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Slate of long-term care facilities reform bills drafted

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A slate of bills proposed has targeted reform for long-term care facilities, but the trade association that represents those groups says there are unintended consequences. | PHOTO COURTESY OF UNSPLASH

DOVER With the number of Delawareans over 65 expected to grow by 60% from 159,000 in 2015 to more than 263,000 by 2050, a set of four bills regulating long-term care facilities was introduced late last month in the Delaware legislature that its sponsors say are needed to ensure adequate patient care. 

The organization representing these facilities has complained it was not consulted before the measures were introduced and says the costs of compliance could raise patient care costs.  

“We have received mixed reviews,” said Rep. Kendra Johnson (D-Bear), co-sponsor of the proposed legislation. “Those who have families in long-term care facilities say, ‘Yes, we want them to be protected and taken care of.’ Others have been concerned about potential expenses of certification.”

“Today’s assisted-living residents need to be made aware of this pending change, its benefits, any unintended consequences and estimates of what these changes could cost residents” warns Cheryl Heiks, executive director of  Delaware Health Care Facilities Association (DHCFA), who also protested her organization’s absence from the planning process..

The four-part package was introduced Feb. 26 by Johnson and co-sponsor Sen. Spiros Mantzavinos (D- Elsmere/Marshalton), who stated that it had been decades since long-term care had been addressed legislatively and cited what they saw as a need for additional oversight and accountability. 

The legislation also had 26 co-sponsors from both sides of the aisle, including Senate minority whip Brian Pettyjohn (R -Georgetown/Long Neck) and Rep. Mike Smith (R-Pike Creek).

“I’ve been working on this with various task forces since I was elected in 2020,” Mantzavinos said. “I felt now was finally the time to move forward. We introduced it as separate bills because they address different sections of the Delaware code and deal with different matters.” 

The legislation follows work done by the Aging-in-Place Working Group in 2022 and the Long-term care and Memory Care Task Force in 2023, sponsors said.

The lead part of the legislation is House Bill 100, which would require assisted living facilities currently unregulated by the federal Centers for Medicare & Medicaid Services to maintain accreditation from an independent organization selected by the Delaware Department of Health and Social Services. The legislation also would define dementia care service in Delaware Code for the first time and require facilities that provide those services to meet independent certification standards. 

Senate Bill 215 would change how often the Division of Health Care Quality is required to conduct in-person inspections of assisted living facilities and nursing homes, stipulating that in-person inspections of the roughly 80 facilities currently in operation must occur at least annually with penalties if they were not. 

Senate Bill 216 would increase civil penalties imposed against long-term care facilities, regardless of whether the violations pose a serious threat to the health and safety of residents. 

 Finally, Senate Bill 217 would attempt to bolster the long-term care workforce by strengthening the pipeline of healthcare workers graduating from Delaware’s institutions of higher learning.

Johnson defended the decision not to seek DHCFA’s input when the bills were being written up. “They were not involved,” she says, “and I understand that they weren’t happy, but everyone knows the legislative process. Sometimes you need to work collaboratively from the beginning. But other times, it’s necessary to put pen to paper and get past perpetual nothingness.”

The two parties did begin talks in mid-March, both reports. 

Both say that a prime point of disagreement is the estimated cost to care facilities and how that cost might affect patient cost of care. 

“It is our understanding that the initial review from the joint commission may be relatively inexpensive,” Heiks said in response to Sen. Johnson’s assertion that her organization may be overestimating its impact, “but achieving accreditation [would require] compliance with a prescribed list of services or capabilities, that Delaware assisted-living do not have and when they were built… and were not designed to have.”

The legislative package has been referred to committees, but no hearings have yet been scheduled.

 Mantzavinos is optimistic about the timetable and the chances of passage. 

“We will be in session through June 30,” he said. “I think we can have hearings before then and it will likely pass. But if not, we will have to reintroduce them next year.”

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