6.__Instrumental activities of daily living.__"Instrumental activities of daily living" means meal preparation, taking medication, using the telephone, handling finances, shopping, light housekeeping, heavy housekeeping and traveling to appointments.

7.__Low income.__"Low income" means having a household income that does not exceed 80% of the median household income, adjusted for family size, for the county in which the facility is located.

8.__Nursing facility.__"Nursing facility" means a facility in which nursing care and medical services are prescribed by or performed under the general direction of person licensed to practice medicine or surgery in the State for the accommodation of convalescent or other persons who are not acutely ill and not in need of care in a hospital but who require skilled nursing care and related medical servcies 24 hours per day because of illness, disease or physical or mental infirmity.

9.__Residential care facility.__"Residential care facility" means a facility licensed pursuant to section 7801, including entities formerly known as adult foster homes and boarding homes but excluding adult family care homes.__Level I residential care facilities are licensed for 6 or fewer residents and Level II residential care facilities are licensed for 7 or more residents.

10.__Supportive services.__"Supportive services" means meals, personal care assistance, monitoring and administering of medications, housekeeping, laundry, transportation and social and recreational activities including activities designed to reduce isolation and sustain a resident's mental and physical health.

11.__Unit.__"Unit" means a single apartment unit with a living and dining area, separate bedroom, private bathroom and kitchen or kitchenette.

§9002.__New units

The department shall subsidize the services in 120 new assisted living units for low-income citizens of the State in each biennium until the total number of such assisted living units in the State reaches 3% of the number of citizens of the State who are 80 years of age or older and whose household income is below 80% of the state median household income.__For purposes

of this section, "new units" means new construction or conversion of existing structures.

§9003.__Funding level

The department shall reimburse a provider of supportive services at a facility for actual costs incurred by that provider in providing the supportive services, less the aggregate revenue from the services copays pursuant to section 9004 and any additional copay revenue pursuant to section 9005, up to a maximum of $35 per day, multiplied by the number of units in the facility rented by residents eligible for reimbursement by the department.__The department shall index the maximum daily reimbursement of $35 per day for inflation in the long-term care industry by use of a nationally recognized and utilized measure of such inflation.

§9004.__Services copay

A resident of a facility may pay not less than 65% and not more than 80% of the resident's household income toward the combination of rent, utilities and the cost of the supportive services, including meals and personal care that are not covered by the State's contribution.

§9005.__Additional copay based on resident assets

1.__Resident assets.__A resident with liquid assets over $10,000 in constant 2001 dollars or a couple with liquid assets over $15,000 in constant 2001 dollars shall pay an additional monthly copay equal to the lesser of:

A.__Three percent of the amount of assets that exceed $10,000 for a resident or $15,000 for a couple in constant 2001 dollars; or

B.__The full monthly cost of supportive services.

2.__Indexing.__The department shall index the $10,000 and $15,000 thresholds in subsection 1 to inflation using the Consumer Price Index.

3.__Rules.__The department shall adopt rules designed to prevent the transfer of assets within the prior 3 years by a consumer or prospective consumer of assisted living services to avoid the copay described in subsection 1.

§9006.__Resident functional eligibility

1.__Persons who are eligible.__Eligibility for subsidies from the department toward the cost of supportive services for a resident entering an assisted living facility is limited to a consumer who needs the following amount and type of support:

A.__Limited assistance plus a one-person physical assist with at least 2 activities of daily living one to 2 times for each activity in the past 7 days;

B.__Limited assistance plus a one-person physical assist with one activity of daily living and assistance, including physical assistance, with at least 2 instrumental activities of daily living; or

C.__Assistance with at least 5 instrumental activities of daily living.

2.__Persons who are not eligible.__A person with the following characteristics is not eligible for initial admission to a facility:

A.__Is unable to be alone for significant periods of time, including overnight;

B.__Requires a 2-person physical assist with at least one activity of daily living on an ongoing basis; or

C.__Is eligible for admission to a nursing facility.

3.__Requirements.__The department may establish requirements as to the income of a resident of a facility whose supportive services are subsidized by the department, provided that such requirements do not conflict with the resident income limitations of public and private sources of capital to the facility.__The department may not establish requirements as to the income of a resident of a facility whose supportive services are not subsidized by the department.

4.__Assessment.__A provider of services may conduct its own assessments of the functional eligibility of a prospective resident of an assisted living facility using an eligibility determination form prescribed by the department.__Alternatively, the department may employ an assessing services agency to assess the functional eligibility for covered services of prospective residents of assisted living facilities, provided that the cost of the assessment conducted by the assessing services agency may not affect the amount of reimbursement available to the provider of supportive services in the facility.__An assessing services agency may not prescribe which resident may enter the facility.__

The assessing services agency may prescribe which resident is eligible for reimbursement of covered services by the department.

5.__Determinations of eligibility.__A determination of resident income eligibility for the housing portion of assisted living is carried out by the owner of the facility or its designated management agent and may not be carried out by an assisted services agency.

§9007.__Distribution of funds

Funds appropriated pursuant to this chapter are available through the department to new assisted living facilities by means of a competitive request for proposal process.__The department shall consider the following 2 criteria exclusively in selecting proposals to fund:

1.__Qualifications.__The qualifications of an applicant to provide services; and

2.__Unmet need.__The unmet need for assisted living units affordable to low-income citizens in the area of the State in which the project is proposed.__In assessing this need, the department shall analyze the number of assisted living units in the area affordable to low-income persons, relative to the number of low-income persons in the area 80 years of age or older.__The department may not use data describing the availability of beds in residential care facilities or other forms of long-term care that are not assisted living.

§9008.__Coverage of all assisted living facilities in State

Notwithstanding any other provision of this Title, this chapter covers all assisted living facilities serving low-income citizens of the State with support from the department, including those developed prior to the effective date of this Act.

§9009.__Rules

Rules adopted by the department pursuant to this chapter are major substantive rules as defined in Title 5, chapter 375, subchapter II-A.

Sec. 2. Appropriation. The following funds are appropriated from the General Fund to carry out the purposes of this Act.

2001-02 2002-03

HUMAN SERVICES, DEPARTMENT OF

Congregate Housing Services Program

All Other $0 $1,533,000

Provides funds to subsidize long-term assisted living facilities in the State.

SUMMARY

This bill provides a comprehensive system by which the Department of Human Services subsidizes assisted living arrangements for low-income citizens of the State.