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Best Practices in Assisted Living: Considering Potential Reforms for California

Eric Carlson and Gwen Orlowski, National Senior Citizens Law Center

While residents of California's assisted living facilities require more health care services than in the past, state regulations haven't kept pace.

A number of troubling incidents that have been chronicled in the media the past few years have forced a re-examination of the regulation of California's assisted living facilities, a popular option for seniors who do not require skilled nursing care but who are no longer able to live at home.

The laws governing assisted living date to 1985, with the enactment of the Residential Care Facilities for the Elderly Act. At that time, most residents of such facilities required relatively limited assistance, and the regulatory standards were correspondingly limited. While the California Department of Social Services, which regulates the facilities, has made some regulatory amendments, those have not altered the law's basic framework in nearly three decades.

In the 1990s, however, residential care facilities began to admit and retain residents with greater care needs. As highlighted in a report by the National Senior Citizens Law Center (NSCLC), unlike California, many other states have enacted assisted living laws that balance a noninstitutional environment with somewhat elevated care standards. As a result, in most cases California lags far behind.

A joint oversight hearing of the California Senate Human Services Committee and Assembly Human Services Committee on increasing accountability in assisted living facilities was held on February 11, 2014. Maribeth Shannon, former director of CHCF's Market and Policy Monitor program, gave testimony.

The complete NSCLC report, along with recent media coverage of the issue and a CHCF quick reference guide, is available through the links below.

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