ANNAPOLIS – Health care officials declared the 1999 General Assembly session a success, but some owners of small assisted living facilities aren’t so sure.
The owners didn’t receive an expected delay in an increased licensing fee and they say they’ll never be able to comply by the May 31 deadline.
One owner who is feeling the crunch is Audrey P. Monroe who operates a small assisted living facility with eight clients out of her home in Baltimore.
In 1996, the legislature passed a law to place the previously unregulated assisted living industry under the same unified rules and regulations, regardless of the size of the facility.
The owners of the smaller facilities said they needed more time to comply with the new regulations, because they could not afford to make all the changes at once.
Officials and legislators agreed, and they were given till 1999 to comply. This year, small assisted facility owners were back fighting for another year.
With the support of the Department of Health and Mental Hygiene the bill passed both houses and is awaiting the governor’s signature.
Small providers are thrilled about the bill passing, said Carol Benner, director of the Licensing and Certification Administration, the regulatory arm of the Department of Health and Mental Hygiene.
But not Monroe.
“They did nothing for us. They system used us” she said. “They talk with forked tongues. I’m very angry. Where do you go from here to make it better? I’m ready to make my house a room and board.”
Small providers are still expected to pay the increased licensing fee by May 31, Monroe said. The fee went from $25 to $100 a year. The providers originally were told that they would continue to pay the $25 fee until 2000.
The small providers are having problems meeting the increase because their clients are on very limited incomes, between $250 to $400 monthly.
“These small facilities are just not in a position to pick up the extra cost. Without funding from the state, many will have no choice but to close down. We already know that some are closing,” said Dianne Dorlester, the executive director of Maryland Assisted Living Association.
Sen. Christopher J. McCabe, R-Howard, proposed a study on how the new regulations will affect the small assisted living facilities. The study also would have determined if the state should subsidize the small facilities. The bill passed unanimously in the Senate but died in a House committee without a floor vote. It was one of the major disappointments for the industry.
Good news did come out of the session for residents of assisted living facilities.
The legislature passed a bill to extend the Medicaid program to cover qualified individuals in assisted living homes, continuing care communities and those who just want to receive home care. Currently, in Maryland Medicaid only covers nursing home care.
In addition, the legislature approved bills to allow one spouse to enter an apartment and another a nursing home under one contract with the same continuing care community.
Previously, couples had to move into an apartment and then the ailing spouse would move into the nursing care unit. Legislators worried that these facilities were using the continuing care communities as a front to obtain more nursing home beds.
Lawmakers became convinced that this contract change benefited the senior residents.
The legislature also approved more inspectors to conduct more frequent and more rigorous nursing home inspections.
The national standards of nursing home care have been raised and state departments of health have struggled to get the homes into compliance before their assigned cut-off date. Two homes have already been closed. A third, Hayes Nursing Home in Baltimore County, has closed after several residents died and the owners determined it was not feasible to stay open.
One bill likely to appear again next session would require background checks for nursing home workers. Nursing homes and legislators were concerned that it would hold up the hiring process for care workers and wind up hurting the nursing home clients, Benner said.
Benner predicts the next session will see more of the same issues come up, especially regarding nursing homes.
“They don’t just give us people,” Benner said, “and expect us not to report on what they’re doing. The legislature is going to hold us accountable.”