1. Health

Gov. Rick Scott's panel goes soft on ALF industry, critics say

TALLAHASSEE — Gov. Rick Scott used tough language in the summer of 2011 when he created a panel to help fix the deadly abuse and neglect in Florida assisted living facilities.

He pledged to provide protections for elderly and disabled ALF residents, who in recent years saw sweeping breakdowns of care as lawmakers stripped regulations and failed to protect the state's most vulnerable people from burns, beatings and death.

Then politics happened.

In a change of tide, Scott's panel issued its final report this week, calling for diminished transparency and fewer regulations. The panel calls for the state to better enforce existing rules rather than create new ones. And to give homes more money to raise their standards but not punish them through fines and other sanctions when they perform badly.

Although some hailed the recommendations as a step forward, not everyone was cheering.

"(Providers) are probably doing cartwheels right now," said Brian Lee, a resident advocate and director of Families for Better Care.

The recommendations are a product of more than a year of contentious meetings and a panel on which advocates for the powerful ALF industry had the lion's share of seats. Scott appointed the group after the Miami Herald reviewed thousands of documents and published a sweeping series on the squalid conditions for many of the state's most vulnerable residents. The series was a Pulitzer Prize finalist.

Some advocates for the elderly have blasted the panel since its formation, accusing Scott of stacking the committee with business-oriented ALF operators. Scott promised a second round of meetings would include more ALF residents and advocates. Critics contend the reverse was true.

On Friday, Scott insisted that the work group is just one step, and that he'll work with lawmakers to pass meaningful reform. He made similar promises last year.

"We need to act this session to make sure that existing regulations are being enforced to protect our seniors from abuse and to make necessary changes to stop facility operators from breaking the law," he said this time around.

The furor from the Herald series prompted Scott's panel to offer a variety of solutions in 2011, from stricter educational requirements for ALF caretakers to more government oversight for facilities that cause patient harm. Those emerged shortly after the series was published and served as a foundation for sweeping legislation that lawmakers softened and then defeated in 2012, under pressure from powerful industry lobbyists.

The new round of proposals offer bits and pieces of that original package.

Larry Polivka, chairman of the panel and head of the Claude Pepper Foundation, touted the group's more resident-friendly proposals. Those include an appeals process to give evicted residents recourse and the creation of an independent nonprofit organization to train and credential providers.

"I think the work group struck a good balance," he said, adding that the first round of proposals still stand. "It has to be a carrot-and-stick approach. You can't live by punitive measures alone."

But Pat Lange, lobbyist and director of the Florida Assisted Living Association, said the final report appears to stand on its own. And she hopes it stays that way.

"The more recent conversations have been much more productive. This agrees with what we've felt from the beginning, which is that the regulations that exist are adequate," she said. "I think (the panel) realized they need to make some differences in some of the ways they were handling recommendations."

Lange bashed the first report but hailed more recent proposals, including one that calls for the Legislature to limit resident lawsuits. She also supports proposals that ask lawmakers for more money for mental health and other services, measures that may face a rough road in the current budget climate.

Lange added that Florida should not offer appeals for evicted residents.

"Who is going to pay for those residents to keep living there while they go through appeal?" she said. "If a resident doesn't fit in, the facility should be able to ask that resident to leave."

Lange also defended a proposal to shield resident complaints from the public and the news media, despite concern from resident advocates that the rule would cloak poor-performing homes and lead to more death and neglect. An alternative would have allowed the complaints to be made public but with the resident's name redacted.

Lange said it's important to protect ALF operators from being sullied by false complaints. Industry representatives also argued during meetings that keeping complaints under wraps would ensure residents can air their grievances without fear of retaliation from their caretakers.

"If every complaint was truly a real complaint, you might be able to go down that road and have everything out in the open," Lange said. "You don't want to create a stir amongst people who don't understand."

Martha Lenderman, a patient advocate and former Department of Children and Families administrator, took exception to that.

"Any time you have secrecy it tends to protect wrongdoers more than the victims," said Lenderman, who argued against the proposal, but was outvoted, 8-5.

Which proposals become law, if any, will depend on the legislators who sponsor them.

Rep. Matt Hudson, R-Naples, who sat on the panel, often told the work group during meetings that the proposals are insignificant if they can't survive the Republican-dominated Legislature.

Lenderman said she fears that lawmakers will forgo patient welfare and cherry pick proposals that favor the industry.

"These are individuals whose very lives, not to mention the quality of their lives, depend on the facility, the administrator and the staff not only to keep them safe but to make them feel like they are a member of the family," she said. "We ended up with nothing last year, and I'd hate to see that happen again."

Brittany Alana Davis can be reached at or 850-323-0353.