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STATE OF OKLAHOMA
1st Session of the 59th Legislature (2023)
SENATE BILL 596 By: Garvin
AS INTRODUCED
An Act relating to long-term care; requiring certain
regulation of intermediate care facilities for
individuals with intellectual disabilities with
sixteen or fewer beds (ICF s/IID-16); directing State
Department of Health to enforce certain federal laws
and regulations; requiring administrator of ICF/IID-
16 to meet certain qualifications; d irecting
promulgation of rules; stating qualifications of
administrator; amending 63 O.S. 2021, Section 1 -1902,
which relates to definitions used in the Nursing Home
Care Act; modifying definitions; excluding ICFs/IID-
16 from certain definition; making language gender
neutral; providing for codification; and providing an
effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-899.2 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. The State Department of Health shall r egulate intermediate
care facilities for individuals with intellectual disabi lities with
sixteen or fewer beds (ICF s/IID-16) as distinct facilities and shall
not regulate ICFs/IID-16 under the Nursing Home Care Act or any
other act that governs a different type of facility.
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B. The State Department of Health shall enforce applicable
federal laws and regulations governi ng intermediate care facilities
for individuals with intellectual disabilities (ICFs/IID) and hired
or contracted staff of ICFs/IID including, but not limited to,
regulations of the Centers for Medicare and Medicaid Services.
C. The administrator of an ICF/IID-16 shall meet the
qualifications of Section 2 of this act.
D. The State Commissioner of H ealth shall promulgate rules to
implement this section with input from experienced professionals
currently working in ICFs/IID-16 in this state. Such rules may
include but not be limited to licensure, licensure fees, staffing,
quality of resident care, minimum standards for facilities,
inspections, penalties, and violations. Such rules shall be
separate and distinct from ru les regulating faciliti es under the
Nursing Home Care Act or any other act that governs a different type
of facility.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 330.53a of Title 63, unless
there is created a duplication in numbering, reads as follows:
The administrator of an intermediate care facility for
individuals with intellectual disabilities with sixteen or fewer
beds (ICF/IID-16) shall be:
1. A nursing facility administrator licensed by the Oklahoma
State Board of Examiners for Long-Term Care Administrators; or
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2. An assisted living facility administrator licensed by the
Oklahoma State Board of Examiners for Long -Term Care Administrators
with not less than three (3) years of experience working with
individuals with intellectual disabilities in a professional
setting.
SECTION 3. AMENDATORY 6 3 O.S. 2021, Section 1 -1902, is
amended to read as follows:
Section 1-1902. As used in the Nursing Home Care Act:
1. “Abuse” means the willful inflictio n of injury, unreasonable
confinement, intimidation or punishment, with resulting physical
harm, impairment or mental anguish;
2. “Access” means the right of a person to enter a facility to
communicate privately and w ithout unreasonable restriction when
invited to do so by a resident. The sta te or local “ombudsman”, as
that term is defined by the Aging S ervices Division of the
Department of Human Servic es pursuant to the Older Americans ’ Act,
42 U.S.C.A., Section 3001 et seq., as amended, and a case manag er
employed by the Department of Mental Health and Substance Abuse
Services or one of its contract age ncies shall have right of access
to enter a facility, communicate privately and without unreasonable
restriction with any resident who consents to the com munication, to
seek consent to communic ate privately and without restriction with
any resident, and to observe all areas of the facility that directly
pertain to the patient care of the resident without infringing upon
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the privacy of the other residents wi thout first obtaining their
consent;
3. “Administrator” means the person licensed by the State of
Oklahoma this state who is in charge of a facility. An
administrator must devote at least one -third (1/3) of such pers on’s
working time to on-the-job supervision of the facility; provided ,
that this requirement shall not apply to an administrator of an
intermediate care facility for individuals with intellectual
disabilities with sixteen or fewer beds (ICF/IID -16), in which case
the person licensed by the sta te may be in charge of more than one
such ICF/IID-16 facility, if such facilities are located within a
circle that has a map radius of not more than fifteen (15) forty
(40) miles, the total number of facilities and beds does not exceed
six facilities and sixty-four beds, and each such ICF/IID-16
facility is supervised by a qualifie d professional. The facilities
may be free-standing in a community or may be on campus with a
parent institution. The ICF/IID -16 facility may be independently
owned and operated or may be part of a l arger institutional
operation;
4. “Advisory Board” means the Long-Term Care Facility Advisory
Board;
5. “Adult companion home ” means any home or establishm ent,
funded and certified by the Dep artment of Human Services, which
provides homelike residential accommodations and suppor tive
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assistance to three or fe wer adults with intellectual or
developmental disabilities;
6. “Board” means State Board of Health;
7. “Commissioner” means State Commissioner of Health;
8. “Department” means the State Department o f Health;
9. “Facility” means a nursing facility and a specialized home;
provided, this term shall not include a residential care home or an
adult companion home;
10. “Nursing facility” means a home, an establishment or an
institution, a distinct part of which is primarily engag ed in
providing:
a. skilled nursing care and related services for
residents who require medical or nursing care,
b. rehabilitation services for the rehabilitation of
injured, disabled, or sick persons, or
c. on a regular basis, heal th-related care and serv ices
to individuals who becaus e of their mental or physical
condition require care and services beyond the level
of care provided by a residential care home and which
can be made available to them only thro ugh a nursing
facility.
“Nursing facility” does not mean, for purposes of Sectio n 1-851.1 of
this title, a facility constr ucted or operated by an entity
described in paragraph 7 of su bsection B of Section 6201 of Title 74
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of the Oklahoma Statutes or the nu rsing care component of a
continuum of care facili ty, as such term is defined un der the
Continuum of Care and Assisted Liv ing Act, to the extent that the
facility constructed or opera ted by an entity described in parag raph
7 of subsection B of Section 6201 of Title 74 of the Oklaho ma
Statutes contains suc h a nursing care component;
11. a. “Specialized facility ” means any home, establishment,
or institution which offers or provides inpati ent
long-term care services on a twenty-four-hour basis to
a limited category of persons requirin g such services,
including but not limited to a facili ty providing
health or habilitation servic es for individuals with
intellectual or developmental disabilit ies, but.
b. Specialized facility does not mean, for:
(1) for purposes of Section 1-851.1 of this title, a
facility constructed or operated by an entity
described in paragraph 7 of subsection B of
Section 6201 of Title 74 of the Oklahoma Statutes
or the nursing care component of a continu um of
care facility, as such term is d efined under the
Continuum of Care and Assisted Li ving Act, to the
extent that the facility constructed or operated
by an entity described in paragraph 7 of
subsection B of Section 6201 of Title 74 of the
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Oklahoma Statutes contains such a nursing care
component, or
(2) an intermediate care facility for individuals
with intellectual disabilities with sixteen or
fewer beds (ICF/IID-16);
12. “Residential care home ” means any home, establishment, or
institution licensed pu rsuant to the provisions of the Reside ntial
Care Act other than a hotel, motel, fraterni ty or sorority house, or
college or university dormitory, which offers o r provides
residential accommodations, food service, and supportive assistance
to any of its residents or houses any resident requirin g supportive
assistance. The residents shall be p ersons who are ambulatory and
essentially capable of managing their own affairs, but who do not
routinely require nursing care; provided, the term “residential care
home” shall not mean a hotel, motel, frat ernity or sorority house,
or college or university dormitory, if the facility operates in a
manner customary to its descri ption and does not house any person
who requires supportive assistance from the facility in orde r to
meet an adequate level of daily l iving;
13. “Licensee” means the person, a corpora tion, partnership, or
association who is the owner of the facility which is licensed by
the Department pursuant to the provisions of the Nursing Home Care
Act;
14. “Maintenance” means meals, shelter, and l aundry services;
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15. “Neglect” means failure to provide goods and/or services
necessary to avoid physical harm, mental an guish, or mental illness;
16. “Owner” means a person, corporation, partnership,
association, or other entity which owns a facility or leases a
facility. The person or entity that sta nds to profit or lose as a
result of the financial success or failure of the operation shall be
presumed to be the owner of the facility. Notwithstanding the
foregoing, any nonstate governmental entity tha t has acquired and
owns or leases a facility and t hat has entered into an agreement
with the Oklahoma Health Care Authorit y to participate in the
nursing facility supplemental payment program ( “UPL Owner”) shall be
deemed the owner of such facility and sha ll be authorized to obtain
management services fro m a management services provider (“UPL
Manager”), and to delegate, alloc ate and assign as between the UPL
Owner and UPL Manager, compensation, profits, losses, liabilit ies,
decision-making authority and res ponsibilities, including
responsibility for the em ployment, direction, supervision and
control of the facility ’s administrator and staff;
17. “Personal care” means assistance with meals, dressing,
movement, bathing or other personal needs or maintenance, or general
supervision of the physical and mental well-being of a person, who
is incapable of maintaining a private, indep endent residence, or who
is incapable of managing his or her person, whether or not a
guardian has been appointed for such person;
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18. “Resident” means a person resid ing in a facility due to
illness, physical or mental infirmity, or advanced age;
19. “Representative of a resident” means a court-appointed
guardian or, if there is no court -appointed guardian, the parent of
a minor, a relative, or other person, designate d in writing by the
resident; provided, that any owner, operator, administrator or
employee of a facility subject to the provisions of the Nursing Home
Care Act, the Residential Care Ac t, or the Group Homes for the
Developmentally Disabled or Physically Ha ndicapped Persons Persons
with Developmental or Physical Disabilities Act shall not be
appointed guardian or limited guardian of a resident of the facility
unless the owner, operator, a dministrator or employee is the spouse
of the resident, or a relative of the resident wi thin the second
degree of consanguinity and is otherwise eligible fo r appointment;
and
20. “Supportive assistance” means the service rendered to any
person which is less than the service provided by a nurs ing facility
but which is sufficient to enable the person to meet an adequate
level of daily living. Supportive assis tance includes but is not
limited to housekeeping, assistance in the preparation of meals,
assistance in the safe storage, distribution, a nd administration of
medications, and assistance i n personal care as is necess ary for the
health and comfort of such p erson. Supportive assistance shall not
include medical service.
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SECTION 4. This act shall become effective November 1, 2 023.
59-1-696 DC 1/17/2023 6:40:19 PM