2024 -- S 2377 | |
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LC004434 | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2024 | |
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A N A C T | |
RELATING TO HEALTH AND SAFETY -- ASSISTED LIVING RESIDENCE LICENSING | |
ACT | |
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Introduced By: Senators Mack, Ujifusa, Valverde, Euer, and Bell | |
Date Introduced: February 12, 2024 | |
Referred To: Senate Health & Human Services | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Section 23-17.4-2 of the General Laws in Chapter 23-17.4 entitled "Assisted |
2 | Living Residence Licensing Act" is hereby amended to read as follows: |
3 | 23-17.4-2. Definitions. |
4 | As used in this chapter: |
5 | (1) “Activities of daily living (ADLs)” means bathing, dressing, eating, toileting, mobility |
6 | and transfer. |
7 | (2) “Administrator” means any person who has responsibility for day to day administration |
8 | or operation of an assisted living residence. |
9 | (3) “Alzheimer’s dementia special care unit or program” means a distinct living |
10 | environment within an assisted living residence that has been physically adapted to accommodate |
11 | the particular needs and behaviors of those with dementia. The unit provides increased staffing, |
12 | therapeutic activities designed specifically for those with dementia and trains its staff on an ongoing |
13 | basis on the effective management of the physical and behavioral problems of those with dementia. |
14 | The residents of the unit or program have had a standard medical diagnostic evaluation and have |
15 | been determined to have a diagnosis of Alzheimer’s dementia or another dementia. |
16 | (4) “Assisted living residence” means a publicly or privately operated residence that |
17 | provides directly or indirectly by means of contracts or arrangements personal assistance and may |
18 | include the delivery of limited health services, as defined under subsection (12), to meet the |
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1 | resident’s changing needs and preferences, lodging, and meals to six (6) or more adults who are |
2 | unrelated to the licensee or administrator, excluding however, any privately operated establishment |
3 | or facility licensed pursuant to chapter 17 of this title, and those facilities licensed by or under the |
4 | jurisdiction of the department of behavioral healthcare, developmental disabilities and hospitals, |
5 | the department of children, youth and families, or any other state agency. The department shall |
6 | develop levels of licensure for assisted living residences within this definition as provided in § 23- |
7 | 17.4-6. Assisted living residences include sheltered care homes, and board and care residences or |
8 | any other entity by any other name providing the services listed in this subdivision which meet the |
9 | definition of assisted living residences. |
10 | (5) “Capable of self-preservation” means the physical mobility and judgmental ability of |
11 | the individual to take appropriate action in emergency situations. Residents not capable of self- |
12 | preservation are limited to facilities that meet more stringent life safety code requirements as |
13 | provided under § 23-17.4-6(b)(3). |
14 | (6) “Director” means the director of the Rhode Island department of health. |
15 | (7) "Family council" means an independent, self-determining group of family members |
16 | and friends established pursuant to § 23-17.4-15.11 that: |
17 | (i) Advocates for the needs and interests of the residents of a managed residential |
18 | community that offers assisted living services; and |
19 | (ii) Facilitates open communication between the managed residential community |
20 | administration, the residents and family and friends of the residents. |
21 | (7)(8) “Licensing agency” means the Rhode Island department of health. |
22 | (8)(9) “Qualified licensed assisted living staff members” means a certified nursing assistant |
23 | as provided under § 23-17.9-2(a)(3), a licensed practical nurse as provided under § 5-34-3(13) |
24 | and/or a registered nurse as provided under § 5-34-3(14). |
25 | (9)(10) “Personal assistance” means the provision of one or more of the following services, |
26 | as required by the resident or as reasonably requested by the resident, on a scheduled or |
27 | unscheduled basis, including: |
28 | (i) Assisting the resident with personal needs including activities of daily living; |
29 | (ii) Assisting the resident with self-administration of medication or administration of |
30 | medications by appropriately licensed staff; |
31 | (iii) Providing or assisting the resident in arranging for health and supportive services as |
32 | may be reasonably required; |
33 | (iv) Monitoring the activities of the resident while on the premises of the residence to |
34 | ensure his or her health, safety, and well-being; and |
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1 | (v) Reasonable recreational, social and personal services. |
2 | (10)(11) “Resident” means an individual not requiring medical or nursing care as provided |
3 | in a healthcare facility but who as a result of choice and/or physical or mental limitation requires |
4 | personal assistance, lodging and meals and may require the administration of medication and/or |
5 | limited health services. A resident must be capable of self-preservation in emergency situations, |
6 | unless the facility meets a more stringent life safety code as required under § 23-17.4-6(b)(3). |
7 | Persons needing medical or skilled nursing care, including daily professional observation and |
8 | evaluation, as provided in a healthcare facility, and/or persons who are bedbound or in need of the |
9 | assistance of more than one person for ambulation, are not appropriate to reside in assisted living |
10 | residences. However, an established resident may receive daily skilled nursing care or therapy from |
11 | a licensed healthcare provider for a condition that results from a temporary illness or injury for up |
12 | to forty-five (45) days subject to an extension of additional days as approved by the department, or |
13 | if the resident is under the care of a Rhode Island licensed hospice agency provided the assisted |
14 | living residence assumes responsibility for ensuring that the required care is received. Furthermore, |
15 | a new resident may receive daily therapy services and/or limited skilled nursing care services, as |
16 | defined through rules and regulations promulgated by the department of health, from a licensed |
17 | healthcare provider for a condition that results from a temporary illness or injury for up to forty- |
18 | five (45) days subject to an extension of additional days as approved by the department, or if the |
19 | resident is under the care of a licensed hospice agency provided that assisted living residence |
20 | assumes responsibility for ensuring that the care is received. For the purposes of this chapter, |
21 | “resident” shall also mean the resident’s agent as designated in writing or legal guardian. |
22 | Notwithstanding the aforementioned, residents who are bed bound or in need of assistance of more |
23 | than one staff person for ambulation may reside in a residence if they are receiving hospice care in |
24 | accordance with the rules and regulations promulgated by the department of health. For the |
25 | purposes of this chapter, “resident” shall also mean the resident’s agent as designated in writing or |
26 | legal guardian. |
27 | (11)(12) “Supervision” means the supervision requirements of qualified licensed assisted |
28 | living staff delivering limited health services in accordance with this chapter, as defined through |
29 | rules and regulations promulgated by the department of health. |
30 | (12)(13) “Limited health services” means health services, as ordered by the resident’s |
31 | physician, provided by qualified licensed assisted living staff members with supervision as required |
32 | in rules and regulations promulgated by the department of health. Nothing in this definition shall |
33 | be construed to limit the right of assisted living residents to access home nursing care or hospice |
34 | provider services. |
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1 | SECTION 2. Chapter 23-17.4 of the General Laws entitled "Assisted Living Residence |
2 | Licensing Act" is hereby amended by adding thereto the following sections: |
3 | 23-17.4-15.10. Establishment of family councils. |
4 | On or before January 1, 2025, all assisted living facilities shall authorize and assist in the |
5 | establishment of a family council in managed residential communities offering assisted living |
6 | services pursuant to the provisions of § 23-17.4-15.11. The family council shall not allow a family |
7 | member or friend of a resident who is not a resident of a dementia special care unit to participate |
8 | in the family council without the consent of the resident. |
9 | 23-17.4-15.11. Family councils. |
10 | (a) For the purposes of this chapter, “family council” means an organized group of the |
11 | family members, friends or representatives of facility residents who may meet in private without |
12 | the presence of facility staff. |
13 | (b) The role of the family council shall be to address issues affecting residents generally at |
14 | the facility, not to pursue individual grievances. The family council shall not be entitled to obtain |
15 | information about individual residents or staff members, or any other information deemed |
16 | confidential under state or federal law. |
17 | (c) No licensed assisted living facility may prohibit the formation of a family council. |
18 | When requested by a member of a resident’s family or a resident’s representative, a family council |
19 | shall be allowed to meet in a common meeting room of the assisted living facility at least once a |
20 | month during mutually agreed upon hours. |
21 | (d) Upon the admission of a resident, the assisted living facility shall inform the resident |
22 | and the resident’s family members, in writing, of their right to form a family council, or if a family |
23 | council already exists, of the date, time and location of scheduled meetings. |
24 | (e) The assisted living facility administration shall notify the state long-term care |
25 | ombudsman of the existence or planned formation of a family council at that facility. |
26 | (f) The family council may exclude members only for good cause, subject to appeal by the |
27 | excluded party to the state long-term care ombudsman. No member shall be excluded on the basis |
28 | of race or color, religion, gender, sexual orientation, disability, age or country of ancestral origin. |
29 | (g) A facility shall provide its family council with adequate space in a prominent posting |
30 | area for the display of information pertaining to the family council. |
31 | (h) Staff or visitors may attend family council meetings at the council’s invitation. |
32 | (i) The assisted living facility shall provide a designated staff person who, at the request of |
33 | the council, shall be responsible for providing assistance to the family council and for responding |
34 | to recommendations and requests made by the family council. |
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1 | (j) The assisted living facility shall consider the recommendations of the family council |
2 | concerning issues and policies affecting resident care and life at the assisted living facility. |
3 | (k) A violation of the provisions of this section shall constitute a violation of the rights of |
4 | assisted living residents. |
5 | SECTION 3. This act shall take effect upon passage. |
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EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO HEALTH AND SAFETY -- ASSISTED LIVING RESIDENCE LICENSING | |
ACT | |
*** | |
1 | This act would establish, encourage and support the establishment of family councils in |
2 | managed residential communities providing assisted living services. |
3 | This act would take effect upon passage. |
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LC004434 | |
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