Category: Uncategorized

Long-Distance Caregivers: Supporting Your Senior Loved One From Afar

Claire Wentz
caringfromafar.com
claire@caringfromafar.com

Most of us need assistance as we age. It’s quite common for seniors to face a variety of challenges, such as financial problems, medical issues, loneliness, mobility limitations, and mistreatment. Although many seniors function just fine on their own, a little help from supportive loved ones ensures they can maintain their health and happiness. If you’re trying to care for a senior loved one who lives miles away, there is still plenty you can do.

Stay Up to Date on Their Coverage

Many seniors depend on Medicare for help with medical expenses, including things like doctor’s visits, short-term nursing care, surgeries, and lab tests. If your loved one doesn’t get online very often, it will be hard for them to stay up to date on their healthcare coverage. You should stay informed of any changes to their plan so they aren’t met with unexpected charges when they go for a routine checkup or if an emergency occurs. There are many excellent resources available online where you can learn about the current plans available in your state and any supplementary options that will cover additional expenses such as prescription drugs. It’s also a good idea to keep track of the Medicare enrollment process and time periods during which your loved one can make any necessary changes to their plan.

Organize Important Documents

Don’t be left scrambling for important documents when an emergency occurs. Instead, gather everything together and organize it now. A Place For Mom recommends obtaining copies of your loved one’s birth certificate, driver’s license, medical insurance card, marriage certificate, Social Security card, and mortgage. Also, keep a list detailing where official records are kept so you can access them when needed. These documents may include a living will, tax returns, power of attorney, investments, funeral arrangements, and insurance policies. These documents will help you protect your loved one’s financial health and ensure their end-of-life care wishes are met. Finally, include contact information for your loved one’s attorney, financial planner, beneficiaries, and credit card companies.

Get to Know People in Their Community

Although you aren’t close enough to check up on your loved one, provide transportation, or respond to an emergency, others are. Get to know your loved one’s neighbors and ask them to keep an eye out for you. They’ll be able to tell if something significant changes in your loved one’s behavior, like if they stop getting their mail or opening the blinds in the morning. Talk to your loved one’s friends, senior centers, and local healthcare providers and tell them that you would like to stay informed about your loved one’s health and happiness. These people may also be able to step in if you have to take a temporary pause in your caregiver tasks to help with scheduling appointments, coordinating transportation, or paying bills for your loved one. Also, ask your loved one’s doctor for a list of their medication and make it clear that you want to receive up-to-date information about their well-being.

Use Technology to Your Advantage

There are a variety of apps, websites, and tech devices to help you stay in contact with your loved one and organize information for their care team. Instead of calling them on the phone, get them set up with a video chat service like Skype or Google Hangouts. This can help you get a better picture of how your loved one is doing while alleviating loneliness for them. Smart home technology and home monitoring devices can also be useful to help ensure your senior loved one is comfortable and safe in their own home. Also, check out this list of handy mobile apps that can help you track the many aspects of caregiving for you and your loved one’s care team.

Many remote caregivers experience guilt that they aren’t doing enough. Care.com stresses the importance of accepting that these feelings are normal and acknowledging that there are real limits on what you can offer as a long-distance caregiver. Providing long-distance care and support can take a toll on your own well-being, so address any problems with chronic stress or burnout as soon as possible. You have to take care of yourself before you can care for others.

Florida 2018 Legislative Wrap-Up

Florida’s legislative session is complete for 2018 and will not take place again until March 2019. The 2018 session was dominated by the tragic loss of life that occurred in the wake of Hurricane Irma and the shooting at Marjorie Stoneman Douglas High School. The end of session produced legislation that adopted emergency generator rules for assisted living communities and nursing homes, and increased safety measures involving guns and public schools. The fewest bills in 15 years ended up passing the full legislature.

Details on bills involving senior living and senior care that were supported, opposed or monitored by the Florida Senior Living Association are as follows:

BILLS THAT PASSED

Emergency Preparedness, SB 7028
(Senate Rules Committee)

This bill ratified and adopted the emergency power source rule for assisted living communities, Rule 58A-5.036. Assisted living communities are currently implementing this rule, which basically requires generators and fuel be maintained at the community in order to provide enough electricity to run equipment that cools portions of the building to 81F° during a power outage.

Status: Approved by Governor, Laws of Florida Chapter No. 2018-122
Effective Date: March 26, 2018

HB 7087
(Rep. Paul Renner, R-Palm Coast)

The only other hurricane related bill that passed provides an exemption from Florida sales tax of up to $15,000 for the purchase of a generator for any single assisted living community or nursing home facility during the period of July 1, 2017 through December 31, 2018. The exemption is applied at the time of purchase or is available through a refund process to be developed by the Florida Department of Revenue. The application for a refund must be submitted by September 23, 2018.

Status: Approved by Governor, Laws of Florida Chapter No. 2018-118
Effective Date: March 23, 2018 and retroactive to July 1, 2017

AHCA Regulation, SB 622
(Sen. Denise Grimsley, R-Sebring)

This bill affects health care providers throughout the state that are regulated by the Agency for Health Care Administration (AHCA). The bill eliminates obsolete language, eliminates licensing of heath care facility risk managers, and repeals state licensure of clinical laboratories in favor of deferring to federal requirements. The bill also revises several assisted living regulations that Florida Senior Living Association worked on with the agency over that past two sessions:

  • Increases penalties for operating an assisted living community without a license;
  • Assisted living community may not be operated more than 120 consecutive days without an administrator who has completed core training;
  • A resident may be charged for a new service without the requirement of a 30-day notice;
  • The resident right of access to adequate and appropriate health care has been revised to better fit the assisted living model with an emphasis on providing assistance;
  • Codifies rule that requires an administrator to complete core training within 90 days of employment;
  • Licensees with multiple communities may request that expiration dates of all licenses be aligned;
  • Expands level II background screening to persons contracted to work 20 or more hours per week who have access to resident funds, personal property or living areas; and
  • Clarifies that no person may have an ownership interest, directly or indirectly, if that person has a disqualifying offense or had an interest in a provider that had a license revoked. This does not apply to shareholders of publicly traded corporations.

Status: Approved by Governor, Laws of Florida Chapter No. 2018-024
Effective Date: July 1, 2018

Exploitation of a Vulnerable Adult, HB 1059
(Rep. Colleen Burton, R-Lakeland)

The bill creates a cause of action and court procedure for obtaining an injunction to protect a vulnerable adult from exploitation by freezing the assets and credit lines of the vulnerable adult, and freezing assets of the individual exploiting the vulnerable adult where assets are traceable to the exploitation. The injunction may be sought by the vulnerable adult, a guardian or another entity that has consent.

Status: Approved by Governor, Laws of Florida Chapter No. 2018-100
Effective Date: July 1, 2018

Opioids, HB 21
(Rep. Jim Boyd, R-Bradenton)

The bill addresses opioid abuse by expanding the use of the Prescription Drug Monitoring Program (PDMP), increasing regulation of prescribers and dispensers, amending criminal laws and making appropriations. The bill also:

  • Limits prescribing of opioids for acute pain to a three-day supply, or a seven-day supply if deemed medically necessary by the prescriber;
  • The bill excludes prescribing limits for pain related to cancer, terminal illness, palliative care and serious traumatic injury; and
  • Requires physicians or their staff members to check with a statewide database before prescribing or dispensing drugs.

Status: Approved by Governor, Laws of Florida Chapter No. 2018-013
Effective Date: July 1, 2018

BILLS THAT DID NOT PASS

Continuing Care Contracts, SB438/HB783

These bills proposed to improve the early warning signs of a CCRC’s solvency issues. The bills proposed to revise the Office of Insurance Regulation’s authority to regulate providers of continuing care, revise and streamlines applications for licensing and acquisition of a CCRC, increase reporting requirements, and revise provisions related to reserve requirements. FSLA was supportive of this legislation.

Additional Regulatory Requirements, SB 1428/HB 443

These companion bills required ALFs to provide copies of notices for relocation or termination of residency to the State Long-Term Care Ombudsman Program, required the ALF to duplicate information already provided to AHCA and provide it separately to the Ombudsman Program, and required nursing home facilities to provide access to or copies of resident’s medical records under certain conditions & within a very short timeframe. The Ombudsman Program has indicated it will pursue this bill again in the 2019 Legislative Session. FSLA opposed this bill.

Elder Abuse Fatality Review Teams, SB 422/HB 259

The bills create an elder abuse fatality review team in each judicial circuit to review closed cases where the death of an elderly person was alleged or found to have been caused by, or related to, abuse or neglect The teams are comprised of volunteers from public and private entities that study, treat, investigate, or prevent elder abuse and may include persons who have knowledge of the laws concerning fatalities due to elder abuse. Each team may review information from law enforcement and Adult Protective Services files under the condition that the information remain confidential. The teams are charged with developing practice standards and recommendations for changes in law, rules, and policy to support the care of elderly person and prevent elder abuse deaths. FSLA opposed provisions of this bill.

Additional bills of interest to senior living providers are available here.

Join us for Legislative Days at the Capitol in 2018

Florida Senior Living Association’s Legislative Advocacy Days is a great opportunity to learn the legislative process as well as to educate legislators about the effect of current proposed legislation on senior living in Florida. You will receive CEs for this event while networking with fellow executive directors, the FSLA Board, industry partners, and some of Florida’s key legislators. We encourage you to join us January 22 -23, 2018 for this event and share your knowledge and passion. Help us shape the future of senior living! Registration information coming soon.

Click http://conta.cc/2iEghu8 for more information.

Political Committee Call to Action

The 2018 Florida Legislative Session is expected to be challenging and hectic considering the slew of emergency preparedness bills in addition to the normal bills we see that that could have a huge impact on senior living.

Since the 2018 session starts on January 9, the Florida Senior Living Association / Florida Argentum has started meeting with various legislators to express our concerns about bills being filed that would create additional regulations and costs for providers without substantial improvements for residents. In addition, we will be proactively working with the Legislature to develop meaningful emergency preparedness legislation that will clarify the conflicting and confusing regulations proposed by AHCA.

Raising funds for Florida’s Senior Living Political Committee (FSL PC) is critical to educating legislators and other key leaders about the complex issues facing senior living communities. FSL PC strengthens relationships with legislators by distributing funds to candidates who will help advance our advocacy agenda and support senior living issues of great concern and significant importance to our membership.

Additionally, supporting legislators who can effectively represent our best interests, especially in the wake of Hurricane Irma’s devastation and the rush to create new policies to address preparedness and resident safety is of utmost importance.

As many of you know, timing is everything. To make a significant impact before the beginning of the 2018 Legislative Session, we are seeking to raise $60,000. We are nearly one-third of the way there, and Argentum’s PAC has committed to matching donations made through December 15, dollar for dollar, up to $25,000 to double the impact of whatever you contribute.

Argentum President & CEO James Balda is encouraging all senior living providers to step up and support FSL PC, saying “This is a critical moment for our industry to educate lawmakers and back those that put the lives and safety of our residents above scoring political points. Florida is ground zero for emergency preparedness in the industry and the rest of the states will look to Florida for guidance going forward. What happens in Florida will have consequences across the country. That is why I am pleased to use Argentum’s Silver PAC to match dollar for dollar, up to $25,000, to support FSL PC. I encourage your company to contribute before December 15 so Florida Argentum has the resources needed to advocate for our industry at this crucial time.”

Can we count on your corporation and communities to help us continue to protect Florida’s senior living communities, and thousands of jobs by contributing to Florida’s Senior Living Political Committee?

Our future depends on your financial support. Thank you for your contribution.

Warm regards,


David Nussbaum
Florida Senior Living PC Chair

Contribution Pledge

FSLA PC is a political action committee established under the laws of the State of Florida. FSLA PC Committee will make contributions to political candidates, political organizations, and to political parties who demonstrate their commitment to our principles and support of the association’s mission and vision.

 

about

New Name, New Mission

We’re excited to announce an important change at FL Argentum. As of today, we will be known as the Florida Senior Living Association. This name change will better reflect what we do and the people we serve throughout the state.

Our mission is to serve professionally managed communities that provide choice, dignity, independence and quality of life for seniors. We will continue to advocate for and promote quality environments for seniors and the communities and workforces that serve them.

We are proud to represent you, our members, before the Florida Legislature, Governor’s Executive Agencies, and other state and local entities where senior living policy is decided. Moving forward, we are thrilled to continue offering our members high-level continuing education, a state-of-the-art conference and responsive support on a number of issues affecting this profession.

If you have any questions, please do not hesitate to contact us, like us on Facebook or visit our LinkedIn page . From all of us here at the Florida Senior Living Association, thank you for your membership and support!

DOEA Publishes Supplement Rule 58AER17-2

Yesterday,  the Department of Elder Affairs (DOEA) filed rule 58AER17-2 Variances from Emergency Rule 58AER17-1 – Procedures Regarding Emergency Environmental Control for Assisted Living Facilities.
In explanation of the rule, DOEA stated, “58AER17-2 is a supplement to the Emergency Rule and outlines the rule variance process where, under extreme circumstances beyond a facility’s control, a facility can request more time to comply with this life-saving rule (58AER17-1) per Florida law” According to 58AER17-2, each variance request must contain the following:
  1. Steps the assisted living facility has taken to implement the detailed plan required by Emergency Rule 58AER17-1,
  2. Specific circumstances beyond the facilities control that have prevented full implementation of the detailed plan within the 60 day time frame,
  3. What arrangements have been made to pending full implementation of the detailed plan to ensure that residents of the ALF will not be exposed to temperatures above 80 degrees in the event of a power failure or loss of AC due to loss of power,
  4. A delineation of the steps remaining for full implementation of the detailed plan and the ALF’s estimate of the time needed to fully implement 58AER17-1, and
  5. All steps taken by the ALF to provided to the residents and family members or legal guardians that the ALF has applied for a variance or waiver from Emergency Rule 58AER17-1 and the steps the ALF is taking to comply with the Emergency Rule.
DOEA also states that it will consider each request and the reasonable efforts undertaken by the assisted living facility to provide the protections required by the Emergency Rule. Administrative action or sanctions for non-compliance with the Emergency Rule will be evaluated based upon the information submitted by the ALF in conjunction with any variance request under existing law (see section 120.542, Florida Statues).
NOTE: This rule does not repeal or modify the requirements of the Emergency Rule.
A notice issued yesterday by the Agency for Health Care Administration (AHCA) stated that on October 11, 2017, “Governor Rick Scott directed AHCA and the Department of Elder Affairs (DOEA) to begin the full rulemaking process to make the emergency power plan rule permanent. Again this variance process is already defined in Florida law and does not change the emergency rule that was issued on September 16 th in any way. AHCA will continue to aggressively enforce this emergency rule to keep patients safe.”
Click here for a copy of the notice of emergency rule.

Updated Q&A Regarding Emergency Rule

AHCA and DOEA have provided a link to an updated Q&A document with answers to questions received, a Frequently Asked Questions document regarding requests for a waiver or variance of portions of the rule, and a NEW County Emergency Management Agency Q&A document.

Links to the licensure web pages, as well as DOEA’s website, where these documents are maintained are also provided below. As responses are finalized to the questions and comments received they will be added to the web pages. Please review the pages frequently for updated information.

Read below for changes to Questions and Answers – The answers to the following questions were revised on 10/10/2017:

Question 4 : Will a mobile generator meet the requirements of the rule?
Answer : The rule does not restrict the type of generator required, but it must be installed and maintained at the facility. If the emergency generator used to meet the temperature requirements in the rule also supplies power for life safety and critical equipment, a level 1 generator must be used and the fuel supply and distribution equipment must be protected from debris impact as required by the Florida Building Code.

Question 5 : Can natural gas be used as a fuel source?
Answer : Yes . Piped natural gas is an allowable fuel source under the rule. The plan submitted for review should include fuel information.

Links to documents related to 58AER17-1

Assisted Living Facility Emergency Rule (58AER17-1)

Statutes and rules related to assisted living facilities can be found on AHCA’s Assisted Living Facility webpage or on DOEA’s homepage.

Rule Waiver/Variance FAQs

NEW County EM Q&As added 10/10/2017

Remember, assisted living facility emergency power plans must be submitted to the local emergency management agency and the Department of Elder Affairs at ALFEMP@elderaffairs.org.

You may submit additional questions or comments regarding the emergency rules to: ALFRuleComment@elderaffairs.org or BHFR@ahca.myflorida.com.

We will continue to send updates as they become available.

Request for Temporary Injunction Against Emergency Rule

Yesterday evening, we filed a petition with the First District Court of Appeal (DCA) to ask for a temporary injunction against the Governor’s Emergency Rule, 58AER17-1. This action is coordinated with our filing at the Division of Administrative Hearings to challenge the rule itself. Download a copy of the petition here. Download a copy of the petition here.
If granted, this petition would stop the current implementation of the rule, providing relief from the looming deadline of Nov. 15to have generators and fuel tanks installed. Our greatest concern is that this deadline will either force rushed — and potentially unsafe — solutions or will put an unimaginable financial burden on communities as they work toward compliance while being fined $1,000 per day past Nov. 15.
The safety of the residents and staff at our member communities remains our top priority, and we will continue advocating on behalf our members throughout this process.

Emergency Rule Q&A Update

This evening, AHCA and DOEA provided an updated to the Q&A document originally issued September 21st. They also created an FAQ document regarding Petitions for Variance or Waiver of an Agency Rule. These documents can be found on AHCA’s Assisted Living Facility webpage under Notices/Updates.
While we support the Governor’s objective to provide generators for emergency power in all ALFs, we believe the complexity involved requires more time than the emergency ruleallows. Florida Argentum members have determined that the best path forward is to file a rule challenge to invalidate the rule rather than having each community file a variance or waiver from the rule. The rule challenge is scheduled for hearing on October 12th & 13th with an expected final order on or before October 30th.
In the meantime, you should continue efforts to comply with the emergency rule, document any obstacles that you encounter in the process, and consider all of your options. Please continue to send your comments, questions, and concerns to DOEA and AHCA by email to ALFRuleComment@elderaffairs.org or BHFR@ahca.myflorida.com.
We will continue to send updates as they become available.