2019 -- H 5141

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

     RELATING TO HEALTH AND SAFETY - ASSISTED LIVING RESIDENCES

     Introduced By: Representatives McNamara, Bennett, Edwards, Canario, and Lyle

     Date Introduced: January 17, 2019

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 23-17.4-2 of the General Laws in Chapter 23-17.4 entitled

"Assisted Living Residence Licensing Act" is hereby amended to read as follows:

     23-17.4-2. Definitions.

     As used in this chapter:

     (1) "Activities of daily living (ADLs)" means bathing, dressing, eating, toileting, mobility

and transfer.

     (2) "Administrator" means any person who has responsibility for day to day

administration or operation of an assisted living residence.

     (3) "Alzheimer's dementia special care unit or program" means a distinct living

environment within an assisted living residence that has been physically adapted to accommodate

the particular needs and behaviors of those with dementia. The unit provides increased staffing,

therapeutic activities designed specifically for those with dementia and trains its staff on an

ongoing basis on the effective management of the physical and behavioral problems of those with

dementia. The residents of the unit or program have had a standard medical diagnostic evaluation

and have been determined to have a diagnosis of Alzheimer's dementia or another dementia.

Upon completion of the disclosures required by § 23-17.4-16.2, a person who does not otherwise

meet the requirements for the special care unit or program may choose to reside in the unit or

area.

     (4) "Assisted living residence" means a publicly or privately operated residence that

provides directly or indirectly by means of contracts or arrangements personal assistance and may

include the delivery of limited health services, as defined under subdivision 23-17.4-2(12), to

meet the resident's changing needs and preferences, lodging, and meals to six (6) or more adults

who are unrelated to the licensee or administrator, excluding however, any privately operated

establishment or facility licensed pursuant to chapter 17 of this title, and those facilities licensed

by or under the jurisdiction of the department of behavioral healthcare, developmental disabilities

and hospitals, the department of children, youth, and families, or any other state agency. The

department shall develop levels of licensure for assisted living residences within this definition as

provided in § 23-17.4-6. Assisted living residences include sheltered care homes, and board and

care residences or any other entity by any other name providing the services listed in this

subdivision which meet the definition of assisted living residences.

     (5) "Capable of self-preservation" means the physical mobility and judgmental ability of

the individual to take appropriate action in emergency situations. Residents not capable of self-

preservation are limited to facilities that meet more stringent life safety code requirements as

provided under § 23-17.4-6(b)(3).

     (6) "Director" means the director of the Rhode Island department of health.

     (7) "Licensing agency" means the Rhode Island department of health.

     (8) "Qualified licensed assisted living staff members" means a certified nursing assistant

as provided under subdivision 23-17.9-2(a)(3), a licensed practical nurse as provided under

subdivision 5-34-3(12) and/or a registered nurse as provided under subdivision 5-34-3(14).

     (9) "Personal assistance" means the provision of one or more of the following services, as

required by the resident or as reasonably requested by the resident, on a scheduled or unscheduled

basis, including:

     (i) Assisting the resident with personal needs including activities of daily living;

     (ii) Assisting the resident with self-administration of medication or administration of

medications by appropriately licensed staff;

     (iii) Providing or assisting the resident in arranging for health and supportive services as

may be reasonably required;

     (iv) Monitoring the activities of the resident while on the premises of the residence to

ensure his or her health, safety, and well-being; and

     (v) Reasonable recreational, social and personal services.

     (10) "Resident" means an individual not requiring medical or nursing care as provided in

a health care facility but who as a result of choice and/or physical or mental limitation requires

personal assistance, lodging and meals and may require the administration of medication and/or

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limited health services. A resident must be capable of self-preservation in emergency situations,

unless the facility meets a more stringent life safety code as required under § 23-17.4-6(b)(3).

Persons needing medical or skilled nursing care, including daily professional observation and

evaluation, as provided in a health care facility, and/or persons who are bedbound or in need of

the assistance of more than one person for ambulation, are not appropriate to reside in assisted

living residences. However, an established resident may receive daily skilled nursing care or

therapy from a licensed health care provider for a condition that results from a temporary illness

or injury for up to forty-five (45) days subject to an extension of additional days as approved by

the department, or if the resident is under the care of a Rhode Island licensed hospice agency

provided the assisted living residence assumes responsibility for ensuring that the required care is

received. Furthermore, a new resident may receive daily therapy services and/or limited skilled

nursing care services, as defined through rules and regulations promulgated by the department of

health, from a licensed health care provider for a condition that results from a temporary illness or

injury for up to forty-five (45) days subject to an extension of additional days as approved by the

department, or if the resident is under the care of a licensed hospice agency provided that assisted

living residence assumes responsibility for ensuring that the care is received. For the purposes of

this chapter, "resident" shall also mean the resident's agent as designated in writing or legal

guardian. Notwithstanding the aforementioned, residents who are bed bound or in need of

assistance of more than one staff person for ambulation may reside in a residence if they are

receiving hospice care in accordance with the rules and regulations promulgated by the

department of health. For the purposes of this chapter, "resident" shall also mean the resident's

agent as designated in writing or legal guardian.

     (11) "Supervision" means the supervision requirements of qualified licensed assisted

living staff delivering limited health services in accordance with this chapter, as defined through

rules and regulations promulgated by the department of health.

     (12) "Limited health services" means health services, as ordered by the resident's

physician, provided by qualified licensed assisted living staff members with supervision as

required in rules and regulations promulgated by the department of health. Nothing in this

definition shall be construed to limit the right of assisted living residents to access home nursing

care or hospice provider services.

     SECTION 2. 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 RESIDENCES

***

     This act would allow some persons, who do not otherwise qualify to reside in a special

care unit in an assisted living residence to get into that unit under certain circumstances.

     This act would take effect upon passage.

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