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Assisted Living Facilities
Assisted Living Facilities (ALFs) are a critical element of Virginia’s long-term care continuum of services for people with Alzheimer’s disease and other forms of dementia. Virginia’s strict medical eligibility requirements for nursing home admission result in an ALF population with more medical needs than in other states. Therefore, Virginia must assure the quality of licensed Assisted Living Facilities and the safety of residents.
Insuring that Virginia’s ALFs are SAFE and provide QUALITY CARE requires:
INFORMED CONSUMERS
ALFs must be required to provide accurate and complete information to allow prospective residents to choose the facility that best meets their needs. DISCLOSURE MUST INCLUDE:
· Services provided;
· Fees, with distinction between basic services, comprehensive services and additional services;
· Admission, transfer between levels, and discharge criteria;
· The general number and qualifications of staff on each shift;
· Range, frequency, number and duration of activities available to residents;
· Complaint procedures;
· Ownership structure.
ADMINISTRATION and STAFF TRAINING
ALFs must have staff sufficiently trained to meet the needs of the residents AND administrators must meet and be held accountable to standardized levels of training and expertise through licensure. RECOMMENDATION:
· Assisted Living Administrators should be licensed.
· Require that all staff that provides personal care be certified as CNAs (certified nursing aides).
· Require medication aides to be certified as CNAs and have an additional 32 hours of training related to medications.
OVERSIGHT and ENFORCEMENT
ALFs must be held accountable when the Commonwealth’s established minimum safety and care requirements are not met. RECOMMENDATION:
· Establish a system of graduated fines for being out of compliance with licensure terms and increase the maximum amount from $500 to $10,000.
· Expedite procedures for suspension of licensure; establish a system to avoid disruption of delivery of care to residents, which may include establishing a system for the use of temporary managers. Establish definition of imminent danger in Virginia Code.
· Increase the number of DSS inspectors devoted to assisted living licensure and inspections. Assure consistent statewide training for inspectors.
PUBLIC FUNDING
ALFs must have sufficient funding provided when State funds are used to provide services to the poorest Virginians in need of ALF services. RECOMMENDATION:
· Make the Auxiliary Grant a state-only program, i.e., do not require local governments to pay 20% toward the cost of the program.
· Increase the Auxiliary Grant rate by 100% for residents.
· Increase Long-Term Care Ombudsman funding – 1 for every 2,000 beds
Issue: Fire & Rescue and EMS, as first responders often lack training to handle and understand individuals with dementia.
Recommendation:
The Alzheimer’s Association supports the implementation of a full-time Curriculum Developer to provide, coordinate and facilitate Alzheimer’s and related disorders training for all “Public Safety Personnel” throughout the Commonwealth. The current $50,000 appropriation to the Department of Criminal Justice Services (DCJS) for law enforcement training only, should be supplemented by an additional $65,000 appropriation, from both the Fire and Emergency Medical Service (EMS) programs for a total program cost of $115,000.
Issue: Alzheimer’s disease causes millions of Americans to lose their ability to recognize familiar places and faces. Six in ten people with Alzheimer’s disease wander. They may become disoriented and lost, even in their own neighborhood. Although common, this wandering behavior can become dangerous. If not found within 24 hours, up to half of those who wander risk serious injury or death. Wandering is among the biggest challenges caregivers face.
Recommendation:
The Alzheimer’s Association proposes to conduct eight safety awareness events throughout Virginia. The event, called the “Safety Awareness for Families Event”, will address a wide range of safety issues, including wandering, home safety, accessibility in the home and community, as well as safety and emergency response resources.
Issue:Home and community-based services (such as in-home care, personal care, home delivered meals, transportation, care coordination, mental health services, adult day care, respite care and Medicaid waiver services) help older Virginians function independently, keep them in the least restrictive setting, strengthen family support, decrease the risk of inappropriate institutionalization, and improve the quality of life.
Recommendation:
The Alzheimer’s Association urges the General Assembly to respond to the documented unmet need of older Virginians for critical services such as personal care, home delivered meals, transportation, care coordination, mental health services, and adult day/respite care.
Prepared by Carter Harrison
Public Policy Coordinator
Alzheimer's Association
4600 Cox Rd., STE 130
Glen Allen, VA 23060
(804)967-2594 voice
(804)967-2588 fax
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