New laws related to eligibility for employment in assisted living, penalties for inspection issues, vaccine administration, TB testing, adult exploitation, and other issues affecting assisted living providers take effect on July 1.

Take a look at the key changes in state statutes affecting assisted living facilities as passed by the General Assembly earlier this year.

Bills VHCA-VCAL Supported

• Adult Vaccine and PPD Testing Administration by LPNs – HB 2301 will allow licensed practical nurses (LPNs) to administer vaccines to adults and conduct tuberculosis (PPD) testing without the immediate and direct supervision of a registered nurse (RN). At the request of multiple member facilities, VHCA-VCAL partnered with other provider organizations to pursue a legislative fix to address the requirement that an RN be immediately physically present when an LPN administers a vaccine or performs PPD testing. VHCA-VCAL worked with affected stakeholder groups to secure their support for this change. It will streamline how nursing centers and assisted living facilities provide care while maintaining safeguards for residents.
• Durable Do Not Resuscitate (DDNR) Orders – HB 2153 establishes reciprocity for DDNR orders or other orders regarding life-sustaining treatment executed in accordance with the laws of another state.

• Advance Medical Directives – HB 1747 and SB 1242 broaden who can assist individuals with completing advance medical directives.

Other Bills

• Criminal History Record Checks regarding Barrier Crimes – SB 1008 clarifies the crimes that constitute a barrier for individuals seeking employment in nursing facilities, assisted living facilities, and other providers; and applicants for licensure, registration, or approval as assisted living facilities. The bill would also add certain offenses to the list of barrier crimes. View the list here.

• Eligibility for Employment in Assisted Living – SB 1434 clarifies that individuals who were convicted of non-abuse misdemeanors would be eligible to work in assisted living facilities (ALF) if five years have elapsed following the conviction.
• Increase in the Cap on Civil Penalties for ALFs – HB 1919 and SB 1191 would increase the aggregate amount of civil penalties that the Commissioner of the Department of Social Services may assess against an ALF for noncompliance with the terms of its license from $10,000 per 24-month period to $10,000 per 12-month period.

• Study of Assisted Living Staffing – A resolution, SJ 266, calling for a report of staffing ratio requirements in assisted living communities and special care units was referred to the Joint Commission on Health Care (JCHC) to study the issue. The JCHC met on May 22 to discuss their 2017 work plan, which will include this issue.  VHCA-VCAL has been in touch with JCHC staff and will be closely monitoring this study and providing input to the JCHC on staffing practices at ALFs.  JCHC staff expect to present their recommendations to the commission in September.
• Suspected Financial Exploitation – HB 1922 and SB 1462 clarify that all cases involving suspected financial exploitation of an adult be immediately referred by Adult Protective Services (APS) to a local law enforcement agency for investigation.  Previously the value had to be over $50,000 for the mandated referral, but there will now be no minimum financial requirement.  The bill also requires that local law enforcement agencies provide a preferred point of contact for those referrals.
• Updated Definition of “Adult Exploitation” – HB 1945 updates the definition of “adult exploitation” for the purposes of social services law to include “the unauthorized, improper, or fraudulent use of an adult,” which applies to anyone over 60 and anyone from 18 to 59 years of age if incapacitated.  It also addresses various forms of financial exploitation and further clarifies what is considered undue influence and coercion.