Policy in Senior Living: Advocating for Change in State Laws

 

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Take a look at the documents needed to move into any assisted living community, and you’ll likely notice that there are references to a lot of regulations. What you may not realize is that the assisted living provider is not setting all of these policies; many of them are set by the state in which they are located. What one state may allow, another state may prohibit. If you’re located in a state where a regulation is affecting your loved one in an adverse way, you may be able to have an impact by becoming an advocate for change.

maribeth-bersani-argentumMaribeth Bersani, chief operating officer for Argentum, urges families to read the policies so they know what to expect before their loved one moves into an assisted living community. People need to know what the requirements are, such as who eligible to move in, are there any restrictions on how long somebody can stay, and when they may need to move out, she explains. While there are similarities between states, there are also differences.

As an example, Bersani cites a restriction in some states that prevents those in need of hospice from staying in an assisted living community. States also regulate such factors as how much notice a resident needs to be given before being asked to move out. Other regulations may govern employment issues, such as requirements for criminal background checks and training.

"I know the last thing a family wants to do is read 100 pages of regulations," Bersani acknowledges, “But they can certainly ask questions when they go visit a community, such as: "What are the regulations that I should know about?’ And the provider should be able to tell them.”


“If people have choices—for instance, one daughter lives in South Carolina while the other lives in New York—you might want to make sure that you look at the regulations to see if you’ll get more of what you need from one state versus the other,” Bersani adds. “That may help with your decision-making.”



Advocacy for Change


Argentum is the leading national association exclusively dedicated to supporting companies that operate senior living communities offering assisted living, independent living, continuing care, and memory care to older adults. It also works with state partners to ensure state rules and regulations serve the best interests of senior living providers, their residents, family members, and staff.

Bersani explains, “It takes a lot of work to get a law or regulation changed. You need to field a coalition and then find the right legislator and a lobbyist. Often the need for change bubbles up from the community—by pointing out, for example, that ‘We need to do something that the law says we cannot do. We have residents with Type 2 diabetes, and we are going to have to discharge them if we can’t give them their insulin.”’

Bersani reports that Benchmark Senior Living has helped Argentum with a number of issues, citing an example in which restrictive regulations in Rhode Island were requiring the frail population to move from assisted living into a skilled nursing facility.

“We worked over a couple of years on improved legislation, and Benchmark was very significant in helping us change that law,” Bersani says. “So we really count on our providers to help us with that grassroots effort that could pass the state and federal level.” Currently, Benchmark is assisting in advocating for change in a Massachusetts law, which prohibits assisted living providers from giving injections and administering certain medications. 

With those types of real-life examples that the provider can point to, it’s often more likely that legislative changes will occur.



Key Issues in 2019


Argentum puts considerable thought into its legislative agenda every year. “We have a public policy committee that gives us direction,” Bersani says. “So we are usually very targeted and proactive on a couple of issues every year.”

Among the legislative issues that Argentum has tackled include elder abuse. The association covers this issue at a new website, Senior Living iQ (the “iQ” stands for “Investing in Quality”). The first Senior Living iQ toolkit, addressing elder abuse in the context of resident safety, is currently available on the site.

cameraAn issue related to elder abuse is the use of video cameras to monitor loved ones and to increase accountability of the senior living provider. Several states have already passed laws allowing electronic monitoring in nursing homes under certain conditions, and Utah recently passed a law that permits the use of cameras in assisted living communities. Other states are following close behind in consideration of this issue. “It’s a real hot button issue on the legislative front,” Bersani says.

emergency-respondersAnother important issue being addressed is emergency preparedness, which has come to the forefront because of the intensity of hurricanes, fires, and other natural disasters over the past two years. We saw a bill pass in Florida—the emergency rule requiring generators—and we also saw a couple of other states introduce similar bills as well as a bill at the federal level,” Bersani reports. While providers have an impact on revising state regulations, residents and family members also play an important role in advocating for change as well.



Stay tuned for more tips and insights at Open Conversations
Want to share a comment or ask question:  openconversations@benchmarkquality.com
Content for Open Conversations was developed in partnership with Caregiving Advice.

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