Protect elders in assisted living
Assisted living is one of the least-regulated options along the long-term care (LTC) continuum. In Florida, regulation of the industry could become even more lenient, affecting thousands of our elders. SB 402 was recently unanimously passed by the Senate’s Committee on Health Policy. Several of the bill’s proposed changes are not consistent with residents’ rights and basic health and safety requirements. The bill, for example, proposes to remove from the already bare-bones reporting requirements the obligation that facilities report their liability claims (for example, settled lawsuits for a violation of residents’ rights or safety) to the Agency for Health Care Administration. It proposes to remove the provision that the agency develop uniform standards to determine facilities’ compliance with residents’ rights and facility standards. The bill will also reduce the obligation of the facility to provide an environment that is safe, healthy and clean by allowing facilities to “promote” rather than “ensure” these basic requirements. With regard to maintenance requirements, the bill will no longer hold facilities accountable for plumbing, heating, cooling, lighting, ventilation, and living space as these are struck out in the text of the bill.
If lawmakers are looking to use regulation to improve quality of care and quality of life, at a minimum, they should aim to reduce the number of persons allowed per bedroom down to 1, require each individual to have their own bathroom, increase minimum staffing levels, strengthen regulation for those ALFs that provide special care for those living with dementia, extend the role of the state’s long-term care ombudsman, and increase the frequency of inspection from once every two years to twice a year. When lawmakers look to revise assisted living regulation, they should begin from the perspective of those living in assisted living.
Dr. Lori Gonzalez, Tallahassee
The writer is on the research faculty at the Claude Pepper Center, Florida State University.
Big data’s promise and peril
Patient privacy must come first | Editorial, Dec. 3
I cannot recall a more important editorial. After 45 years in medical research, I appreciate both the promise and perils of population-level data analyzed via machine learning. Inductive models using “big data” hold high potential, not only in diagnostic and therapeutic options, but also in the organizational and financial determinations of “what works.” Facing a future where chronic disease management will be the challenge, this is particularly important. Our endless debates about who and how to insure, should have been always subordinated to answering the core: most health for least dollars. On the other hand, nothing is more personal to us than us. Improper use of identifiable information about our health, and use of care, already has had catastrophic effects on many. This is despite the many legal protections that we incorrectly presume to be impenetrable. We have only belatedly realized that we are the product, rather than the consumer, of big tech.
We still underestimate that algorithms now deployed to define us, are increasingly being used to re-define us. We are already plagued by “-ists” and “-isms” speciously based on superficial traits. Imagine a scenario in which discrimination can be derived from irrefutable, fundamental, consequential, often immutable, differences among us. This is, in sum, a really big deal, which the Times’ editorial highlights for us, good and bad. Here, the clock on remedy is no doubt ticking faster than most of our other concerns, such as climate change. Fortunately, we have some institutional organs, including but not limited to, the National Academy of Sciences. This is not a job for politicians, nor is it one in which regulation is the only or best intervention.
Pat Byrne, Largo
Making criminals in prison
Prisons chief delivers warning | Dec. 3
Recently a loved one of mine was sentenced to five years in a Florida prison. A non-violent, first-time offender who made a terrible decision, he has landed at Central Florida Reception Center to attend orientation before he is assigned to his permanent camp.
As much as our hearts are aching, we fully understand that the magnitude of this crime mandates a sentence. The issue is that such facilities are submerging these offenders into a culture riddled with extortion, drugs and criminal activity that must ensue in order to protect your own life.
How does this happen? How do those who are sentenced to prison as first-time, non-violent offenders get dumped into a violence-filled, corrupt atmosphere?
This is introducing this type of criminal to a world where drugs and violence reign supreme — watching others fight, beating other inmates beyond recognition, knowing that they cannot access help from the guards, witnessing those who do not have the capacity to deal with such absurdities take their own life. This is, in turn, creating a criminal rather than rehabilitating.
How do these acts keep occurring in Florida prisons? How can this continue, this inhumane treatment of human beings? All of this is contributing to creating a criminal, one who will possibly return to jail, or will use the knowledge they gained in jail to deceive the outside population.
Why are we creating a criminal out of a non-violent first-time offender? If Florida’s intention is to turn to the rehabilitation model of prisoners, certainly Central Florida Reception Center and most prisons alike are failing at that goal.
Shannon Q. Elliott, Sun City Center
Spend money where needed
Move the money, not the children | Editorial, Nov. 30
The Legislature’s funding model needs to be replaced with a model based primarily on the number of children and families served by each district or region.
The Legislature also needs to reassess the level of priority assigned to the funding of the Department of Children and Families (DCF). Surely the DCF mission “to protect the vulnerable, promote strong and economically self-sufficient families, and advance personal and family recovery and resiliency” should be a high priority in the Legislature’s funding, although it has been a low priority for the past 20 years.
Rick Warrener, Odessa
Tall towers aren’t better
Urban life reaches for the skies | Dec. 6
The powers that be in St. Petersburg need to understand that bigger isn’t always better.
Angeline McTighe, Tierra Verde