Legislation before the D.C. Council would update nearly 20-year-old laws regulating the city’s assisted-living facilities, but the bill has provisions that have caused outcry from seniors and senior advocates.
Within the proposed updated policies are provisions that would prohibit facilities from admitting patients who “is or has ever been diagnosed with moderate to severe dementia or requires hospice care.”
The legislation was introduced by the entire council in February. Aside from the one-sentence provision that would bar the facilities from accepting new residents in need of hospice or with dementia, the 76-page draft will establish the right to civil action against the facilities for violations, require the live-in facilities to establish a plan for daily operations as well as requires staff to resident rations, among other things.
“I intend to pay particular attention to how we revise provisions on nurse staffing requirements and dementia care to ensure we protect patient safety while avoiding unintended consequences that could adversely impact Medicaid funding or assisted living access for our seniors,” said the legislation’s lead council member, Vincent Gary (D-Ward 7), who chairs the council’s health committee.
Nearly 600 people live in the District’s 12 assisted-living facilities, according to LeadingAge D.C., a local chapter of a network of organizations that care for the elderly. It is estimated that, nationally, 50 percent of the people that live in assisted care have dementia.
“I support the intent of the legislation, the intent to provide greater transparency and addition protocols to protect our senior residents; however, as drafted I have some concerns,” said Council member Brandon Todd (D-Ward 4). “A primary concern is that we are inadvertently eliminating viability for diverse housing options.”
Though the bill would bar the facilities from accepting new patients with dementia or in need of hospice, the provision would not displace those already in a facility.
Members of the Alzheimer’s Association and AARP also called for the removal of another provision that would require residents who pose a risk of wandering to carry identification that includes their name and the name, address and phone number of their facility.
Those in favor and opposition of the changes both agreed that the 18-year-old laws needed updating, though some called for new restrictions rather than amending current law.
As the council works to amend the current law, the District’s health department has also begun working on new regulations that have not made public.
“We all agree that we need to improve care at assisted living residences; we all share that goal,” said Councilwoman Mary Cheh. “[The bill’s] attempt to regulate every aspect of the assisted living experience in the way that it does, I have to conclude that the bill, as drafted, is extremely flawed and requires significant revision.”