1. Florida Politics

Politics blamed in latest demise of Florida's assisted-living reforms

Published May 13, 2014

TALLAHASSEE — Legislative leaders identified reform of Florida's assisted-living facilities as one of their top goals this session, but once again lawmakers did not adopt measures to improve conditions in the state's 3,048 facilities.

It is the third year the Legislature has not passed reforms proposed after a 2011 Miami Herald investigation revealed the neglect, abuse and death of residents at some ALFs.

The most recent Senate and House proposals fell apart in the final days when the House attached other health care-related bills to the Senate's ALF bill and they couldn't resolve their differences.

"We still have the same antiquated, dangerous system that was in place when the Miami Herald wrote its series," said Brian Lee, executive director of Families for Better Care. The state "has not fixed the abuse and neglect, and residents are still in trouble."

Getting rid of the "bad apples" in the ALF industry and adding more oversight affects not only the elderly who live in one of the facilities, which house more than 80,000 residents, but also Florida's economy and future generations, said Jack McRay, advocacy manager for AARP Florida.

What happened this session "is a classic example of politics again trumping policy," McRay said. "It became part of a health care 'train' that became a train wreck."

The Senate unanimously passed SB 248 early in the session. The House passed its version, HB 573, at the end of April. While House Speaker Will Weatherford and Senate President Don Gaetz identified ALF reform as one of their session goals in their "Work Plan 2014" program, it failed to make any progress. Gaetz blames the House and the ALF industry for the bill's demise.

"It wasn't the trains that killed the bill. It was the House that killed the bill,'' he told the Times/Herald. "Speaker Weatherford gave me his commitment they would try to do this. The ALF industry lobbied very hard against reforms. They lost a lot of credibility. It's a real shame."

He said that when the House bill began to be "picked apart" in the House, he urged the Senate's prime sponsor, Sen. Eleanoer Sobel, D-Hollywood, to start attaching it to several high-priority House bills. In retaliation, the House attached language to the ALF bill that the Senate didn't want — language about surgery centers and visitation rights for grandparents.

"Health care is a complex issue, and we just weren't able to get agreement between the two chambers," Weatherford said after the session ended May 2.

Gaetz said he vowed to be Sobel's first co-sponsor and will work to pass the bill next year.

The House sponsor, Rep. Larry Ahern, R-Seminole, said the important thing for next year "is to agree on something the first month of session and get this done early."

Among its provisions, the ALF bill would have required facilities with one or more, rather than three or more, state-supported mental health residents to obtain a limited mental health license; authorized ALF staff members with increased training to perform additional medication-related duties; and changed the fee system.

The most contentious issue was a new rating system for all licensed ALFs, similar to that used for nursing homes.

Shaddrick Haston, CEO of the Florida Assisted Living Association, contends that the industry was not trying to sabotage the bill.

"Actually, most of the bill had great things to help residents age in place," said Haston, the state's former head of licensing for assisted-living facilities. "The industry wanted an ALF bill this year."

This story has been updated to reflect the following correction: Jack McRay is advocacy manager for AARP Florida.

Herald/Times staff reporter Mary Ellen Klas contributed to this report.