Senate Bill #302 (2019)

AN ACT RELATING TO HEALTH AND SAFETY -- ASSISTED LIVING RESIDENCE LICENSING ACT

Allows those individuals who do not otherwise meet the requirements, to reside in an Alzheimer's special care unit or program.

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Changes since original draft

  • 2019 – S 0302
  • 2019 – S 0302 SUBSTITUTE A
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  • LC001264
  • LC001264/SUB A
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  • S T A T E O F R H O D E I S L A N D
  • IN GENERAL ASSEMBLY
  • JANUARY SESSION, A.D. 2019
  • ____________
  • A N A C T
  • RELATING TO HEALTH AND SAFETY – ASSISTED LIVING RESIDENCE LICENSING
  • ACT
  • Introduced By: Senators Coyne, Miller, Satchell, Lynch Prata, and Gallo
  • Date Introduced: February 13, 2019
  • Referred To: Senate Health & Human Services
  • It is enacted by the General Assembly as follows:
  • SECTION 1. Section 23-17.4-2 of the General Laws in Chapter 23-17.4 entitled "Assisted Living Residence Licensing Act" is hereby amended to read as follows:
  • 23-17.4-2. Definitions.
  • As used in this chapter:
  • (1) "Activities of daily living (ADLs)" means bathing, dressing, eating, toileting, mobility and transfer.
  • (2) "Administrator" means any person who has responsibility for day to day administration or operation of an assisted living residence.
  • (3) "Alzheimer's dementia special care unit or program" means a distinct living environment within an assisted living residence that has been physically adapted to accommodate the particular needs and behaviors of those with dementia. The unit provides increased staffing, therapeutic activities designed specifically for those with dementia and trains its staff on an ongoing basis on the effective management of the physical and behavioral problems of those with dementia. The residents of the unit or program have had a standard medical diagnostic evaluation and have been determined to have a diagnosis of Alzheimer's dementia or another dementia. Upon completion of the disclosures required by § 23-17.4-16.2, a person who does not otherwise meet the requirements for the special care unit or program, may choose to reside in the unit or area.
  • (4) "Assisted living residence" means a publicly or privately operated residence that provides directly or indirectly by means of contracts or arrangements personal assistance and may include the delivery of limited health services, as defined under subdivision 23-17.4-2(12), to meet the resident's changing needs and preferences, lodging, and meals to six (6) or more adults who are unrelated to the licensee or administrator, excluding however, any privately operated establishment or facility licensed pursuant to chapter 17 of this title, and those facilities licensed by or under the jurisdiction of the department of behavioral healthcare, developmental disabilities and hospitals, the department of children, youth, and families, or any other state agency. The department shall develop levels of licensure for assisted living residences within this definition as provided in § 23-17.4-6. Assisted living residences include sheltered care homes, and board and care residences or any other entity by any other name providing the services listed in this subdivision which meet the definition of assisted living residences.
  • (5) "Capable of self-preservation" means the physical mobility and judgmental ability of the individual to take appropriate action in emergency situations. Residents not capable of self- preservation are limited to facilities that meet more stringent life safety code requirements as provided under § 23-17.4-6(b)(3).
  • (6) "Director" means the director of the Rhode Island department of health.
  • (7) "Licensing agency" means the Rhode Island department of health.
  • (8) "Qualified licensed assisted living staff members" means a certified nursing assistant as provided under subdivision 23-17.9-2(a)(3), a licensed practical nurse as provided under subdivision 5-34-3(12) and/or a registered nurse as provided under subdivision 5-34-3(14).
  • (9) "Personal assistance" means the provision of one or more of the following services, as required by the resident or as reasonably requested by the resident, on a scheduled or unscheduled basis, including:
  • (i) Assisting the resident with personal needs including activities of daily living;
  • (ii) Assisting the resident with self-administration of medication or administration of medications by appropriately licensed staff;
  • (iii) Providing or assisting the resident in arranging for health and supportive services as may be reasonably required;
  • (iv) Monitoring the activities of the resident while on the premises of the residence to ensure his or her health, safety, and well-being; and
  • (v) Reasonable recreational, social and personal services.
  • (10) "Resident" means an individual not requiring medical or nursing care as provided in a health care facility but who as a result of choice and/or physical or mental limitation requires personal assistance, lodging and meals and may require the administration of medication and/or limited health services. A resident must be capable of self-preservation in emergency situations, unless the facility meets a more stringent life safety code as required under § 23-17.4-6(b)(3). Persons needing medical or skilled nursing care, including daily professional observation and evaluation, as provided in a health care facility, and/or persons who are bedbound or in need of the assistance of more than one person for ambulation, are not appropriate to reside in assisted living residences. However, an established resident may receive daily skilled nursing care or therapy from a licensed health care provider for a condition that results from a temporary illness or injury for up to forty-five (45) days subject to an extension of additional days as approved by the department, or if the resident is under the care of a Rhode Island licensed hospice agency provided the assisted living residence assumes responsibility for ensuring that the required care is received. Furthermore, a new resident may receive daily therapy services and/or limited skilled nursing care services, as defined through rules and regulations promulgated by the department of health, from a licensed health care provider for a condition that results from a temporary illness or injury for up to forty-five (45) days subject to an extension of additional days as approved by the department, or if the resident is under the care of a licensed hospice agency provided that assisted living residence assumes responsibility for ensuring that the care is received. For the purposes of this chapter, "resident" shall also mean the resident's agent as designated in writing or legal guardian. Notwithstanding the aforementioned, residents who are bed bound or in need of assistance of more than one staff person for ambulation may reside in a residence if they are receiving hospice care in accordance with the rules and regulations promulgated by the department of health. For the purposes of this chapter, "resident" shall also mean the resident's agent as designated in writing or legal guardian.
  • (11) "Supervision" means the supervision requirements of qualified licensed assisted living staff delivering limited health services in accordance with this chapter, as defined through rules and regulations promulgated by the department of health.
  • (12) "Limited health services" means health services, as ordered by the resident's physician, provided by qualified licensed assisted living staff members with supervision as required in rules and regulations promulgated by the department of health. Nothing in this definition shall be construed to limit the right of assisted living residents to access home nursing care or hospice provider services.
  • SECTION 2. This act shall take effect upon passage. ======== LC001264 ========
  • SECTION 1. Section 23-17.4-16.2 of the General Laws in Chapter 23-17.4 entitled "Assisted Living Residence Licensing Act" is hereby amended to read as follows:
  • 23-17.4-16.2. Special care unit and limited health services disclosure by residences.
  • (a) Any assisted living residence which offers to provide or provides services to residents with Alzheimer's disease or other dementia by means of an Alzheimer's special care unit and/or limited health services shall be required to disclose the type of services provided, in addition to those services required by the rules and regulations for the licensing of assisted living residences. Disclosures shall be made to the licensing agency and to any person seeking placement in an Alzheimer's special care unit and/or any person receiving limited health services from an assisted living residence. The information disclosed shall explain that additional care is provided in each of the following areas:
  • (1) Philosophy. The Alzheimer's special care unit and/or delivery of limited health services shall develop a written statement of its overall philosophy and mission which reflects the needs of residents afflicted with dementia and/or needing limited health services.
  • (2) Pre-occupancy, occupancy, and termination of residence. The process and criteria for occupancy, transfer, or termination of residency from the unit and/or the termination of limited health services.
  • (3) Assessment, service planning, and implementation. The process used for assessment and establishing the plan of service and its implementation, including the method by which the plan of service evolves and is responsive to changes in condition.
  • (4) Staffing patterns and training ratios. Staff training and continuing education practices.
  • (5) Physical environment. The physical environment and design features appropriate to support the functioning of cognitively impaired adult residents.
  • (6) Resident activities. The frequency and types of resident activities.
  • (7) Family role in providing support and services. The involvement in families and family support programs.
  • (8) Program costs. The cost of care and any additional fees.
  • (b) The licensing agency shall develop a standard disclosure form and shall review the information provided on the disclosure form by the residential care and assisted living facility to verify the accuracy of the information reported on it. Any significant changes in the information provided by the residential care and assisted living facility will be reported to the licensing agency at the time the changes are made.
  • (c) Upon completion of the disclosures required pursuant to this section, a person who does not otherwise meet the requirements for the special care unit or program, may choose to reside in the unit or area in accordance with § 23-17.4-16.
  • SECTION 2. This act shall take effect upon passage.
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  • LC001264/SUB A
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  • EXPLANATION
  • BY THE LEGISLATIVE COUNCIL
  • OF
  • A N A C T
  • OF
  • A N A C T
  • RELATING TO HEALTH AND SAFETY – ASSISTED LIVING RESIDENCE LICENSING
  • ACT
  • ***
  • ***
  • This act would allow those individuals who do not otherwise meet the requirements, to reside in an Alzheimer's special care unit or program.
  • This act would take effect upon passage. ======== LC001264 ========
  • This act would take effect upon passage. ======== LC001264/SUB A ========

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