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Senate committee vows to shut down unlicensed ALFs, improve regulated facilities

A Senate committee on Tuesday vowed to put an end to unlicensed assisted living facilities after a Miami Herald story revealed that homes have been using loopholes to escape state scrutiny.

The Herald story uncovered facilities that billed themselves as shelters, rooming houses or “sober homes”, but in actuality operated as ALFs. Many had deplorable conditions and at least one owner had a criminal history.

“I want to be equipped to go into those bad actors and shut them down now,” said Sen. Alan Hays, R-Umatilla, at a meeting of the Children, Families and Elder Affairs Committee.

Sen. Miguel Diaz de la Portilla , R-Coral Gables, said that a lack of resources or funds shouldn't be an excuse to regulate the industry, which cares for roughly 80,000 residents.

"This has to be a priority to shut down unlicensed facilities as a public health hazard as a clear and present danger to the living conditions of a human being," Diaz de la Portilla said. "If there isn't money in the budget, then we need to find it." 

Along with providing housing, the state’s nearly 3,000 licensed ALFs help residents with tasks like bathing, dressing and taking medication. Owners must pass a background check, pay fees and pass regular inspections.

Elizabeth Dudek, secretary of the Florida Agency for Health Care Administration, told the committee that her staff could issue “cease and desist” orders but that owners often disappeared when inspectors returned. There was also discussion about working more with law enforcement.

AHCA can impose fines of up to $1,000 a day when unlicensed ALFs continue to operate after getting notice from the agency. But regulators fined just seven of the 93 unlicensed providers it has identified since the beginning of 2012, according to agency records.

Hays, who said there was “documentation of horrific treatment of people” told Dudek to instruct her department’s legal team “to embrace the intent of this committee, which is to be very decisive, very quickly, to act on these unlicensed people and don’t treat them with kid gloves but to treat them with a hammer.”

Lawmakers have been trying to reform the state’s licensed homes since a 2011 Herald investigation revealed neglect, abuse and death of ALF residents.

Committee chairwoman Sen. Eleanor Sobel, D-Hollywood, said she was “extremely frustrated” after her reform bill passed the Senate last year but failed to pass the House.

On Tuesday, the 10-member Children, Families and Elder Affairs Committee started again, unanimously passing SB 7000, similar to last year’s attempt, as a committee bill.

This year’s bill, Sobel said, has 25 changes that include improving enforcement of existing regulations, increasing care provided to mentally diminished residents, requiring additional training to new staff before they begin work, and allowing residents to remain in a familiar setting as they become impaired (as long as they don’t need 24-hour nursing supervision).

Consumers will also be able to add comments on a ratings website, similar to the system used for nursing homes.

The bill was met with little opposition at the meeting, though some industry groups were not represented.

Peggy Rigsby, director of government services for the Florida Health Care Association, said after the meeting that the group supports the bill, but “we just don’t want to go and add even more above and beyond what’s in the proposal … It seems to me that the professional associations that represent assisted living facilities seem to have reached a point where they’re more interested in having something happen.”

The need for improvements to ALFS becomes more critical as Florida’s aging population grows. Amy Baker, the legislature’s chief economist, said that between 2010 and 2030 Florida’s population is expected to grow by almost 4.8 million and residents 60 and older will account for 56.9 percent of that growth.

"It's clear we need to prepare for this population," Sobel said.