A Florida Senate panel Tuesday instructed the Agency for Health Care Administration to draft legislation --- fast --- that would allow the state to shut down unlicensed assisted-living facilities as quickly as possible.
"Tell them to hustle," said Sen. Alan Hays, a Umatilla Republican and vice-chairman of the Senate Children, Families and Elder Affairs Committee.
Hays was addressing AHCA Secretary Liz Dudek, who briefed senators as they consider a third attempt in three years at tightening oversight of Florida's assisted-living facilities.
But he seemed to be speaking for all the members of the committee.
"Don't treat them with kid gloves," Hays urged Dudek. "Treat them with a hammer."
Committee members were irate over reports that unlicensed assisted-living facilities, or ALFs, were failing to provide proper health care, background checks of staffers or basic safety and cleanliness --- and that state regulators were missing or ignoring the transgressions.
"Last year, state health-care regulators received more than 200 complaints about unlicensed activity and confirmed that 62 were, indeed, unlicensed ALFs, including 15 in Miami-Dade and Broward," The Miami Herald reported Sept. 9. "These numbers have risen more than 60 percent from 2010. By June this year, the Agency for Health Care Administration had identified another 37 unlicensed homes around the state."
The panel's discussion focused on why unlicensed facilities were flying under the state's radar.
"You don't know they're there until somebody brings it to your attention," Dudek said. She called SB 7000, the committee's new ALF reform proposal, "really great" and said it provided her agency additional help with enforcement.
Lawmakers have been trying to pass ALF reforms since the Herald reported in 2011 that at least 70 residents of Florida's 3,015 assisted-living facilities had died from abuse and neglect since 2002. The series prompted Gov. Rick Scott to form an ALF task force that year, but the House and Senate couldn't agree on a 2012 bill based on the task force's recommendations.
And during the 2013 session, the Senate passed a reform measure 38-0, but it died in the House.
This year, Sen. Eleanor Sobel, the Hollywood Democrat who chairs the Children, Families and Elder Affairs Committee, is pushing the Senate's latest reform effort.
"There's a message that needs to come out of Florida," Sobel said. "We're going to protect our seniors…It's these unlicensed ones that give the good ones bad reputations. And it hurts our image in terms of being a place baby boomers are coming to, and we have to fix this problem."
Working with prosecutors and law enforcement would help, she said.
Asked whether the House would be the stumbling block again this year, Sobel said she's almost ready to announce the bill's House sponsor. She added that she'd met with most of the associations representing nursing homes and assisted living facilities, and that they support the current proposal.
"You can't please all the groups," Sobel said. "We just need to get the members in the House to agree with us that this is the best bill for Florida."
On Tuesday, the panel unanimously passed the measure, which would beef up fines and sanctions on ALFs, including doubling the fines for repeated serious violations. It would require the Office of Program Policy Analysis and Government Accountability to conduct a study of AHCA's consistency in regulating the facilities. And it would specify who is responsible for assuring that mental health residents of ALFs receive necessary services.
Additionally, the bill would require AHCA to create a rating system for ALFs by November 2014.
Peggy Rigsby, director of government services at the Florida Health Care Association, which represents nursing home providers, said her organization supports SB 7000 and the regulation it contains --- but no more.
"There are current regulations as well, that exist now, and there are regulations in this bill, and we support that," Rigsby said. "We just don't want to go and add even more above and beyond what's in the proposal."
Rigsby said the unlicensed facilities were the biggest concern. She agreed with earlier suggestions by the committee that involving law enforcement and greater regulatory authority by AHCA would be effective in closing more unlicensed ALFs.
"The profession is looking for certainty," said Bob Asztalos, chief lobbyist for the Florida Health Care Association. "Passing legislation so that everyone knows what the rules are going to be helps us provide better care to our residents. That's why, this year, Florida Health Care is going to try very hard to pass this bill, putting some certainty out there and making sure that the bad actors can be cleaned up."