perform the duties conferred upon it by this chapter, 16 not inconsistent with any statute of this state. These rules, regulations,and 17 standards shall be promulgated in accordance with the provisions of the Idaho 18 administrative procedure act. 19 SECTION 14. That Section 39-3306, Idaho Code, be, and the same is hereby 20 amended to read as follows: 21 39-3306. STATE LICENSING TO SUPERSEDE LOCAL REGULATION. This chapter and 22 the rules promulgated pursuant to this chapter shall supersede any program of 23 any political subdivision of the state which licenses or sets standards for 24 licensed residentialcareor assisted living facilities. 25 SECTION 15. That Section 39-3307, Idaho Code, be, and the same is hereby 26 amended to read as follows: 27 39-3307. ADMISSIONS. (1) A licensed residentialcareor assisted living 28 facility shall not admit or retain any resident requiring a level of services 29 or type of service for which the facility is not licensed or which the facil- 30 ity does not provide or arrange for, or if the facility does not have the 31 staff, appropriate in numbers and with appropriate skills, to provide. 32 (2) The department shall develop rules governing admissions to licensed 33 residentialcareor assisted living facilities. 34 SECTION 16. That Section 39-3310, Idaho Code, be, and the same is hereby 35 amended to read as follows: 36 39-3310. PERIODIC REVIEW. The negotiated service agreementmayshall be 37 reviewedas necessary but must be reviewed at least every six (6) monthswhen 38 a significant change in condition or function occurs or at least every twelve 39 (12) months. 40 SECTION 17. That Section 39-3311, Idaho Code, be, and the same is hereby 41 amended to read as follows: 42 39-3311. PHYSICIAN'S ORDER. A physician's or authorized provider's order 43 shall include the following: 44 (1) A history and physical documenting any medical or health problems of 45 the resident which are relevant to the services needed by the resident. 15 1 (2) A description of the functional abilities of the resident including 2 his specific strengths and limitations. 3 (3) The specific needs of the resident for personal assistance. 4 SECTION 18. That Section 39-3313, Idaho Code, be, and the same is hereby 5 amended to read as follows: 6 39-3313. ADMISSION AGREEMENTS. Upon admission to a licensed residential 7careor assisted living facility, the facility and the resident shall enter 8 into an admission agreement. The agreement shall be in writing and shall be 9 signed by both parties. The board shall promulgate rules governing admission 10 agreements which may be integrated with the negotiated service agreement. 11 SECTION 19. That Section 39-3314, Idaho Code, be, and the same is hereby 12 amended to read as follows: 13 39-3314. TERMINATION OF ADMISSION AGREEMENTS. Admission agreements may 14 only be terminated pursuant to rulesand regulationspromulgated by the board. 15 SECTION 20. That Section 39-3315, Idaho Code, be, and the same is hereby 16 amended to read as follows: 17 39-3315. ADMISSION RECORDS. Records required for admission to a facility 18 shall be maintained and updated for administrative purposes only and shall be 19 confidential. Their availability, subject to Idaho department of health and 20 welfare rules, chapter 1, title 5,chapter 1,shall be limited to administra- 21 tion, professional consultants, the resident's physician or authorized pro- 22 vider, and representatives of the licensing agency. They shall include at 23 least the following information: 24 (1) Name and social security number. 25 (2) Permanent address if other than the facility. 26 (3) Marital status and sex. 27 (4) Birthplace and date of birth. 28 (5) Name, address and telephone number of responsible agent or agency. 29 (6) Personal physician or authorized provider and dentist. 30 (7) Admission date and by whom admitted. 31 (8) Results of a physical or health status examination performed by a 32 licensed physician ornurse practitionerauthorized provider within six (6) 33 months prior to admission. 34 (9) A list of medications, treatments and diet prescribed for the resi- 35 dent which is signed and dated by the physician or authorized provider giving 36 the order(s). 37 (10) The results of an assessment of any developmentally disabled or men- 38 tally ill person which support the ability of the facility to meet the needs 39 of the resident. 40 (11) Psychosocial history, current within six (6) months prior to admis- 41 sion, completed by a licensed social worker, psychologist, psychiatrist, or 42 licensed physician for clients of the department. For residents who are either 43 developmentally disabled or mentally ill, the psychosocial history shall be 44 performed by either a qualified mental retardation professional or qualified 45 mental health professional. 46 (12) Religious affiliation if resident chooses to so state. 47 (13) Interested relatives and friends other than those in subsection (5) 48 of this section. Names, addresses and telephone numbers of family members 49 and/or significant others. 16 1 (14) Resident assessment. 2 SECTION 21. That Section 39-3316, Idaho Code, be, and the same is hereby 3 amended to read as follows: 4 39-3316. RESIDENT RIGHTS. A licensed residentialcareor assisted living 5 facility must protect and promote the rights of each resident, including each 6 of the following rights: 7 (1) Resident records. Each facility must maintain and keep current a 8 record of the following information on each resident: 9 (a) A copy of the resident's current negotiated service agreement and 10 physician's order. 11 (b) Written acknowledgement that the resident has received copies of the 12 rights. 13 (c) A record of all personal property and funds which the resident has 14 entrusted to the facility, including copies of receipts for the property. 15 (d) Information about any specific health problems of the resident which 16 may be useful in a medical emergency. 17 (e) The name, address and telephone number of an individual identified by 18 the resident who should be contacted in the event of an emergency or death 19 of the resident. 20 (f) Any other health-related, emergency, or pertinent information which 21 the resident requests the facility to keep on record. 22 (g) The current admission agreement between the resident and the facil- 23 ity. 24 (2) Privacy. Each resident must be assured the right to privacy with 25 regard to accommodations, medical and other treatment, written and telephone 26 communications, visits, and meetings of family and resident groups. 27 (3) Humane care and environment (dignity and respect). 28 (a) Each resident shall have the right to humane care and a humane envi- 29 ronment, including the following: 30 1. The right to a diet which is consistent with any religious or 31 health-related restrictions. 32 2. The right to refuse a restricted diet. 33 3. The right to a safe and sanitary living environment. 34 (b) Each resident shall have the right to be treated with dignity and 35 respect, including: 36 1. The right to be treated in a courteous manner by staff. 37 2. The right to receive a response from the facility to any request 38 of the resident within a reasonable time. 39 (4) Personal possessions. Each resident shall have the right to: 40 (a) Wear his own clothing. 41 (b) Determine his own dress or hair style. 42 (c) Retain and use his own personal property in his own living area so as 43 to maintain individuality and personal dignity. 44 (d) Be provided a separate storage area in his own living area and at 45 least one (1) locked cabinet or drawer for keeping personal property. 46 (5) Personal funds. Residents whose board and care is paid for by public 47 assistance shall retain, for their personal use, the difference between their 48 total income and the applicable board and care allowance established by 49 department rules. 50 (a) A facility shall not require a resident to deposit his personal funds 51 with the facility. 52 (b) Once the facility accepts the written authorization of the resident, 53 must hold, safeguard, and account for such personal funds under a system 17 1 established and maintained by the facility in accordance with this sub- 2 paragraph. 3 (6) Management of personal funds. Upon a facility's acceptance of written 4 authorization of a resident, the facility must manage and account for the per- 5 sonal funds of the resident deposited with the facility as follows: 6 (a) The facility must deposit any amount of a resident's personal funds 7 in excess of one hundred dollars ($100) in an interest-bearing account (or 8 accounts) that is separate from any of the facility's operating accounts 9 and credit all interest earned on such separate account to such account. 10 The facility must maintain any other personal funds in a noninterest-bear- 11 ing account or petty cash fund. 12 (b) The facility must assure a full and complete separate accounting of 13 each resident's personal funds, maintain a written record of all financial 14 transactions involving each resident's personal funds deposited with the 15 facility, and afford the resident (or a legal representative of the resi- 16 dent) reasonable access to such record. 17 (c) Upon the death of a resident with such an account, the facility must 18 promptly convey the resident's personal funds (and a final accounting of 19 such funds) to the individual administering the resident's estate. For 20 clients of the department, the remaining balance of funds shall be 21 refunded to the department. 22 (7) Access and visitation rights. Each facility must permit: 23 (a) Immediate access to any resident by any representative of the depart- 24 ment, by the state ombudsman for the elderly or his designees, or by the 25 resident's individual physician. 26 (b) Immediate access to a resident, subject to the resident's right to 27 deny or withdraw consent at any time, by immediate family or other rela- 28 tives. 29 (c) Immediate access to a resident, subject to reasonable restrictions 30 and the resident's right to deny or withdraw consent at any time, by 31 others who are visiting with the consent of the resident. 32 (d) Reasonable access to a resident by any entity or individual that pro- 33 vides health, social, legal, or other services to the resident, subject to 34 the resident's right to deny or withdraw consent at any time. 35 (8) Employment. Each resident shall have the right to refuse to perform 36 services for the facility except as contracted for by the resident and the 37 operator of the facility. If the resident is hired by the facility to perform 38 services as an employee of the facility, the wage paid to the resident shall 39 be consistent with state and federal law. 40 (9) Confidentiality. Each resident shall have the right to confidential- 41 ity of personal and clinical records. 42 (10) Freedom from abuse, neglect, and restraints. Each resident shall have 43 the right to be free from physical, mental or sexual abuse, neglect, corporal 44 punishment, involuntary seclusion, and any physical or chemical restraints 45 imposed for purposes of discipline or convenience. 46 (11) Freedom of religion. Each resident shall have the right to practice 47 the religion of his choice or to abstain from religious practice. Residents 48 shall also be free from the imposition of the religious practices of others. 49 (12) Control and receipt of health-related services. Each resident shall 50 have the right to control his receipt of health-related services, including: 51 (a) The right to retain the services of his own personal physician,and52 dentist and other health care professionals. 53 (b) The right to select the pharmacy or pharmacist of his choice. 54 (c) The right to confidentiality and privacy concerning his medical or 55 dental condition and treatment. 18 1 (13) Grievances. Each resident shall have the right to voice grievances 2 with respect to treatment or care that is (or fails to be) furnished, without 3 discrimination or reprisal for voicing the grievances and the right to prompt 4 efforts by the facility to resolve grievances the resident may have, including 5 those with respect to the behavior of other residents. 6 (14) Participation in resident and family groups. Each resident shall have 7 the right to organize and participate in resident groups in the facility and 8 the right of the resident's family to meet in the facility with the families 9 of other residents in the facility. 10 (15) Participation in other activities. Each resident shall have the right 11 to participate in social, religious, and community activities that do not 12 interfere with the rights of other residents in the facility. 13 (16) Examination of survey results. Each resident shall have the right to 14 examine, upon reasonable request, the results of the most recent survey of the 15 facility conducted by the department with respect to the facility and any plan 16 of correction in effect with respect to the facility. 17 (17) Other rights. Each resident shall have any other right established by 18 the department. 19 SECTION 22. That Section 39-3318, Idaho Code, be, and the same is hereby 20 amended to read as follows: 21 39-3318. FACILITY RESPONSE TO INCIDENTS AND COMPLAINTS. (1) In addition 22 to any other requirements of this chapter, the licensed residentialcareor 23 assisted living facility shall provide a procedure approved by the licensing 24 agency for immediate response to incidents and complaints. This procedure 25 shall include a method of assuring that the owner, licensee, or person desig- 26 nated by the owner or licensee is notified of the incident, that the owner, 27 licensee, or person designated by the owner or licensee has personally inves- 28 tigated the matter, and that the person making the complaint or reporting the 29 incident has received a response of action taken or a reason why no action 30 needs to be taken. In the case of anonymous complaints, the 31 administrator/operator shall document the action taken or a reason why no 32 action needs to be taken. 33 (2) In order to assure the opportunity for complaints from the residents, 34 the neighborhood, and the community to be made directly to the owner, licen- 35 see, or person designated by the owner or licensee, each facility shall estab- 36 lish a regular time when the owner, licensee, or person designated by the 37 owner or licensee will be present to respond to such incidents or complaints. 38 SECTION 23. That Section 39-3319, Idaho Code, be, and the same is hereby 39 amended to read as follows: 40 39-3319. ACCESS BY ADVOCATES AND REPRESENTATIVES. A licensed residential 41careor assisted living facility shall permit advocates and representatives of 42 community legal services programs, whose purposes include rendering assistance 43 without charge to residents, to have access to the facility at reasonable 44 times in order to: 45 (1) Visit, talk with, and make personal, social and legal services avail- 46 able to all residents. 47 (2) Inform residents of their rights and entitlements, and their corre- 48 sponding obligations under state, federal and local laws by distribution of 49 educational materials and discussion in groups and with individuals. 50 (3) Assist residents in asserting their legal rights regarding claims for 51 public assistance, medical assistance, and social security benefits, as well 19 1 as in all other matters in which residents are aggrieved, which may be pro- 2 vided individually, or in a group basis, and may include organizational activ- 3 ity, counseling, and litigation. 4 (4) Engage in all other methods of assisting, advising, and representing 5 residents so as to extend to them the full enjoyment of their rights. 6 (5) Communicate privately and without restrictions with any resident who 7 consents to the communication. 8 (6) Observe all common areas of the facility. 9 SECTION 24. That Section 39-3320, Idaho Code, be, and the same is hereby 10 amended to read as follows: 11 39-3320. RESIDENT COUNCILS. (1) Every licensed residentialcareor 12 assisted living facility over fifteen (15) beds shall assist the residents in 13 establishing and maintaining a resident council. The council shall be composed 14 of residents of the facility and may include their family members. The council 15 may extend membership to advocates, friends and others. 16 (2) The council shall have the following duties: 17 (a) To assist the facility in developing a grievance procedure. 18 (b) To communicate resident opinions and concerns. 19 (c) To obtain information from the facility and disseminate the informa- 20 tion to the residents. 21 (d) To identify problems and participate in the resolution of those prob- 22 lems. 23 (e) To act as a liaison with the community. 24 (3) This section may be waived provided that the operator meets regularly 25 with residents and that residents decline to participate in a formal council 26 and appropriate documentation exists to indicate the residents' decision. 27 SECTION 25. That Section 39-3321, Idaho Code, be, and the same is hereby 28 amended to read as follows: 29 39-3321. QUALIFICATIONS AND REQUIREMENTS OF ADMINISTRATOR/OPERATOR. Each 30 licensed residentialcareor assisted living facility must employ at least one 31 (1) full-time administrator licensed by the board responsible for licensing 32 residentialcareor assisted living administrators for the state of Idaho who: 33 (1) Is of good moral and responsible character and has not been 34 convicted, or is not under the influence or control of anyone convicted, of 35any felony or defrauding the federal government: 36 (a) A criminal offense related to the delivery of an item or service 37 under medicare, medicaid or other state health care program; or 38 (b) A criminal offense related to the neglect or abuse of a patient, in 39 connection with the delivery of a health care item or service; or 40 (c) A criminal offense related to fraud, theft, embezzlement, breach of 41 fiduciary responsibility, or other financial misconduct; or 42 (d) A criminal offense resulting in death or injury to a person. 43 (2) Has sufficient physical, emotional, and mental capacity to carry out 44 the requirements of this chapter. 45 (3) Has sufficient management and administrative ability to carry out the 46 requirements of this chapter. 47 Multiple facilities under one (1) administrator may be allowed by the 48 department based on an approved plan of operation. 49 SECTION 26. That Section 39-3322, Idaho Code, be, and the same is hereby 50 amended to read as follows: 20 1 39-3322. QUALIFICATIONS AND REQUIREMENTS FOR FACILITY STAFF. Each facil- 2 ity must employ or arrange for sufficient trained staff to fully meet the 3 needs of its residents and the requirements of this chapter. The facility 4 shall have sufficient staff to provide care during all hours required in each 5 resident's negotiated service plan. Additional staff may be required if phys- 6 ical plant and disability of residents indicate that staff assistance in emer- 7 gencies is required. Benchmarks shall be established in the assessment crite- 8 ria where the need for certified nursing assistants or licensed nurses is 9 indicated. Licensed rResidentialcareor assisted living facilities shall not 10 retain residents who requireroutine nursing care on a daily basisthe care 11 provided by nursing facilities under section 39-1301(b), Idaho Code, other 12 than for short exceptional stays pursuant to negotiated rulemaking as defined 13 in chapter 52, title 67, Idaho Code. 14 SECTION 27. That Section 39-3324, Idaho Code, be, and the same is hereby 15 amended to read as follows: 16 39-3324. STAFF TRAINING. All employees of a licensed residentialcareor 17 assisted living facility shall receive department approved orientation and 18 continuing education pertinent to their job responsibilities. 19 SECTION 28. That Section 39-3325, Idaho Code, be, and the same is hereby 20 amended to read as follows: 21 39-3325. REQUIREMENTS FOR LOCATION AND PHYSICAL ENVIRONMENT OF FACILI- 22 TIES. (1) Licensed rResidentialcareor assisted living facilities shall: 23 (a) Be located in geographical areas which are accessible to supportive 24 services and are free from conditions which would pose a danger to the 25 residents. 26 (b) Be maintained internally and externally in good repair and condition. 27 (c) Be maintained in a clean and sanitary manner, including proper sewage 28 disposal, food handling, and hygiene practices. 29 (d) Be maintained in such a manner as to be free from fire/safety haz- 30 ards. 31 (2) The department shall promulgate rulesand regulationsconcerning 32 physical structure, fire safety, health and sanitation, household items and 33 furnishings, diet, self-administered medications, and rooms. 34 SECTION 29. That Section 39-3330, Idaho Code, be, and the same is hereby 35 amended to read as follows: 36 39-3330. BOARD AND CARE COUNCIL. (1) The department shall establish a 37 state level board and care council consisting of twenty (20) members appointed 38 by the director. The director, or his designee, shall serve as chairman of the 39 council. The members of the council shall be: 40 (a) The representative of the department's adult services unit or his 41 designee. 42 (b) The representative of the department's mental health unit or his des- 43 ignee. 44 (c) The representative of the department's developmental disabilities 45 unit or his designee. 46 (d) The state ombudsman for the elderly or his designee. 47 (e) The director of the state protection and advocacy system or his des- 48 ignee. 49 (f) An advocate for mentally ill citizens in the state. 21 1 (g) An advocate for physically disabled citizens in the state. 2 (h) The director of the state developmental disabilities council or his 3 designee. 4 (i)Six (6)Four (4) administrators or licensees of licensed residential 5careor assisted living facilities, one (1) of whom shall be the president 6 of the state association representing residentialcareor assisted living 7 facilities and two (2) of whom shall be designees representing such asso- 8 ciation. 9 (j)Two (2) adult foster careFour (4) certified family home providers, 10 certified pursuant to this chapter. 11 (k) Three (3) residents of licensed residentialcareor assisted living 12 facilities who are mentally ill, developmentally disabled or physically 13 disabled or individuals residing inadult foster carecertified family 14 homes. 15 (2) In appointing the first members of the council who are not state 16 agency representatives, the director shall appoint eight (8) members for a 17 term of two (2) years and seven (7) members for a term of three (3) years. 18 After the initial appointment, members who are not state agency representa- 19 tives shall serve three (3) year terms. A vacancy shall be filled for the 20 remainder of the unexpired term from the same class of persons represented by 21 the outgoing member. 22 SECTION 30. That Section 39-3331, Idaho Code, be, and the same is hereby 23 amended to read as follows: 24 39-3331. POWERS AND DUTIES. The board and care council shall have the 25 following powers and duties: 26 (1) To make policy recommendations regarding the coordination of licens- 27 ing, certifying and enforcement standards inboard and careresidential or 28 assisted living facilities and certified family homes and the provision of 29 services to residents ofboard and careresidential or assisted living facili- 30 ties and certified family homes. 31 (2) To advise the department regarding methods for identification of 32 unlicensedboard and careresidential or assisted living facilities and uncer- 33 tified family homes. 34 (3) To advise the agency during development and revision of rules.and35regulations.36 (4) To review and comment upon proposed rules.and regulations.37 (5) To submit an annual report to the legislature stating opinions and 38 recommendations which would further the state's capability in addressingboard39and careresidential or assisted living facility and certified family home 40 issues. 41 SECTION 31. That Section 39-3340, Idaho Code, be, and the same is hereby 42 amended to read as follows: 43 39-3340. LICENSING OF RESIDENTIALCAREOR ASSISTED LIVING FACILITIES FOR 44 THE MENTALLY ILL, DEVELOPMENTALLY DISABLED AND PHYSICALLY DISABLED. After July 45 1, 1991, no person, firm, partnership, association, or corporation within the 46 state and no state or local public agency shall operate, establish, manage, 47 conduct, or maintain a residentialcareor assisted living facility in the 48 state without a current valid license issued by the licensing agency of the 49 department. 50 SECTION 32. That Section 39-3341, Idaho Code, be, and the same is hereby 22 1 amended to read as follows: 2 39-3341. INITIAL APPLICATION AND ISSUANCE OF A LICENSE. Any person or 3 governmental unit proposing to operate a residentialcareor assisted living 4 facility shall apply for a license to the licensing agency specifying the 5 types of residents to be served and the level(s) of care to be provided. 6 SECTION 33. That Section 39-3342, Idaho Code, be, and the same is hereby 7 amended to read as follows: 8 39-3342. APPLICATION. The applicant shall apply for a license upon forms 9 provided by the licensing agency giving such information as the licensing 10 agency shall require including, but not limited to: 11 (1) Evidence satisfactory to the licensing agency of the ability of the 12 applicant to comply with the provisions of this chapter and with the rules,13regulations and standardsadopted under this chapter by the department. 14 (2) Evidence satisfactory to the department that the applicant is of rep- 15 utable and responsible character. 16 (3) The evidence shall include, but not be limited to: 17 (a) A criminal record clearance; 18 (b) Fingerprinting; 19 (c) Employment history; 20 (d) Credit report; 21 (e) Character references. 22 (4) If the applicant is a firm, association, organization, partnership, 23 business trust, corporation, or company, like evidence shall be submitted as 24 to the members or shareholders holding ten percent (10%) or more interest 25 thereof, and the administrator/operator of the licensed residentialcareor 26 assisted living facility. 27 (5) Evidence satisfactory to the licensing agency that the applicant has 28 sufficient financial resources to maintain the standards of service required 29 by rules, regulations and standardsadopted pursuant to this chapter. 30 (6) Evidence satisfactory to the licensing agency that the 31 administrator/operator has successfully completed the department approved ori- 32 entation. 33 (7) Disclosure of any revocation or other disciplinary action taken, or 34 in the process of being taken, against a license held or previously held by 35 the entities in Idaho as specified in section 39-3345, Idaho Code, or any 36 other jurisdiction. 37 (8) Any other information as may be required by the licensing agency for 38 the proper administration and enforcement of the provisions of this chapter. 39 (9) Failure of the applicant to cooperate with the licensing agency in 40 the completion of the application shall result in the denial of the applica- 41 tion. Failure to cooperate means that the information described in this sec- 42 tion and inregulationsrules of the department has not been provided, or not 43 provided in the form requested by the licensing agency, or both. 44 (10) A signed statement that the person desiring issuance or renewal of a 45 license has read and understands the provisions of this chapter and residen- 46 tialcareor assisted living facility rules which apply to individuals who are 47 mentally ill, developmentally disabled or physically disabled. 48 SECTION 34. That Section 39-3345, Idaho Code, be, and the same is hereby 49 amended to read as follows: 50 39-3345. DENIAL OR REVOCATION OF A LICENSE. The licensing agency may deny 23 1 the issuance of a license or revoke any license when persuaded by a preponder- 2 ance of evidence that such conditions exist as to endanger the health or 3 safety of any resident, or when the facility is not in substantial compliance 4 withtheany provisionsof this chapterandor the rules, regulations and5standardspromulgated pursuant to this chapter. 6 SECTION 35. That Section 39-3348, Idaho Code, be, and the same is hereby 7 amended to read as follows: 8 39-3348.REGULATIONSRULES PROVIDED. Upon initial licensure, residential 9careor assisted living facilities shall be provided a printed copy of all 10 applicableregulationsrules by the department, without charge. 11 SECTION 36. That Section 39-3349, Idaho Code, be, and the same is hereby 12 amended to read as follows: 13 39-3349. RESPONSIBILITY FOR INSPECTIONS AND LICENSING -- NONTRANSFERABIL- 14 ITY OF LICENSES. The licensing agency shall inspect and license residential 15careor assisted living facilities. A license is not transferable. 16 SECTION 37. That Section 39-3350, Idaho Code, be, and the same is hereby 17 amended to read as follows: 18 39-3350. CONSULTING SERVICES. The department may provide consulting ser- 19 vices upon request to any residentialcareor assisted living facility to 20 assist in the identification or correction of deficiencies and in the upgrad- 21 ing of the quality of care provided by the facility. 22 SECTION 38. That Section 39-3352, Idaho Code, be, and the same is hereby 23 amended to read as follows: 24 39-3352. UNLICENSED RESIDENTIALCAREOR ASSISTED LIVING FACILITIES. (1) 25 No unlicensed residentialcareor assisted living facility which provides ser- 26 vices to individuals who are mentally ill, developmentally disabled or physi- 27 cally disabled shall operate in this state. 28 (2) A facility shall be deemed to be an "unlicensed residentialcareor 29 assisted living facility" and "maintained and operated to provideresidential30careservices" if it is unlicensed and not exempt from licensure, and any one 31 (1) of the following conditions is satisfied: 32 (a) The facility is, or is held out as or represented as, providing care, 33 supervision and services. 34 (b) The facility accepts or retains residents who demonstrate the need 35 for care, supervision, and services, as defined in this chapter or the 36 rules adopted pursuant to this chapter. 37 (3) Upon discovery of an unlicensed residentialcareor assisted living 38 facility which provides services to individuals who are mentally ill, develop- 39 mentally disabled or physically disabled, the department shall refer residents 40 to the appropriate placement or adult protective services agency if either of 41 the following conditions exist: 42 (a) There is an immediate threat to the resident's health and safety. 43 (b) The facility will not cooperate with the licensing agency to apply 44 for a license, meet licensing standards, and obtain a valid license. 45 (4) A person found to be operating a residentialcareor assisted living 46 facility which provides services to individuals who are mentally ill, develop- 47 mentally disabled or physically disabled, without a license shall be guilty of 24 1 a misdemeanor punishable by imprisonment in a county jail not to exceed six 2 (6) months, or by a fine not to exceed five thousand dollars ($5,000). 3 (5) In the event the county attorney in the county where the alleged 4 violation occurred fails or refuses to act within thirty (30) days of notifi- 5 cation of the violation, the attorney general is authorized to prosecute 6 violations under the provisions of this section. 7 SECTION 39. That Section 39-3353, Idaho Code, be, and the same is hereby 8 amended to read as follows: 9 39-3353. PLACEMENT OF PERSONS INTO AN UNLICENSED RESIDENTIALCAREOR 10 ASSISTED LIVING FACILITY. No person or public agency employee shall place, 11 refer, or recommend placement of a person into a residentialcareor assisted 12 living facility which is operating without a license. 13 Failure to comply with the provisions of this subsection shall constitute 14 a misdemeanor. 15 SECTION 40. That Section 39-3354A, Idaho Code, be, and the same is hereby 16 amended to read as follows: 17 39-3354A. SPECIAL WAIVER PERMITTED. The department may grant a special 18 waiver of the requirement for licensure as a residentialcareor assisted liv- 19 ing facility when it is deemed in the best interests of individuals and with 20 due consideration of the following criteria: 21 (1) The individuals are residents of a facility operated by a nonprofit 22 health care and/or housing organization established as such in the state of 23 Idaho and satisfying the requirements of U.S. Internal Revenue Code section 24 501(c); 25 (2) The support services required by the individuals are furnished by an 26 entity approved to provide such services in the state of Idaho in good stand- 27 ing as demonstrated by routine inspections required for the type of entity 28 providing services; 29 (3) Facilities seeking such waivers and providing meal service shall be 30 inspected and licensed as a food service establishment by the district health 31 department unless the meal service is provided by a kitchen already part of a 32 facility licensed by the department; 33 (4) The costs of obtaining the needed services from another source are 34 significantly greater and/or would pose a significant hardship on these indi- 35 viduals. 36 Any waiver granted under this section shall be reviewed annually and is 37 subject to inspection by the department to ensure safety and sanitation. 38 SECTION 41. That Section 39-3355, Idaho Code, be, and the same is hereby 39 amended to read as follows: 40 39-3355. INSPECTIONS. (1) The licensing agency shall cause to be made 41 such inspections and investigationsas it may deem necessaryat least every 42 twelve (12) months to determine compliance with this chapter and applicable 43 rulesand standards. 44 (2) All inspections for such purposes will be made unannounced and with- 45 out prior notice at intervals determined by the licensing agency. 46 (3) An inspector shall have full access and authority to examine, among 47 other things, quality of care and service delivery, a facility's records, res- 48 ident accounts, physical premises, including buildings, grounds and equipment, 49 and any other areas necessary to determine compliance with this chapter and 25 1 applicable rulesand standards. 2 (4) An inspector shall have authority to interview the licensee, 3 administrator/operator, staff and residents. Interviews with residents shall 4 be confidential and conducted privately unless otherwise specified by the res- 5 ident. 6 (5) The licensing agency shall notify the facility, in writing, of all 7 deficiencies and shall approve a reasonable length of time for compliance by 8 the facility. 9 (6) Current lists of deficiencies, including plans of correction, shall 10 be available to the public upon request in the individual facilities or by 11 written request to the regional office of the department or the licensing 12 agency. 13 SECTION 42. That Section 39-3357, Idaho Code, be, and the same is hereby 14 amended to read as follows: 15 39-3357. ENFORCEMENT PROCESS. (1) If the licensing agency finds, on the 16 basis of inspections as defined in this chapter or otherwise, that a residen- 17 tialcareor assisted living facility no longer meets a requirement of this 18 chapter, and further finds that the facility's deficiencies: 19 (a) Immediately jeopardize the health or safety of its residents, the 20 department shall take immediate action to remove the jeopardy and correct 21 the deficiencies through the remedy specified in section 39-3358(1)(c), 22 Idaho Code, or prohibit the facility from keeping or admitting residents 23 and may provide, in addition, for one (1) or more of the other remedies 24 described in section 39-3358, Idaho Code. 25 (b) Do not immediately jeopardize the health or safety of its residents, 26 the department shall provide for one (1) or more of the remedies described 27 in section 39-3358, Idaho Code. 28 (2) Nothing in this section shall be construed as restricting the reme- 29 dies available to the department to remedy a facility's deficiencies. If the 30 department finds that a facility meets the requirements of this chapter, but, 31 as of a previous period, intentionally did not meet such requirements, the 32 department may provide for a civil money penalty under section 39-3358(1)(b), 33 Idaho Code, for the days in which it finds that the facility was not in com- 34 pliance with such requirements. 35 SECTION 43. That Section 39-3358, Idaho Code, be, and the same is hereby 36 amended to read as follows: 37 39-3358. SPECIFIED REMEDIES. (1) The department shall establish at least 38 the following remedies: 39 (a) Prohibit the facility from admitting residents or prohibit a facility 40 from keeping or admitting residents with a specific diagnosis. 41 (b) A civil money penalty assessed and collected, with interest, for each 42 day the facility is or was out of compliance with a requirement of this 43 chapter. Funds collected by the department as a result of imposition of 44 such a penalty shall be applied to the protection of the health or prop- 45 erty of residents of residentialcareor assisted living facilities that 46 the department finds deficient, including payment for the costs of reloca- 47 tion of residents to other facilities, maintenance of operation of a 48 facility pending correction of deficiencies or closure, and reimbursement 49 of residents for personal funds lost. 50 (c) The appointment of temporary management to oversee the operation of 51 the facility and to assure the health and safety of the facility's resi- 26 1 dents, where there is a need for temporary management while: 2 (i) There is an orderly closure of the facility. 3 (ii) Improvements are made in order to bring the facility into com- 4 pliance with all the requirements of this chapter. 5 (iii) The temporary management under this clause shall not be termi- 6 nated until the department has determined that the facility has the 7 management capability to ensure continued compliance with all the 8 requirements of this chapter. 9 (d) The authority, in the case of an emergency, to summarily suspend the 10 license, to close the facility, and/or to transfer residents in that 11 facility to other facilities. 12 (2) The department shall also specify criteria as to when and how each of 13 such remedies is to be applied, the amounts of any fines, and the severity of 14 each of these remedies, to be used in the imposition of such remedies. Such 15 criteria shall be designed so as to minimize the time between the identifica- 16 tion of violations and final imposition of the remedies and shall provide for 17 the imposition of incrementally more severe fines for repeated or uncorrected 18 deficiencies. 19 SECTION 44. That Section 39-3359, Idaho Code, be, and the same is hereby 20 amended to read as follows: 21 39-3359. TRANSFER OF RESIDENTS. The department may transfer residents 22 from a residentialcareor assisted living facility to an alternative place- 23 ment on the following grounds: 24 (1) As a result of a violation of a provision of this chapter or an 25 applicable rule,regulation or standard,the facility is unable or unwilling 26 to provide an adequate level of meals, lodging, personal assistance or super- 27 vision to persons residing in the facility at the time of the violation. 28 (2) A violation of a resident's rights as provided in section 39-3316, 29 Idaho Code. 30 (3) The number of residents currently in the facility exceeds the number 31 of residents the facility is licensed to serve. 32 (4) The facility is operating without a license. 33 (5) A violation of a provision of this chapter or an applicable rule,34regulation or standardresults in conditions that present an imminent danger. 35 SECTION 45. That Section 39-3370, Idaho Code, be, and the same is hereby 36 amended to read as follows: 37 39-3370. PURPOSE OFADULT FOSTER CARECERTIFIED FAMILY HOMES. The purpose 38 of an adult foster carecertified family home in Idaho is to provide a resi- 39 dential alternative designedto help delay the need for individuals to enter40residential care facilities, skilled nursing facilities, or institutional41care, andto allowsuchindividuals to remain in more normal family-style liv- 42 ing, usually within their own communities.Families who provide adult foster43care share their homes with adults who need assistance in daily living. Per-44sons who live in adult foster care are thoseCertified family homes provide a 45 home to persons who are elderly,or unable to live alone and/orwhose mental, 46 emotional, developmental, and physical conditionsare such that the care given47 can be met by thefostercare provider.will meet the person's needs. Individ-48uals requiring nursing home care, or who are unable to administer their own49medication, are not suitable for adult foster careThe home must obtain a 50 waiver under section 39-1301A, Idaho Code, to care for two (2) persons requir- 51 ing the care described in section 39-1301(b), Idaho Code. Homes may add ser- 27 1 vices which allow an individual's needs to be met. 2 SECTION 46. That Section 39-3371, Idaho Code, be, and the same is hereby 3 amended to read as follows: 4 39-3371. RULES. The board shall have the power and it shall be its duty 5 to promulgate appropriate rules necessary to implement and enforce the stan- 6 dards forcertifying adult foster carecertified family homes pursuant to this 7 act including, but not limited to, the following: 8 (1) A home shall not be certified for more than two (2) adults, however, 9 upon an application by the owner and upon a finding by the department that 10 residents can be cared for safely and appropriately based on the residents' 11 specific needs, the department may authorize not more than four (4) adults to 12 be placed in a certified family home which is owner-occupied and which applies 13 to the department for the authorization. Certification as a four (4) resident 14 certified family home shall not be transferable to another person or entity. 15 Four (4) resident certified family homes shall be subject to all statutes and 16 rules governing certified family homes but shall not be subject to the resi- 17 dential or assisted living administrator licensing requirements of chapter 42, 18 title 54, Idaho Code, section 39-3340, Idaho Code, licensing of residential or 19 assisted living facilities for the mentally ill, developmentally disabled and 20 physically disabled, or section 39-3540, Idaho Code, licensing of residential 21 or assisted living facilities for the elderly. This provision implementing 22 four (4) resident certified family homes shall be effective on July 1, 2001. 23 Prior to the effective date, the department shall promulgate rules for four 24 (4) resident certified family homes through the negotiated rulemaking process. 25 Nothing in this subsection shall be construed to authorize increased group 26 size for providers of any form of care other than certified family homes. 27 (2) An adult fostercare provider may be a couple or a single individual. 28 (3) A home cannot be approved as a certifiedfor adult foster carefamily 29 home if it also provides room and board for other persons. 30 (4) A home cannot be approved as a certifiedfor adult foster carefamily 31 home and for child foster care at the same time, unless a waiver of this 32 requirement is granted by the department. 33 (5) Theadult fostercare provider must have sufficient income to main- 34 tain the home and the services offered. 35 (6) Information obtained by thefostercare provider shall be held confi- 36 dential except to representatives of the department to provide services or 37 determine compliance with this chapter or upon consent of the individual or 38 his legal guardian. 39 (7)Record keepingRecordkeeping and reporting requirements as may be 40 deemed necessary. 41 (8) Requirements to assure the safety and adequate care of residents. 42 SECTION 47. That Section 39-3372, Idaho Code, be, and the same is hereby 43 amended to read as follows: 44 39-3372. APPLICATION FOR CERTIFICATION. An application for certification 45 shall be made to regional offices of the department upon forms provided by the 46 department and shall contain such information as the department reasonably 47 requires which will include a background check and fingerprinting with the 48 Idaho department of law enforcement. Following receipt of an application, the 49 department shall conduct a study, including a visit to the home, to determine 50 the capability of the provider to provideadult fostercare as a certified 51 family home. 28 1 SECTION 48. That Section 39-3373, Idaho Code, be, and the same is hereby 2 amended to read as follows: 3 39-3373. ISSUANCE AND RENEWAL OF CERTIFICATION. Each certificate shall be 4 issued only for the home and foster care provider named in the application and 5 shall not be transferable or assignable. Eachadult foster carecertified fam- 6 ily home is required to renewtheirits certification annually. The applica- 7 tion for renewal shall be filed with the regional office of the department 8 within thirty (30) days prior to the date of expiration. The existing certifi- 9 cate, unless suspended or revoked, shall remain in force and effect until the 10 department has acted upon the application renewal when such application for 11 renewal is timely filed. 12 SECTION 49. That Section 39-3374, Idaho Code, be, and the same is hereby 13 amended to read as follows: 14 39-3374. TEMPORARY CERTIFICATION. Upon initial investigation, should an 15 applicant for a certificate be unable to meet a standard because of conditions 16 that are unlikely to endure beyond six (6) months, the department may grant a 17 temporary certificate pending the satisfactory correction of all deficiencies 18 and provided that the deficiencies do not jeopardize the health and safety of 19 residents. No more than one (1) provisional certificate shall be issued to the 20 sameadult foster carecertified family home in any twelve (12) month period. 21 SECTION 50. That Section 39-3375, Idaho Code, be, and the same is hereby 22 amended to read as follows: 23 39-3375. DENIAL OR REVOCATION OF A CERTIFICATE. The department may deny 24 the issuance of a certificate or revoke any certificate when persuaded by a 25 preponderance of evidence that such conditions exist as to endanger the health 26 or safety of any resident, or when the home is not in substantial compliance 27 with the provisions of this chapter or rulesand regulationspromulgated pur- 28 suant to this chapter. 29 SECTION 51. That Section 39-3378, Idaho Code, be, and the same is hereby 30 amended to read as follows: 31 39-3378.REGULATIONSRULES PROVIDED. Upon initial certification,adult32foster carecertified family homes shall be provided a printed copy of all 33 applicableregulationsrules by the department, without charge. 34 SECTION 52. That Section 39-3379, Idaho Code, be, and the same is hereby 35 amended to read as follows: 36 39-3379. MANDATORY INSPECTIONS. For the purpose of determining whether 37 everyadult foster carecertified family home consistently maintains confor- 38 mity with thestandardsrules established under the authority herein, the 39 department, through a certifying agent, shall visit the premises of each home 40as it deems necessary but in any event at intervals not to exceed six (6)at 41 least every twelve (12) months. 42 SECTION 53. That Section 39-3380, Idaho Code, be, and the same is hereby 43 amended to read as follows: 44 39-3380. ENFORCEMENT PROCESS. Section 39-3357, Idaho Code, governing res- 29 1 identialcareor assisted living facilities shall also governadult foster2carecertified family homes. 3 SECTION 54. That Section 39-3381, Idaho Code, be, and the same is hereby 4 amended to read as follows: 5 39-3381. OPERATING WITHOUT CERTIFICATION -- MISDEMEANOR. Any person who 6 operates an adult foster carecertified family home within the state without 7 first obtaining certification as provided in this chapter shall be guilty of a 8 misdemeanor. 9 SECTION 55. That Section 39-3382, Idaho Code, be, and the same is hereby 10 amended to read as follows: 11 39-3382. PLACEMENT OF PERSONS INTO AN UNLICENSEDADULT FOSTER CARECERTI- 12 FIED FAMILY HOME. Section 39-3353, Idaho Code, governing residentialcareor 13 assisted living facilities shall also governunlicensed adult foster care14 uncertified family homes. 15 SECTION 56. That Section 39-3383, Idaho Code, be, and the same is hereby 16 amended to read as follows: 17 39-3383. NEGOTIATED SERVICE AGREEMENT. The negotiated service agreement 18 as set out in section 39-33089, Idaho Code, shall govern the content, prepara- 19 tion and review of the negotiated service agreement for residents ofadult20foster carecertified family homes. 21 SECTION 57. That Section 39-3384, Idaho Code, be, and the same is hereby 22 amended to read as follows: 23 39-3384. PHYSICIAN'S ORDER FORNONCLIENTS OF THE DEPARTMENTCERTIFIED 24 FAMILY HOMES. The physician's order as set out in section 39-3311, Idaho Code, 25 governing licensed residentialcareor assisted living facilities shall also 26 governadult foster carecertified family homes. 27 SECTION 58. That Section 39-3385, Idaho Code, be, and the same is hereby 28 amended to read as follows: 29 39-3385. WRITTEN SERVICE PLAN. The department and thefostercare 30 providers serving clients of the department shall negotiate a written plan 31 annually. The purpose of the plan shall be to ensure that a client receives 32services necessary to maintain him at the highest level of independencethe 33 level of care based upon the negotiated service agreement as described in sec- 34 tion 39-3309, Idaho Code. The plan is to establish a basis for coordination 35 and communication between thefosterhome family and the department. The plan 36 shall be maintained in the home. 37 SECTION 59. That Section 39-3386, Idaho Code, be, and the same is hereby 38 amended to read as follows: 39 39-3386.FOSTERCARE AGREEMENTS. Eachfostercare provider shall negoti- 40 ate a written, signed and dated agreement between thefostercare provider and 41 a resident specifying the amount of monthly payment to be paid by the resident 42 and the method for payment. 30 1 SECTION 60. That Section 39-3387, Idaho Code, be, and the same is hereby 2 amended to read as follows: 3 39-3387. RESIDENT RIGHTS. Section 39-3316, Idaho Code, governing licensed 4 residentialcareor assisted living facilities shall also governadult foster5carecertified family homes. 6 SECTION 61. That Section 39-3388, Idaho Code, be, and the same is hereby 7 amended to read as follows: 8 39-3388. TRAINING. The department shall insure thatfoster careproviders 9 receive, at a minimum, training which shall include the rights of the resi- 10 dent, and a basic understanding of the psychosocial and physical needs of res- 11 idents to be served. The department will specify annual continuing education 12 requirements forfostercare providers. 13 SECTION 62. That Section 39-3389, Idaho Code, be, and the same is hereby 14 amended to read as follows: 15 39-3389. PHYSICAL AND ENVIRONMENTAL STANDARDS. Standards shall be devel- 16 oped through the regulatory process by the department to insure a safe, sani- 17 tary and comfortable environment for residents ofadult foster carecertified 18 family homes. 19 SECTION 63. That Section 39-3393, Idaho Code, be, and the same is hereby 20 amended to read as follows: 21 39-3393. APPLICATION OF PROVISIONS. The provisions of section 39-33089, 22 Idaho Code, governing licensed residentialcareor assisted living facilities, 23 shall also apply toadult foster carecertified family homes. Any individual 24 providing care and housing commercially to the developmentally disabled or the 25 mentally ill shall, at a minimum, meet the requirements of this chapter or 26 other provisions of law governing care and housing for the mentally ill, 27 developmentally disabled or physically disabled if those provisions are more 28 restrictive. 29 SECTION 64. That Section 39-3501, Idaho Code, be, and the same is hereby 30 amended to read as follows: 31 39-3501. LEGISLATIVE INTENT AND DECLARATION. The purpose of a licensed 32 residentialcareor assisted living facility for the elderly in Idaho is to 33 provide a humane, safe, and home-like housing and living arrangement for per- 34 sons who are elderly, who need some assistance with activities of daily living 35 and personal care and to delay the need for a more expensive nursing facility 36 or other institutional care as long as possible. Occupancy in a residential 37careor assisted living facility for the elderly will be considered the 38 person's primary residence. 39 It is the intent of the legislature that residentialcareor assisted liv- 40 ing facilities for the elderly be available to meet the needs of those resid- 41 ing in these facilities by recognizing the capabilities of individuals to 42 direct their care.and self-medication or to use supervised self-medication43techniques when ordered and approved by an individual licensed to prescribe44medication.45 Nothing in this chapter is intended to reduce or eliminate any duty of the 46 department or any other public or private entity for provision of services for 31 1 any resident. 2 SECTION 65. That Section 39-3502, Idaho Code, be, and the same is hereby 3 amended to read as follows: 4 39-3502. DEFINITIONS. As used in this chapter: 5 (1) "Activities of daily living" means the performance of basic self-care 6 activities in meeting an individual's needs to sustain him in a daily living 7 environment. 8 (2) "Administrator/operator" means any person who has responsibility for 9 day-to-day administration or operation of a licensed residentialcareor 10 assisted living facility for the elderly. 11 (3) "Adult" means a person who has attained the age of eighteen (18) 12 years. 13 (4)"Adult foster care family" means all individuals related by blood or14marriage, other than residents, residing in the adult foster care home.15(5) "Adult foster care home" means a family home in which two (2) or16fewer adults are placed to live who are not able to reside in their own home17and who require family care, help in daily living, protection and security18(may be referred to as a "home").19(6)"Advocate" means an authorized or designated representative of a pro- 20 gram or organization operating under federal or state mandate to represent the 21 interests of a population group served by the facility. 22 (75) "Assessment" means the conclusion reached using uniform criteria 23 developed by the department and relevant councils for determining a person's 24 need for care and services. 25 (86) "Board" means the board of health and welfare. 26 (7) "Care provider" means an adult member or members of the home family 27 responsible for maintaining the certified family home. The care provider(s) 28 and the legal owner may not necessarily be the same person. 29 (98) "Certificate" means a one (1) year certificate issued by the certi- 30 fying agent of the department toadult foster carecertified family homes com- 31 plying with this chapter. 32 (9) "Certified family home" means a family home in which two (2) or fewer 33 adults are placed to live who are not able to reside in their own home and who 34 require family care, help in daily living, protection and security (may be 35 referred to as a "home"). Notwithstanding the foregoing, upon application by 36 the owner the department may authorize not more than four (4) adults to be 37 placed in a certified family home which is owner-occupied. 38 (10) "Certifying agent" means a personrepresenting the areas of social39services or mental health,acting under the authority of the department to 40 participate in the certification, inspection, and regulation of an adult fos-41ter carefamily home. 42 (11) "Client" means any person who receives financial aid and/or services 43 from an organized program of the department. 44 (12) "Continuing" means personal assistance services required over an 45 extended period of time. 46 (13) "Department" means the Idaho department of health and welfare. 47 (14) "Director" means the director of the Idaho department of health and 48 welfare. 49 (15) "Facility" means a licensed residentialcareor assisted living 50 facility for the elderly or certified family home. 51 (16)"Foster care provider" means an adult member or members of the foster52care family responsible for maintaining the adult foster care home. The foster53care provider(s) and the legal owner may not necessarily be the same person.32 1(17)"Governmental unit" means the state, any county, any city, other 2 political subdivision, or any department, division, board or other agency 3 thereof. 4 (17) "Home family" means all individuals related by blood or marriage, 5 other than residents, residing in the certified family home. 6 (18)"Him or his" means him or her.7(19)"License" means a basic permit to operate a licensed residentialcare8 or assisted living facility for the elderly. 9 (2019) "Licensee" means the holder of a license to operate a licensed res- 10 identialcareor assisted living facility for the elderly under this chapter. 11 (210) "Licensing agency" means the unit of the department of health and 12 welfare that conducts inspections and surveys and issues licenses based on 13 compliance with this chapter. 14 (221) "Mixed populations" means that two (2) or more of the following pop- 15 ulations: mentally ill, developmentally disabled, physically disabled, and/or 16 elderly, are provided care and/or housing within the facility. 17 (232) "Negotiated service agreement" means the agreement reached by the 18 resident and/or their representative and the facility, based on the assess- 19 ment, physician's orders if any, admission records if any, and desires of the 20 client, and which outlines services to be provided and the obligations of 21 facility and resident. 22 (243) "Person" means any individual, firm, partnership, corporation, com- 23 pany, association or joint stock association, and the legal successor thereof. 24 (254) "Personal assistance" means the provision by the staff of the facil- 25 ity of one (1) or more of the following services: 26 (a) Assisting the resident with activities of daily living. 27 (b) Arranging for supportive services. 28 (c) Being aware of the resident's general whereabouts. 29 (d) Monitoring the activities of the resident while on the premises of 30 the facility to ensure the resident's health, safety and well-being. 31 (25) "Authorized provider" means an individual who is a nurse practitioner 32 or clinical nurse specialist, licensed by the Idaho state board of nursing, or 33 a physician assistant, licensed by the Idaho state board of medicine. 34 (26) "Political subdivision" means a city or county. 35 (27) "Representative of the department" means an employee of the depart- 36 ment. 37 (28) "Resident" means anindividualadult who, by reason of age or infir-38mity, requires personal assistance and who is not related by blood or marriage39to the licensee of the facilitylives in a licensed residential or assisted 40 living facility or certified family home and who requires personal assistance 41 or supervision. 42 (29) "Residentialcareor assisted living council for the elderly" means 43 the interdisciplinary group appointed by the director to advise the agency and 44 legislature on matters of policy relating to residentialcareor assisted liv- 45 ing facilities for the elderly. 46 (30) "Residentialcareor assisted living facility for the elderly" means 47 a facility or residence, however named, operated on either a profit or non- 48 profit basis for the purpose of providing necessary supervision, personal 49 assistance, meals and lodging to three (3) or more elderly adults not related 50 to the owner. 51 (31) "Room and board" means lodging and meals. 52 (32) "Substantial compliance" means there are no deficiencies whichwould53 endanger the health, safety or welfare of the residents. It also means defi- 54 ciencies affecting resident welfare including resident rights, resident prop- 55 erty, and the opportunity, where appropriate, to work and be involved in rec- 33 1 reation and education opportunities in the community. 2 (33) "Supervision" means administrative activity which provides the fol- 3 lowing: protection, guidance, knowledge of the resident's whereabouts and 4 assistance with activities of daily living. The operator is responsible for 5 providing appropriate supervision based on each resident's negotiated service 6 agreement. 7 (34) "Supportive services" means the specific services that are provided 8 to the resident in the community and that are required by the negotiated ser- 9 vice agreement or reasonably requested by the resident. 10 SECTION 66. That Section 39-3503, Idaho Code, be, and the same is hereby 11 amended to read as follows: 12 39-3503. PAYMENT LEVELS. Clients of the department receiving financial 13 aid as set out in sections 56-207, 56-208 and 56-209a, Idaho Code, seeking 14 placement in a licensed residentialcareor assisted living facility for the 15 elderly or an adult foster carecertified family home will be assessed by the 16 department. Based upon the assessed need, the specific types of services and 17 supports required will determine the level of payment to be received by the 18 resident according to the following criteria: 19 (1) Level I. The client requires room, board, and supervision and may 20 require one (1) or more of the following: 21 (a) Minimal assistance with activities of daily living and nonmedical 22 personal assistance. 23 (b) Minimal assistance with mobility, i.e., client is independently 24 mobile. 25 (c) Minimal assistance in an emergency, i.e., client is capable of self- 26 preservation in an emergency. 27 (d) Minimal assistance with medications, i.e., client does not require 28 medication management or supervision. 29 (e) Minimal behavior management substantiated by the client's history. 30 (2) Level II. The client requires room, board and supervision and may 31 require one (1) or more of the following: 32 (a) Moderate assistance with activities of daily living and nonmedical 33 personal assistance. 34 (b) Moderate assistance with mobility, but easily mobile with assistance. 35 (c) Moderate assistance in an emergency, but client is capable of self- 36 preservation with assistance. 37 (d) Moderate assistance with medications. 38 (e) Moderate assistance with behavior management. 39 (3) Level III. The client requires room, board, and staff up and awake 40 on a twenty-four (24) hour basis and may require one (1) or more of the fol- 41 lowing: 42 (a) Extensive assistance with activities of daily living. 43 (b) Extensive personal assistance. 44 (c) Extensive assistance with mobility and may be immobile without exten- 45 sive assistance. 46 (d) Extensive assistance in an emergency and may be incapable of self- 47 preservation without assistance. 48 (e) Extensive assistance with and monitoring of medications. 49 (f) Extensive assistance with training and/or behavior management. 50 (4) Other levels and amounts as determined by the department pursuant to 51 negotiated rulemaking as defined in chapter 52, title 67, Idaho Code. 52 SECTION 67. That Section 39-3505, Idaho Code, be, and the same is hereby 34 1 amended to read as follows: 2 39-3505. RULES. The board shall have the authority to adopt, amend, 3 repeal and enforce such reasonable rules as may be necessary or proper to 4 carry out the purpose and intent of this chapter which are designed to protect 5 the health, safety and individual rights of residents in residentialcareor 6 assisted living facilities for the elderly and provide adequate nutrition, 7 supervision, and therapeutic recreational activities and to enable the depart- 8 ment to exercise the powers and perform the duties conferred upon it in this 9 chapter, not inconsistent with any statute of this state. Providers who care 10 for a mixed population shall comply with the rules that are the most restric- 11 tive based on the populations being served. These rules shall be promulgated 12 in accordance with the provisions of the Idaho administrative procedure act. 13 Rules will be adopted July 1, 1996, but prior to that time, the existing rules 14 as provided by this section will apply. 15 SECTION 68. That Section 39-3506, Idaho Code, be, and the same is hereby 16 amended to read as follows: 17 39-3506. STATE LICENSING TO SUPERSEDE LOCAL REGULATION. The provisions of 18 this chapter, and the rules promulgated pursuant to this chapter, shall super- 19 sede any program of any political subdivision of the state which licenses or 20 sets standards for residentialcareor assisted living facilities for the 21 elderly. 22 SECTION 69. That Section 39-3507, Idaho Code, be, and the same is hereby 23 amended to read as follows: 24 39-3507. ADMISSIONS. (1) A licensed residentialcareor assisted living 25 facility for the elderly shall not admit or retain any resident requiring a 26 level of services or type of service for which the facility is not licensed or 27 which the facility does not provide or arrange for, or if the facility does 28 not have the staff, appropriate in numbers and with appropriate skills, to 29 provide. 30 (2) The department shall develop rules governing admissions to licensed 31 residentialcareor assisted living facilities for the elderly. 32 SECTION 70. That Section 39-3510, Idaho Code, be, and the same is hereby 33 amended to read as follows: 34 39-3510. PERIODIC REVIEW. The negotiated service agreementmaymust be 35 reviewedas necessary but must be reviewedwhen a significant change in condi- 36 tion or function occurs, or at least everysix (6)twelve (12) months. 37 SECTION 71. That Section 39-3511, Idaho Code, be, and the same is hereby 38 amended to read as follows: 39 39-3511. PHYSICIAN'S ORDER. A physician's or authorized provider's order 40 shall include the following: 41 (1) A history and physical documenting any medical or health problems of 42 the resident which are relevant to the services needed by the resident. 43 (2) A description of the functional abilities of the resident including 44 his specific strengths and limitations. 45 (3) The specific needs of the resident for personal assistance. 35 1 SECTION 72. That Section 39-3513, Idaho Code, be, and the same is hereby 2 amended to read as follows: 3 39-3513. ADMISSION AGREEMENTS. Upon admission to a licensed residential 4careor assisted living facility for the elderly, the facility and the resi- 5 dent shall enter into an admission agreement. The agreement shall be in writ- 6 ing and shall be signed by both parties. The board shall promulgate rules gov- 7 erning admission agreements which may be integrated with the negotiated ser- 8 vice agreement. 9 SECTION 73. That Section 39-3515, Idaho Code, be, and the same is hereby 10 amended to read as follows: 11 39-3515. ADMISSION RECORDS. Records required for admission to a facility 12 shall be maintained and updated for administrative purposes only and shall be 13 confidential. Their availability, subject to Idaho department of health and 14 welfare rules, chapter 1, title 5,chapter 1,shall be limited to administra- 15 tion, professional consultants, the resident's physician or authorized pro- 16 vider, and representatives of the licensing agency. They shall include at 17 least the following information: 18 (1) Name and social security number. 19 (2) Permanent address if other than the facility. 20 (3) Marital status and sex. 21 (4) Birthplace and date of birth. 22 (5) Name, address and telephone number of responsible agent or agency. 23 (6) Personal physician or authorized provider and dentist. 24 (7) Admission date and by whom admitted. 25 (8) Results of a physical or health status examination performed by a 26 licensed physician ornurse practitionerauthorized provider within six (6) 27 months prior to admission. 28 (9) A list of medications, treatments and diet prescribed for the resi- 29 dent which is signed and dated by the physician or authorized provider giving 30 the order(s). 31 (10) Religious affiliation if resident chooses to so state. 32 (11) Interested relatives and friends other than those in subsection (5) 33 of this section. Names, addresses and telephone numbers of family members 34 and/or significant others. 35 (12) Resident assessment. 36 SECTION 74. That Section 39-3516, Idaho Code, be, and the same is hereby 37 amended to read as follows: 38 39-3516. RESIDENT RIGHTS. A licensed residentialcareor assisted living 39 facility for the elderly must protect and promote the rights of each resident, 40 including each of the following rights: 41 (1) Resident records. Each facility must maintain and keep current a 42 record of the following information on each resident: 43 (a) A copy of the resident's current negotiated service agreement and 44 physician's order. 45 (b) Written acknowledgement that the resident has received copies of the 46 rights. 47 (c) A record of all personal property and funds which the resident has 48 entrusted to the facility, including copies of receipts for the property. 49 (d) Information about any specific health problems of the resident which 50 may be useful in a medical emergency. 36 1 (e) The name, address and telephone number of an individual identified by 2 the resident who should be contacted in the event of an emergency or death 3 of the resident. 4 (f) Any other health-related, emergency or pertinent information which 5 the resident requests the facility to keep on record. 6 (g) The current admission agreement between the resident and the facil- 7 ity. 8 (2) Privacy. Each resident must be assured the right to privacy with 9 regard to accommodations, medical and other treatment, written and telephone 10 communications, visits, and meetings of family and resident groups. 11 (3) Humane care and environment (dignity and respect). 12 (a) Each resident shall have the right to humane care and a humane envi- 13 ronment, including the following: 14 (i) The right to a diet which is consistent with any religious or 15 health-related restrictions. 16 (ii) The right to refuse a restricted diet. 17 (iii) The right to a safe and sanitary living environment. 18 (b) Each resident shall have the right to be treated with dignity and 19 respect, including: 20 (i) The right to be treated in a courteous manner by staff. 21 (ii) The right to receive a response from the facility to any 22 request of the resident within a reasonable time. 23 (4) Personal possessions. Each resident shall have the right to: 24 (a) Wear his own clothing. 25 (b) Determine his own dress or hair style. 26 (c) Retain and use his own personal property in his own living area so as 27 to maintain individuality and personal dignity. 28 (d) Be provided a separate storage area in his own living area and at 29 least one (1) locked cabinet or drawer for keeping personal property. 30 (5) Personal funds. Residents whose board and care is paid for by public 31 assistance shall retain, for their personal use, the difference between their 32 total income and the applicable board and care allowance established by 33 department rules. 34 (a) A facility shall not require a resident to deposit his personal funds 35 with the facility. 36 (b) Once the facility accepts the written authorization of the resident, 37 the facility must hold, safeguard and account for such personal funds 38 under a system established and maintained by the facility in accordance 39 with this subparagraph. 40 (6) Management of personal funds. Upon a facility's acceptance of written 41 authorization of a resident, the facility must manage and account for the per- 42 sonal funds of the resident deposited with the facility as follows: 43 (a) The facility must deposit any amount of a resident's personal funds 44 in excess of one hundred dollars ($100) in an interest-bearing account, or 45 accounts, that is separate from any of the facility's operating accounts 46 and credit all interest earned on such separate account to such account. 47 The facility must maintain any other personal funds in a noninterest-bear- 48 ing account or petty cash fund. 49 (b) The facility must assure a full and complete separate accounting of 50 each resident's personal funds, maintain a written record of all financial 51 transactions involving each resident's personal funds deposited with the 52 facility, and afford the resident, or a legal representative of the resi- 53 dent, reasonable access to such record. 54 (c) Upon the death of a resident with such an account, the facility must 55 promptly convey the resident's personal funds, and a final accounting of 37 1 such funds, to the individual administering the resident's estate. For 2 clients of the department, the remaining balance of funds shall be 3 refunded to the department. 4 (7) Access and visitation rights. Each facility must permit: 5 (a) Immediate access to any resident by any representative of the depart- 6 ment, by the state ombudsman for the elderly or his designee, or by the 7 resident's individual physician. 8 (b) Immediate access to a resident, subject to the resident's right to 9 deny or withdraw consent at any time, by immediate family or other rela- 10 tives. 11 (c) Immediate access to a resident, subject to reasonable restrictions 12 and the resident's right to deny or withdraw consent at any time, by 13 others who are visiting with the consent of the resident. 14 (d) Reasonable access to a resident by any entity or individual that pro- 15 vides health, social, legal or other services to the resident, subject to 16 the resident's right to deny or withdraw consent at any time. 17 (8) Employment. Each resident shall have the right to refuse to perform 18 services for the facility except as contracted for by the resident and the 19 operator of the facility. If the resident is hired by the facility to perform 20 services as an employee of the facility, the wage paid to the resident shall 21 be consistent with state and federal law. 22 (9) Confidentiality. Each resident shall have the right to confidential- 23 ity of personal and clinical records. 24 (10) Freedom from abuse, neglect and restraints. Each resident shall have 25 the right to be free from physical, mental or sexual abuse, neglect, corporal 26 punishment, involuntary seclusion, and any physical or chemical restraints 27 imposed for purposes of discipline or convenience. 28 (11) Freedom of religion. Each resident shall have the right to practice 29 the religion of his choice or to abstain from religious practice. Residents 30 shall also be free from the imposition of the religious practices of others. 31 (12) Control and receipt of health-related services. Each resident shall 32 have the right to control his receipt of health-related services, including: 33 (a) The right to retain the services of his own personal physician,and34 dentist and other health care professionals. 35 (b) The right to select the pharmacy or pharmacist of his choice. 36 (c) The right to confidentiality and privacy concerning his medical or 37 dental condition and treatment. 38 (13) Grievances. Each resident shall have the right to voice grievances 39 with respect to treatment or care that is (or fails to be) furnished, without 40 discrimination or reprisal for voicing the grievances and the right to prompt 41 efforts by the facility to resolve grievances the resident may have, includ- 42 ing those with respect to the behavior of other residents. 43 (14) Participation in resident and family groups. Each resident shall have 44 the right to organize and participate in resident groups in the facility and 45 the right of the resident's family to meet in the facility with the families 46 of other residents in the facility. 47 (15) Participation in other activities. Each resident shall have the right 48 to participate in social, religious and community activities that do not 49 interfere with the rights of other residents in the facility. 50 (16) Examination of survey results. Each resident shall have the right to 51 examine, upon reasonable request, the results of the most recent survey of the 52 facility conducted by the department with respect to the facility and any plan 53 of correction in effect with respect to the facility. 54 (17) Other rights. Each resident shall have any other right established by 55 the department. 38 1 SECTION 75. That Section 39-3518, Idaho Code, be, and the same is hereby 2 amended to read as follows: 3 39-3518. FACILITY RESPONSE TO INCIDENTS AND COMPLAINTS. (1) In addition 4 to any other requirements of this chapter, the licensed residentialcareor 5 assisted living facility for the elderly shall provide a procedure approved by 6 the licensing agency for immediate response to incidents and complaints. This 7 procedure shall include a method of assuring that the owner, licensee, or per- 8 son designated by the owner or licensee is notified of the incident, that the 9 owner, licensee or person designated by the owner or licensee has personally 10 investigated the matter, and that the person making the complaint or reporting 11 the incident has received a response of action taken or a reason why no action 12 needs to be taken. In the case of anonymous complaints, the 13 administrator/operator shall document the action taken or a reason why no 14 action needs to be taken. 15 (2) In order to assure the opportunity for complaints from the residents, 16 the neighborhood and the community to be made directly to the owner, licensee, 17 or person designated by the owner or licensee, each facility shall establish a 18 regular time when the owner, licensee, or person designated by the owner or 19 licensee will be present to respond to such incidents or complaints. 20 SECTION 76. That Section 39-3519, Idaho Code, be, and the same is hereby 21 amended to read as follows: 22 39-3519. ACCESS BY ADVOCATES AND REPRESENTATIVES. A licensed residential 23careor assisted living facility for the elderly shall permit advocates and 24 representatives of community legal services programs, whose purposes include 25 rendering assistance without charge to residents, to have access to the facil- 26 ity at reasonable times in order to: 27 (1) Visit, talk with, and make personal, social and legal services avail- 28 able to all residents. 29 (2) Inform residents of their rights and entitlements, and their corre- 30 sponding obligations under state, federal and local laws by distribution of 31 educational materials and discussion in groups and with individuals. 32 (3) Assist residents in asserting their legal rights regarding claims for 33 public assistance, medical assistance and social security benefits, as well as 34 in all other matters in which residents are aggrieved, which may be provided 35 individually or in a group basis, and may include organizational activity, 36 counseling and litigation. 37 (4) Engage in all other methods of assisting, advising and representing 38 residents so as to extend to them the full enjoyment of their rights. 39 (5) Communicate privately and without restrictions with any resident who 40 consents to the communication. 41 (6) Observe all common areas of the facility. 42 SECTION 77. That Section 39-3520, Idaho Code, be, and the same is hereby 43 amended to read as follows: 44 39-3520. RESIDENT COUNCILS. (1) Every licensed residentialcareor 45 assisted living facility for the elderly over fifteen (15) beds shall assist 46 the residents in establishing and maintaining a resident council. The council 47 shall be composed of residents of the facility and may include their family 48 members. The council may extend membership to advocates, friends and others. 49 (2) The council shall have the following duties: 50 (a) To assist the facility in developing a grievance procedure. 39 1 (b) To communicate resident opinions and concerns. 2 (c) To obtain information from the facility and disseminate the informa- 3 tion to the residents. 4 (d) To identify problems and participate in the resolution of those prob- 5 lems. 6 (e) To act as a liaison with the community. 7 (3) This section may be waived provided that the operator meets regu- 8 larly with residents and that residents decline to participate in a formal 9 council and appropriate documentation exists to indicate the residents' deci- 10 sion. 11 SECTION 78. That Section 39-3521, Idaho Code, be, and the same is hereby 12 amended to read as follows: 13 39-3521. QUALIFICATIONS AND REQUIREMENTS OF ADMINISTRATOR/OPERATOR. Each 14 licensed residentialcareor assisted living facility for the elderly must 15 employ at least one (1) full-time administrator licensed by the board respon- 16 sible for licensing residentialcareor assisted living administrators for the 17 state of Idaho who: 18 (1) Is of good moral and responsible character and has not been 19 convicted, or is not under the influence or control of anyone convicted, of 20any felony or defrauding the federal government: 21 (a) A criminal offense related to the delivery of an item or service 22 under medicare, medicaid or other state health care program; or 23 (b) A criminal offense related to the neglect or abuse of a patient, in 24 connection with the delivery of a health care item or service; or 25 (c) A criminal offense related to fraud, theft, embezzlement, breach of 26 fiduciary responsibility, or other financial misconduct; or 27 (d) A criminal offense resulting in death or injury to a person. 28 (2) Has sufficient physical, emotional and mental capacity to carry out 29 the requirements of this chapter. 30 (3) Has sufficient management and administrative ability to carry out the 31 requirements of this chapter. 32 Multiple facilities under one (1) administrator may be allowed by the 33 department based upon an approved plan of operation. 34 SECTION 79. That Section 39-3522, Idaho Code, be, and the same is hereby 35 amended to read as follows: 36 39-3522. QUALIFICATIONS AND REQUIREMENTS FOR FACILITY STAFF. Each facil- 37 ity must employ or arrange for sufficientlytrained staff to fully meet the 38 needs of its residents and the requirements of this chapter. The facility 39 shall have sufficient staff to provide care during all hours required in each 40 resident's negotiated service plan. Additional staff may be required if physi- 41 cal plant conditions and disability of residents indicate that staff assis- 42 tance in emergencies is required. Benchmarks shall be established in the 43 assessment criteria where the need for certificated nursing assistants or 44 licensed nurses is indicated. Licensed rResidentialcareor assisted living 45 facilities shall not retain residents who requireroutine nursing care on a46daily basisthe care provided by nursing facilities under section 39-1301(b), 47 Idaho Code, other than for short exceptional stays pursuant to negotiated 48 rulemaking as defined in chapter 52, title 67, Idaho Code. 49 SECTION 80. That Section 39-3524, Idaho Code, be, and the same is hereby 50 amended to read as follows: 40 1 39-3524. STAFF TRAINING. All employees of a licensed residentialcareor 2 assisted living facility for the elderly shall receive department approved 3 orientation and continuing education pertinent to their job responsibilities. 4 SECTION 81. That Section 39-3525, Idaho Code, be, and the same is hereby 5 amended to read as follows: 6 39-3525. REQUIREMENTS FOR LOCATION AND PHYSICAL ENVIRONMENT OF FACILI- 7 TIES. (1) Licensed rResidentialcareor assisted living facilities for the 8 elderly shall: 9 (a) Be located in geographical areas which are accessible to supportive 10 services and are free from conditions which would pose a danger to the 11 residents. 12 (b) Be maintained internally and externally in good repair and condition. 13 (c) Be maintained in a clean and sanitary manner, including proper sewage 14 disposal, food handling and hygiene practices. 15 (d) Be maintained in such a manner as to be free from fire/safety haz- 16 ards. 17 (2) The department shall promulgate rules concerning physical structure, 18 fire safety, health and sanitation, household items and furnishings, diet, 19 self-administered medications and rooms. 20 SECTION 82. That Section 39-3530, Idaho Code, be, and the same is hereby 21 amended to read as follows: 22 39-3530. RESIDENTIALCAREOR ASSISTED LIVING COUNCIL FOR THE ELDERLY. (1) 23 The department shall establish a residentialcareor assisted living council 24 for the elderly consisting ofeighttwelve (812) members appointed by the 25 director. The director, or his designee, shall serve as chairman of the coun- 26 cil. The members of the council shall be: 27 (a) The state ombudsman for the elderly or his designee. 28 (b) The director of the bureau of facility standards or his designee. 29 (c) An advocate for individuals who are elderly in the state. 30 (d) Four (4) administrators or licensees of licensed residentialcareor 31 assisted living facilities for the elderly, one (1) of whom shall repre- 32 sent facilities licensed for nine (9) beds or less, one (1) of whom shall 33 represent facilities licensed for ten (10) to sixty (60) beds, one (1) of 34 whom shall represent facilities licensed for sixty-one (61) beds or more, 35 and one (1) of whom represents a combination of nursing facility and resi- 36 dentialcareor assisted living facility. 37 (e) Four (4) certified family home providers certified under this chap- 38 ter. 39 (2) In appointing the first members of the council who are not state 40 agency representatives, the director shall appoint one (1) member for a term 41 of one (1) year, one (1) member for a term of two (2) years and two (2) mem- 42 bers for a term of three (3) years. After the initial appointments, members 43 who are not state agency representatives shall serve three (3) year terms. A 44 vacancy shall be filled for the remainder of the unexpired term from the same 45 class of persons represented by the outgoing member. 46 SECTION 83. That Section 39-3531, Idaho Code, be, and the same is hereby 47 amended to read as follows: 48 39-3531. POWERS AND DUTIES. The residentialcareor assisted living coun- 49 cil for the elderly shall have the following powers and duties: 41 1 (1) To make policy recommendations regarding the coordination of licens- 2 ing, certifying and enforcement standards in residentialcareor assisted liv- 3 ing facilities for the elderly and the provision of services to residents of 4 board and care facilities. 5 (2) To advise the department regarding methods for identification of 6 unlicensed residentialcareor assisted living facilities for the elderly. 7 (3) To advise the agency during development and revision of rules. 8 (4) To review and comment upon proposed rules. 9 (5) To submit an annual report to the legislature stating opinions and 10 recommendations which would further the state's capability in addressing resi- 11 dentialcareor assisted living for the elderly issues. 12 SECTION 84. That Section 39-3532, Idaho Code, be, and the same is hereby 13 amended to read as follows: 14 39-3532. MEETINGS. The residentialcareor assisted living council for 15 the elderly shall meet as necessary but not less than two (2) times a year. 16 Meetings of the council shall be open to the public. The department shall pro- 17 vide: 18 (1) Staff necessary to assist the council in performing its duties. 19 (2) Space for meetings of the council. 20 SECTION 85. That Section 39-3533, Idaho Code, be, and the same is hereby 21 amended to read as follows: 22 39-3533. REIMBURSEMENT OF EXPENSES. Members of the residentialcareor 23 assisted living council for the elderly shall be reimbursed by the department 24 for their actual expenses incurred in the performance of their duties. 25 SECTION 86. That Section 39-3540, Idaho Code, be, and the same is hereby 26 amended to read as follows: 27 39-3540. LICENSING OF RESIDENTIALCAREOR ASSISTED LIVING FACILITIES FOR 28 THE ELDERLY. After July 1, 1993, no person, firm, partnership, association, or 29 corporation within the state and no state or local public agency shall oper- 30 ate, establish, manage, conduct or maintain a residentialcareor assisted 31 living facility for the elderly in the state without a current valid license 32 issued by the licensing agency of the department. 33 SECTION 87. That Section 39-3541, Idaho Code, be, and the same is hereby 34 amended to read as follows: 35 39-3541. INITIAL APPLICATION AND ISSUANCE OF A LICENSE. Any person or 36 governmental unit proposing to operate a residentialcareor assisted living 37 facility for the elderly shall apply for a license to the licensing agency 38 specifying the types of residents to be served and the level(s) of care to be 39 provided. 40 SECTION 88. That Section 39-3542, Idaho Code, be, and the same is hereby 41 amended to read as follows: 42 39-3542. APPLICATION. The applicant shall apply for a license upon forms 43 provided by the licensing agency giving such information as the licensing 44 agency shall require including, but not limited to: 45 (1) Evidence satisfactory to the licensing agency of the ability of the 42 1 applicant to comply with the provisions of this chapter and with the rules 2 adopted under this chapter by the department. 3 (2) Evidence satisfactory to the department that the applicant is of rep- 4 utable and responsible character. 5 (3) The evidence shall include, but not be limited to: 6 (a) A criminal record clearance; 7 (b) Fingerprinting; 8 (c) Employment history; 9 (d) Credit report; 10 (e) Character references. 11 (4) If the applicant is a firm, association, organization, partnership, 12 business trust, corporation or company, like evidence shall be submitted as to 13 the members or shareholders holding ten percent (10%) or more interest 14 thereof, and the administrator/operator of the residentialcareor assisted 15 living facility for the elderly. 16 (5) Evidence satisfactory to the licensing agency that the applicant has 17 sufficient financial resources to maintain the standards of service required 18 by rules adopted pursuant to this chapter. 19 (6) Evidence satisfactory to the licensing agency that the 20 administrator/operator has successfully completed the department approved ori- 21 entation. 22 (7) Disclosure of any revocation or other disciplinary action taken, or 23 in the process of being taken, against a license held or previously held by 24 the entities in Idaho as specified in section 39-3545, Idaho Code, or any 25 other jurisdiction. 26 (8) Any other information as may be required by the licensing agency for 27 the proper administration and enforcement of the provisions of this chapter. 28 (9) Failure of the applicant to cooperate with the licensing agency in 29 the completion of the application shall result in the denial of the applica- 30 tion. Failure to cooperate means that the information described in this sec- 31 tion and in rules of the department has not been provided, or not provided in 32 the form requested by the licensing agency, or both. 33 (10) A signed statement that the person desiring issuance or renewal of a 34 license has read and understands the provisions of this chapter and residen- 35 tialcareor assisted living facilities for the elderly rules. 36 SECTION 89. That Section 39-3545, Idaho Code, be, and the same is hereby 37 amended to read as follows: 38 39-3545. DENIAL OR REVOCATION OF A LICENSE. The licensing agency may deny 39 the issuance of a license or revoke any license when persuaded by a preponder- 40 ance of evidence that such conditions exist as to endanger the health or 41 safety of any resident, or when the facility is not in substantial compliance 42 withtheany provisionsof this chapterandor the rules promulgated pursuant 43 to this chapter. 44 SECTION 90. That Section 39-3548, Idaho Code, be, and the same is hereby 45 amended to read as follows: 46 39-3548. RULES PROVIDED. Upon initial licensure, residentialcareor 47 assisted living facilities for the elderly shall be provided a printed copy of 48 all applicable rules by the department, without charge. 49 SECTION 91. That Section 39-3549, Idaho Code, be, and the same is hereby 50 amended to read as follows: 43 1 39-3549. RESPONSIBILITY FOR INSPECTIONS AND LICENSING -- NONTRANSFERABIL- 2 ITY OF LICENSES. The licensing agency shall inspect and license residential 3careor assisted living facilities for the elderly. A license is not transfer- 4 able. 5 SECTION 92. That Section 39-3550, Idaho Code, be, and the same is hereby 6 amended to read as follows: 7 39-3550. CONSULTING SERVICES. The department may provide consulting ser- 8 vices upon request to any residentialcareor assisted living facility for the 9 elderly to assist in the identification or correction of deficiencies and in 10 the upgrading of the quality of care provided by the facility. 11 SECTION 93. That Section 39-3552, Idaho Code, be, and the same is hereby 12 amended to read as follows: 13 39-3552. UNLICENSED RESIDENTIALCAREOR ASSISTED LIVING FACILITIES FOR 14 THE ELDERLY. (1) No unlicensed residentialcareor assisted living facility 15 for the elderly shall operate in this state. 16 (2) A facility shall be deemed to be an "unlicensed residentialcareor 17 assisted living facility for the elderly" and "maintained and operated to pro- 18 vide residentialcareor assisted living for the elderly" if it is unlicensed 19 and not exempt from licensure, and any one (1) of the following conditions is 20 satisfied: 21 (a) The facility is, or is held out as or represented as, providing care, 22 supervision and services. 23 (b) The facility accepts or retains residents who demonstrate the need 24 for care, supervision and services, as defined by this chapter or the 25 rules adopted pursuant to this chapter. 26 (3) Upon discovery of an unlicensed residentialcareor assisted living 27 facility for the elderly, the department shall refer residents to the appro- 28 priate placement or adult protective services agency if either of the follow- 29 ing conditions exist: 30 (a) There is an immediate threat to the resident's health and safety. 31 (b) The facility will not cooperate with the licensing agency to apply 32 for a license, meet licensing standards, and obtain a valid license. 33 (4) A person found to be operating a residentialcareor assisted living 34 facility for the elderly without a license shall be guilty of a misdemeanor 35 punishable by imprisonment in a county jail not to exceed six (6) months, or 36 by a fine not to exceed five thousand dollars ($5,000). 37 (5) In the event the county attorney in the county where the alleged 38 violation occurred fails or refuses to act within thirty (30) days of notifi- 39 cation of the violation, the attorney general is authorized to prosecute 40 violations under the provisions of this section. 41 SECTION 94. That Section 39-3553, Idaho Code, be, and the same is hereby 42 amended to read as follows: 43 39-3553. PLACEMENT OF PERSONS INTO AN UNLICENSED RESIDENTIALCAREOR 44 ASSISTED LIVING FACILITY FOR THE ELDERLY. No person or public agency employee 45 shall place, refer or recommend placement of a person into a residentialcare46 or assisted living facility for the elderly which is operating without a 47 license. 48 Failure to comply with the provisions of this subsection shall constitute 49 a misdemeanor. 44 1 SECTION 95. That Section 39-3554A, Idaho Code, be, and the same is hereby 2 amended to read as follows: 3 39-3554A. SPECIAL WAIVER PERMITTED. The department may grant a special 4 waiver of the requirement for licensure as a residentialcareor assisted liv- 5 ing facility for the elderly when it is deemed in the best interests of indi- 6 viduals and with due consideration of the following criteria: 7 (1) The individuals are residents of a facility operated by a nonprofit 8 health care and/or housing organization established as such in the state of 9 Idaho and satisfying the requirements of U.S. Internal Revenue Code section 10 501(c); 11 (2) The support services required by the individuals are furnished by an 12 entity approved to provide such services in the state of Idaho in good stand- 13 ing as demonstrated by routine inspections required for the type of entity 14 providing services; 15 (3) Facilities seeking such waivers and providing meal service shall be 16 inspected and licensed as a food service establishment by the district health 17 department unless the meal service is provided by a kitchen already part of a 18 facility licensed by the department; 19 (4) The costs of obtaining the needed services from another source are 20 significantly greater and/or would pose a significant hardship on these indi- 21 viduals. 22 Any waiver granted under this section shall be reviewed annually and is 23 subject to inspection by the department to ensure safety and sanitation. 24 SECTION 96. That Section 39-3555, Idaho Code, be, and the same is hereby 25 amended to read as follows: 26 39-3555. INSPECTIONS. (1) The licensing agency shall cause to be made 27suchinspections and investigationsas it may deem necessaryat least every 28 twelve (12) months to determine compliance with the provisions of this chapter 29 and applicable rules. 30 (2) All inspections for such purposes will be made unannounced and with- 31 out prior notice at intervals determined by the licensing agency. 32 (3) An inspector shall have full access and authority to examine, among 33 other things, quality of care and service delivery, a facility's records, res- 34 ident accounts, physical premises, including buildings, grounds and equipment, 35 and any other areas necessary to determine compliance with the provisions of 36 this chapter and applicable rules. 37 (4) An inspector shall have authority to interview the licensee, 38 administrator/operator, staff and residents. Interviews with residents shall 39 be confidential and conducted privately unless otherwise specified by the res- 40 ident. 41 (5) The licensing agency shall notify the facility, in writing, of all 42 deficiencies and shall approve a reasonable length of time for compliance by 43 the facility. 44 (6) Current lists of deficiencies, including plans of correction, shall 45 be available to the public upon request in the individual facilities or by 46 written request to the regional office of the department or the licensing 47 agency. 48 SECTION 97. That Section 39-3557, Idaho Code, be, and the same is hereby 49 amended to read as follows: 50 39-3557. ENFORCEMENT PROCESS. (1) If the licensing agency finds, on the 45 1 basis of inspections as defined in this chapter or otherwise, that a residen- 2 tialcareor assisted living facility for the elderly no longer meets a 3 requirement of this chapter, and further finds that the facility's deficien- 4 cies: 5 (a) Immediately jeopardize the health or safety of its residents, the 6 department shall take immediate action to remove the jeopardy and correct 7 the deficiencies through the remedy specified in section 39-3558(1)(c), 8 Idaho Code, or prohibit the facility from keeping or admitting residents 9 and may provide, in addition, for one (1) or more of the other remedies 10 described in section 39-3558, Idaho Code. 11 (b) Do not immediately jeopardize the health or safety of its residents, 12 the department shall provide for one (1) or more of the remedies described 13 in section 39-3558, Idaho Code. 14 (2) Nothing in this section shall be construed as restricting the reme- 15 dies available to the department to remedy a facility's deficiencies. If the 16 department finds that a facility meets the requirements of this chapter, but, 17 as of a previous period, intentionally did not meet such requirements, the 18 department may provide for a civil money penalty under section 39-3558(1)(b), 19 Idaho Code, for the days in which it finds that the facility was not in com- 20 pliance with such requirements. 21 SECTION 98. That Section 39-3558, Idaho Code, be, and the same is hereby 22 amended to read as follows: 23 39-3558. SPECIFIED REMEDIES. (1) The department shall establish at least 24 the following remedies: 25 (a) Prohibit the facility from admitting residents or prohibit a facility 26 from keeping or admitting residents with a specific diagnosis. 27 (b) A civil money penalty assessed and collected, with interest, for each 28 day the facility is or was out of compliance with a requirement of this 29 chapter. Funds collected by the department as a result of imposition of 30 such a penalty shall be applied to the protection of the health or prop- 31 erty of residents of residentialcareor assisted living facilities for 32 the elderly that the department finds deficient, including payment for the 33 costs of relocation of residents to other facilities, maintenance of oper- 34 ation of a facility pending correction of deficiencies or closure, and 35 reimbursement of residents for personal funds lost. 36 (c) The appointment of temporary management to oversee the operation of 37 the facility and to assure the health and safety of the facility's resi- 38 dents, where there is a need for temporary management while: 39 (i) There is an orderly closure of the facility. 40 (ii) Improvements are made in order to bring the facility into com- 41 pliance with all the requirements of this chapter. 42 (iii) The temporary management under this clause shall not be termi- 43 nated until the department has determined that the facility has the 44 management capability to ensure continued compliance with all the 45 requirements of this chapter. 46 (d) The authority, in the case of an emergency, to summarily suspend the 47 license, to close the facility, and/or to transfer residents in that 48 facility to other facilities. 49 (2) The department shall also specify criteria as to when and how each of 50 such remedies is to be applied, the amounts of any fines, and the severity of 51 each of these remedies, to be used in the imposition of such remedies. Such 52 criteria shall be designed so as to minimize the time between the identifica- 53 tion of violations and final imposition of the remedies and shall provide for 46 1 the imposition of incrementally more severe fines for repeated or uncorrected 2 deficiencies. 3 SECTION 99. That Section 39-3559, Idaho Code, be, and the same is hereby 4 amended to read as follows: 5 39-3559. TRANSFER OF RESIDENTS. The department may transfer residents 6 from a residentialcareor assisted living facility for the elderly to an 7 alternative placement on the following grounds: 8 (1) As a result of a violation of a provision of this chapter or an 9 applicable rule the facility is unable or unwilling to provide an adequate 10 level of meals, lodging, personal assistance or supervision to persons resid- 11 ing in the facility at the time of the violation. 12 (2) A violation of a resident's rights as provided in section 39-3516, 13 Idaho Code. 14 (3) The number of residents currently in the facility exceeds the number 15 of residents the facility is licensed to serve. 16 (4) The facility is operating without a license. 17 (5) A violation of a provision of this chapter or an applicable rule 18 results in conditions that present an imminent danger. 19 SECTION 100. That Section 39-3560, Idaho Code, be, and the same is hereby 20 amended to read as follows: 21 39-3560. PURPOSE OFADULT FOSTER CARECERTIFIED FAMILY HOMES. The purpose 22 of an adult foster carecertified family home in Idaho is to provide a resi- 23 dential alternative designed to allow elderly persons to remain in more normal 24 family-style living, usually within their own communities.Families who pro-25vide adult foster care share their homes with elderly persons who are able to26administer their own medications but who need assistance with activities of27daily living. Persons who live in adult foster care are thoseCertified family 28 homes provide a home to persons who are elderly,or unable to live alone 29 and/orwhose mental, emotional and physical conditionsare such that the care30givencan be met by thefostercare provider.will meet the person's needs.31Individuals requiring nursing home care, or who are unable to administer their32own medication, are not suitable for adult foster careThe home must obtain a 33 waiver under section 39-1301A, Idaho Code, to care for two (2) persons requir- 34 ing the care described in section 39-1301(b), Idaho Code. Homes may add ser- 35 vices which will allow an individual's needs to be met. 36 SECTION 101. That Section 39-3561, Idaho Code, be, and the same is hereby 37 amended to read as follows: 38 39-3561. RULES. The board shall have the power and it shall be its duty 39 to promulgate appropriate rules necessary to implement and enforce the stan- 40 dards forcertifying adult foster carecertified family homes pursuant to this 41 act including, but not limited to, the following: 42 (1) A home shall be certified for no more than two (2) adults, however, 43 upon an application by the owner and upon a finding by the department that 44 residents can be cared for safely and appropriately based on the residents' 45 specific needs, the department may authorize not more than four (4) adults to 46 be placed in a certified family home which is owner-occupied and which applies 47 to the department for the authorization. Certification as a four (4) resident 48 certified family home shall not be transferable to another person or entity. 49 Four (4) resident certified family homes shall be subject to all statutes and 47 1 rules governing certified family homes but shall not be subject to the resi- 2 dential or assisted living administrator licensing requirements of chapter 42, 3 title 54, Idaho Code, section 39-3340, Idaho Code, licensing of residential or 4 assisted living facilities for the mentally ill, developmentally disabled and 5 physically disabled, or section 39-3540, Idaho Code, licensing of residential 6 or assisted living facilities for the elderly. This provision implementing 7 four (4) resident certified family homes shall be effective on July 1, 2001. 8 Prior to the effective date, the department shall promulgate rules for four 9 (4) resident certified family homes through the negotiated rulemaking process. 10 Nothing in this subsection shall be construed to authorize increased group 11 size for providers of any form of care other than certified family homes. 12 (2) An adult fostercare provider may be a couple or a single individual. 13 (3) A home cannot be approved as a certified foradult fosterfamily home 14 care if it also provides room and board for other persons. 15 (4) A home cannot be approved as a certifiedfor adult foster carefamily 16 home and for child foster care at the same time, unless a waiver is granted by 17 the department. 18 (5) Theadult fostercare provider must have sufficient income to main- 19 tain the home and the services offered. 20 (6) Information obtained by thefostercare provider shall be held confi- 21 dential except to representatives of the department to provide services or 22 determine compliance with this chapter or upon consent of the individual or 23 his legal guardian. 24 (7) Recordkeeping and reporting requirements as may be deemed necessary. 25 (8) Requirements to assure the safety and adequate care of residents. 26 (9) Until July 1, 1994, residential care facilities serving four (4) or 27 fewer residents and holding a valid license or with an application for a 28 license pending with the department as of July 1, 1994, shall have the option 29 of being certified as an adult foster carecertified family home. Certifica- 30 tion as an adult foster carecertified family home under this subsection shall 31 not be transferable to another person or entity.Adult foster careCertified 32 family home providers certified under this subsection shall not be subject to 33residential care administratorthe licensing requirements of chapter 42, title 34 54, Idaho Code,orsection 39-3340, Idaho Code,licensing of residential care35facilities for the mentally ill, developmentally disabled and physically dis-36abled,or section 39-3540, Idaho Code, licensing of residential care facili-37ties for the elderly. This provision in and of itself shall not be construed 38 to authorize increased group size for providers of any form of care other than 39adult foster carecertified family homes. 40 SECTION 102. That Section 39-3562, Idaho Code, be, and the same is hereby 41 amended to read as follows: 42 39-3562. APPLICATION FOR CERTIFICATION. An application for certification 43 shall be made to regional offices of the department upon forms provided by the 44 department and shall contain such information as the department reasonably 45 requires which will include a background check and fingerprinting with the 46 Idaho department of law enforcement. Following receipt of an application, the 47 department shall conduct a study, including a visit to the home, to determine 48 the capability of the provider to provideadult fostercare as a certified 49 family home. 50 SECTION 103. That Section 39-3563, Idaho Code, be, and the same is hereby 51 amended to read as follows: 48 1 39-3563. ISSUANCE AND RENEWAL OF CERTIFICATION. Each certificate shall be 2 issued only for the home andfoster careprovider named in the application and 3 shall not be transferable or assignable. Eachadult foster carecertified fam- 4 ily home is required to renewtheirits certification annually. The applica- 5 tion for renewal shall be filed with the regional office of the department 6 within thirty (30) days prior to the date of expiration. The existing certifi- 7 cate, unless suspended or revoked, shall remain in force and effect until the 8 department has acted upon the application renewal when such application for 9 renewal is timely filed. 10 SECTION 104. That Section 39-3564, Idaho Code, be, and the same is hereby 11 amended to read as follows: 12 39-3564. TEMPORARY CERTIFICATION. Upon initial investigation, should an 13 applicant for a certificate be unable to meet a standard because of conditions 14 that are unlikely to endure beyond six (6) months, the department may grant a 15 temporary certificate pending the satisfactory correction of all deficiencies 16 and provided that the deficiencies do not jeopardize the health and safety of 17 residents. No more than one (1) provisional certificate shall be issued to the 18 sameadult foster carecertified family home in any twelve (12) month period. 19 SECTION 105. That Section 39-3568, Idaho Code, be, and the same is hereby 20 amended to read as follows: 21 39-3568. RULES PROVIDED. Upon initial certification,adult foster care22 certified family homes shall be provided a printed copy of all applicable 23 rules by the department, without charge. 24 SECTION 106. That Section 39-3569, Idaho Code, be, and the same is hereby 25 amended to read as follows: 26 39-3569. MANDATORY INSPECTIONS. For the purpose of determining whether 27 everyadult foster carecertified family home consistently maintains confor- 28 mity with the standards established under the authority herein, the depart- 29 ment, through a certifying agent, shall visit the premises of each homeas it30deems necessary but in any event at intervals not to exceed sixat least every 31 twelve (612) months. 32 SECTION 107. That Section 39-3570, Idaho Code, be, and the same is hereby 33 amended to read as follows: 34 39-3570. ENFORCEMENT PROCESS. Section 39-3557, Idaho Code, governing res- 35 identialcareor assisted living facilities shall also governadult foster36carecertified family homes. 37 SECTION 108. That Section 39-3571, Idaho Code, be, and the same is hereby 38 amended to read as follows: 39 39-3571. OPERATING WITHOUT CERTIFICATION -- MISDEMEANOR. Any person who 40 operates an adult foster carecertified family home within the state without 41 first obtaining certification as provided in this chapter shall be guilty of a 42 misdemeanor. 43 SECTION 109. That Section 39-3572, Idaho Code, be, and the same is hereby 44 amended to read as follows: 49 1 39-3572. PLACEMENT OF PERSONS INTO ANUNLICENSED ADULT FOSTER CAREUNCER- 2 TIFIED FAMILY HOME. Section 39-3553, Idaho Code, governing residentialcareor 3 assisted living facilities shall also governunlicensed adult foster care4 uncertified family homes. 5 SECTION 110. That Section 39-3573, Idaho Code, be, and the same is hereby 6 amended to read as follows: 7 39-3573. NEGOTIATED SERVICE AGREEMENT. The negotiated service agreement 8 as set out in section 39-35089, Idaho Code, shall govern the content, prepara- 9 tion and review of the negotiated service agreement for residents ofadult10foster carecertified family homes. 11 SECTION 111. That Chapter 35, Title 39, Idaho Code, be, and the same is 12 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 13 ignated as Section 39-3573A, Idaho Code, and to read as follows: 14 39-3573A. PHYSICIAN'S ORDER FOR CERTIFIED FAMILY HOMES. The physician's 15 order as set out in section 39-3511, Idaho Code, governing licensed residen- 16 tial or assisted living facilities for the elderly shall also govern certi- 17 fied family homes. 18 SECTION 112. That Section 39-3574, Idaho Code, be, and the same is hereby 19 amended to read as follows: 20 39-3574. WRITTEN SERVICE PLAN. The department and thefostercare 21 providers serving clients of the department shall negotiate a written plan 22 annually. The purpose of the plan shall be to ensure that a client receives 23 the level of care based upon the negotiated service agreement as described in 24 sections 39-3503 and 39-350839-3509, Idaho Code. The plan is to establish a 25 basis for coordination and communication between thefosterhome family and 26 the department. The plan shall be maintained in the home. 27 SECTION 113. That Section 39-3575, Idaho Code, be, and the same is hereby 28 amended to read as follows: 29 39-3575.FOSTER CAREAGREEMENTS. Eachfostercare provider shall negoti- 30 ate a written, signed and dated agreement between thefostercare provider and 31 a resident specifying the amount of monthly payment to be paid by the resident 32 and the method for payment. 33 SECTION 114. That Section 39-3576, Idaho Code, be, and the same is hereby 34 amended to read as follows: 35 39-3576. RESIDENT RIGHTS. Section 39-3516, Idaho Code, governing licensed 36 residentialcareor assisted living facilities shall also governadult foster37carecertified family homes. 38 SECTION 115. That Section 39-3577, Idaho Code, be, and the same is hereby 39 amended to read as follows: 40 39-3577. TRAINING. The department shall insure thatfostercare providers 41 receive, at a minimum, training which shall include the rights of the resi- 42 dent, and a basic understanding of the psychosocial and physical needs of res- 43 idents to be served. The department will specify annual continuing education 50 1 requirements forfostercare providers. 2 SECTION 116. That Section 39-3578, Idaho Code, be, and the same is hereby 3 amended to read as follows: 4 39-3578. PHYSICAL AND ENVIRONMENTAL STANDARDS. Standards shall be devel- 5 oped through the regulatory process by the department to insure a safe, sani- 6 tary and comfortable environment for residents ofadult foster carecertified 7 family homes. 8 SECTION 117. That Section 39-3580, Idaho Code, be, and the same is hereby 9 amended to read as follows: 10 39-3580. APPLICATION OF PROVISIONS. The provisions of section 39-35089, 11 Idaho Code, governing licensed residentialcareor assisted living facili- 12 ties, shall also governadult foster carecertified family homes. Any individ- 13 ual providing care and housing commercially to the elderly general public 14 shall at a minimum meet the requirements of this chapter or other provision of 15 law governing care and housing for the elderly if those provisions are more 16 restrictive. 17 SECTION 118. That Section 39-4803, Idaho Code, be, and the same is hereby 18 amended to read as follows: 19 39-4803. IMMUNIZATION REGISTRY. (1) The department of health and welfare 20 shall provide for the establishment of a voluntary registry of the immuniza- 21 tion status of Idaho children against childhood diseases. The registry may be 22 maintained and its data disclosed as set out herein to further the following 23 purposes: 24 (a) To make immunizations readily available to every Idaho citizen that 25 desires to have their child immunized; 26 (b) To increase the voluntary immunization rate in Idaho to the maximum 27 extent possible without mandating such immunizations; 28 (c) To recognize and respect the rights of parents and guardians to make 29 health care decisions for their children; 30 (d) To provide for timely reminders to parents of children in the regis- 31 try. 32 (2) The name of a child or information relating to the immunization sta- 33 tus of that child may be collected or included in the registry only upon the 34 separate and specific written authorization of a parent, guardian or other 35 person legally responsible for the care of the child. Such authorization may 36 not be part of a general authorization or release. The registry may contain 37 only the following information for each child: 38 (a) The child's name, address and birth date; 39 (b) The name and address of each parent of the child; 40 (c) The month, day, year and type of each immunization that has been 41 administered to the child; 42 (d) The name, address and phone number of each provider that has adminis- 43 tered an immunization to the child; 44 (e) If requested by a parent or guardian, any statement made pursuant to 45 subsection (4) of this section; 46 (f) Other information as authorized or requested by a parent or guardian. 47 (3) The department of health and welfare may only disclose information 48 relating to an individual child in the registry to the following upon a spe- 49 cific request: 51 1 (a) Employees of the health district in which the child resides or seeks 2 medical services; 3 (b) Health records staff of the school or school district in which the 4 child is enrolled; 5 (c) The operator of a licensed child care facility in which the child is 6 enrolled; 7 (d) Persons who are legally responsible for the long-term care of the 8 child, including operators of licensed ICF/MR's and residentialcareor 9 assisted living facilities, adoptive and foster parents and a guardian 10 appointed pursuant to chapter 5, title 15, Idaho Code; 11 (e) Any health care provider rendering treatment to the child, and the 12 provider's agents; 13 (f) Any person possessing a lawful release, properly executed by the 14 child's parent or guardian; 15 (g) A parent of the child; 16 (h) Any hospital where the child is receiving care. 17 (4) A parent or guardian of the child shall have free and open access to 18 all information in the registry that relates to their child or themselves. 19 Upon the written request of a parent or guardian, the department of health and 20 welfare shall: 21 (a) Cause all information relating to the child to be removed from the 22 registry and any databases or files of other entities or persons to which 23 information in the database has been disclosed; 24 (b) Include in the registry the statement of a physician or parent pursu- 25 ant to section 39-4802(2) or 39-1118(2), Idaho Code. 26 (5) All information contained in the registry or disclosed from it is 27 confidential and may not be sold and may only be disclosed as specifically 28 authorized in this section. A person or entity to whom information is dis- 29 closed from the registry may not thereafter disclose it to others. Any person 30 who discloses or authorizes disclosure of any information contained in the 31 registry, except as authorized in this section is guilty of a misdemeanor and 32 is liable for civil damages in the amount of one hundred dollars ($100) for 33 each violation. 34 SECTION 119. That Section 39-5303, Idaho Code, be, and the same is hereby 35 amended to read as follows: 36 39-5303. DUTY TO REPORT CASES OF ABUSE, NEGLECT OR EXPLOITATION OF VUL- 37 NERABLE ADULTS. (1) Any physician, nurse, employee of a public or private 38 health facility, or a state licensed or certified residential facility serving 39 vulnerable adults, medical examiner, dentist, ombudsman for the elderly, 40 osteopath, optometrist, chiropractor, podiatrist, social worker, police offi- 41 cer, pharmacist, physical therapist, or home care worker who has reasonable 42 cause to believe that a vulnerable adult is being or has been abused, 43 neglected or exploited shall immediately report such information to the com- 44 mission. Provided however, thatskillednursing facilities defined in section 45 39-1301(b), Idaho Code, and employees of such facilities shall make reports 46 required under this chapter to the department. When there is reasonable cause 47 to believe that abuse or sexual assault has resulted in death or serious phys- 48 ical injury jeopardizing the life, health or safety of a vulnerable adult, any 49 person required to report under this section shall also report such informa- 50 tion within four (4) hours to the appropriate law enforcement agency. 51 (2) Failure to report as provided under this section is a misdemeanor 52 subject to punishment as provided in section 18-113, Idaho Code. If an 53 employee at a state licensed or certified residential facility fails to report 52 1 abuse or sexual assault that has resulted in death or serious physical injury 2 jeopardizing the life, health or safety of a vulnerable adult as provided 3 under this section, the department shall also have the authority to: 4 (a) Revoke the facility's license and/or contract with the state to pro- 5 vide services; 6 (b) Deny payment; 7 (c) Assess and collect a civil monetary penalty with interest from the 8 facility owner and/or facility administrator; 9 (d) Appoint temporary management; 10 (e) Close the facility and/or transfer residents to another certified 11 facility; 12 (f) Direct a plan of correction; 13 (g) Ban admission of persons with certain diagnoses or requiring special- 14 ized care; 15 (h) Ban all admissions to the facility; 16 (i) Assign monitors to the facility; or 17 (j) Reduce the licensed bed capacity. 18 Any action taken by the department pursuant to this subsection shall be 19 appealable as provided in chapter 52, title 67, Idaho Code. 20 (3) Any person, including any officer or employee of a financial institu- 21 tion, who has reasonable cause to believe that a vulnerable adult is being 22 abused, neglected or exploited may report such information to the commission 23 or its contractors. 24 (34) The commission and its contractors shall make training available to 25 officers and employees of financial institutions in identifying and reporting 26 instances of abuse, neglect or exploitation involving vulnerable adults. 27 (45) Any person who makes any report pursuant to this chapter, or who 28 testifies in any administrative or judicial proceeding arising from such 29 report, or who is authorized to provide supportive or emergency services pur- 30 suant to the provisions of this chapter, shall be immune from any civil or 31 criminal liability on account of such report, testimony or services provided 32 in good faith, except that such immunity shall not extend to perjury, reports 33 made in bad faith or with malicious purpose nor, in the case of provision of 34 services, in the presence of gross negligence under the existing circum- 35 stances. 36 (56) Any person who makes a report or allegation in bad faith, with mal- 37 ice or knowing it to be false, shall be liable to the party against whom the 38 report was made for the amount of actual damages sustained or statutory dam- 39 ages in the amount of five hundred dollars ($500), whichever is greater, plus 40 attorney's fees and costs of suit. If the court finds that the defendant acted 41 with malice or oppression, the court may award treble actual damages or treble 42 statutory damages, whichever is greater. 43 SECTION 120. That Section 39-5304, Idaho Code, be, and the same is hereby 44 amended to read as follows: 45 39-5304. REPORTING REQUIREMENTS, INVESTIGATION, EMERGENCY ACCESS. (1) 46 When a report is required pursuant to this chapter, such report shall be made 47 immediately to the commission or appropriate contractor. Provided however, 48 thatskillednursing facilities defined in section 39-1301(b), Idaho Code, and 49 employees of such facilities shall make reports required under this chapter to 50 the department. If known, the report shall contain the name and address of the 51 vulnerable adult; the caretaker; the alleged perpetrator; the nature and 52 extent of suspected abuse, neglect or exploitation; and any other information 53 that will be of assistance in the investigation. 53 1 (2) If the allegations in the report indicate that an emergency exists, 2 the commission or contractor must initiate an investigation immediately, and 3 initiate contact with the alleged vulnerable adult within twenty-four (24) 4 hours. All other investigations must be initiated within seventy-two (72) 5 hours. 6 (3) The investigation shall include a determination of the nature, extent 7 and cause of the abuse, neglect, or exploitation, examination of evidence and 8 consultation with persons thought to have knowledge of the circumstances and 9 identification, if possible, of the person alleged to be responsible for the 10 abuse, neglect or exploitation of the vulnerable adult. 11 (4) The investigation shall include an interview with the vulnerable 12 adult, if possible. The commission or contractor shall conduct the interview, 13 preferably, by means of a personal visit with the vulnerable adult in the 14 adult's dwelling. If that is not possible, the interview may occur in the 15 local office of the commission or contractor, or by telephone conversation, 16 or by any other means available to the commission or contractor. 17 (5) Upon completion of an investigation, the commission or contractor 18 shall prepare a written report of the investigation. The name of the person 19 making the original report or any person mentioned in the report shall not be 20 disclosed unless those persons specifically request such disclosure or unless 21 the disclosure is made pursuant to a request to law enforcement for emergency 22 access, a court order or hearing. 23 If the abuse, neglect, or exploitation is substantiated to have occurred 24 in a state certified or licensed facility, a copy of the findings shall be 25 sent to the licensing and certification office of the department. 26 If the commission or contractor determines that a report is unsubstanti- 27 ated and that no other law has been violated, all records related to the 28 report shall be expunged no later than three (3) years following the comple- 29 tion of the investigation. 30 SECTION 121. That Section 39-5308, Idaho Code, be, and the same is hereby 31 amended to read as follows: 32 39-5308. INTERAGENCY COOPERATION. (1) In performing the duties set forth 33 in this chapter, the commission or contractor may request the assistance of 34 the staffs and resources of all appropriate state departments, agencies and 35 commissions and local health directors, and may utilize any other public or 36 private agencies, groups or individuals who are appropriate and who may be 37 available. Interagency cooperation shall include the involvement, when appro- 38 priate, of law enforcement personnel, department personnel, medical personnel, 39 and any other person or entity deemed necessary due to their specialized 40 training in providing services to vulnerable adults. Interagency cooperation 41 may also include access to client information necessary for the provision of 42 services to vulnerable adults. 43 (2) The commission shall provide to the department on at least a quar- 44 terly basis a listing of all alleged perpetrators against whom an allegation 45 of adult abuse, neglect or exploitation has been substantiated. Upon request, 46 all available supportive information shall be provided to enable the depart- 47 ment to conduct criminal background checks and other required investigations. 48 (3) The department shall provide to the commission or contractor any 49 report received under this chapter from askillednursing facility defined in 50 section 39-1301(b), Idaho Code, or an employee of such facility. 51 (4) The commission or contractor shall provide the department with any 52 report received under this chapter involving allegations of abuse, neglect or 53 exploitation occurring in askillednursing facility as defined in section 54 1 39-1301(b), Idaho Code. 2 (5) The commission, contractors and the department shall use interagency 3 staffing when necessary and share client and facility information necessary to 4 provide services to vulnerable adults. 5 SECTION 122. That Section 39-5601, Idaho Code, be, and the same is hereby 6 amended to read as follows: 7 39-5601. LEGISLATIVE INTENT. The purpose and intent of this chapter is to 8 authorize personalcareassistance services for medicaid eligiblerecipients9 participants in therecipient'sparticipant's home and community. It is fur- 10 ther the purpose of this chapter to help maintain these eligiblerecipients11 participants in their own homes in order to provide for the greatest degree of 12 independence and self-reliance possible. 13 Personalcareassistance services are an integral component of the long- 14 term care service delivery system and they are to be designed to provide a 15 range of services for persons who are elderly and for persons with disabili- 16 ties. These services are to help individuals compensate for functional limita- 17 tions and are to be delivered over a sustained period of time to persons who 18 lost or never acquired some degree of functional capacity.Personal care19sServices will be viewed asservices which enhanceenhancing the quality of 20 life, individual choice, consumer control, independence and community integra- 21 tion. 22Community centered, in-home, medically relatedPersonal assistance ser- 23 vices related to functional need shall be provided, for as long as possible,24that willin order to maintain the independence, privacy, and dignity of the 25 individual in the least restrictive, most cost-effective setting. 26 The participant and, at the option of the participant, the family of the 27recipientparticipant, if available,and/or the recipientshall be involved in 28 the development of the individual service planof care to insure the plan will29enhance the existing base of support provided by the familybased on the 30 participant's needs identified through an assessment conducted by the depart- 31 ment. 32 SECTION 123. That Section 39-5602, Idaho Code, be, and the same is hereby 33 amended to read as follows: 34 39-5602. DEFINITIONS. As used in this chapter, the following terms shall 35 have the following meanings: 36 (1)"Associated services" means those tasks performed which do not37require hands-on care such as incidental housekeeping, cooking, laundry, shop-38ping, and transportation included in the care plan"Attendant care" means ser- 39 vices provided under a medicaid home and community-based services waiver that 40 involve personal and medically orientated tasks dealing with the functional 41 needs of the participant and accommodating the participant's needs for long- 42 term maintenance, supportive care or IADLs. These services may include, but 43 are not limited to, personal assistance and medical tasks that can be done by 44 unlicensed persons or delegated to unlicensed persons by a health care profes- 45 sional or participant. Services shall be based on the participant's abilities 46 and limitations, regardless of age, medical diagnosis or other category of 47 disability. 48 (2) "Case management" means a service which coordinates multiple services 49 for individualclientsparticipants through a process of assessment, planning, 50 arranging for and monitoring services. 51 (3) "Department" means the department of health and welfare of the state 55 1 of Idaho. 2 (4) "Director" means the director of the department of health and wel- 3 fare. 4 (5) "Eligiblerecipientparticipant" or "recipientparticipant" means an 5 individual determined eligible by the department forthe services provided in6the state plan forIdaho medicaid services, as authorized by title XIX, of the 7 social security act, as amended. 8 (6) "Fiscal intermediary services" means services that allow the partici- 9 pant receiving personal assistance services, or his designee or legal repre- 10 sentative, to choose the level of control he will assume in recruiting, 11 selecting, managing, training, and dismissing his personal assistant regard- 12 less of who the employer of record is, and allows the participant control over 13 the manner in which services are delivered. 14 (7) "Individual service plan" means a document which outlines all ser- 15 vices including, but not limited to, personal assistance services and IADLs, 16 required to maintain the individual in his or her home and community. 17 (8) "Instrumental activities of daily living (IADL)" means those activi- 18 ties performed in supporting the activities of daily living, including, but 19 not limited to: managing money, preparing meals, shopping, light housekeeping, 20 using the telephone, or getting around in the community. 21 (9) "Personal assistance agency" means an entity that recruits, hires, 22 fires, trains, supervises, schedules, oversees quality of work, takes respon- 23 sibility for services provided, provides payroll and benefits for personal 24 assistants working for them, is the employer of record and in fact, and may 25 provide fiscal intermediary services. 26 (10) "Personal assistance services" includes attendant care and personal 27 care services. 28 (611) "Personalcare attendantassistant" means anperson whose name29appears on the Idaho state board of nurse's registry of certificated nurse30aid's (CNA) or is determined by the director to meet equivalent requirements31and holds, or works for a provider agency that holds, a valid Idaho medicaid32provider agreement for personal care services; and provides hands-onindivid- 33 ual who directly provides personalcareassistance services. 34 (712) "Personal care services" means services ordered by a physician or 35 authorized provider that involve personal and medically orientated tasks deal- 36 ing with thephysical requirementsfunctional needs of thepatient performed37in the patient's homeparticipant and accommodating thepatient's38 participant's needs for long-term maintenance, supportive care orassociated39servicesIADLs. These services may include, but are not limited to, personal 40 assistance and medical tasks that can be done by unlicensed persons or dele- 41 gated to unlicensed persons by a health care professional or participant. Ser- 42 vices shall be based on the participant's abilities and limitations, regard- 43 less of age, medical diagnosis or other category of disability. 44(8) "Plan of care" means a document which outlines all services, includ-45ing but not limited to, personal care services, required to maintain the indi-46vidual in his or her community.47 (913) "Provider" means a personalcare attendant or providerassistance 48 agency. 49(10) "Provider agency" means an entity that recruits, hires, fires,50trains, supervises, schedules, oversees quality of work, takes responsibility51for care given, and provides payroll and benefits for care providers working52for them.53 (114) "Representative" means an employee of the department of health and 54 welfare. 55 (15) "Voucher service option" means a method of service provision whereby 56 1 the participant receives vouchers to pay for personal assistance services. 2 SECTION 124. That Section 39-5603, Idaho Code, be, and the same is hereby 3 amended to read as follows: 4 39-5603. STANDARDS FOR PROVISION OF PERSONALCAREASSISTANCE SERVICES. 5 The director shall have the power and it shall be his duty to promulgate and 6 adopt appropriate rules necessary to implement and enforce standards for pro- 7 vision of personalcareassistance services. 8 The following standards for provision of personalcareassistance services 9 and other provisions contained throughout this chapter and rules shall apply 10 torecipientsparticipants and providers receiving or providing personalcare11 assistance services either as a medicaid option service or a waivered service, 12 unless prohibited by federal law or contents of the federal waiver agreement. 13 (1) Personal care services shall be included as a state plan service 14 under medicaid.Services under a waiver shall be available to those individu-15als who would not qualify for medicaid in the absence of a waiver or to those16whose needs cannot be met with personal care services under the plan.17 (2) Personal care services shall be ordered by a physician or authorized 18 provider. 19 (3) Attendant care shall be included as a service under medicaid home and 20 community-based waiver(s). 21 (4) All attendant care services must be authorized by the department or 22 its designee. 23 (5) The department will establish by rule maximum hours per month of per- 24 sonal care services available to the individualrecipientparticipant under 25 the state medicaid plan. 26 (46) The department shall enter into agreements with providers for the 27 provision of personalcareassistance services. The department may deny pro- 28 vider status or revoke that status when a provider is found to endanger the 29 health, person or property of therecipientparticipant, or is in violation of 30 rules promulgated by the department or the provider agreement. 31 (57) A provider agency shall have the responsibility for the following: 32 (a) Recruitment, hiring, firing, training, supervision, scheduling, pay- 33 roll, and the assurance of quality of service, of its personalcare atten-34dantsassistants; 35 (b) Complying with state and federal labor and tax laws, rules and regu- 36 lations; 37 (c) Maintaining liability insurance coverage; 38 (d) Provision of an appropriately qualified nurseto complete the plan of39care and ongoing supervision of the recipients carewhen required; 40 (e) Assignment of a qualified personalcare attendantassistant to each 41 authorizedrecipientparticipant after consultation with and prior 42 approval of thatrecipientparticipant; 43 (f) Assuring all personalcare attendantsassistants providing services,44whether themselves or their agent,meet the standards and qualifications 45 of this chapter; 46 (g) Billing medicaid for services approved and authorized;by them;47 (h)Making referrals for personal care service recipientsReferring par- 48 ticipants to case management services based on established criteria; 49 (i) Providing for care by a qualified replacement when the regular per- 50 sonalcare attendantassistant is unable to provide the services, and pro- 51 viding for unanticipated services approved on the individual service plan 52of carewhen requested by therecipientparticipant; and 53 (j) Conducting, at least annually,clientparticipant 57 1 satisfaction/quality control reviews available to the department and gen- 2 eral public. 3 (8) A personal assistance agency that provides fiscal intermediary ser- 4 vices shall have the responsibility for the following: 5 (a) To assure compliance with legal requirements related to the employ- 6 ment of participant/family directed personal assistants; and 7 (b) To offer supportive services to enable participants or families to 8 perform required employer tasks themselves; and 9 (c) To bill the medicaid program for services approved and authorized by 10 the department; and 11 (d) To collect any participant contribution due; and 12 (e) To pay personal assistants for services; and 13 (f) To perform all necessary withholding as required by state and federal 14 labor and tax laws, rules and regulations; and 15 (g) To offer a full range of services and perform all services contained 16 in a written agreement between the participant and the provider. 17 (69) Personalcare attendantsassistants are not employees of the state. 18The department will provide a qualified nurse to establish a plan of care and19ongoing care supervision, where a personal care attendant is providing ser-20vice.21 (710) Case management shall be made available to personalcare service22recipientsassistance participants where and when appropriate. In order to 23 avoid a conflict of interest, case management shall not be provided by the 24 same agency that provides personalcareassistance services to therecipient25 participant.Services provided by case managers include but are not limited26to:27(a) Comprehensive assessment;28(b) Assistance with eligibility and application processes;29(c) Service plan development;30(d) Service plan implementation;31(e) Reassessment and service termination planning; and32(f) Supportive functions which may include client advocacy, assistance,33consultation, including training to enable the recipient to manage and34evaluate the care they receive, family support, crisis intervention or35follow-up after termination from case management when necessary.36 (811) The department's regional medicaid staff shall review and approve 37 the individual service plan,of care,authorize personalcareassistance ser- 38 vices, the hours of service, and make appropriate referrals for case manage- 39 ment for eligible individuals. 40 (912) The department shall establish and maintain a community awareness 41 program that will educate Idaho citizens regarding the purpose and function of 42 all long-term care alternatives including, but not limited to, personalcare43 assistance services and individualrecipientparticipant rights. This program 44 will be developed in cooperation with other state agencies including, but not 45 limited to, theofficecommission on aging and thedivision of vocational46rehabilitationstate independent living council. 47 (103) It shall be the responsibility of therecipient, his parents or48guardianparticipant or his designee or legal representative, whenpossible49 appropriate, to select the provider of personalcareassistance services. 50 (114) The department shall provide therecipientparticipant, hisparents51or guardiandesignee or legal representative, with a list of available 52 providers of personalcareassistance services; however, this does not relieve 53 therecipient,participant or hisparents or guardiandesignee or legal repre- 54 sentative of the responsibility of provider selection. 55 (125) In those cases where therecipient,participant or hisparents or58 1guardiandesignee or legal representative cannot arrange for personalcare2 assistance services or asks for help in making arrangements, a representative 3 of the department may arrange for or help arrange for personalcareassistance 4 services on behalf of therecipientparticipant. 5 SECTION 125. That Section 39-5604, Idaho Code, be, and the same is hereby 6 amended to read as follows: 7 39-5604.PROVIDERS OF PERSONAL CARE SERVICESHEALTH AND BACKGROUND 8 CHECKS. The director shall require, for both personal care attendants andpro- 9 vidersagencies,to obtain health tests or screens, criminal background and 10 nurse's aide registry checks, and licenses and/or certifications necessary to 11 protect the health, person and property of therecipient to be servedpartici- 12 pant for any personal assistant acting as an employee, agent, or contractor of 13 a provider. He may deny provider status or revoke that status when acarepro- 14 vider or an employee, agent, or contractor of a provider, is found to endanger 15 the health, person or property of therecipientparticipant. 16 SECTION 126. That Section 39-5605, Idaho Code, be, and the same is hereby 17 amended to read as follows: 18 39-5605. TRAINING OFPROVIDERSPERSONAL ASSISTANTS. The director may 19 require aproviderpersonal assistant to successfully complete a training pro- 20 gram established by the rules before beginning to provide personalcareassis- 21 tance services. Those providing personalcareassistance services when the 22 rule is established will be given a reasonable period of time to obtain the 23 required training. The director may establish different training requirements 24 for different services provided and forproviderspersonal assistants serving 25recipientsparticipants withspecialintensive needs. The department shall 26 conduct training to include, but not be limited to, administrative rules, 27 billing procedures and service requirements. 28 SECTION 127. That Section 39-5606, Idaho Code, be, and the same is hereby 29 amended to read as follows: 30 39-5606. PAYMENT TO BE MADE TO PROVIDER. Within the appropriations pro- 31 vided by law, and as authorized by rule, the department shall reimburse the 32 provider for personalcareassistance services received by therecipientpar- 33 ticipant. To qualify for reimbursement, personalcareassistance services must 34 beprescribed by a physiciandelivered in accordance with therecipient's35 participant's individual service planof careandbe provided by an individual36who is:37(a) A personal care attendant;38(b) Supervised by a registered nurse; and39(c) Not a member of the recipient's familyall federal requirements. 40 The department will establish annually uniform reimbursement rates for 41 providers. This rate will be based on the prevailing hourly rate paid for com- 42 parable positions in the state for nursing home industry employees. Providers 43agenciesshall also receive a fifty-five percent (55%) supplemental component 44 to cover travel, administration, training and all payroll taxes and fringe 45 benefits.Personal care attendant rates shall have a supplemental component to46cover training, worker's compensation, social security and liability insur-47ance. The department may establish different rates for associated services.48When the assessment tool referred to in sections 39-3308 and 39-3508, Idaho49Code, becomes available, it shall be applied to establish reimbursement lev-59 1els.2 The director shall promulgate and adopt such necessary rules to implement 3 the requirements of this section. 4 SECTION 128. That Chapter 56, Title 39, Idaho Code, be, and the same is 5 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 6 ignated as Section 39-5607, Idaho Code, and to read as follows: 7 39-5607. EFFECT OF PERSONAL ASSISTANCE AGENCY RATES. Applicants for and 8 participants of personal assistance services shall not lose their eligibility 9 for such services as a result of changing from an existing provider to a per- 10 sonal assistance agency, or from any increased cost of their individual ser- 11 vice plan required by this act. 12 SECTION 129. That Section 39-5608, Idaho Code, be, and the same is hereby 13 amended to read as follows: 14 39-5608. LIABILITY OF ACTIONS UNDER THIS CHAPTER. (1) Therecipientpar- 15 ticipant, hisparents or guardiansdesignee or legal representative, if such 16 are responsible, shall be liable for any acts of therecipientparticipant 17 performed or committed while receivingpersonalcare or services under the 18 provisions of this chapter. 19 (2) The department shall not be held liable for any actions under this 20 chapter, except pursuant to section 39-5603(114), Idaho Code, when the repre- 21 sentative of the department is actinginon behalf of therecipientpartici- 22 pant, hisparents or guardiandesignee or legal representative; however, the 23 provisions of section 39-5603(912), Idaho Code, shall remain in force. 24 (3) Nothing in this chapter shall exempt the provider ofpersonal care25 services from any liability caused by suchproviders'provider's negligence, 26 abuse, or other improper action of the provider. 27 SECTION 130. That Chapter 56, Title 39, Idaho Code, be, and the same is 28 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 29 ignated as Section 39-5609, Idaho Code, and to read as follows: 30 39-5609. PERSONAL ASSISTANCE OVERSIGHT COMMITTEE. The department shall 31 establish, as part of the medical care advisory committee (MCAC), an oversight 32 subcommittee consisting of providers of personal assistance services and par- 33 ticipants of such services and advocacy organizations representing such par- 34 ticipants, and other interested parties, for the purpose of planning, monitor- 35 ing, and recommending changes to the medicaid waiver and personal assistance 36 programs to the MCAC. At least fifty-one percent (51%) of the committee mem- 37 bership shall be participants or their representatives. The director shall 38 determine when and if this role shall be performed by the MCAC. 39 SECTION 131. That Section 54-1601, Idaho Code, be, and the same is hereby 40 amended to read as follows: 41 54-1601. DEFINITIONS. (1) As used in this act, unless otherwise stated, 42 the following terms shall have the respective meanings hereinafter set forth 43 or indicated: 44 (2) "Board" means the board of examiners of nursing home administrators 45 of the state of Idaho. 46 (3) "Examiner" means a member of the board of examiners of nursing home 47 administrators of the state of Idaho. 60 1 (4) "Executive secretary" means the secretary of the board of examiners 2 of nursing home administrators of the state of Idaho. 3 (5) "Nursing home administrator" means any individual responsible for 4 planning, organizing, directing, and controlling the operation of a nursing 5 home, or who in fact performs such functions, whether or not such functions 6 are shared by one (1) or more other persons. 7 (6) "Nursing home administrator-in-training" means an individual regis- 8 tered as such under and pursuant to the provisions of this act. 9 (7) "Practice of nursing home administration" means that planning, orga- 10 nizing, directing, and control of the operation of a nursing home. 11 (8) "Health care facility" means any institution or facility which sup- 12 plies all of the functional needs of an individual in need of residence care, 13 and defined as such for licensing purposes under state law or pursuant to the 14 rules for nursing homes, hospitals, residentialcare homesor assisted living 15 facilities, whether proprietary or nonprofit, and shall include, but not be 16 limited to, health care facilities owned or administered by the state govern- 17 ment or any agency or political subdivisions thereof. 18 SECTION 132. That Section 54-1705, Idaho Code, be, and the same is hereby 19 amended to read as follows: 20 54-1705. DEFINITIONS. (1) "Board of pharmacy" or "board" means the Idaho 21 state board of pharmacy. 22 (2) "Counseling or counsel" means the effective communication by the 23 pharmacist of information as set out in this chapter, to the patient or 24 caregiver, in order to improve therapeutic outcomes by maximizing proper use 25 of prescription medications and devices. Specific areas of counseling shall 26 include, but are not limited to: 27 (a) Name and strength and description of the medication; 28 (b) Route of administration, dosage, dosage form, continuity of therapy 29 and refill information; 30 (c) Special directions and precautions for preparation, administration, 31 storage and use by the patient as deemed necessary by the pharmacist; 32 (d) Side effects or adverse effects and interactions and therapeutic 33 contraindications that may be encountered, including their avoidance, 34 which may interfere with the proper use of the medication or device as was 35 intended by the prescriber, and the action required if they occur; 36 (e) Techniques for self-monitoring drug therapy; and 37 (f) Action to be taken in the event of a missed dose. 38 (3) "Deliver" or "delivery" means the actual, constructive or attempted 39 transfer of a drug or device from one (1) person to another, whether or not 40 for a consideration. 41 (4) "Device" means an instrument, apparatus, implement, machine, contriv- 42 ance, implant, invitro reagent or other similar related article including any 43 component part or accessory which is: 44 (a) Recognized in the official United States Pharmacopoeia or official 45 National Formulary, other drug compendia or any supplement to them; 46 (b) Intended for use in the diagnosis of disease or other conditions, or 47 the cure, mitigation, treatment or prevention of disease in man or other 48 animal; 49 (c) Intended to effect the structure or any function of the body of man 50 or other animal, and which does not achieve any of its principal intended 51 purposes through chemical action within or on the body of man or other 52 animal, and which is not dependent upon being metabolized for the 53 achievement of any of its principal intended purposes. 61 1 (5) "Dispense" or "dispensing" means the preparation and delivery of a 2 prescription drug pursuant to a lawful order of a practitioner in a suitable 3 container appropriately labeled for subsequent administration to or use by a 4 patient or other individual entitled to receive the prescription drug. 5 (6) "Distribute" means the delivery of a drug other than by administering 6 or dispensing. 7 (7) "Drug" means: 8 (a) Articles recognized as drugs in the official United States Pharmaco- 9 poeia, official National Formulary, official Homeopathic Pharmacopoeia, 10 other drug compendia or any supplement to any of them; 11 (b) Articles intended for use in the diagnosis, cure, mitigation, treat- 12 ment or prevention of disease in man or other animal; 13 (c) Articles, other than food, intended to affect the structure or any 14 function of the body of man or other animals; and 15 (d) Articles intended for use as a component of any articles specified in 16 paragraph (a), (b) or (c) of this subsection. 17 (8) "Drug order" means a written order, in a hospital or other health 18 care institution, for an ultimate user of any drug or device issued and signed 19 by a practitioner, or an order transmitted by other means of communication 20 from a practitioner, which is immediately reduced to writing by a pharmacist, 21 registered nurse or other licensed health care practitioner authorized by the 22 hospital or institution. The order shall contain the name and bed number of 23 the patient, the name and strength or size of the drug or device, unless spec- 24 ified by individual institution policy or guideline, the amount to be dis- 25 pensed, either in quantity or days, adequate directions for the proper use of 26 the drug or device when it is administered to the patient, and the name of the 27 prescriber. 28 (9) "Drug outlet" means all pharmacies, nursing homes, residentialcare29homesor assisted living facilities, convalescent homes, extended care facili- 30 ties, drug abuse treatment centers, penal institutions, hospitals, family 31 planning clinics, retail stores, wholesalers, manufacturers and mail order 32 vendors with facilities located in this state which are engaged in dispensing, 33 delivery or distribution of drugs and drug manufacturers and wholesalers with 34 facilities located outside the state, but doing business within this state. 35 (10) "Prospective drug review" includes, but is not limited to, the fol- 36 lowing activities: 37 (a) Evaluation of the prescription or medication order for: 38 1. Known allergies; 39 2. Rational therapy contraindications; 40 3. Reasonable dose and route of administration; and 41 4. Reasonable directions for use. 42 (b) Evaluation of the prescription or medication order for duplication of 43 therapy. 44 (c) Evaluation of the prescription or medication order for interactions: 45 1. Drug-drug; 46 2. Drug-food; and 47 3. Drug-disease. 48 (d) Evaluation of the prescription or medication order for proper utili- 49 zation: 50 1. Over or under utilization; and 51 2. Abuse/misuse. 52 (11) "Extern" means a bona fide student enrolled in an approved college of 53 pharmacy who has not received his first professional degree in pharmacy. 54 (12) "Externship" means a structured practical experience program in phar- 55 macy, approved by the board and administered by a college of pharmacy. 62 1 (13) "Intern" means any person who has completed a course of study at an 2 approved college of pharmacy, received the first professional degree in phar- 3 macy and is registered with the board as an intern. Interns must register with 4 the board prior to commencement of an internship program. 5 (14) "Internship" means a postgraduate practical experience program under 6 the supervision of a licensed pharmacist registered as a preceptor. 7 (15) "Investigational or new drug" means any drug which is limited by 8 state or federal law to use under professional supervision of a practitioner 9 authorized by law to prescribe or administer such drug. 10 (16) "Labeling" means the process of preparing and affixing of a label to 11 any drug container, exclusive however, of the labeling by a manufacturer, 12 packer or distributor of a nonprescription drug or commercially packaged leg- 13 end drug or device. Any such label shall include all information required by 14 federal and state law or regulation. 15 (17) "Manufacture" means the production, preparation, propagation, com- 16 pounding, conversion or processing of a device or a drug, either directly or 17 indirectly by extraction from substances of natural origin or independently by 18 means of chemical synthesis or by a combination of extraction and chemical 19 synthesis and includes any packaging or repackaging of the substance or label- 20 ing or relabeling of its container, except that this term does not include the 21 preparation or compounding of a drug by an individual for his own use or the 22 preparation, compounding, packaging or labeling of a drug: 23 (a) By a pharmacist or practitioner as an incident to his administering 24 or dispensing of a drug in the course of his professional practice; or 25 (b) By a practitioner or by his authorization under his supervision for 26 the purpose of or as an incident to research, teaching or chemical analy- 27 sis and not for sale. 28 (18) "Manufacturer" means a person who by compounding, cultivating, har- 29 vesting, mixing or other process, produces or prepares legend drugs, and 30 includes persons who prepare such drugs in dosage forms by mixing, compound- 31 ing, encapsulating, entableting, or other process, or who packages or 32 repackages such drugs, but does not include pharmacists or practitioners in 33 the practice of their profession. 34 (19) "Precursor" means a substance, other than a legend drug which is an 35 immediate chemical intermediate that can be processed or synthesized into a 36 legend drug, and is used or produced primarily for use in the manufacture of a 37 legend drug by persons other than persons licensed to manufacture such legend 38 drugs by the Idaho board of pharmacy, registered by the state board of health 39 and welfare, or licensed to practice pharmacy by the Idaho board of pharmacy. 40 (20) "Person" means an individual, corporation, partnership, association 41 or any other legal entity. 42 (21) "Pharmaceutical care" means drug therapy and other pharmaceutical 43 patient care services intended to achieve outcomes related to the cure or pre- 44 vention of a disease, elimination or reduction of a patient's symptoms, or 45 arresting or slowing of a disease process as defined in theregulationsrules 46 of the board. 47 (22) "Pharmacist" means an individual licensed by this state to engage in 48 the practice of pharmacy. 49 (23) "Pharmacy" means any facility, department or other place where pre- 50 scriptions are filled or compounded and are sold, dispensed, offered or dis- 51 played for sale, which has, as its principal purpose, the dispensing of drug 52 and health supplies intended for the general health, welfare and safety of the 53 public. 54 (24) "Practitioner" shall mean a physician, dentist, veterinarian, scien- 55 tific investigator or other person (other than a pharmacist) licensed in this 63 1 state and permitted by such license to dispense, conduct research with respect 2 to or administer drugs in the course of professional practice or research in 3 this state. 4 (25) "Preceptor" means a pharmacist licensed in the state and in good 5 standing, who supervises the internship training of a registered intern. The 6 preceptor must be registered as a preceptor and shall be actively engaged on a 7 full-time employment basis in the approved training area. 8 (26) "Prescription drug or legend drug" means a drug which, under federal 9 law is required, prior to being dispensed or delivered, to be labeled with 10 either one of the following statements: 11 (a) "Caution: Federal law prohibits dispensing without a prescription;"; 12 or 13 (b) "Caution: Federal law restricts this drug to use by or on the order 14 of a licensed veterinarian;"; 15 or a drug which is required by any applicable federal or state law or regula- 16 tion to be dispensed on prescription only or is restricted to use by practi- 17 tioners only. 18 (27) "Prescription drug order" means a lawful written or verbal order of a 19 practitioner for a drug. 20 (28) "Nonprescription drugs" means medicines or drugs which may be sold 21 without a prescription and which are prepackaged for use by the consumer and 22 labeled in accordance with the requirements of the statutes and regulations of 23 this state and the federal government. 24 (29) "Record" means all papers, letters, memoranda, notes, prescriptions, 25 drug orders, invoices, statements, patient medication charts or files, comput- 26 erized records or other written indicia, documents or objects which are used 27 in any way in connection with the purchase, sale or handling of any drug or 28 device. 29 (30) "Sale" means every sale and includes: 30 (a) Manufacturing, processing, transporting, handling, packaging or any 31 other production, preparation or repackaging; 32 (b) Exposure, offer, or any other proffer; 33 (c) Holding, storing or any other possession; 34 (d) Dispensing, giving, delivering or any other supplying; and 35 (e) Applying, administering or any other usage. 36 (31) "Warehouseman" means a person who stores legend drugs for others and 37 who has no control over the disposition of such drugs except for the purpose 38 of such storage. 39 (32) "Wholesaler" means a person engaged in the business of distributing 40 legend drugs that he himself has not produced or prepared, to persons included 41 in any of the classes named in subsection (2) (a) through (f) of section 42 54-1734, Idaho Code. 43 SECTION 133. That Section 54-4201, Idaho Code, be, and the same is hereby 44 amended to read as follows: 45 54-4201. SHORT TITLE. This chapter shall be known and may be cited as the 46 "Idaho ResidentialCareor Assisted Living Facility Administrators Act." 47 SECTION 134. That Section 54-4202, Idaho Code, be, and the same is hereby 48 amended to read as follows: 49 54-4202. DEFINITIONS. As used in this chapter: 50 (1) "Board" means the board of examiners of residentialcareor assisted 51 living facility administrators of the state of Idaho. 64 1 (2) "Examiner" means a member of the board of examiners of residential 2careor assisted living facility administrators of the state of Idaho. 3 (3) "Executive secretary" means the secretary of the board of examiners 4 of residentialcareor assisted living facility administrators of the state of 5 Idaho. 6 (4) "Practice of residentialcareor assisted living facility administra- 7 tion" means that planning, organizing, directing, and control of the operation 8 of a residentialcareor assisted living facility. 9 (5) "Provisional license" means a temporary license issued to a provi- 10 sional residentialcareor assisted living facility administrator under and 11 pursuant to the provisions of this chapter. 12 (6) "Provisional residentialcareor assisted living facility administra- 13 tor" means an individual who has been licensed as such under and pursuant to 14 the provisions of this chapter. 15 (7) "Residentialcareor assisted living facility" means a facility or 16 residence, however named, operated on either a profit or nonprofit basis for 17 the purpose of providing necessary supervision, personal assistance, meals and 18 lodging to three (3) or more elderly, developmentally disabled, physically 19 disabled and/or mentally ill adults not related to the owner. 20 (8) "Residentialcareor assisted living facility administrator" means 21 any individual responsible for planning, organizing, directing, and control- 22 ling the operation of a residentialcareor assisted living facility, or who 23 in fact performs such functions, whether or not such functions are shared by 24 one (1) or more other persons. 25 SECTION 135. That Section 54-4203, Idaho Code, be, and the same is hereby 26 amended to read as follows: 27 54-4203. FACILITY SUPERVISION BY LICENSED ADMINISTRATOR REQUIRED -- PRAC- 28 TICE BY UNLICENSED PERSON PROHIBITED -- PROVISIONAL LICENSE. Effective July 1, 29 1991, no residentialcareor assisted living facility in the state shall be 30 operated unless it is under the supervision of an administrator who holds a 31 currently valid residentialcareor assisted living facility administrator's 32 license and registration, or provisional license, issued pursuant to this 33 chapter. No person shall practice or offer to practice residentialcareor 34 assisted living facility administration in this state or use any title, sign, 35 card, or device to indicate that he is a residentialcareor assisted living 36 facility administrator unless such person shall have been duly licensed and 37 registered as a residentialcareor assisted living facility administrator or 38 licensed as a provisional residentialcareor assisted living facility admin- 39 istrator as required by this chapter. 40 SECTION 136. That Section 54-4204, Idaho Code, be, and the same is hereby 41 amended to read as follows: 42 54-4204. BOARD OF EXAMINERS OF RESIDENTIALCAREOR ASSISTED LIVING FACIL- 43 ITY ADMINISTRATORS. (1) There is hereby created in the department of self-gov- 44 erning agencies a board of examiners of residentialcareor assisted living 45 facility administrators, which board shall consist of five (5) members, and 46 composed of two (2) residentialcareor assisted living facility administra- 47 tors, duly licensed and registered under this chapter, and three (3) other 48 members as hereinafter described, except that such members of the initial 49 board shall be required only to possess the qualifications and be eligible for 50 licensure as required under this chapter, one (1) member shall be selected 51 from any other profession or agency or institution concerned with the care of 65 1 persons requiring assistance with the daily activities of living; one (1) 2 licensed nurse from the nursing profession; and one (1) member representative 3 of the public at large; but no more than two (2) of the members of the board 4 shall be officials or full-time employees of state or local governments. All 5 members of the board shall be citizens of the United States or shall have 6 declared their intent to become citizens of the United States and shall be 7 residents of this state. 8 (2) One (1) member of the initial board shall be appointed for a one (1) 9 year term of office, two (2) members of the initial board shall be appointed 10 for a two (2) year term of office, and two (2) members of the initial board 11 shall be appointed for a three (3) year term of office. Thereafter, the term 12 of office for each member of the board shall be three (3) years. 13 (3) (a) Appointments to the board shall be made by the governor after 14 consultation with the executive board of any organized and generally rec- 15 ognized group concerned with residentialcareor assisted living facility 16 administration. Each member of the board shall hold office until his suc- 17 cessor is duly appointed and qualified. Dismissals shall be by the gover- 18 nor, for reasonable cause. 19 (b) The two (2) residentialcareor assisted living facility administra- 20 tors must be appointed from a list of three (3) submitted by any organized 21 and generally recognized group concerned with residentialcareor assisted 22 living facility administration. 23 (c) Members of the board shall be compensated as provided in section 24 59-509(f), Idaho Code. 25 (4) The board shall elect annually from its membership a chairman and 26 vice chairman. The board shall hold two (2) or more meetings each year. A 27 majority of the board membership shall constitute a quorum. 28 (5) The board shall exercise its powers and perform its duties and func- 29 tions specified by this chapter. 30 (6) The board may appoint an executive secretary. He shall be the execu- 31 tive officer to the board but shall not be a member of the board. He shall 32 have such powers and shall perform such duties as are prescribed by law and 33 the rulesand regulationsof the board. A clerk and sufficient deputy clerks 34 to adequately assist the board and the executive secretary in the keeping of 35 the records and in the performance of their duties may be appointed by the 36 board. All employees of the board shall be appointed, and serve in accordance 37 with the provisions of law. 38 (7) The board may, by written agreement, authorize the bureau of occupa- 39 tional licenses, or other appropriate body as provided by law, as agent to act 40 in its interest. 41 SECTION 137. That Section 54-4205, Idaho Code, be, and the same is hereby 42 amended to read as follows: 43 54-4205. FUNCTIONS AND DUTIES OF THE BOARD -- FEE FOR LICENSE APPLICANTS 44 -- RULES.AND REGULATIONS.(1) It shall be the functions and duties of such 45 board to: 46 (a) Develop, impose and enforce standards consistent with this chapter 47 which shall be met by individuals in order to receive and retain a license 48 as a residentialcareor assisted living facility administrator which 49 standards shall be designed to ensure that residentialcareor assisted 50 living facility administrators will be individuals who are of good charac- 51 ter and are otherwise suitable, and who, by training or experience in the 52 field of institutional administration, are qualified to serve as residen- 53 tialcareor assisted living facility administrators; 66 1 (b) Develop and apply appropriate techniques, including examinations and 2 investigations, for determining whether an individual meets such stan- 3 dards; 4 (c) Issue licenses and registrations to individuals determined, after 5 application of such techniques, to meet such standards, and revoke or sus- 6 pend licenses and registrations previously issued by the board in any case 7 where the individual holding any such license or registration is deter- 8 mined substantially to have failed to conform to the requirements of such 9 standards; 10 (d) Establish and carry out procedures designed to ensure that individu- 11 als licensed as residentialcareor assisted living facility administra- 12 tors will, during any period that they serve as such, comply with the 13 requirements of such standards; 14 (e) Receive, investigate, and take appropriate action with respect to any 15 charge or complaint filed with the board charging that any individual 16 licensed as a residentialcareor assisted living facility administrator 17 has failed to comply with the requirements of such standards; 18 (f) Conduct a continuing study and investigation of administrators of 19 residentialcareor assisted living facilities within the state with a 20 view to the improvement of the standards imposed for the licensing of such 21 administrators and of procedures and methods for the enforcement of such 22 standards with respect to administrators of residentialcareor assisted 23 living facilities who have been licensed as such; 24 (g) The board shall establish by rule a fee schedule not to exceed one 25 hundred dollars ($100) each for applications for licenses, provisional 26 licenses, annual recertification of registration and applications for a 27 reciprocal endorsement of a license issued by the proper authorities in 28 another state. 29 (2) The board or any committee or member thereof or any hearing officer 30 designated by such board, acting in an official capacity, shall have powers 31 and duties as provided by law. Such board shall not be bound by the strict 32 rules of evidence in the conduct of its proceedings but any determinations 33 made shall be founded upon sufficient legal evidence to sustain them. 34 (3) The board shall also have the authority to make rules not inconsis- 35 tent with law as may be necessary for the proper performance of its duties. 36 SECTION 138. That Section 54-4206, Idaho Code, be, and the same is hereby 37 amended to read as follows: 38 54-4206. QUALIFICATIONS FOR EXAMINATION FOR LICENSE. (1) The board shall 39 admit to the examination for licensure as a residentialcareor assisted liv- 40 ing facility administrator any candidate who pays a fee as determined by the 41 board, and submits evidence of good moral character and suitability prescribed 42 by the board, is at least twenty-one (21) years old except: 43 (a) That on and after July 1, 1991, no applicant for a license as a resi- 44 dentialcareor assisted living facility administrator shall be admitted 45 to such licensing examination nor shall such applicant be entitled to or 46 be granted a license as a residentialcareor assisted living facility 47 administrator unless such applicant shall submit written evidence, on 48 forms provided for such purpose by the board, that he has successfully 49 completed a course of study and has been graduated from a high school 50 approved and recognized by the educational authorities of the state in 51 which such school is located, or a political division thereof or has sub- 52 mitted a certificate indicating that he has obtained high school or sec- 53 ondary school equivalency, such certificate being duly certified by a 67 1 state educational authority or a political division thereof, and except 2 that he shall have complied with the provisions of subsection (2) of this 3 section. 4 (b) On or after July 1, 1991, each applicant who has not completed a reg- 5 ular course of study or program which course of study or program shall 6 have been approved by the board as being adequate academic preparation for 7 residentialcareor assisted living facility administration, shall submit 8 evidence satisfactory to the board that he has successfully completed spe- 9 cialized courses or a program of study in the area of residentialcareor 10 assisted living facility administration as required and approved by the 11 rules of the board. 12 (2) A candidate who applies for examination under and pursuant to subsec- 13 tion (1) of this section, in lieu of the educational requirements provided for 14 therein, may submit evidence satisfactory to the board that such applicant has 15 obtained two (2) years of satisfactory practical experience in residential 16careor assisted living facility administration or in a related health admin- 17 istration area for each year of high school education. 18 SECTION 139. That Section 54-4207, Idaho Code, be, and the same is hereby 19 amended to read as follows: 20 54-4207. SUBJECT MATTER OF EXAMINATION -- FREQUENCY. (1) The board shall 21 determine the subjects of examination for applicants for licensure as residen- 22 tialcareor assisted living facility administrators and the scope, content, 23 and format of such examinations which in any examination shall be the same for 24 all candidates; except that such examination shall include examination of the 25 applicant to demonstrate his proficiency in the practice of, and knowledge of, 26 applicable rules of health and safety within the state. 27 (2) Examinations shall be held at least semiannually at such times and 28 places as the board shall designate. 29 SECTION 140. That Section 54-4208, Idaho Code, be, and the same is hereby 30 amended to read as follows: 31 54-4208. ISSUANCE OF LICENSE -- EXEMPTION -- EDUCATIONAL PROGRAMS. (1) An 32 applicant for a license as a residentialcareor assisted living facility 33 administrator who has successfully complied with the requirements of section 34 54-4206, Idaho Code, and the standards provided for therein, has passed the 35 examination provided for in section 54-4207, Idaho Code, and, where applica- 36 ble, has complied with the requirements of section 54-4211, Idaho Code, shall 37 be issued a license, on a form provided for that purpose by the board, certi- 38 fying that such applicant has met the requirements of the laws and rules enti- 39 tling him to serve, act, practice, and otherwise hold himself out as a duly 40 licensed residentialcareor assisted living facility administrator. 41 (2) (a) The board shall issue a provisional license to any individual 42 applying therefor who has served as a residentialcareor assisted living 43 facility administrator for all of the calendar year immediately preceding 44 July 1, 1991, meets the standards of the board and of this chapter relat- 45 ing to good character, suitability, age, and citizenship, and has paid the 46 fee as set by the board. No license shall be issued under the provisions 47 of this section prior to July 1, 1991. 48 (b) Such provisional license shall terminate two (2) years from date of 49 issuance but shall be subject to the payment of the annual fee, and shall 50 be canceled and be of no legal force or effect except that if, prior to 51 the expiration of such provisional license, such provisional residential 68 1careor assisted living facility administrator shall have passed a quali- 2 fying examination and otherwise complied with the provisions of section 3 54-4206, Idaho Code, as required by the board, a residentialcareor 4 assisted living facility administrator license shall be issued to him. 5 (3) Any license issued by the board under or pursuant to the provisions 6 of this section shall be under the hand and seal of the chairman and executive 7 secretary of the board. 8 (4) If the board finds that programs of training and instruction con- 9 ducted within the state are not sufficient in number or content to enable 10 applicants for residentialcareor assisted living facility administrators' 11 licenses and residentialcareor assisted living facility administrators to 12 meet requirements established pursuant to this chapter, it shall institute and 13 conduct or arrange with others to conduct one (1) or more such programs, and 14 shall make provision for their accessibility to appropriate residents of this 15 state. The board may approve programs conducted within and without this state 16 as sufficient to meet education and training requirements established pursuant 17 to this chapter. 18 SECTION 141. That Section 54-4209, Idaho Code, be, and the same is hereby 19 amended to read as follows: 20 54-4209. CERTIFICATE OF REGISTRATION -- ATTENDANCE AT CONTINUING EDUCA- 21 TION PROGRAM -- REVOCATION OR SUSPENSION -- RENEWAL OF LAPSED REGISTRATIONS -- 22 REGISTER OF APPLICATIONS. (1) Every individual who holds a valid license as a 23 residentialcareor assisted living facility administrator issued by the board 24 under section 54-4208(1), Idaho Code, shall immediately upon issuance thereof 25 be deemed registered with the board and be issued a certificate of registra- 26 tion. Thereafter, such individual shall annually be required to apply to the 27 board for a recertification of registration and report any facts requested by 28 the board on forms provided for such purpose. 29 (2) Upon making an application for a recertification of registration, 30 such individual shall pay an annual registration fee, and at the same time 31 shall submit evidence satisfactory to the board that during the twelve (12) 32 month period immediately preceding such application for recertification of 33 registration he has successfully attended a continuing education program or 34 course of study as may be provided in the rules of the board. 35 (3) Upon receipt of such application for recertification of registration, 36 the registration fee, and the evidence required with respect to continuing 37 education, the board shall issue a recertification of registration to such 38 residentialcareor assisted living facility administrator. 39 (4) The license of a residentialcareor assisted living facility admin- 40 istrator who fails to comply with the provisions of this section, and who con- 41 tinues to act as a residentialcareor assisted living facility administrator, 42 shall be suspended or revoked by the board, in accordance with the provisions 43 of this chapter. 44 (5) A residentialcareor assisted living facility administrator who has 45 been duly licensed and registered in this state and whose license shall not 46 have been revoked or suspended, and whose registration has expired for a 47 period of not longer than five (5) years, may reregister within the state upon 48 complying with the provisions of this section for recertification of registra- 49 tion and also filing with the board an affidavit in accordance with the rules 50 of the board, and payment of a twenty-five dollar ($25.00) reinstatement fee 51 together with fees for back years. 52 (6) A residentialcareor assisted living facility administrator whose 53 license has been expired for five (5) or more years, must reapply for licen- 69 1 sure under the provisions of section 54-4206, Idaho Code. 2 (7) The board shall maintain a register of all applications for licensing 3 and registration of residentialcareor assisted living facility administra- 4 tors, which register shall show: The place of residence, name and address of 5 each applicant, the name and address of employer or business connection of 6 each applicant, the date of application, complete information of educational 7 and experiential qualifications, the action taken by the board, the serial 8 number of the license and of registration certificates issued to the appli- 9 cant, the date on which the board reviewed and acted upon the application, and 10 such other pertinent information as the board may deem necessary. 11 SECTION 142. That Section 54-4210, Idaho Code, be, and the same is hereby 12 amended to read as follows: 13 54-4210. INTERSTATE RECIPROCAL ENDORSEMENT OF LICENSES. The board, in its 14 discretion, and otherwise subject to the provisions of this chapter, and the 15 rules of the board promulgated thereunder prescribing the qualifications for a 16 residentialcareor assisted living facility administrator license, may 17 endorse a residentialcareor assisted living facility administrator license 18 issued by the proper authorities of any other state upon payment of a fee and 19 upon submission of evidence satisfactory to the board that such other state 20 maintained a system and standard of qualifications and examinations for a res- 21 identialcareor assisted living facility administrator license which were 22 substantially equivalent to those required in this state at the time such 23 other license was issued by such other state. 24 SECTION 143. That Section 54-4211, Idaho Code, be, and the same is hereby 25 amended to read as follows: 26 54-4211. TEMPORARY PERMITS -- EXCEPTIONS. (1) Pending issuance of a 27 license, the board may issue a temporary permit for a period not exceeding six 28 (6) months, without an examination to an applicant who files a written appli- 29 cation for a temporary permit and who is otherwise qualified but does not meet 30 the experience requirements or who is applying to fill a vacancy on an emer- 31 gency basis. 32 (2) Any individual who holds a valid Idaho nursing home administrator's 33 license and is in good standing according to the provisions of chapter 16, 34 title 54, Idaho Code, shall be deemed to meet the requirements for issuance of 35 a residentialcareor assisted living facility administrator's license and 36 shall be issued one, upon application and payment of appropriate fees. 37 SECTION 144. That Section 54-4212, Idaho Code, be, and the same is hereby 38 amended to read as follows: 39 54-4212. MISDEMEANORS LISTED -- PENALTIES. (1) It shall be a misdemeanor 40 for any person to: 41 (a) Sell or fraudulently obtain or furnish any license or aid or abet 42 therein; or 43 (b) Practice as a residentialcareor assisted living facility adminis- 44 trator under cover of any license or registration illegally or fraudu- 45 lently obtained or unlawfully issued; or 46 (c) Practice as a residentialcareor assisted living facility adminis- 47 trator or use in connection with his or her name any designation tending 48 to imply that he or she is a residentialcareor assisted living facility 49 administrator unless duly licensed and registered to so practice under the 70 1 provisions of this chapter; or 2 (d) Practice as a residentialcareor assisted living facility adminis- 3 trator during the time his or her license or registration issued under the 4 provisions of this chapter shall be suspended or revoked; or 5 (e) Otherwise violate any of the provisions of this chapter. 6 (2) Such misdemeanor shall be punishable by a fine of not more than five 7 hundred dollars ($500) or by imprisonment in the county jail for not more than 8 ninety (90) days, or by both such fine and imprisonment. 9 SECTION 145. That Section 54-4213, Idaho Code, be, and the same is hereby 10 amended to read as follows: 11 54-4213. REVOCATION OR SUSPENSION OF LICENSE OR REGISTRATION, REPRIMAND, 12 CENSURE, OR OTHER DISCIPLINE. (1) The license or registration of any person 13 practicing or offering to practice residentialcareor assisted living facil- 14 ity administration, or the license of a provisional residentialcareor 15 assisted living facility administrator, may be revoked or suspended, or such 16 licensee may be reprimanded, censured, or otherwise disciplined in accordance 17 with the provisions of this section upon decision and after due hearing in any 18 of the following cases: 19 (a) Upon proof that such licensee is reasonably unfit to operate a resi- 20 dentialcareor assisted living facility; 21 (b) Upon proof that such licensee has willfully or repeatedly violated 22 any of the provisions of this chapter or the rules enacted in accordance 23 with, or willfully or repeatedly acted in a manner inconsistent with the 24 health and safety of the patients of the home in which he is the adminis- 25 trator; 26 (c) Upon proof that such licensee is guilty of fraud or deceit in the 27 practice of residentialcareor assisted living facility administration or 28 related activities, or in his or her admission to such practice. 29 (2) The board, or a hearing officer designated by it, shall have juris- 30 diction to hear all charges brought under the provisions of this section 31 against persons licensed and registered as residentialcareor assisted living 32 facility administrators, or licensed as provisional residentialcareor 33 assisted living facility administrators, and upon such hearings shall deter- 34 mine such charges upon their merits. If the board determines that such person 35 is guilty of the charges, the board may revoke his or her license and regis- 36 tration, suspend him or her from practice or reprimand, censure, or otherwise 37 discipline such licensee. 38 (3) Proceedings under this section shall be initiated by filing with the 39 board, charges in writing and under oath. The board on its own motion may con- 40 duct an investigation and initiate charges. The procedures for notification 41 and the hearing on such charges, unless dismissed by the board as unfounded or 42 trivial, shall be conducted pursuant to the provisions of chapter 52, title 43 67, Idaho Code. 44 SECTION 146. That Section 56-101, Idaho Code, be, and the same is hereby 45 amended to read as follows: 46 56-101. DEFINITIONS. Unless the context clearly requires otherwise, the 47 definitions in this section apply throughout this chapter and shall have the 48 following meanings: 49 (1) "Appraisal" means the method of determining the value of the property 50 as determined by an appraisal conducted by a member of the appraisal institute 51 (MAI), or successor organization. The appraisal must specifically identify the 71 1 values of land, building, equipment, and goodwill. 2 (2) "Assets" means economic resources of the contractor, recognized and 3 measured in conformity with generally accepted accounting principles. 4 (3) "Bed-weighted median" is determined by arraying the average per diem 5 cost per bed of all facilities from high to low and identifying the bed at the 6 point in the array at which half of the beds have equal or higher per diem 7 costs and half have equal or lower per diem costs. The identified bed is the 8 median bed. The per diem cost of the median bed is the bed-weighted median. 9 (4) "Case mix index" is a numeric score assigned to each facility resi- 10 dent, based on the resident's physical and mental condition, which projects 11 the amount of relative resources needed to provide care to the resident. 12 (5) "Depreciation" means the systematic distribution of the cost or other 13 basis of tangible assets, less salvage, over the estimated useful life of the 14 assets. 15 (6) "Direct care costs" consists of the following costs directly assigned 16 to the nursing facility or allocated to the nursing facility through medicare 17 cost finding principles: 18 (a) Direct nursing salaries which include the salaries of registered 19 nurses, licensed professional nurses, certificated nurse's aides, and unit 20 clerks; and 21 (b) Routine nursing supplies; and 22 (c) Nursing administration; and 23 (d) Direct portion of medicaid related ancillary services; and 24 (e) Social services; and 25 (f) Raw food; and 26 (g) Employee benefits associated with the direct salaries. 27 (7) "Director" means the director of the department of health and welfare 28 or the director's designee. 29 (8) "Equity" means the new book value of all tangible and intangible 30 assets less the recorded value of all liabilities, as recognized and measured 31 in conformity with generally accepted accounting principles. 32 (9) "Facility" means an entity which contracts with the director to pro- 33 vide services to recipients in a structure owned, controlled, or otherwise 34 operated by such entity, and which entity is responsible for operational deci- 35 sions. In conjunction with the use of the term "facility": 36 (a) "Free-standing intermediate care" means an intermediate care facil- 37 ity, as defined in and licensed under chapter 13, title 39, Idaho Code, 38 which is not owned, managed, or operated by, nor is otherwise a part of a 39 hospital, as defined in section 39-1301(a), Idaho Code; and 40 (b) "Free-standing skilled care" means askillednursing facility, as 41 defined in and licensed under chapter 13, title 39, Idaho Code, which is 42 not owned, managed, or operated by, nor is otherwise a part of a hospital, 43 as defined in section 39-1301(a), Idaho Code; and 44 (c) "Free-standing special care" means a facility that provides either 45 intermediate care, or skilled care, or intermediate care for the mentally 46 retarded, or any combination of either, which is not owned, managed, or 47 operated by, nor is otherwise a part of a hospital, as defined in section 48 39-1301(a), Idaho Code; and 49 (d) "Hospital-based" means askillednursing or intermediate care facil- 50 ity, as defined in and licensed under chapter 13, title 39, Idaho Code, 51 which is owned, managed, or operated by, or is otherwise a part of a hos- 52 pital, as defined in section 39-1301(a), Idaho Code. 53 (10) "Forced sale" is a sale required by a bankruptcy, foreclosure, the 54 provisions of a will or estate settlement pursuant to the death of an owner, 55 physical or mental incapacity of an owner which requires ownership transfer to 72 1 existing partner or partners, or a sale required by the ruling of a federal 2 agency or by a court order. 3 (11) "Goodwill" means the amount paid by the purchaser that exceeds the 4 net tangible assets received. The value of goodwill is derived from the eco- 5 nomic benefits that a going concern may enjoy, as compared with a new one, 6 from established relations in the related markets, with government departments 7 and other noncommercial bodies and with personal relationships. These intangi- 8 ble assets cannot be separated from the business and sold as can plant and 9 equipment. Under the theory that the excess payment would be made only if 10 expected future earnings justified it, goodwill is often described as the 11 price paid for excess future earnings. The amortization of goodwill is 12 nonallowable, nonreimbursable expense. 13 (12) "Historical cost" means the actual cost incurred in acquiring and 14 preparing an asset for use, including feasibility studies, architect's fees, 15 and engineering studies. 16 (13) "Indirect care costs" consists of the following costs either directly 17 coded to the nursing facility or allocated to the nursing facility through the 18 medicare step-down process: 19 (a) Administrative and general care cost; and 20 (b) Activities; and 21 (c) Central services and supplies; and 22 (d) Laundry and linen; and 23 (e) Dietary (non-"raw"non-raw food" costs); and 24 (f) Plant operation and maintenance (excluding utilities); and 25 (g) Medical records; and 26 (h) Employee benefits associated with the indirect salaries; and 27 (i) Housekeeping; and 28 (j) Other costs not included in direct care costs or costs exempt from 29 cost limits. 30 (14) "Interest rate limitation" means that the interest rate allowed for 31 working capital loans and for loans for major movable equipment for intermedi- 32 ate care facilities for the mentally retarded shall be the prime rate as pub- 33 lished in the western edition of the Wall Street Journal or successor publica- 34 tion, plus one percent (1%) at the date the loan is made. All interest expense 35 greater than the amount derived by using the limitation above shall be 36 nonreimbursable; provided, however, that this interest rate limitation shall 37 not be imposed against loans or leases which were made prior to July 1, 1984. 38 Said loans or leases shall be subject to the tests of reasonableness, rela- 39 tionship to patient care and necessity. 40 (15) "Intermediate care facility for the mentally retarded" means an 41 habilitative facility designed and operated to meet the educational, training, 42 habilitative and intermittent medical needs of the developmentally disabled. 43 (16) "Major movable equipment" means such items as accounting machines, 44 beds, wheelchairs, desks, furniture, vehicles, etc. The general characteris- 45 tics of this equipment are: 46 (a) A relatively fixed location in the building; 47 (b) Capable of being moved, as distinguished from building equipment; 48 (c) A unit cost sufficient to justify ledger control; 49 (d) Sufficient size and identity to make control feasible by means of 50 identification tags; and 51 (e) A minimum life of approximately three (3) years. 52 (17) "Medicaid" means the 1965 amendments to the social security act (P.L. 53 89-97), as amended. 54 (18) "Minor movable equipment" includes such items as wastebaskets, 55 bedpans, syringes, catheters, silverware, mops, buckets, etc. The general 73 1 characteristics of this equipment are: 2 (a) In general, no fixed location and subject to use by various depart- 3 ments of the provider's facility; 4 (b) Comparatively small in size and unit cost; 5 (c) Subject to inventory control; 6 (d) Fairly large quantity in use; and 7 (e) Generally, a useful life of approximately three (3) years or less. 8 (19) "Net book value" means the historical cost of an asset, less accumu- 9 lated depreciation. 10 (20) "Normalized per diem costs" refers to direct care costs that have 11 been adjusted based on the facility's case mix index for purposes of making 12 the per diem costs comparable among facilities. Normalized per diem costs are 13 calculated by dividing the facility's direct care per diem costs by its 14 facility-wide case mix index, and multiplying the result by the statewide 15 average case mix index. 16 (21) "Nursing facility inflation rate" means the most specific skilled 17 nursing facility inflation rate applicable to Idaho established by data 18 resources, inc., or its successor. If a state or regional index has not been 19 implemented, the national index shall be used. 20 (22) "Patient-day" means a calendar day of care which will include the day 21 of admission and exclude the day of discharge unless discharge occurs after 22 3:00 p.m. or it is the date of death, except that, when admission and dis- 23 charge occur on the same day, one (1) day of care shall be deemed to exist. 24 (23) "Property costs" means the total of allowable interest expense, plus 25 depreciation, property insurance, real estate taxes, amortization, and allow- 26 able lease/rental expense. The department may require and utilize an appraisal 27 to establish those components of property costs which are identified as an 28 integral part of an appraisal. 29 (24) "Raw food" means food used to meet the nutritional needs of the resi- 30 dents of a facility, including liquid dietary supplements, liquid thickeners, 31 and tube feeding solutions. 32 (25) "Reasonable property insurance" means that the consideration given is 33 an amount that would ordinarily be paid by a cost-conscious buyer for compara- 34 ble insurance in an arm's length transaction. Property insurance per licensed 35 bed in excess of two (2) standard deviations above the mean of the most 36 recently reported property insurance costs per licensed bed of all facilities 37 in the reimbursement class as of the end of a facility's fiscal year shall not 38 be considered reasonable. 39 (26) "Recipient" means an individual determined eligible by the director 40 for the services provided in the state plan for medicaid. 41 (27) "Rural hospital-based nursing facilities" are those hospital-based 42 nursing facilities not located within a metropolitan statistical area (MSA) as 43 defined by the United States bureau of the census. 44 (28) "Urban hospital-based nursing facilities" are those hospital-based 45 nursing facilities located within a metropolitan statistical area (MSA) as 46 defined by the United States bureau of the census. 47 (29) "Utilities" means all expenses for heat, electricity, water and 48 sewer. 49 SECTION 147. That Section 56-120, Idaho Code, be, and the same is hereby 50 amended to read as follows: 51 56-120. PROPERTY REIMBURSEMENT FOR HOSPITAL-BASED SKILLED NURSING FACILI- 52 TIES. In addition to the basic payment per patient-day of care, each hospital- 53 basedskilled carenursing facility shall be paid on a prospective basis its 74 1 actual property and utility costs per patient-day, to be determined by divid- 2 ing its total projected property and utility costs, as calculated from the 3 cost report selected for rate setting, by the total number of patient-days 4 from the same cost reporting period. 5 SECTION 148. That Section 56-201, Idaho Code, be, and the same is hereby 6 amended to read as follows: 7 56-201. DEFINITIONS. As used in this act: 8 (a) "State department" means the state department of health and welfare; 9 (b) "Director" means the director of the department of health and wel- 10 fare; 11 (c) "Public welfare" means public assistance and social services; 12 (d) "Social services" means activities of the department in efforts to 13 bring about economic, social and vocational adjustment of families and per- 14 sons; 15 (e) "Public assistance" includes general assistance, old-age assistance, 16 aid to the blind, assistance to families with children, aid to the disabled, 17 and medical assistance; 18 (f) "General assistance" means direct assistance in cash, direct assis- 19 tance in kind, and supplementary assistance; 20 (g) "Direct assistance in cash" means money payments to eligible people 21 not classified as old-age assistance, or aid to the blind, or assistance to 22 families with children, or aid to the disabled, or medical assistance; 23 (h) "Direct assistance in kind" means payments to others on behalf of a 24 person or family for food, rent, clothing, and other normal subsistence needs; 25 (i) "Supplementary assistance" means payments to othersinon behalf of a 26 person or family for transportation and costs incidental to vocational adjust- 27 ment or employment; 28 (j) "Old-age assistance" means money payments to orinon behalf of needy 29 aged people; 30 (k) "Aid to the blind" means money payments to orinon behalf of blind 31 people who are needy; 32 (l) "Assistance to families with children" means money payments, direct 33 assistance in kind, supplementary assistance, and social services targeted 34 toward self-sufficiency with respect to orinon behalf of eligible families 35 with children; 36 (m) "Aged" means any person sixty-five (65) years or older; 37 (n) "Aid to the disabled" means money payments to orinon behalf of 38 needy individuals who are disabled, and whose disability prevents self-support 39 through employment for a period of at least one (1) year from the date of 40 onset of the disability; 41 (o) "Medical assistance" means payments for part or all of the cost of 42 such care and services allowable within the scope of title XIX of the federal 43 social security act as amended as may be designated by department rule; 44 (p) "Provider" means any individual, partnership, association, corpora- 45 tion or organization, public or private, who provides residentialcareor 46 assisted living services, certified family home services, nursinghomefacil- 47 ity services, services offered pursuant to the medicaid program, or services 48 offered pursuant to titles IV or XX of the social security act; 49 (q) "Needy" means the condition where a person or family does not have 50 income and available resources in accordance with the provisions of section 51 56-210, Idaho Code. 52 SECTION 149. That Section 63-701, Idaho Code, be, and the same is hereby 75 1 amended to read as follows: 2 63-701. DEFINITIONS. As used in this chapter: 3 (1) "Claimant" means a person who has filed a claim under the provisions 4 of sections 63-701 through 63-710, Idaho Code. Except as provided in section 5 63-702(2), Idaho Code, on January 1 of the year in which the claim was filed a 6 claimant must be an owner of a homestead and be: 7 (a) Not less than sixty-five (65) years old; or 8 (b) A fatherless or motherless child under the age of eighteen (18) years 9 of age; or 10 (c) A widow or widower; or 11 (d) A disabled person who is recognized as disabled by the social secu- 12 rity administration pursuant to title 42 of the United States Code, or by 13 the railroad retirement board pursuant to title 45 of the United States 14 Code, or by the office of management and budget pursuant to title 5 of the 15 United States Code; or 16 (e) A disabled veteran of any war engaged in by the United States, whose 17 disability is recognized as a service-connected disability of a degree of 18 ten percent (10%) or more, or who has a pension for nonservice-connected 19 disabilities, in accordance with laws and regulations administered by the 20 United States veterans administration; or 21 (f) A person as specified in 42 USC 1701, who was or is entitled to 22 receive benefits because he is known to have been taken by a hostile force 23 as a prisoner, hostage or otherwise; or 24 (g) Blind. 25 (2) "Homestead" means the dwelling, owner-occupied by the claimant and 26 used as the primary dwelling place of the claimant and occupied by any members 27 of the household as their home, and so much of the land surrounding it, not 28 exceeding one (1) acre, as is reasonably necessary for the use of the dwelling 29 as a home. It may consist of a part of a multidwelling or multipurpose build- 30 ing and part of the land upon which it is built. Homestead does not include 31 personal property such as furniture, furnishings or appliances, but a manufac- 32 tured home may be a homestead. 33 (3) "Household" means the claimant and any person or persons who live in 34 the same dwelling, and share its furnishings, facilities, accommodations or 35 expenses. The term includes any person owing a duty of support to the appli- 36 cant pursuant to section 32-1002, Idaho Code, unless the person qualifies as a 37 "nonhousehold member" pursuant to subsection (6) of this section. The term 38 does not include bona fide lessees, tenants, or roomers and boarders on con- 39 tract. "Household" includes persons described in subsection (9)(b) of this 40 section. 41 (4) "Household income" means all income received by all persons of a 42 household in a calendar year while members of the household. 43 (5) "Income" means the sum of federal adjusted gross income as defined in 44 the internal revenue code, as defined in section 63-3004, Idaho Code, and to 45 the extent not already included in federal adjusted gross income, alimony, 46 support money, income from inheritances, nontaxable strike benefits, the non- 47 taxable amount of any individual retirement account, pension or annuity, 48 (including railroad retirement benefits, all payments received under the fed- 49 eral social security act, state unemployment insurance laws, and veterans dis- 50 ability pensions and compensation, excluding rollovers as provided in section 51 402 or 403 of the internal revenue code), nontaxable interest received from 52 the federal government or any of its instrumentalities or a state government 53 or any of its instrumentalities, worker's compensation and the gross amount of 54 loss of earnings insurance. It does not include capital gains, gifts from non- 76 1 governmental sources or inheritances. To the extent not reimbursed, cost of 2 medical care as defined in section 213(d) of the internal revenue code, incur- 3 red by the household may be deducted from income. "Income" does not include 4 veterans disability pensions received by a person described in subsection 5 (1)(e) who is a claimant or a claimant's spouse, provided however, that the 6 disability pension is received pursuant to a service-connected disability of a 7 degree of forty percent (40%) or more. Documentation of medical expenses may 8 be required by the county assessor, board of equalization and state tax com- 9 mission. "Income" shall be that received in the calendar year immediately pre- 10 ceding the year in which a claim is filed. Where a claimant does not file a 11 federal tax return the claimant's federal adjusted gross income, for purposes 12 of this section, shall be an income equivalent to federal adjusted gross 13 income had the claimant filed a federal tax return. 14 (6) "Nonhousehold member" means any nonspouse who lives in the claimant's 15 dwelling for the purpose of providing protective oversight, caregiving, or 16 personalcareassistance services to the claimant, or who is receiving dis- 17 ability benefits pursuant to subsection (1)(d) or (e) of this section, or who 18 is over age sixty-five (65) and lives in the claimant's dwelling and receives 19 protective oversight, caregiving or personalcareassistance services provided 20 by the claimant. 21 (7) "Occupied" means actual use and possession. 22 (8) "Owner" means a person holding title in fee simple or holding a cer- 23 tificate of motor vehicle title (either of which may be subject to mortgage, 24 deed of trust or other lien) or who has retained or been granted a life estate 25 or who is a person entitled to file a claim under section 63-702, Idaho Code. 26 "Owner" shall also include any person who as grantor created a revocable or 27 irrevocable trust and named himself as beneficiary of that trust, or who is a 28 partner of a limited partnership, member of a limited liability company or 29 shareholder of a corporation which holds title in fee simple or holds a cer- 30 tificate of motor vehicle title and who has retained or been granted a life 31 estate. "Owner" shall not include any person that otherwise occupies property 32 as beneficiary of a trust. "Owner" includes a vendee in possession under a 33 land sale contract. Any partial ownership shall be considered ownership for 34 determining qualification for property tax reduction benefits, however, the 35 amount of property tax reduction under section 63-704, Idaho Code, and rules 36 promulgated pursuant to section 63-705, Idaho Code, shall be computed on the 37 value of the claimant's partial ownership. "Partial ownership," for the pur- 38 poses of this section, means any one (1) person's ownership when property is 39 owned by more than one (1) person. The combined community property interests 40 of both spouses shall not be considered partial ownership. The proportional 41 reduction required under this subsection shall not apply to community property 42 interests. Where title to property is held by a person who has died without 43 timely filing a claim for property tax reduction, the estate shall be the 44 "owner." 45 (9) (a) "Primary dwelling place" means the claimant's dwelling place on 46 January 1 of the year for which the claim is made. The primary dwelling 47 place is the single place where a claimant has his true, fixed and perma- 48 nent home and principal establishment, and to which whenever the individ- 49 ual is absent he has the intention of returning. A claimant must establish 50 the dwelling to which the claim relates as his primary dwelling place by 51 clear and convincing evidence or by establishing that the dwelling is 52 where the claimant resided on January 1 and: 53 (i) At least six (6) months during the prior year; or 54 (ii) The majority of the time the claimant owned the dwelling if 55 owned by the claimant less than one (1) year; or 77 1 (iii) The majority of the time after the claimant first occupied the 2 dwelling if occupied by the claimant less than one (1) year. 3 (b) Notwithstanding the provisions of paragraph (a) of this subsection, 4 the property upon which the claimant makes application shall be deemed to 5 be the claimant's primary dwelling place if the claimant is otherwise 6 qualified and resides in a care facility and does not allow the property 7 upon which the claimant has made application to be occupied by persons 8 paying a consideration to occupy the dwelling. A claimant's spouse who 9 resides in a care facility shall be deemed to reside at the claimant's 10 primary dwelling place and to be a part of the claimant's household. A 11 care facility is a hospital,skillednursing facility, intermediate care12facilityor intermediate care facility for the mentally retarded as 13 defined in section 39-1301, Idaho Code, or a facility as defined in sec- 14 tion 39-3302(16), Idaho Code, or a dwelling other than the one(1)upon 15 which the applicant makes application where a claimant who is unable to 16 reside in the dwelling upon which the application is made lives and 17 receives help in daily living, protection and security. 18 SECTION 150. That Section 63-3022K, Idaho Code, be, and the same is 19 hereby amended to read as follows: 20 63-3022K. MEDICAL SAVINGS ACCOUNT. (1) For taxable years commencing on 21 and after January 1, 1995, annual contributions to a medical savings account 22 not exceeding two thousand dollars ($2,000) for the account holder and inter- 23 est earned on a medical savings account shall be deducted from taxable income 24 by the account holder, if such amount has not been previously deducted or 25 excluded in arriving at taxable income. For married individuals the maximum 26 deduction shall be computed separately for each individual. Contributions to 27 the account shall not exceed the amount deductible under this section. 28 (2) For the purpose of this section, the following terms have the follow- 29 ing meanings unless the context clearly denotes otherwise: 30 (a) "Account holder" means an individual, in the case of married individ- 31 uals each spouse, including a self-employed person, on whose behalf the 32 medical savings account is established. 33 (b) "Dependent" means a person for whom a deduction is permitted under 34 section 151(b) or (c) of the Internal Revenue Code if a deduction for the 35 person is claimed for that person on the account holder's Idaho income tax 36 return. 37 (c) "Dependent child" means a child or grandchild of the account holder 38 who is not a dependent if the account holder actually pays the eligible 39 medical expenses of the child or grandchild and the child or grandchild is 40 any of the following: 41 (i) Under nineteen (19) years of age, or enrolled as a full-time 42 student at an accredited college or university. 43 (ii) Legally entitled to the provision of proper or necessary sub- 44 sistence, education, medical care or other care necessary for his or 45 her health, guidance or well-being and not otherwise emancipated, 46 self-supporting, married or a member of the armed forces of the 47 United States. 48 (iii) Mentally or physically incapacitated to the extent that he or 49 she is not self-sufficient. 50 (d) "Depository" means a state or national bank, savings and loan associ- 51 ation, credit union or trust company authorized to act as a fiduciary or 52 an insurance administrator or insurance company authorized to do business 53 in this state, a broker or investment advisor regulated by the department 78 1 of finance, a broker or insurance agent regulated by the department of 2 insurance or a health maintenance organization, fraternal benefit society, 3 hospital and professional service corporation as defined in section 4 41-3403, Idaho Code, or nonprofit mutual insurer regulated under title 41, 5 Idaho Code. 6 (e) "Eligible medical expense" means an expense paid by the taxpayer for 7 medical care described in section 213(d) of the Internal Revenue Code, 8 medical insurance premiums, dental and long-term care expenses of the 9 account holder and the spouse, dependents and dependent children of the 10 account holder. 11 (f) "Long-term care expenses" means expenses incurred in providing custo- 12 dial care in askillednursing facilityor intermediate care facilityas 13those terms aredefined in section 39-1301, Idaho Code, and for insurance 14 premiums relating to long-term care insurance under chapter 46, title 41, 15 Idaho Code. 16 (g) "Medical savings account" means an account established with a deposi- 17 tory to pay the eligible medical expenses of the account holder and the 18 dependents and dependent children of the account holder. Medical savings 19 accounts shall carry the name of the account holder, a designated benefi- 20 ciary or beneficiaries of the account holder and shall be designated by 21 the depository as a "medical savings account." 22 (3) Upon agreement between an employer and employee, an employer may 23 establish and contribute to the employee's medical savings account or contrib- 24 ute to an employee's existing medical savings account. The total combined 25 annual contributions by an employer and the account holder shall not exceed 26 two thousand dollars ($2,000) for the account holder. Employer contributions 27 to an employee's medical savings account shall be owned by the employee. 28 (4) Funds held in a medical savings account may be withdrawn by the 29 account holder at any time. Withdrawals for the purpose of paying eligible 30 medical expenses shall not be subject to the tax imposed in this chapter. The 31 burden of proving that a withdrawal from a medical savings account was made 32 for an eligible medical expense is upon the account holder and not upon the 33 depository or the employer of the account holder. Other withdrawals shall be 34 subject to the following restrictions and penalties: 35 (a) There shall be a distribution penalty for withdrawal of funds by the 36 account holder for purposes other than the payment of eligible medical 37 expenses. The penalty shall be ten percent (10%) of the amount of with- 38 drawal from the account and, in addition, the amount withdrawn shall be 39 subject to the tax imposed in this chapter. The direct transfer of funds 40 from a medical savings account to a medical savings account at a different 41 depository shall not be considered a withdrawal for purposes of this sec- 42 tion. Charges relating to the administration and maintenance of the 43 account by the depository are not withdrawals for purposes of this sec- 44 tion. 45 (b) After an account holder reaches fifty-nine and one-half (59 1/2) 46 years of age, withdrawals may be made for eligible medical expenses or for 47 any other reason without penalty, but subject to the tax imposed by this 48 section. 49 (c) Upon the death of an account holder, the account principal, as well 50 as any interest accumulated thereon, shall be distributed without penalty 51 to the designated beneficiary or beneficiaries. 52 (d) Funds withdrawn which are later reimbursed shall be taxable unless 53 redeposited into the account within sixty (60) days of the reimbursement. 54 Deposits of reimbursed eligible medical expenses shall not be included in 55 calculating the amount deductible. 79 1 (e) Funds deposited in a medical savings account which are deposited in 2 error or unintentionally and which are withdrawn within thirty (30) days 3 of being deposited shall be treated as if the amounts had not been depos- 4 ited in the medical savings account. Funds withdrawn from a medical sav- 5 ings account which are withdrawn in error or unintentionally and which are 6 redeposited within thirty (30) days of being withdrawn shall be treated as 7 if the amounts had not been withdrawn from the medical savings account. 8 (f) Funds withdrawn which are, not later than the sixtieth day after the 9 day of the withdrawal, deposited into another medical savings account for 10 the benefit of the same account holder are not a withdrawal for purposes 11 of this section and shall not be included in calculating the amount 12 deductible. 13 (5) Reporting.--Depositories shall provide to the state tax commission 14 the following information regarding medical savings accounts: the name of the 15 account holder, the address of the account holder, the taxpayer identification 16 number of the account holder, deposits made during the tax year by the account 17 holder, withdrawals made during the tax year by the account holder, interest 18 earned on the proceeds of a medical savings account or other information 19 deemed necessary by the commission. Reports shall be filed annually on or 20 before the last day of February following the year to which the information in 21 the report relates. 22 (6) Any medical care savings account established pursuant to chapter 53, 23 title 41, Idaho Code, as enacted by chapter 186, laws of 1994, may be contin- 24 ued pursuant to the provisions of this section and all duties, privileges and 25 liabilities imposed in this section upon medical care savings accounts and the 26 beneficiaries of those accounts shall apply to medical care savings accounts 27 and their beneficiaries established pursuant to chapter 53, title 41, Idaho 28 Code, as enacted by chapter 186, laws of 1994, as if the medical care savings 29 account were a medical savings account established pursuant to this section. 30 (7) (a) If the account holder's surviving spouse acquires the account 31 holder's interest in a medical savings account by reason of being the des- 32 ignated beneficiary of such account at the death of the account holder, 33 the medical savings account shall be treated as if the spouse were the 34 account holder. 35 (b) If, by reason of the death of the account holder, any person acquires 36 the account holder's interest in a medical savings account in a case to 37 which subparagraph (7)(a) of this section does not apply: 38 (i) Such account shall cease to be a medical savings account as of 39 the date of death; and 40 (ii) An amount equal to the fair market value of the assets in such 41 account on such date shall be includable, if such person is not the 42 estate of such holder, in such person's Idaho taxable income for the 43 taxable year which includes such date, or if such person is the 44 estate of such holder, in such holder's Idaho taxable income for the 45 last taxable year of such holder. 46 (c) The amount includable in Idaho taxable income under subparagraph (b) 47 of this subsection (7) by any person, other than the estate, shall be 48 reduced by the amount of qualified medical expenses which were incurred by 49 the decedent before the date of the decedent's death and paid by such per- 50 son within one (1) year after such date. 51 SECTION 151. That Section 66-402, Idaho Code, be, and the same is hereby 52 amended to read as follows: 53 66-402. DEFINITIONS. As used in this chapter: 80 1 (1) "Adult" means an individual eighteen (18) years of age or older. 2 (2) "Artificial life-sustaining procedures" means any medical procedure 3 or intervention which utilizes mechanical means to sustain or supplant a vital 4 function. Artificial life-sustaining procedures shall not include the adminis- 5 tration of medication, and it shall not include the performance of any medical 6 procedure deemed necessary to alleviate pain, or any procedure which could be 7 expected to result in the recovery or long-term survival of the patient and 8 his restoration to consciousness. 9 (3) "Department" means the Idaho department of health and welfare. 10 (4) "Director" means the director of the department of health and wel- 11 fare. 12 (5) "Developmental disability" means a chronic disability of a person 13 which appears before the age of twenty-two (22) years of age and: 14 (a) Is attributable to an impairment, such as mental retardation, cere- 15 bral palsy, epilepsy, autism or other condition found to be closely 16 related to or similar to one (1) of these impairments that requires simi- 17 lar treatment or services, or is attributable to dyslexia resulting from 18 such impairments; and 19 (b) Results in substantial functional limitations in three (3) or more of 20 the following areas of major life activity; self-care, receptive and 21 expressive language, learning, mobility, self-direction, capacity for 22 independent living, or economic self-sufficiency; and 23 (c) Reflects the need for a combination and sequence of special, inter- 24 disciplinary or generic care, treatment or other services which are of 25 lifelong or extended duration and individually planned and coordinated. 26 (6) "Emancipated minor" means an individual between fourteen (14) and 27 eighteen (18) years of age who has been married or whose circumstances indi- 28 cate that the parent-child relationship has been renounced. 29 (7) "Evaluation committee" means an interdisciplinary team of at least 30 three (3) individuals designated by the director or his designee to evaluate 31 an individual as required by the provisions of this chapter. Each committee 32 must include a physician licensed to practice medicine in the state of Idaho, 33 a licensed social worker, with field training or experience in working with 34 partially disabled or disabled persons, and a clinical psychologist. 35 (8) "Facility" means the Idaho state school and hospital, askillednurs- 36 ing facility, an intermediate care facility, an intermediate care facility for 37 the mentally retarded, a licensed residentialcare homeor assisted living 38 facility, a group foster home, other organizations licensed to provide twenty- 39 four (24) hour care, treatment and training to the developmentally disabled, a 40 mental health center, or an adult and child development center. 41 (9) "Lacks capacity to make informed decisions" means the inability, by 42 reason of developmental disability, to achieve a rudimentary understanding of 43 the purpose, nature, and possible risks and benefits of a decision, after con- 44 scientious efforts at explanation, but shall not be evidenced by improvident 45 decisions within the discretion allowed nondevelopmentally disabled individu- 46 als. 47 (10) "Likely to injure himself or others" means: 48 (a) A substantial risk that physical harm will be inflicted by the 49 respondent upon his own person as evidenced by threats or attempts to com- 50 mit suicide or inflict physical harm on himself; or 51 (b) A substantial risk that physical harm will be inflicted by the 52 respondent upon another as evidenced by behavior which has caused such 53 harm or which places another person or persons in reasonable fear of sus- 54 taining such harm; or 55 (c) That the respondent is unable to meet essential requirements for 81 1 physical health or safety. 2 (11) "Manage financial resources" means the actions necessary to obtain, 3 administer and dispose of real, personal, intangible or business property, 4 benefits and/or income. 5 (12) "Meet essential requirements for physical health or safety" means the 6 actions necessary to provide health care, food, clothing, shelter, personal 7 hygiene and/or other care without which serious physical injury or illness 8 would occur. 9 (13) "Minor" means an individual seventeen (17) years of age or less. 10 (14) "Protection and advocacy system" means the agency designated by the 11 governor of the state of Idaho to provide advocacy services for people with 12 disabilities pursuant to 42 USC section 6042. 13 (15) "Respondent" means the individual subject to judicial proceedings 14 authorized by the provisions of this chapter. 15 SECTION 152. That Section 67-2601, Idaho Code, be, and the same is hereby 16 amended to read as follows: 17 67-2601. DEPARTMENT CREATED -- ORGANIZATION -- DIRECTOR -- BUREAU OF 18 OCCUPATIONAL LICENSES CREATED. (1) There is hereby created the department of 19 self-governing agencies. The department shall, for the purposes of section 20, 20 article IV of the constitution of the state of Idaho, be an executive depart- 21 ment of the state government. 22 (2) The department shall consist of the following: 23 (a)aAgricultural commodity commissions: Idaho apple commission, as pro- 24 vided by chapter 36, title 22, Idaho Code; Idaho bean commission, as pro- 25 vided by chapter 29, title 22, Idaho Code; Idaho beef council, as provided 26 by chapter 29, title 25, Idaho Code; Idaho cherry commission, as provided 27 by chapter 37, title 22, Idaho Code; Idaho dairy products commission, as 28 provided by chapter 31, title 25, Idaho Code; Idaho pea and lentil commis- 29 sion, as provided by chapter 35, title 22, Idaho Code; Idaho potato com- 30 mission, as provided by chapter 12, title 22, Idaho Code; Idaho prune com- 31 mission, as provided by chapter 30, title 22, Idaho Code; and the Idaho 32 wheat commission, as provided by chapter 33, title 22, Idaho Code; and,33 (b)pProfessional and occupational licensing boards: Idaho state board of 34 certified public accountancy, as provided by chapter 2, title 54, Idaho 35 Code; board of architectural examiners, as provided by chapter 3, title 36 54, Idaho Code; office of the state athletic director, as provided by 37 chapter 4, title 54, Idaho Code; board of barber examiners, as provided by 38 chapter 5, title 54, Idaho Code; board of commissioners of the Idaho state 39 bar, as provided by chapter 4, title 3, Idaho Code; board of chiropractic 40 physicians, as provided by chapter 7, title 54, Idaho Code; Idaho board of 41 cosmetology, as provided by chapter 8, title 54, Idaho Code; Idaho coun- 42 selor licensing board, as provided by chapter 34, title 54, Idaho Code; 43 state board of dentistry, as provided by chapter 9, title 54, Idaho Code; 44 state board of denturitry, as provided by chapter 33, title 54, Idaho 45 Code; state board of engineering examiners, as provided by chapter 12, 46 title 54, Idaho Code; board of environmental health specialists examiners, 47 as provided by chapter 24, title 54, Idaho Code; state board for registra- 48 tion of professional geologists, as provided by chapter 28, title 54, 49 Idaho Code; board of hearing aid dealers and fitters, as provided by chap- 50 ter 29, title 54, Idaho Code; Idaho state board of landscape architects, 51 as provided by chapter 30, title 54, Idaho Code; state board of medicine, 52 as provided by chapter 18, title 54, Idaho Code, and its associated physi- 53 cal therapist advisory board, as provided by chapter 22, title 54, Idaho 82 1 Code; state board of morticians, as provided by chapter 11, title 54, 2 Idaho Code; board of nurses, as provided by chapter 14, title 54, Idaho 3 Code; board of examiners of nursing home administrators, as provided by 4 chapter 16, title 54, Idaho Code; state board of optometry, as provided by 5 chapter 15, title 54, Idaho Code; Idaho outfitters and guides board, as 6 provided by chapter 21, title 36, Idaho Code; board of pharmacy, as pro- 7 vided by chapter 17, title 54, Idaho Code; state board of podiatry, as 8 provided by chapter 6, title 54, Idaho Code; Idaho state board of psychol- 9 ogist examiners, as provided by chapter 23, title 54, Idaho Code; public 10 works contractors licensing board, as provided by chapter 19, title 54, 11 Idaho Code; Idaho real estate commission, as provided by chapter 20, title 12 54, Idaho Code; real estate appraiser board, as provided by chapter 41, 13 title 54, Idaho Code; board of social work examiners, as provided by chap- 14 ter 32, title 54, Idaho Code; the board of veterinary medicine, as pro- 15 vided by chapter 21, title 54, Idaho Code; and the board of examiners of 16 residentialcareor assisted living facility administrators, as provided 17 by chapter 42, title 54, Idaho Code. 18 (c)tThe board of examiners, pursuant to section 67-2001, Idaho Code. 19 (d)tThe division of building safety, to be headed by a division admin- 20 istrator and comprised of four (4) bureaus: plumbing, electrical, build- 21 ings, and logging and industrial safety. The division administrator and 22 bureau chiefs shall be nonclassified employees exempt from the provisions 23 of chapter 53, title 67, Idaho Code. The administrator of the division 24 shall administer the provisions of chapter 40, title 39, Idaho Code, 25 relating to manufactured homes and recreational vehicles; chapter 41, 26 title 39, Idaho Code, relating to modular buildings; chapter 21, title 44, 27 Idaho Code, relating to manufactured home dealer and broker licensing; 28 chapter 10, title 54, Idaho Code, relating to electrical contractors and 29 journeymen; chapter 26, title 54, Idaho Code, relating to plumbing and 30 plumbers; and shall perform such additional duties as are imposed upon him 31 by law. The division administrator shall cooperate with the industrial 32 commission and aid and assist the commission in its administration of sec- 33 tions 72-720, 72-721 and 72-723, Idaho Code, and at the request of the 34 commission shall make inspection of appliances, tools, equipment, machin- 35 ery, practices or conditions, and make a written report to the commission. 36 The administrator shall make recommendations to the commission to aid the 37 commission in its administration of sections 72-720, 72-721 and 72-723, 38 Idaho Code, provided however, that nothing herein shall be construed as 39 transferring to the administrator any of the authority or powers now 40 vested in the industrial commission. 41 (3) The bureau of occupational licenses is hereby created within the 42 department of self-governing agencies. 43 SECTION 153. That Section 67-2602, Idaho Code, be, and the same is hereby 44 amended to read as follows: 45 67-2602. BUREAU OF OCCUPATIONAL LICENSES. (1) The bureau of occupational 46 licenses created in the department of self-governing agencies by section 47 67-2601, Idaho Code, shall be empowered, by written agreement between the 48 bureau and each agency for which it provides administrative or other services 49 as provided by law, to provide such services for the board of architectural 50 examiners, board of barber examiners, board of chiropractic physicians, board 51 of cosmetology, counselor licensing board, board of environmental health spe- 52 cialist examiners, state board of denturitry, board of hearing aid dealers and 53 fitters, board of landscape architects, board of morticians, board of examin- 83 1 ers of nursing home administrators, board of optometry, board of podiatrists, 2 board of psychologist examiners, real estate appraiser board, board of examin- 3 ers of residentialcareor assisted living facility administrators, board of 4 social work examiners, and such other professional and occupational licensing 5 boards or commodity commissions as may request such services. The bureau may 6 charge a reasonable fee for such services provided any agency not otherwise 7 provided for by law and shall maintain proper accounting methods for all funds 8 under its jurisdiction. 9 (2) Notwithstanding the statutes governing specific boards, for any board 10 that contracts with the bureau of occupational licenses, each board member 11 shall hold office until a successor has been duly appointed and qualified. 12 SECTION 154. That Section 67-6532, Idaho Code, be, and the same is hereby 13 amended to read as follows: 14 67-6532. LICENSURE, STANDARDS AND RESTRICTIONS. (a) The department of 15 health and welfare may require such residences to be licensed and set minimum 16 standards for providing services or operation. Such licensure may be under the 17 residentialcare home regulationsor assisted living facility rules, or under 18 the intermediate care facilities for mentally retarded or related conditions 19regulationsrules, or underregulationsrules specifically written for such 20 residences. 21 (b) No conditional use permit, zoning variance, or other zoning clearance 22 shall be required of a residential facility which serves eight (8) or fewer 23 mentally and/or physically handicapped or elderly persons and is supervised as 24 required in section 67-6531, Idaho Code, which is not required of a single 25 family dwelling in the same zone. 26 (c) No local ordinances or local restrictions shall be applied to or 27 required for a residential facility which serves eight (8) or fewer mentally 28 and/or physically handicapped or elderly persons and is supervised as required 29 in section 67-6531, Idaho Code, which is not applied to or required for a sin- 30 gle family dwelling in the same zone.
AS1365|||| LEGISLATURE OF THE STATE OF IDAHO |||| Fifty-fifth Legislature Second Regular Session - 2000Moved by Henbest Seconded by Bieter IN THE HOUSE HOUSE AMENDMENTS TO S.B. NO. 1365 1 AMENDMENTS TO SECTION 5 2 On page 8 of the printed bill, in line 13, delete "Physician extender" and 3 insert: "Authorized provider", and also in line 13, following "practitioner" 4 insert: "or clinical nurse specialist"; delete lines 15, 16, 17 and in line 5 18, delete "the Idaho state board of nursing". 6 AMENDMENTS TO SECTION 10 7 On page 12, in line 14, delete "Physician extender" and insert: "Autho- 8 rized provider", also in line 14, delete "an advanced practice" and in line 9 15, delete "professional nurse" and insert: "a nurse practitioner or clinical 10 nurse specialist". 11 AMENDMENT TO SECTION 17 12 On page 14, in line 42, delete "physician extender's" and insert: "autho- 13 rized provider's". 14 AMENDMENTS TO SECTION 20 15 On page 15, in line 21, delete "physician" and in line 22, delete 16 "extender" and insert: "authorized provider"; in line 29, delete "physician 17 extender" and insert: "authorized provider"; in line 32, delete "physician 18 extender" and insert: "authorized provider"; and in line 35, delete "physician 19 extender" and insert: "authorized provider". 20 AMENDMENTS TO SECTION 65 21 On page 32, in line 7, delete "Physician extender" and insert: "Authorized 22 provider", also in line 7, delete "an advanced practice" and in line 8, delete 23 "professional nurse" and insert: "a nurse practitioner or clinical nurse spe- 24 cialist". 25 AMENDMENT TO SECTION 71 26 On page 34, in line 18, delete "physician extender's" and insert: "autho- 27 rized provider's". 28 AMENDMENTS TO SECTION 73 29 On page 34, in line 39, delete "physician" and in line 40, delete 30 "extender" and insert: "authorized provider"; on page 35, in line 1, delete 31 "physician extender" and insert: "authorized provider"; in line 4, delete 32 "physician extender" and insert: "authorized provider"; and in line 7, delete 33 "physician extender" and insert: "authorized provider". 34 AMENDMENT TO SECTION 123 35 On page 54, in line 44, delete "physician extender" and insert: "autho- 36 rized provider". 2 1 AMENDMENT TO SECTION 124 2 On page 55, in line 26, delete "physician" and in line 27, delete 3 "extender" and insert: "authorized provider". 4 CORRECTIONS TO TITLE 5 On page 1, in line 21, delete "PHYSICIAN EXTENDER" and insert: "AUTHORIZED 6 PROVIDER"; and in line 24, delete "PHYSICIAN EXTENDER" and insert: "AUTHORIZED 7 PROVIDER"; on page 2, in line 12, delete "PHYSICIAN" and in line 13, delete 8 "EXTENDER" and insert: "AUTHORIZED PROVIDER"; in line 14, delete "PHY-" and in 9 line 15, delete "SICIAN EXTENDER" and insert: "AUTHORIZED PROVIDER". Moved by Sali Seconded by Loertscher IN THE HOUSE OF REPRESENTATIVES HOUSE AMENDMENTS TO S.B. NO. 1365 10 AMENDMENTS TO SECTION 25 11 On page 19 of the printed bill, in line 33, following "convicted" insert: 12 ", or is not under the influence or control of anyone convicted,"; in line 34, 13 following "of" delete the remainder of the line and all of lines 35, 36 and 14 37, and insert: "any felony or defrauding the federal government: 15 (a) A criminal offense related to the delivery of an item or service 16 under medicare, medicaid or other state health care program; or 17 (b) A criminal offense related to the neglect or abuse of a patient, in 18 connection with the delivery of a health care item or service; or 19 (c) A criminal offense related to fraud, theft, embezzlement, breach of 20 fiduciary responsibility, or other financial misconduct; or 21 (d) A criminal offense resulting in death or injury to a person.". 22 AMENDMENTS TO SECTION 78 23 On page 38, in line 47, following "convicted" insert: ", or is not under 24 the influence or control of anyone convicted,"; in line 48, following "of" 25 delete the remainder of the line and all of lines 49, 50 and 51, and insert: 26 "any felony or defrauding the federal government: 27 (a) A criminal offense related to the delivery of an item or service 28 under medicare, medicaid or other state health care program; or 29 (b) A criminal offense related to the neglect or abuse of a patient, in 30 connection with the delivery of a health care item or service; or 31 (c) A criminal offense related to fraud, theft, embezzlement, breach of 32 fiduciary responsibility, or other financial misconduct; or 33 (d) A criminal offense resulting in death or injury to a person.". Moved by Loertscher Seconded by Sali IN THE HOUSE OF REPRESENTATIVES HOUSE AMENDMENTS TO S.B. NO. 1365 34 AMENDMENT TO SECTION 10 35 On page 11 of the printed bill, in line 31, following ""home")." insert: 36 "Notwithstanding the foregoing, upon application by the owner the department 3 1 may authorize not more than four (4) adults to be placed in a certified family 2 home which is owner-occupied.". 3 AMENDMENT TO SECTION 46 4 On page 27, in line 5, following "adults" insert: ", however, upon an 5 application by the owner and upon a finding by the department that residents 6 can be cared for safely and appropriately based on the residents' specific 7 needs, the department may authorize not more than four (4) adults to be placed 8 in a certified family home which is owner-occupied and which applies to the 9 department for the authorization. Certification as a four (4) resident certi- 10 fied family home shall not be transferable to another person or entity. Four 11 (4) resident certified family homes shall be subject to all statutes and rules 12 governing certified family homes but shall not be subject to the residential 13 or assisted living administrator licensing requirements of chapter 42, title 14 54, Idaho Code, section 39-3340, Idaho Code, licensing of residential or 15 assisted living facilities for the mentally ill, developmentally disabled and 16 physically disabled, or section 39-3540, Idaho Code, licensing of residential 17 or assisted living facilities for the elderly. This provision implementing 18 four (4) resident certified family homes shall be effective on July 1, 2001. 19 Prior to the effective date, the department shall promulgate rules for four 20 (4) resident certified family homes through the negotiated rulemaking process. 21 Nothing in this subsection shall be construed to authorize increased group 22 size for providers of any form of care other than certified family homes". 23 AMENDMENT TO SECTION 65 24 On page 31, in line 15, following ""home")." insert: "Notwithstanding the 25 foregoing, upon application by the owner the department may authorize not more 26 than four (4) adults to be placed in a certified family home which is owner- 27 occupied.". 28 AMENDMENT TO SECTION 101 29 On page 46, in line 18, following "adults" insert: ", however, upon an 30 application by the owner and upon a finding by the department that residents 31 can be cared for safely and appropriately based on the residents' specific 32 needs, the department may authorize not more than four (4) adults to be placed 33 in a certified family home which is owner-occupied and which applies to the 34 department for the authorization. Certification as a four (4) resident certi- 35 fied family home shall not be transferable to another person or entity. Four 36 (4) resident certified family homes shall be subject to all statutes and rules 37 governing certified family homes but shall not be subject to the residential 38 or assisted living administrator licensing requirements of chapter 42, title 39 54, Idaho Code, section 39-3340, Idaho Code, licensing of residential or 40 assisted living facilities for the mentally ill, developmentally disabled and 41 physically disabled, or section 39-3540, Idaho Code, licensing of residential 42 or assisted living facilities for the elderly. This provision implementing 43 four (4) resident certified family homes shall be effective on July 1, 2001. 44 Prior to the effective date, the department shall promulgate rules for four 45 (4) resident certified family homes through the negotiated rulemaking process. 46 Nothing in this subsection shall be construed to authorize increased group 47 size for providers of any form of care other than certified family homes".
STATEMENT OF PURPOSE RS09503 The proposed legislation amends several provisions of law to allow for more home and community-based service options under the Medicaid program for the elderly and persons with disabilities. Specifically, it updates the personal care section in Idaho Code to match certain changes in the federal Medicaid program description of personal care services. "Attendant care" is added to this section. It updates the language to reflect "certified family homes" rather than "adult foster care" and changes "residential care facility" to "residential or assisted living facility." "Physician extender" is added to reflect changes in the Idaho Nurse Practice Act. A waiver is allowed for certified family homes to accept nursing home level clients under certain conditions. It brings the Idaho Code language defining a nursing home into conformance with current Medicaid program language by eliminating the terms "skilled nursing care" and "intermediate care," and replaces them with "nursing facility." FISCAL IMPACT The impact of the proposed legislation on the state General Fund would be neutral. Approval will enhance the state's ability to capture Medicaid federal matching funds. Contact: Theo Murdock or Kathleen Allyn Agency Division of Medicaid 334-5747 STATEMENT OF PURPOSE/FISCAL NOTE S 1365