State lawmakers across the country are delving into a variety of issues that touch assisted living communities, including improving communication, increasing transparency, expanding the use of cameras in resident rooms, loosening certification requirements and improving emergency services.
Aligning quality efforts
In Illinois, a proposal to improve communication between long-term care providers in the state and state regulators is being embraced by senior living providers.
HB 3428 would require joint training sessions twice a year between assisted living and nursing home staff, the Illinois Department of Public Health surveyors and the state’s long-term care ombudsman. The sessions would address quality of care and potential violations, aligning providers and regulators to improve resident outcomes.
LeadingAge Illinois told McKnight’s Senior Living that it fully supports the bill and is actively advocating for its passage.
“This bill represents a crucial step toward a unified approach to advancing quality in nursing homes and assisted living establishments,” LeadingAge Illinois President and CEO Angela Schnepf said. “By fostering collaboration between the Illinois Department of Pubic Health and providers, it would ensure alignment in our quality efforts, as well as enhance communication and consistency.”
Schnepf added that the alignment not only improves relationships; it also achieves a shared goal of elevating quality across the state.
Assigning licensing responsibility
In Minnesota, HF 1477 / SF 1130 would repeal a recent law that prohibits cities from imposing rental licensing on group assisted living communities that have six or fewer residents. The bill would reinstate city authority to impose rental licensing on group homes and introduce broader spacing considerations for licensing agencies.
Proponents believe that by restoring local authority, cities can ensure compliance with health and safety standards for those state-licensed settings. An amendment to the original bill also would give agencies the ability to deny initial licenses to assisted living communities with six or fewer residents if the community is located within 1,320 feet of an existing one.
Another bill, HF 2115, is a human services policy bill that affects assisted living in several areas. One section of the bill reinforces an assisted living resident’s right to have a designated support person, which state advocates support. Another section exempts assisted living providers from direct care staff compensation requirements under the Disability Waiver Rate System. Other aspects of the bill protect resident contracts during ownership changes.
Senior living industry representatives, however, have raised concerns about another section that they say places burdens on assisted living providers by restricting their ability to manage their communities. The Long-Term Care Imperative, a partnership between Care Providers of Minnesota and LeadingAge Minnesota, said that the bill limits the ability of assisted living providers to terminate a contract based on resident acuity or behaviors that threaten the safety of others. This portion of the bill was supported by the Alzheimer’s Association and AARP Minnesota, among other resident advocacy groups.
Expanding the use of cameras
Nevada is considering expanding the scope of a law that allows residents to install cameras in their rooms. Under Assembly Bill 368, Henry’s Law would be expanded to allow cameras to be installed in residents’ rooms at any type of assisted living community or supported living facility.
Under the proposed bill, state health agencies could deny new license applications or suspend or revoke existing licenses for facilities that do not comply with the camera law. It also would add civil and criminal penalties for violations of the law.
Laws allowing assisted living residents and their families to install cameras in their rooms have become more common over the past decade, although the practice remains more widespread in nursing homes. In 2016, Utah became the first state in more than a decade, and only the second state overall, to pass such a law covering assisted living communities. Texas became the first state with a camera law applying to assisted living in 2003 when it amended a 2001 law covering nursing homes to also apply to assisted living.
By 2021, at least five more states — Minnesota, Missouri, North Dakota, Oklahoma and South Dakota — had laws on the books mandating that assisted living communities accommodate resident requests to install electronic monitoring equipment in their rooms. New Jersey also has a “Safe Care Cam” program that loans micro-surveillance equipment to healthcare consumers, including families of assisted living and nursing homes residents. In January, Rhode Island’s Electronic Monitoring in Nursing and Assisted Facilities Act went into effect.
Loosening certification requirements
Under current Pennsylvania law, direct care work requires a high school diploma or GED equivalent certificate, or completion of a nurse’s aid program. A new proposal instead would require potential workers to pass a competency exam assessing interpersonal communication skills, basic reading and writing comprehension, understanding of cultural and diverse communities, and awareness of mental and behavioral health needs.
Although advocates for caregivers and older adults largely support SB 115’s intent, they argue that higher pay would better address the issue of attracting workers to the industry. The state’s hourly reimbursement rate is approximately $45 lower than that of surrounding states.
Educating beneficiaries on Medicaid benefits
Ohio, reportedly one of the most aggressive states in the country when it comes to estate recovery, according to WBNS. HB 130 seeks to educate people who sign up for Medicaid in the Buckeye State that they could be on the hook for paying back those care costs once a recipient dies.
A 1993 federal law requires state Medicaid programs to recover the costs of certain Medicaid benefits through estate recovery. In 2024, Ohio collected $94 million through Medicaid estate recovery.
Improving emergency services
The Oregon Department of Human Services has issued $2.35 million in grants to fund four local pilot projects that address the emergency medical services needs of older adults living in long-term care. The grants are part of the Senior Emergency Medical Services Innovation Program, created in 2021, and run January 2025 through December 2026.
The grants will fund a fire and rescue unit to respond to emergency calls from licensed facilities to reduce unnecessary hospital visits, fund a risk reduction and prevention and education program to partner with licensed long-term care facilities to develop emergency plans, and fund the Care Facility Response Safety Program to train staff members on using lifting devices and responding to falls.
Source: McKnights Seniorliving
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