CALIFORNIA ASSISTED LIVING REGULATORY IMPROVEMENTS
When originally regulated in 1985, assisted living facilities were conceived as places where older adults could live with minor support from staff. As opposed to a nursing facility which would provide support to adults with more chronic conditions. Today, as the aging look for the comforts of home, more individuals are turning to assisted living facilities. In turn, these facilities are providing support to individuals with chronic conditions like dementia.
The Residential Care Facility for the Elderly (RCFE) Reform Act of 2014 made notable improvements to California’s assisted living structure. However, the Act did not completely eliminate the out-of-date statutory provisions and an extremely limited Medicaid waiver program which continues to hinder the system today.
The continuing challenges include gaps in medication administration because facilities are not required to employ healthcare professionals like doctors and nurses. Instead, the regulations say facilities can contract healthcare providers as needed. As a result, staff is unable to administer medicine to residents.
Facilities also have the ability to admit residents but then evict them if it is decided the facility cannot meet the resident’s needs. This results in a great deal of uncertainty for the family. Finally, the Limited Medicaid Assisted Living Waiver program operated by the Department of Health is only available to 3,700 individuals in California causing a severe shortage in necessary support.
However, there have been visible improvements in the regulations focused on transparency and quality assurance. Consumers can now search the Community Care Licensing transparency site (http://ccld.ca.gov/PG3581.htm ) which includes biographical information on facilities and citations and inspections. Quality assurance has been improved as now facilities will be inspected once every three years up from once every five years. The regulations also created the Quality Assurance, Advocacy and Technical Support Bureau which provides support and information to the facilities and public. A publication from the California Department of Social Services outlines the most common deficiencies in assisted living facilities in California in 2015. http://www.ccld.ca.gov/res/pdf/RCFE_Cap6MostCommonDeficiencies.pdf.
Before you or a loved one has to make the decision to enter an assisted living facility it is important to have a strong estate plan in place. Contact the Law Office of Stephanie Macuiba to discuss how an estate plan can protect from unwanted legal fees and costs.