After three years of efforts, the Florida Legislature has yet to pass nursing home reforms. (Photo by Susan Sermoneta)

After three years of efforts, the Florida Legislature has yet to pass nursing home reforms. (Photo by Susan Sermoneta)

By Ashley Lopez
Florida Center for Investigative Reporting

Following a 2011 Miami Herald investigation showing neglect, abuse and death in the state’s assisted living facilities, lawmakers vowed to put reforms in place. However, three years later, the Florida Legislature has yet to pass anything.

Much like the past few years, state lawmakers said putting protections in place for the residents of assisted living facilities (ALF) would be a priority for this year’s legislative session. Bills were introduced and passed in the Florida House and Senate that would add more oversight and accountability to these facilities.

But, The Miami Herald/Tampa Bay Times reports, yet again the bills got bogged down by politics at the last minute:

The most recent Senate and House proposals fell apart in the final days when the House attached other health care related bills to the Senate’s ALF bill and they couldn’t resolve their differences.

…What happened this session “is a classic example of politics again trumping policy,” [Jack McCrory, advocacy manager for AARP Florida] said. “It became part of a healthcare ‘train’ that became a train wreck.”

The Senate unanimously passed SB 248 early in the session. The House passed its version, HB 573, at the end of April. While House Speaker Will Weatherford and Senate President Don Gaetz identified ALF reform as one of their session goals in their “Work Plan 2014” program, it failed to make any progress.

Gaetz blames the House, and the ALF industry, for the bill’s demise.

“It wasn’t the trains that killed the bill. It was the House that killed the bill,’’ he told the Herald/Times. “Speaker Weatherford gave me his commitment they would try to do this. The ALF industry lobbied very hard against reforms. They lost a lot of credibility. It’s a real shame.”

He said that when the House bill began to be “picked apart” in the House, he urged the Senate prime sponsor, Sen. Eleanor Sobel, D-Hollywood, to start attaching it to several high priority House bills. In retaliation, the House attached language to the ALF bill that the Senate didn’t want — language about surgery centers and visitation rights for grandparents.

An effort in 2013 to pass reforms failed, as well. That year, the Florida Senate was able to pass a bill unanimously, but the House didn’t take the effort as seriously.

According to the Herald/Times in May 2013:

A last-ditch attempt to pass legislation to reform the state’s assisted living facilities, measures sought since a 2011 Miami Herald investigation revealed neglect, abuse and death of ALF residents, failed on the last day of Florida’s legislative session.

The Senate had passed a bill (SB 646) by Sen. Eleanor Sobel, D-Hollywood, which tightened oversight of Florida’s nearly 3,000 assisted living facilities, by a 38-0 vote on April 11, but a companion measure in the House never got any traction.

Still, the House could have passed the Senate bill.

To increase the odds of getting a bill passed, Sobel added the reforms to an omnibus healthcare bill (SB 966) sponsored by Sen. Aaron Bean, Fernandina Beach, that was later weighed down with dozens of amendments. With the clock ticking, the bill was never heard Friday afternoon.

“I am hugely disappointed,” said AARP Florida advocacy manager Jack McRay. “I think that in the next go-around, the Legislature ought to focus more on protecting residents of ALFs than protecting the industry.”

This year’s bill would have required facilities with a limited number of state-supported mental health residents to get a limited mental health license. Provisions would have also changed the fee system and expanded medication-related duties for some staff members in ALFs.

However, there was one provision that riled up the ALF industry. If passed, the measures would have created a rating system for all licensed facilities, which would have been a boon for consumers, but it rattled industry officials.

According to the Herald/Times, “one industry group, the Florida Assisted Living Association (FALA), raised objections that people could post anonymous, possibly damaging comments on a website that would be managed by the state’s Agency for Health Care Administration.” The paper also noted that, “along with a change in the penalty structure that FALA said could affect smaller homes, were the group’s key objections, but Shaddrick Haston, its CEO, contends that members were not trying to sabotage the bill.”

Advocates for reform have long argued that the revolving door between the state agency regulating ALFs and the industry has also been a barrier to reform.

Haston, for example, was the chief state official monitoring and enforcing laws for elder-care homes before he took a job in the industry he was regulating.

Before that, Gov. Rick Scott appointed Jim Crochet to the position of long-term care ombudsman at the Department of Elder Affairs, a program meant to protect elderly people placed in nursing homes and assisted living facilities. However, the appointment was controversial because Crochet was someone heavily favored by the ALF industry. After allegations of wrongdoing, Crochet resigned.

According to the Herald/Times, Senate leadership has said they will tackle ALF reform again next year.