Florida assisted living facilities (ALF) raise questions about new emergency management regulations being proposed by health care regulatory agencies.
The Agency for Healthcare Administration (AHCA) held a one-hour workshop on Tuesday with ALF providers, local disaster response officials and others who share their concerns with the proposed regulations.
The proposals deal with comprehensive disaster management and emergency environmental control plans tied to a 2020 law.
Florida Senior Living Association (FSLA) Vice President of Public Policy Jason hands calls the proposed regulations for Comprehensive Emergency Management Plans, or CEMPs, “massive”. He is asking the state to “press pause” on the regulatory process or “to host multiple workshops where we can all look at this together.”
“I totally understand it’s hard work to do this the right way,” said Hand. “But I think if we all sit down together and work on it, we can do it.”
Hand was not alone in asking the state to work more closely with affected parties on the rules. Lake County Deputy Director of the Office of Emergency Management Nicholas Gert suggested that the state participate in an emergency management working group that meets and conducts similar discussions.
“It would be very valuable,” Gerth argued.
AHCA senior management analyst Jeremy Roberts told Gerth that AHCA could not participate in the task force, but that the state would accept the group’s recommendations.
But at the end of the meeting — and after hearing the widespread concerns of most participants — Roberts said the agency “will clearly host another workshop.”
Roberts also agreed to extend the time frame for the public to comment on the proposed rules by two weeks. AHCA was initially set to accept public comments until Dec. 6, but Roberts said the agency will accept written comments on the proposal until Dec. 20.
“That way we can do an in-depth investigation,” Roberts said.
There are approximately 3,020 licensed ALFs in Florida providing a combined 113,789 beds to adults who are unable or unwilling to live independently. In addition to housing, ALFs provide meals and one or more personal services to one or more adults who are not related to the owner or manager.
Comprehensive emergency management plans provide insight into the fundamentals of risk-based planning and decision-making. They help officials create integrated, coordinated, and synchronized threat plans.
The legislature in 2020 tried to remove a regulatory snag that ALFs faced. Although Florida law at the time required ALFs to have locally approved CEMP plans before being licensed by the state, some jurisdictions refused to review ALF’s plans until the state had already licensed the facility.
Lawmakers agreed to change the law to allow ALFs to be licensed without a previously approved comprehensive emergency management plan, but required the ALFs to have their CEMPs approved within 30 days of licensing. The 2020 law also required ALFs to notify AHCA of their plans within 30 days of approval.
AHCA first announced in 2020 that it would update its rules to include the new statutes. It published a notice of an extension in March 2021, saying it needed more time to seek public input. AHCA then issued another renewal notice in March 2022.
A workshop on rules was held in September, according to a state website. AHCA announced a second workshop for October 11, but it was subsequently canceled Hurricane Ian embarked in Southwest Florida. The October workshop has been moved to November 29.
Meanwhile, FSLA’s Hand said at Tuesday’s workshop that he was “concerned” that the changes AHCA is proposing for the licensed ALFs would create a overview of estimated regulatory costs, or a SERC. He predicted that the SERC would show that the proposed rules would increase the industry’s operating costs by a total of more than $200,000 a year, or $1 million over five years.
Any scheme that increases the cost of doing business by that amount must be approved by the legislature before being implemented.
“And that means none of these changes would be effective,” Hand said.
To underline his point, Hand noted that the proposed rules would require ALFs to resubmit for approval any CEMP that has changed significantly. The rule further defines significant change as “a change to a previously approved plan that is not a change to correct spelling or grammar, or a change to the name, address, telephone number, e-mail address, or position of personnel employed in the plan is stated. .”
The rules also require CEMPs to be reviewed and submitted for approval annually.
Hand said he was concerned the rules are “a bit unwieldy” and could turn the CEMP into “more of a horn book than a real resource”.