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Assisted living legislative and regulatory trends.

Assisted living is regulated in all 50 states and the District of Columbia. Thoughtful laws and regulations ensure a framework for providers and protections for consumers. During 2006, the District of Columbia and 44 state legislatures are in session; hundreds of bills affecting assisted living providers and consumers will be introduced, discussed, and debated. While only a small percentage of the bills will actually be passed into law, those that do not pass are also significant because they give insight into areas of concern, interest, and emerging trends. Furthermore, what is introduced in New York today could very well be introduced in Pennsylvania and New Jersey tomorrow.

The Assisted Living Federation of America (ALFA) monitors legislative and regulatory proposals in all 50 states. The information is updated weekly and is an excellent way for ALFA to stay on top of what is being proposed across the country. In addition, ALFA continues to be a resource for legislative staff looking for best practices and examples of successful laws and regulations.

Over the past few years, the overall trend in assisted living legislation continues to support the mission and philosophy of consumer-driven resident-centered care. The 2006 legislative session continues this trend by following emerging issues.

Disaster planning is not new to the industry; however, the hurricanes in 2005 raised awareness about the importance of disaster planning and implementation. Providers and residents in Louisiana, Texas, Florida, and Alabama have provided a number of success stories and lessons learned that are being shared across the industry. A number of states are using this information as an opportunity to review and modify existing disaster-planning requirements.

Informed choice continues to be a theme in legislation. The success of assisted living is a result of the mission and philosophy of providing consumer-driven resident-centered care in a residential environment. Many states have recognized that this choice needs to be provided to consumers of all incomes, and they are exploring ways to provide long-term care to low-income seniors in the most appropriate and least restrictive setting. A clear trend has been the expansion of Home and Community-Based Waiver programs for assisted living residents across the country.


The cost of long-term care to individuals and state governments has also generated legislation to incentivize personal responsibility and planning for long-term care needs. Many states are considering legislation to offer tax incentives for consumers who purchase long-term care insurance. This legislation can also help state governments reduce spiraling Medicaid costs as more consumers start planning and saving for future long-term care expenses.

Providing consumers with the information and tools they need to make the best choice possible about where to live is also a recent legislative trend. Residency agreements have improved through legislation addressing information that should be included in these agreements. In addition to the residency agreement, many states now require providers to disseminate disclosure documents to prospective residents and families. These new requirements are welcomed by the industry to ensure that consumers have all the information they need to compare different options and make an informed choice when selecting a community.

Staff training and education are also important issues. One area that has received attention has been training for medication aides. More states are now allowing unlicensed staff, provided they are adequately trained, to assist in the administration of medications.

Another positive trend has been the development of collaborative work groups to study state laws and regulations and determine if they need to be revised. Many states are calling together all interested stakeholders--providers, consumers, advocacy groups, state regulators, and others--to work together to make sure state laws and regulations are meeting the needs and preferences of consumers. ALFA embraces this model, as well, by calling together other trade associations and advocacy groups to work together to move the mission of senior living forward. The outcome has been positive, and we hope this collaborative model will continue across the country.

Maribeth Bersani is Senior Vice-President for Public Policy for ALFA. For further information, call (703) 894-1805 or visit To send your comments to the author and editors, e-mail
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Title Annotation:ASSISTED LIVING review
Author:Bersani, Maribeth
Publication:Nursing Homes
Date:Jun 1, 2006
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