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Panel revives effort to reform residential care for the elderly

JACKSONVILLE — After a failed attempt to pass legislation to protect the frail and elderly in assisted living facilities, industry experts reconvened in Jacksonville Monday with the hope of hammering out measures to curb abuse while appeasing the powerful long term care industry.

The panel was appointed by Gov. Rick Scott last year to address rampant wrongdoing in ALFs, but lawmakers failed to pass any of the workgroup's proposals in March. The meeting was first attempt to revive the effort.

The panel's recommendations, and the resulting bills, would have yielded the most sweeping reforms in a generation for the state's 2,850 assisted living facilities, but the proposals fell through at the last minute amid heavy lobbying by the industry and political infighting.

State budget concerns, combined with the industry's lobbying grip on the Legislature, make it unclear whether the panel's recommendations will ever make it to law. Some panelists said they would like to see more state oversight, but the Agency for Health Care Administration, which oversees the state's ALFs, faces already-strained resources.

"Some of the things we're talking about now that require extra funding may not occur this year or next year," said Larry Polivka, chair of the meeting and head of the Claude Pepper Foundation. "But given the importance of this program, I really do believe it's going to be at the top of the priority list when more funding does become available."

This year, the workgroup will hold three meetings in an effort to produce suggestions for lawmakers to adopt next session. The group plans to address, among other things, how to better protect mental health residents and enforce the state's existing regulations.

The committee is also looking for models to encourage high-quality resident care on the front-end, rather than impose punishment after the resident is injured or killed.

The state ramped up facility inspections in recent months, but resident advocates say increased surveillance barely scratches the surface of needed reform.

"There's no excuse for anybody to be harmed," said Jack McRay, advocacy manager of AARP Florida. "We're not recognizing the signs early enough…there has to be a way."

The thrust for change comes after a two-year Miami Herald investigation revealed that lawmakers had stripped back regulations for decades and, in many cases, left the state's most vulnerable people to fend for themselves.

In the worst cases, ALF residents were raped, locked in closets, or infections were allowed to fester unchecked.

But ALF representatives say those cases are few and that the panel's suggestions for "endless" regulations," may cause homes to shut down, displacing residents.

"Every year somebody wants to do something more to fix something," said Bob Sharpe, CEO of the Florida Council for Community Mental Health. "If you put those new requirements on providers, something has got to give."

He added that low Medicaid payments put the facilities under constant financial strain, and he questioned the need for extra regulation because it's unclear how many facilities are actually abusing patients.

But Polivka countered, "It's not just a matter of a good facility or a bad facility, there are degrees of good and bad, and some of these measures, over time, make a qualitative difference."

Sen. Rene Garica, R-Hialeah, who sponsored a sweeping bill that failed to pass during the last session, attended the meeting, but didn't say much.

Rep. Matt Hudson, R-Naples, a member of the panel and one of the Legislature's most influential voices on health care, did not show up. He also attended only less than half of one of the three meetings held last year.

Panel revives effort to reform residential care for the elderly 06/25/12 [Last modified: Monday, June 25, 2012 5:58pm]
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