The General Assembly has taken a look at numerous bills this session that would have affected assisted living operations. In our weekly bill wrap up in CareConnection, we have detailed bills on generator testing and disclosure. Now we take a closer look at VHCA-VCAL’s advocacy efforts on those bills as well as others on overnight staffing, bed limits, and administrator licensing.

Disclosure of Assisted Living Generators – HB 1815 will require assisted living facilities (ALFs) to disclose in writing whether the facility has an on-site emergency electrical power source for the provision of electricity during an interruption of the normal electric power supply.

VHCA-VCAL’s Vice President of Quality Improvement and Director of VCAL April Payne testified in support of the bill when it was first heard in committee in January. VHCA-VCAL also worked closely with the bill patron, Del. Patrick Hope (D-Arlington) on small, but meaningful amendments to the bill. Those changes ensure that the new disclosure requirement could be incorporated into existing disclosure documents provided to residents and families upon admission and did not need to be a separate form. We are deeply appreciative of Del. Hope’s support of this change.

This legislation reflects the recommendation of Virginia’s Joint Commission on Health Care, which studied this issue in 2018. As we have previous reported, VHCA-VCAL provided significant input into that study. HB 1815 awaits action by Gov. Ralph Northam. The governor can sign, veto or amend any legislation.

ALF Generator Testing – VHCA-VCAL is pleased to report that Sen. Janet Howell, who introduced a bill that would have mandated that ALFs install an on-site generator was amenable to modifying her bill SB 1077 to instead implement testing requirements for on-site generators and connection testing for mobile generators.

The bill directs the Department of Social Services (DSS) to issue regulations to implement the following, which the agency considered when it worked on the updating the ALF Standards last year:

• ALFs with on-site emergency generators must include a description of its capacity as outlined in the emergency response plan.
• ALFs that maintain a connection for mobile generators must have agreements with vendors to provide emergency generators as well as backup agreements should the initial vendors be unable to fulfill their supply agreements during an emergency.
• ALFs must test the connection for any on-site generators at installation and then every two years; and
• ALFs must conduct monthly testing of all on-site generators and maintain records of such testing.

VHCA-VCAL expressed significant concern about the prospect that, as introduced, SB 1077 would have required ALFs licensed for six or more residents have an on-site temporary emergency electrical power source sufficient to provide power for medical equipment; refrigeration for food and medications; 60 square feet of heating, cooling, and lighting per resident; and operation of at least one elevator.

SB 1077 also awaits action by Gov. Northam. VHCA-VCAL wrote to him requesting that he sign the bill as it preserves the flexibility for ALFs to develop emergency response plans, including preparation for electrical outages, that are tailored to the needs of their communities and resident populations. 

ALF Staffing During Overnight Hours – SB 1410 and HB 2521 would direct the State Board of Social Services to amend regulations governing staffing of ALF units with residents who have serious cognitive impairment due to a primary psychiatric diagnosis of dementia or any other diagnosis and are unable to recognize danger or protect their own safety and welfare to create an exception to certain staffing requirements for overnight hours.

The bill language specifies that DSS should draft regulations to allow for the following number of direct care staff members be awake and on duty and responsible for the care and supervision of the residents at all times during night hours:

1. When 22 or fewer residents are present, at least two direct care staff members;
2. When 23 to 32 residents are present, at least three direct care staff members;
3. When 33 to 40 residents are present, at least four direct care staff members; and
4. When more than 40 residents are present, at least four direct care staff members plus at least one additional direct care staff member for every 10 residents or portion thereof in excess of 40 residents.

Gov. Northam has until January 21 to take action on the bill. If he signs the legislation, VHCA-VCAL plans to closely watch the regulatory process to provide input to the Board and to help members understand the implications of the changes.

Regulations Regarding Bed Limits for Licensed ALFs – SB 1326 would have allowed the State Board of Social Services to allow an ALF licensee that was grandfathered from the requirement that no more than two residents reside in a bedroom to transfer its license in the same facility one time. The bill was initially reported by the Senate Rehabilitation and Social Services Committee and advanced to the Senate floor for a vote. However, concerns about the bill prompted the Senate to recommit it to the committee after the deadline for committee action on bills, which effectively killed the measure for the year. 

ALF Requirement for Licensed Administrator – SB 1409 Increases from one to two the amount of times a licensed assisted living facility may operate under the supervision of an acting administrator during any two-year period. The bill now awaits action by Gov. Ralph Northam.

Language in the introduced version of the bill to extend the notification window from immediately to within 14 days the time for an ALF to notify DSS regional office and the Board of Long-Term Care Administrators that the facility administrator has died, resigned, been discharged, or become unable to perform his duties. VHCA-VCAL participated in discussions with other affected stakeholders and the bill patron, which concluded that this provision should remain unchanged.