It’s a busy time for state-level advocacy efforts for assisted living. All 50 legislatures are in session, and in the first two months of the year 677 bills related to assisted living were introduced. During that time, many efforts have focused on fending off bills that would reduce resident rights or impact consumers’ ability to have resident-centered care. In addition to being reactive, however, many state affiliates and chapters are championing legislation to improve residents’ lives. They are working to implement adequate criminal background checks for employees, drafting adequate elder abuse measures, and supporting a range of bills that would prohibit smoking in all businesses, including assisted living communities, among various other efforts.
Here’s a look at several of the advocacy efforts going on right now at the state level.
Texas
Assisted living advocates in Texas have introduced a resolution opposing the so-called Employee Free Choice Act, which would take away a worker’s right to a federally supervised ballot when deciding whether or not to join a union. The Texas Assisted Living Association (TALA) also is working with the legislature to ensure providers are able to open communities in as timely a way as possible. In a state faced with a shortage of inspectors, the proposed regulations would allow provisional licenses for providers who are compliant with resident care standards.
The inspector shortage in Texas is a challenge for providers there. Providers want to open buildings on time to ensure residents can move in when they choose. However, residents also need to be assured of timely license renewals to guarantee continued access to long-term care insurance. (Insurance carriers need to receive valid licenses from providers.)
TALA directed a highly successful advocacy day in February, bringing together providers, families, and others in a day of grassroots education and advocacy. A number of states, including Texas, have decided to tackle the issue of allowing frail seniors the right to remain in assisted living. AL is committed to the principle that consumers should be able to live the rest of their lives in the place they call home, yet some states make it difficult to implement this principle-for example, by disallowing individuals receiving hospice care to remain in assisted living.
Georgia
Providers in Georgia are working on a bill that would redefine the term “ambulatory” to more clearly govern when a resident may be required to leave assisted living. South Carolina’s ALFA chapter meanwhile has been backing Bill SB-273, which would allow individuals in hospice care to remain in assisted living.
Just as Georgia is seeking to clarify who may stay in assisted living, so are advocates in California striving to rework the language defining a “bed-ridden” condition. Today’s too-broad definitions create confusion for local fire protection departments, and can cause residents to leave assisted living sooner than they might wish.
California
The California Assisted Living Association also is advocating budget measures that would help facilitate more efficient licensing. Currently, regulators conduct a 30 percent random sample for inspections. If not inspected through the sample, no community is allowed to go more than five years without an inspection. Providers say they want more frequent oversight to safeguard the integrity of the industry, and they are advocating a 20 percent increase in licensing fees to fund additional inspectors.
Virginia
The first legislative session of the year in Virginia was a successful one for AL advocates. They successfully thwarted a bill that would have required an extremely burdensome and ineffective reporting system to the Department of Social Services on all stages of pressure ulcers.
Advocates also were able to work with legislators to improve a bill governing the registration of individuals who distribute medications. As originally crafted, regulations were overly complicated, making it too difficult for many to register. The modified bill extends deadlines and creates new, more realistic testing procedures. Less travel time is required for those seeking registration, and new registrants would be allowed to continue practicing while waiting to be approved.
Pennsylvania
In addition to legislative work, state-level affiliates also have been actively pursuing appropriate regulatory oversight. In Pennsylvania, for example, providers were challenged in 2008 by a new set of assisted living regulations that were overly prescriptive, to the point where some providers might be discouraged from seeking licensure. At press time, the state’s Department of Public Welfare was gathering public comment and considering amendments to the proposed legislation.
These examples represent just a sampling of the legislative and regulatory advocacy presently at play at the state level. While the government shakeup at the national level has many watching the federal regulatory landscape, the wheels keep turning in statehouses and regulatory agencies across the nation. Consistent messaging from assisted living advocates, community allies, and friends is helping to forge an environment that is conducive to the well-being of residents and the success of AL.