CALA News & Views | Issue 48 | Impact

improving the Operating Environment for Workforce and Education advocating helping Members Access talent

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News &Views CALA I m P a c t News &Views Issue 48 | November 2023

Issue 45 | November 2022

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Specialists in Innovative Senior Housing Design

Douglas Pancake Architects (DPA) specializes in design for aging and serves the senior living and healthcare industries across the United States. For 30 years, Douglas Pancake has been a leader in the evolution of senior housing design, code development, and advocacy for our elders. The architects at DPA are compassionate and talented individuals, who are focused on creating supportive and meaningful healing environments for the frailest and most vulnerable members of our communities.

19000 MacArthur Blvd., Ste. 500, Irvine, CA 92612 | Phone: (949) 720-3850 info@pancakearchitects.com | www.pancakearchitects.com

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THIS ISSUE

LETTER FROM THE PRESIDENT & CEO in advocacy, workforce development and education, establishing itself as a leading advocate and resource for the senior living community in the state. Our dedication to these areas has played a crucial role in raising the bar for senior care quality. CALA's mission remains clear: to ensure that seniors in California receive the highest quality care and support they deserve. Looking ahead, CALA serves as a shining example of what can be achieved through collaboration and dedication to a meaningful cause. We are proud of our accomplishments this year and believe that together, we can reach even greater heights in the future. CALA extends its gratitude to all of you for your invaluable support. With your dedication, CALA eagerly anticipates representing your interests in 2024, further solidifying our commitment to serving California's senior living community with excellence and compassion. Together, we will continue to make a meaningful difference in the lives of our seniors. In 2023, CALA demonstrated its strong commitment to strengthening senior living in California. Throughout the year, CALA achieved significant milestones

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Improving the Operating Environment

Impacting Legislation

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Advocating for Workforce and Education

Policy and Compliance Webinars Helping Members Access Talent

Educational Excellence Grassroots Advocacy

Shining Stars: Celebrating Our Award Recipients The Redesigned CALA Website: Navigating the Future

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Joining Together

Nancy Ball Director of Meetings and Events nancy@CAassistedliving.org

Selena Coppi Hornback Director of Public Policy selena@CAassistedliving.org Agnes de la Vega Education and Workforce Associate agnes@CAassistedliving.org Heather Harrison Senior Vice President of Public Policy & Public Affairs heather@CAassistedliving.org Jason Hunter Director of Membership jason@CAassistedliving.org

CALA STAFF

Katherine McLoskey Director of Operations katherine@CAassistedliving.org Sally Michael President & CEO sally@CAassistedliving.org Haty Pietrasz

Director of Creative Design haty@CAassistedliving.org Maddie Robbie Associate Director of Public Policy maddie@CAassistedliving.org Kevin Swartzendruber Director of Marketing & Communications kevin@CAassistedliving.org Jan Trifiro Vice President of Workforce & Professional Development jan@CAassistedliving.org

CALA: 455 Capitol Mall, Suite 222 Sacramento, CA 95814 Phone: (916) 448-1900 www.CAassistedliving.org

Sally Michael

Copyright © 2023 California Assisted Living Association. All rights reserved. No part of this publication may be reproduced or transmitted in any form - print, electronic, or otherwise - without written permission from CALA.

CALA’S 2023 BOARD OF DIRECTORS THANK YOU

officers

PAST CHAIR Rick Jensen Northstar Senior Living

CHAIR Danielle Morgan Clearwater Living

SECRETARY Todd Shetter ActivCare Living

TREASURER Ron Mead Senior Resource Group, LLC

VICE CHAIR Dave Eskenazy Cogir Management USA, Inc.

directors

Carmel Dolcine Joseph Elder Care Alliance

Laura Fischer Brookdale Senior Living

Tara Cope Vi Senior Living

Dave Coluzzi Carlton Senior Living

Josh Allen Allen Flores Consulting Group

Michel Augsburger Chancellor Health Care, Inc

Nancy Schier Anzelmo Alzheimer’s Care Associates LLC

Douglas Lessard Belmont Village Senior Living

Rodger Lederer Marsh

Collette Gray Integral Senior Living

Paula Hertel Senior Living Consult

Joel Goldman Hanson Bridgett, LLP

Courtney Siegel Oakmont Management Group

Jay Thomas Atria Senior Living

Lisa Thompson Sunrise Senior Living

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I m P a c t OUR ADVOCACY

Influencing the Pandemic Exit

CALA’S ADVOCACY EXTENDS BEYOND LEGISLATION AND INCLUDES A RANGE OF PRESSING POLICY AND REGULATORY ISSUES THAT IMPACT MEMBERS’ ABILITY TO OPERATE EFFECTIVELY AND EFFICIENTLY, AND RESIDENTS’ ABILITY TO CONTINUE TO HAVE ACCESS TO SENIOR LIVING COMMUNITIES THAT REFLECT THEIR NEEDS AND PREFERENCES. HERE’S THE WORK CALA HAS BEEN DOING ON YOUR BEHALF. OPERATING ENVIRONMENT IMPROVING THE

With residents, staff and the viability of licensed residential care at the forefront, CALA fought for alignment with CDC guidance that treated RCFEs like the non-health care residential settings they are rather than health facilities. This meant aligning on an end to the broad mask and vaccine mandates. Ultimately successful, CALA’s advocacy helped residents who were increasingly frustrated and challenged by communicating and connecting with masked staff and visitors in their Assisted Living community. It provided relief for staff who had been wearing masks throughout their shifts for more than three years . This advocacy helped ease the major barrier to hiring that mandatory masking created and greatly improved communication and the overall residential living experience for older adults. Influencing Response to Future Emergencies CALA has been representing members on the California Department of Aging’s Long-Term Care Facility Access Policy Workgroup to make recommendations to the Legislature to ensure that older adults in licensed settings continue to have the right to in-person visits with loved ones during future states of emergency. The underlying premise in the search for balance is that safeguards that enable staff to interact with residents should apply to visitors. The final recommendations are not yet finalized but will be released soon. Impacting Environmental Fee Increases A dramatic and unannounced increase to an employer-based fee quickly got CALA involved with the Department of Toxic Substances Control to seek relief and avoid yet another fee increase. CALA learned earlier this year that the environmental fee that businesses that generate hazardous waste are required to pay, which broadly incorporates most employers unless they are nonprofit or do not meet the employee threshold, increased 221% and 220% for the two highest employee tiers in one year. support or opposition. Unfortunately for many businesses, no advance notice was provided other than a notice to pay. In addition to not communicating with employers regarding the fee increase, there was no gradual increase in the fees that instead jumped from $16,000 to $32,000 for employers with 500 to 999 employees and from $54,100 to $108,200 for employers with 1,000 or more employees. The Board of Environmental Safety has the authority to increase the fees every year after they were set by the initial trailer bill, and it was suggested that next year they raise the fee another 100% and extend the fee to businesses with 100 or more employees. CALA staff testified in support of the recommendation not to raise fees next year and followed up with written comments to the board emphasizing the need to hold off on immediate increases. This was the result of a trailer bill passed at the very end of the 2021 legislative session that happened so quickly there was no registered

Correcting the Plan of Correction Process

CALA secured statewide communication from DSS to all adult and senior care licensing staff to ensure that plans of correction are drafted by the licensee and not unilaterally imposed by the LPA. While this is the department’s official process, it was not being followed in a large number of instances. A provider-led plan of correction effort ensures the plan is comprehensive, specific to the situation and implementable, while providing for compliance. Thank you to CALA members who brought this issue to us.

CALA also met with the director of the Board of Environmental Safety to help educate the director about senior living and the harm this substantial increase will cause to senior living providers and current and future residents. CALA urged against imposing another exorbitant increase in fees so quickly, recommended improved communication with the businesses affected by these changes and suggested more gradual increases to fees over time. The executive director understood these concerns and the Board of Environmental Safety officially adopted the position not to increase the fees. For employers hardest hit, this allows time to budget for next year and consider increases in the next year. Fee increases will be addressed each September with any changes going into effect in October. CALA will continue to monitor these meetings and board correspondence and will advocate for members. Voice for RCFE s in the Long-Term Care Insurance Task Force CALA and the Residential Care Facilities for the Elderly (RCFEs) task force representative, Aron Alexander, Regional Vice President for Atria Senior Living , have been actively engaging in the Department of Insurance led effort to design a potential long term care insurance benefit for California. CALA has been focused on promoting the senior living model as an option for any long term care benefit because senior living is an attractive setting with high resident and family satisfaction rates, and Californians that pay into this benefit should be able to choose senior living if they desire. The Long-Term Care Insurance Task Force is now analyzing the cost of each of the five possible benefit designs with various options that will inform the governor and Legislature about the feasibility of creating a statewide long-term care insurance benefit. This additional information will be included in the final feasibility study that must be submitted to the governor and Legislature no later than Jan. 1, 2024. CALA staff attend meetings and provide comments as needed to support the inclusion of RCFE care in the feasibility report. At this time, it is not clear whether the Legislature will introduce legislation to create this benefit, but once the final report is provided it is a possibility that one or more legislators will move forward with the idea. CALA will continue to engage in the task force and will be monitoring for any legislation that may be introduced in the coming years and continue to advocate for the inclusion of an RCFE benefit. Advocating Balance in the Dementia Care Regulations CALA has been actively engaged in the process to shape the dementia care regulations to help ensure residents live in the least restrictive setting possible by considering their changing needs, rather than a diagnosis alone, when implementing more restrictive measures. The first draft of the dementia care regulations were released for public comment in September. There will likely be several rounds of comments before the department releases the final regulatory package.

materialized in this first draft. The department has not recognized that resident independence must be weighed against the inevitable risks and has not included necessary regulatory support to allow residents to age in place in the least restrictive environment. CALA will continue to advocate for a balanced approach to aging in place that recognizes the importance of independence and safety. CALA is thankful to the many board and public policy committee members and companies that provided input during this process and continue to do so. Representing RCFE s ’ Role in Future Assisted Living Waiver/CalAIM Program Design CALA is working to shape today’s Assisted Living Waiver program as well as the future integration in managed care through the CalAIM program. The Assisted Living Waiver (ALW), which allows Medi-Cal beneficiaries access to Assisted Living, is nearing the end of the five-year approval period and is being renewed for another five-year term. The Department of Health Care Services (DHCS), which oversees the ALW, planned to integrate ALW services into the Home and Community-Based Alternatives waiver (HCBA), but recently told stakeholders they will instead seek to address ALW services through CalAIM. CalAIM is a separate Medi-Cal waiver program that intends to provide a more coordinated, person-centered model of care for all Californians. Nursing home transitions or diversions into Assisted Living are provided through Community Supports under the CalAIM program. Currently, managed care health plans are not required to provide Community Supports but it seems that this will become a requirement by 2027 as DHCS begins to phase out the ALW, which will result in ALW services being available through managed care. In the meantime, DHCS is renewing the ALW for an additional five-year term to minimize issues with

“Who is better to provide updates and advocate on our behalf? CALA is informed, listens and responds to the members – their efforts have a lasting impact, with tangible results. As general manager, I depend on them for real solutions. Their relationship with DSS is an excellent resource.” SHERRY FISCHER, EXECUTIVE DIRECTOR, MERRILL GARDENS AT WEST COVINA "

CALA NEWS & VIEWS I ISSUE 48 | NOVEMBER 2023

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While there are some positive changes in the proposed regulations, the stated goal of these regulations has not

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www.CAassistedliving.org

transitioning current enrollees into CalAIM and to allow time to build up provider networks in the counties not currently participating in the ALW.

DHCS opened a month-long comment period to the public in September leading up to submission of the ALW renewal to CMS to be implemented prior to the expiration of the waiver on Feb. 29, 2024. DHCS has stated they only intend to make minor technical changes but could submit waiver amendments based on stakeholder comments after the waiver is approved. CALA provided comments for the ALW renewal that highlighted the need for DHCS to address low reimbursement rates that do not account for regional variations in wages and the cost of providing care and rising minimum wages and other wage pressures in the waiver counties. During the 2019 renewal process, CALA and other stakeholders were able to get significant changes to the waiver, such as not requiring kitchenettes in all rooms when it conflicts with Title 22 and allowing use of centralized showers as needed for residents that need assistance, which better allow for providers to accommodate residents with dementia in the ALW program. CALA will continue to engage with DHCS on the ALW and monitor this change to CalAIM. Providers that choose to partner with managed care health plans to provide Assisted Living services could see higher reimbursement rates as they will negotiate rates directly with the plans and there will be no state set rates. CALA is included in a learning collaborative to help managed care plans understand Assisted Living and begin building connections between providers and plans and will be working with members to provide education on this new program.

" Our organization is proud to be part of the CALA community. We rely on CALA to keep us informed regarding regulatory updates, to advocate on our behalf in Sacramento, and to provide resources as needed. I especially appreciate that we can ask questions of other CALA members and learn best practices from other communities.”

MARY LINDE, CEO, HERITAGE ON THE MARINA

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SAVE THE DATES!

2024 CALA CONFERENCE & TRADE SHOWS June 3-5 Hyatt Regency Hotel and Safe Credit Union Convention Center, Sacramento November 4-6 Renaissance Palm Springs Hotel & Palm Springs Convention Center

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IMPACTING LEGISLATION

BILLS SIGNED Budget Victory Speeds Background Check Processing CALA led a successful effort to secure state funding and additional staff so DSS could speed up the highly backlogged background check process and supported the DSS proposal to flat out replace the failed “Guardian” IT system. While the replacement process will take several years, the effort is underway and additional staff positions are available to DSS to fill in the gaps and speed processing in the meantime. A huge thank you to CALA members who wrote letters to legislators and the governor, and who met with legislators during CALA’s Assisted Living Advocacy Day and Day in Your District! INNOVATIVE OPTIONS FOR OLDER ADULTS TODAY AND IN THE FUTURE. OUR EFFORTS ON LEGISLATION BEGIN BEFORE BILLS ARE EVEN INTRODUCED AND CONTINUE BEYOND THE BILL SIGNING DEADLINE TO INCLUDE IMPLEMENTATION AND COMPLIANCE ROLLOUT. HERE ARE HIGHLIGHTS FROM THE FIRST YEAR OF THE TWO-YEAR LEGISLATIVE SESSION. AB 839 (Addis) RCFE Financing – Support AB 839 updates the California Health Facilities Financing Authority Act (CHFFA) to enable not-for-profit RCFEs to access CHFFA financing and funding programs. The CHFFA program currently serves community care facility settings but does not recognize similar stand-alone residential care facilities YOUR VOICE AT THE STATE CAPITOL, THE CALA TEAM WORKS TO ENSURE THAT ASSISTED LIVING, MEMORY CARE AND CONTINUING CARE RETIREMENT COMMUNITIES REMAIN VIBRANT,

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www.CAassistedliving.org

TWO-YEAR BILLS SB 875 (Glazer) RCFE Referral Agencies – Support Statute regulating referral agencies and requiring basic consumer disclosure and protection will have to wait another year. While the language in this bill didn’t provide everything that all groups wanted, it did represent general agreements among many stakeholders negotiated over many years, while also responding to a prior veto by Gov. Newsom. Late concerns stalled the bill for now. SB 809 (Smallwood-Cuevas) California Fair Employment and Housing Act: Fair Chance Act: Conviction History – Oppose Unless Amended CALA was part of a large CalChamber-led coalition in opposition to this burdensome background check bill. The intent of the bill is to expand upon previous legislation to help previously incarcerated individuals who have served their time not to be intentionally excluded from the workforce. Unfortunately, for employers required by the state or other government entities to condition employment upon a background check, this bill would have created unnecessary obstacles. Initially the bill would not have allowed employers to restrict employment based on certain conviction history, which was resolved with amendments, but it would still require these employers to undergo a duplicative assessment and appeals process even though DSS has its own exemption and appeals process that cannot be bypassed. Other concerns include workplace posting requirements and extensive information that would have to be included in every job advertisement. SB 809 is currently in the Senate Appropriations Committee, and we will continue to work to exempt senior living providers if it moves next year. 2024 ADVOCACY DAY SAVE THE DATE April 3, 2024 Stay tuned for more details. www.CAassistedliving.org

serving the elderly. Currently, only RCFEs that are associated with a skilled nursing facility have access to this program. AB 839 corrects that discrepancy. CALA secured amendments that enabled us to support this bill. AB 979 (Alvarez) Long-Term Care: Family Councils – Opposition Removed This bill modernizes the existing family council statute for RCFEs and SNFs primarily by recognizing virtual meetings and helping ensure designated individuals are aware of council meetings, among other things. CALA secured amendments to maintain the current response time for family council letters, maintain that “willful” interference is prohibited and maintain that residents in RCFEs will not be prohibited from activities during family council meetings, among other things. healthcare sector and for senior living due to the direct impact and significant wage pressures. Late amendments on the Assembly Floor that removed much of the opposition and secured the bill’s passage, established various phase-in schedules based on a number of factors including health care facility size, facility type and payor mix. The amendments also preempt city and county minimum wage ballot initiatives for 10 years and preempt local executive compensation cap ballot initiatives for six years. For RCFEs affiliated with an acute care provider or owned, operated or controlled by a hospital, and for licensed skilled nursing facilities operated or controlled by a hospital or health system, as defined, the minimum wage for all covered health care employees will be as follows: X From June 1, 2024, to May 31, 2026, inclusive, $21 per hour X From June 1, 2026, to May 31, 2028, inclusive, $23 per hour X From June 1, 2028, and until adjusted, $25 per hour CALA was part of a large opposition coalition. Thank you to members who wrote opposition letters and expressed opposition directly to legislators during CALA’s Day in Your District. CALA has been supportive of this bill’s goal of streamlining the complex elder abuse reporting process and appreciates the amendments that at least partially acknowledge situations involving dementia-related behaviors. CALA continues to have some concerns about reporting dementia-related altercations to law enforcement, however, federal law that requires such reports for nursing homes has set a precedent. As this bill, sponsored by the California’s Long-Term Care Ombudsman Association (CLTCOA), moves to the implementation phase, CALA will continue to work with the Long-Term Care Ombudsman, the Alzheimer’s Association and other stakeholders on ways to mitigate any possible negative impact on those with dementia. SB 525 (Durazo) Minimum Wage: Health Care Workers – Oppose SB 525 imposes a $25 minimum wage for “health care workers” and will result in significant cost increases throughout the AB 1417 (Wood) Elder and Dependent Adult Abuse: Mandated Reporting – Opposition Removed

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Dementia/Alzheimer’s Disease: AB 21 (Gipson) Peace Officers: Training – Support This bill, sponsored by the Alzheimer’s Association, is a reintroduction of a bill from last session that would require police officers receive dementia-specific training to help with interactions with people living with dementia. The Alzheimer’s Association will continue to work to pass this important legislation. AB 21 is currently on the Assembly Appropriations suspense file due to fiscal impact. AB 387 (Aguiar-Curry) Alzheimer’s Disease – Support This Alzheimer’s Association sponsored bill would expand the number and representation on the Alzheimer’s Disease and Related Disorders Advisory Committee and rename it the Alzheimer’s Disease and Related Conditions Advisory Committee. This bill was a partial reintroduction of one from last session. Importantly, new representation on this advisory committee would include a primary care physician and a first responder. This bill is in the Senate Appropriations Committee, and we expect work will continue on this bill next year. AB 423 (Maienschein) Department of Justice: Missing Persons – Suppor t AB 423 is similar to a bill from last session and is sponsored by the Alzheimer’s Associations of Orange County, Los Angeles County and San Diego County. This bill would establish a workgroup through the state attorney general to study wandering and create a report to provide education and training to professionals and family members, technological solutions, coordination of social services and law enforcement, and public awareness. CALA believed it was important to support this bill because there is a barrier with various law enforcement agencies sharing information about wandering individuals that makes it more difficult to find them. This bill is currently in the Assembly Appropriations Committee. SB 639 (Limón) Alzheimer’s Disease – Support SB 639 (Limón), sponsored by the Alzheimer’s Association, builds on previous legislation that would provide a comprehensive approach to the diagnosis, treatment and education of Alzheimer’s disease and related dementias across the state and encourage the creation of diagnostic hubs to help secure access to new clinical therapies coming to market. This bill would also continue and expand upon the cognitive health assessment training and validated tool for Medi-Cal beneficiaries and provide information to persons diagnosed with dementia and their care partners about home- and community-based services. This bill was very close to moving to the governor but the Department of Health Care Services had late amendments relating to the Medi-Cal portion so it was pulled from consideration to allow more time to work on it.

CALA NEWS & VIEWS I ISSUE 48 | NOVEMBER 2023

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www.CAassistedliving.org

WORKFORCE AND EDUCATION ADVOCATING FOR AT THE FOREFRONT OF EFFORTS TO STREAMLINE PROCESSES AND ENHANCE EFFICIENCY. CALA HAS DILIGENTLY WORKED TO IMPROVE THE GUARDIAN BACKGROUND CHECK SYSTEM AND ADMINISTRATOR CERTIFICATION PROCESSING, WHICH HAS LED TO SIGNIFICANT IMPROVEMENTS.

Progress with Guardian and Background Checks CALA has worked throughout the year to improve the Guardian background check system and processing of background checks while also providing education to members to make the process as smooth as possible. As a result, we’ve seen improvement. CALA elevated concerns to the Care Provider Management Branch (CPMB) related to the “error batch” black hole where fingerprints with inconsistencies in information were relegated without notice until an inquiry prompted an analyst to investigate and try to match the fingerprints to an individual.

in the error batch to just a little over 200 for all licensee categories under Community Care Licensing and it is now being actively monitored. At CALA’s urging regarding the need to speed simplified exemptions, which are granted automatically with no action needed on behalf of the applicant or the employer, CPMB worked with the Guardian vendor to automate the process to the extent possible. The list of individuals that may qualify for a simplified exemption are also actively monitored so if there is a need for manual intervention the department can act quickly to ensure they are approved in a timely manner. There have been many opportunities for CALA staff to help members experiencing significant delays in background check responses understand what could be holding up the clearance or exemption and ways to help the process go as quickly

CALA pursued this issue with CPMB and they have made significant progress in working down the number of fingerprints

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and smoothly as possible. Best practices have been shared through CALA’s weekly e-newsletter Update to help members avoid common pitfalls. CALA staff have worked with CPMB to elevate stalled background checks, which has given providers information about whether there is criminal history and an exemption is needed, if there is some issue with the fingerprints or other action the provider needs to take, or a clearance or simplified exemption may also be granted. Another change that CPMB has made due to CALA’s ongoing work was to allow analysts that answer the phone lines access to information to help callers when they call for an applicant that is “In Process.” Prior to this, call center staff could not answer any questions like whether an applicant has criminal history or whether an applicant with criminal history could qualify for a simplified exemption or would have to go through the standard exemption process. The Guardian vendor made system updates throughout the year to help solve issues that CALA repeatedly raised with the department to find solutions to the most pressing issues. Some of the updates made it possible to expedite and auto generate exemption needed letters, more information needed letters and other legal letters which has dramatically increased efficiency. The Guardian system has implemented additional checks that will help cut down on applicants going into the “error batch.” Another system update helps to match up applicants that get Live Scanned even though they are already in the system with a clearance or exemption, which will help cut down duplicates and lengthy delays waiting for the notice that they are eligible to work. As the department moves toward a replacement system for Guardian, CALA continues to remind the department of the need for stakeholder input prior to a system being implemented. Doing so will help avoid mistakes that were made during the Guardian acquisition process. In addition to a formal stakeholder process, CALA will proactively gather information from members to provide to CPMB to help them better understand the positives of Guardian, what does not work well in Guardian, and what new things a different system should have to make it efficient and easier for all to use. Administrator Certification Processing Improvements Coming Soon Another area of priority focus is improving the processing times for new administrators and renewals, which are taking roughly six months and eight months, respectively. CALA made clear that these delays are completely unacceptable and not sustainable. As a result of CALA’s advocacy, during the CALA spring conference, DSS outlined and then followed up on a framework to address issues when new and continuing administrator’s certification packages are delayed: ● Administrator Certification Section (ACS) coordinates with the Centralized Applications Bureau (CAB) to identify

www.CAassistedliving.org 13 DSS and the Administrator Certification Section (ACS) is actively looking for short and long-term solutions, much as they did with background checks. With their own hiring challenges and lack of authority to grant “provisional certification,” resolution to this problem will take us into 2024. " " “I am quite certain that without CALA’s involvement and direction in opposing or guiding legislation, Assisted Living would not exist as we know it. CALA works everyday to ensure that our legislators understand what differentiates us from skilled nursing, and how senior living has grown & adapted over the years.” Eric A. Hostetter, Executive Director, Bruceville Point, Tenfold Senior Living current and prospective administrators tied to a new licensure and will process them in tandem. ● New administrators with a job offer may submit a written request to expedite their package, which must include verifiable documentation of a job offer and proof of submission to ACS. ● Licensing Program Analysts (LPAs) are continuing to be made aware of processing delays with ACS. During inspections, if there is no current certification and licensing can validate the submission of paperwork the LPA will take that into account when determining whether to cite. This is done on a case-by-case basis. (If you are cited, elevate to the regional manager right away and let CALA know). ● If an administrator certification package is deemed incomplete the administrator has 90-days to remediate. At this point, the case has been assigned a case manager and the process will move as quickly as the administrator does to get their information processed and the certificate emailed. A delinquency fine isn’t assessed if the package was submitted prior to expiration. ACS is working on an online portal that should help speed the process by allowing online payment and submission of renewal applications and supporting documentation. CALA is urging that a group of licensees test the system and provide feedback prior to launch so any issues on the end user side can be addressed.

POLICY AND COMPLIANCE WEBINARS

Public Policy Playbook CALA introduced a new member benefit this year, the Public Policy Playbook webinars. By the end of 2023, CALA’s public policy team will have hosted four webinars as way to bring up-to-the-minute information to members on legislative and regulatory issues. CALA members hear from the public policy team during Advocacy Day and during the two CALA conferences and through weekly articles in the e-newsletter and News & Views articles. The idea behind this new benefit was to find a way to communicate short policy updates with members in between current communication and make it interactive so attendees can ask their pressing policy questions. OPPORTUNITIES. WHETHER YOU'RE INTERESTED IN POLICY UPDATES, RISK REDUCTION STRATEGIES OR OTHER CRITICAL ASPECTS OF SENIOR LIVING, OUR WEBINARS ARE A VALUABLE RESOURCE TO HELP YOU STAY AHEAD IN YOUR FIELD. KEEP AN EYE ON OUR UPCOMING WEBINARS AND MAKE THE MOST OF THESE OPPORTUNITIES. Here's a recap of topics addressed during the four 2023 Public Policy Playbook webinars: ● February – This webinar provided a first look at the bills introduced during the new legislative session just after the bill introduction deadline; CALA’s priority for a solution to the Guardian background check backlog; the end of the COVID-19 state of emergency and what that meant for providers; and information about the upcoming Advocacy Day. ● June – Just after the legislative deadline to pass the budget, this webinar focused on CALA’s work to fix the broken Guardian background check system through a budget solution; and background on member impact through CALA’s Day in Your District . ● September – After the end of the first year of the legislative session, this webinar addressed SB 525, the “health care worker” minimum wage and other labor bills that directly or indirectly affect senior living providers and residents; an update on several RCFE bills (AB 839 (Addis) RCFE financing: CHHFA; AB 979 (Alvarez) Family Councils; AB 1417 (Wood) Elder Abuse Reporting; and two-year bill SB 875 (Glazer) RCFE Referral Agencies); an update on several dementia/ Alzheimer’s bills (SB 639 (Limon), AB 387 (Aguiar-Curry), AB 21 (Gipson); and AB 423 (Maienschein); CALA’s action on the recently released first draft of the new dementia AT CALA, WE UNDERSTAND THE IMPORTANCE OF CONTINUOUS LEARNING AND STAYING INFORMED IN THE EVER-EVOLVING FIELD OF SENIOR LIVING. TO SERVE THIS PURPOSE, WE OFFER A SERIES OF INFORMATIVE WEBINARS DESIGNED TO PROVIDE OUR MEMBERS WITH VALUABLE INSIGHTS, KNOWLEDGE AND INTERACTIVE

care regulations; progress on the Guardian background check system; and continuing delays in administrator certification/ recertification processing. ● December – Prior to the second year of session, this webinar will start the discussion on which two-year bills are expected to move; potential new bills we could see; and updates on DSS issues like background check and administrator certification processing and dementia regulations. Hazardous Waste Webinars Earlier this year, members alerted CALA to increased scrutiny of senior living employee handling and disposal of hazardous pharmaceutical waste by CalOSHA and local inspectors working under the purview of the Department of Toxic Substances Control. To aid in compliance, CALA secured an update from Hanson Bridgett that included disposal of hazardous pharmaceutical waste. We also designed a two-part webinar to educate members on safe handling of these medications from an employee/CalOSHA perspective and identification and proper disposal of these medications. By involving the Department of Toxic Substances Control (DTSC) in the webinar, we were able to help educate them on senior living and the range of operational issues providers face. This relationship will help as DTSC moves forward in reviewing their rules. Missed the webinars? Recordings can be accessed from CALA’s Webinar Archive. Risk Reduction Webinar Members interested in current trends and underlying causal factors that heighten exposure to potential professional liability claims gained practical insights and strategies to help reduce risk during CALA’s webinar in early 2023. Tara Clayton, Senior Vice President, Marsh Senior Living & LTC Industry Practice and Joel Goldman, Partner, Hanson Bridgett, LLP covered the latest stats, offered practical approaches and answered members’ questions during this interactive webinar.

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I m P a c t OUR workforce

HELPING MEMBERS ACCESS TALENT CALA BOASTS A ROBUST WORKFORCE DEVELOPMENT PROGRAM, OFFERING AN ARRAY OF VALUABLE RESOURCES TO BOTH ASPIRING PROFESSIONALS IN THE FIELD AND ORGANIZATIONS SEEKING TO ONBOARD NEW TALENT. CALA REMAINED STEADFAST IN ITS RECRUITMENT INITIATIVES, AIMING TO ENHANCE THE VISIBILITY OF ITS MEMBERS ACROSS DIVERSE REGIONS, APPEALING TO INDIVIDUALS DEEPLY COMMITTED TO SENIOR CARE AND HONORING REMARKABLE INDIVIDUALS. CALA ACTIVELY FOSTERED EMPLOYEE GROWTH THROUGH INITIATIVES

SUCH AS THE ONLINE LEADERSHIP DEVELOPMENT SERIES AND THE USC SCHOLARSHIP PROGRAM.

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Growing Your Workforce Pipeline - Exploring Strategies, Resources and Best Practices

Each of the 2023 conferences opened with a breakout session entitled Growing Your Workforce Pipeline – Exploring Strategies, Resources and Best Practices where attendees discussed critical issues and considerations as well as shared recruitment and retention resources and best practices. They also learned about numerous ready-to use tools and resources developed by and for CALA members at their disposal to support their efforts to recruit and retain a talented workforce. Additionally, attendees heard about numerous organizations throughout the state that they can partner with to gain access to a potential talent pipeline.

Introducing Next Generation Leaders to the Profession Once again, students, recent graduates and others with an interest in the profession were afforded the opportunity to attend a CALA conference, meet with prospective employers and gain helpful career navigation insights and strategies. Thanks to CALA members' generous contributions to the Scholarship Fund, 21 individuals from 11 schools and organizations were able to take advantage of this experiential learning opportunity, some being hired as a result of the experience. Special thanks to Layla Eskenazy, owner & CEO of Senior Talent Group, for generously donating her time to with recent and past scholarship recipients by providing guidance and insights at conferences, as well as holding monthly Zoom calls and supporting those individuals pursuing positions. How can you connect with students who may be prospective employees and increase visibility for the profession? Consider these possibilities: ● As many learning institutions use Handshake to post announcements, consider joining the platform. For more information, go to https://joinhandshake.com/employers/ or the individual Handshake page for campuses near you. ● For a list of campuses and programs near you, go to this page on the CALA website: https://caassistedliving.org/ CALA/Workforce_Resources/Partnering_with_Schools.aspx ● CALA regularly forwards announcements to members in corresponding regions where career events are held – from job fairs to resume reviews, mock interviews, guest speaker opportunities and more. ● Consider hosting interns at your community. Go here to explore The Ins & Outs of Offering Internships. ● And visit CALA’s Workforce Development webpages

CALA provides us with a treasure trove of vetted resources. These resources allow us to streamline our operations and focus our time and energy on what truly matters – providing excellent care for seniors. From regulatory updates to best practices, CALA's resources are indispensable for staying at the top of our game.

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Kevin J Spoor, Executive Director, La Marea Senior Living

l Gain direct access to talented individuals from numerous college programs l Increase your company’s visibility l Support the development of future leaders Contribute to the STUDENT SCHOLARSHIP FUND!

CALA NEWS & VIEWS I ISSUE 48 | NOVEMBER 2023

for more tools, resources and information: https:// caassistedliving.org/CALA/Workforce_Resources/ Workforce_Resources_Intro.aspx

EMAIL JAN @ CAASSISTEDLIVING.ORG FOR MORE INFO

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www.CAassistedliving.org

Transforming Lives & Careers Through the CALA USC Graduate Degree Scholarship

What Can a Graduate Degree from USC Do for You and Rising Stars on Your Team?

Further Your Career – Apply for the 2024 USC Scholarship! Key Dates & Deadlines ● March 15: Graduate School Application priority deadline* ● June 14: Scholarship Application deadline** ● August 26: Fall Semester classes begin or corporate position that resides in California – from regionals to executive directors, program directors, rising stars and beyond. ● Applicants must first apply and be accepted into graduate school. Since 2014, in recognition of CALA members' unwavering dedication to providing outstanding care and upholding sound business practices, the University of Southern California, Leonard Davis School of Gerontology has granted a full scholarship to a deserving CALA provider member, paving the way for the recipient to pursue a master’s degree of their choice. Each past recipient has shared how transformative the experience has been, impacting their personal and professional development and opening pathways for career advancement. Here's What You May Not Know: ● Program values range from $36,000 to $100,000. ● Courses can be completed either online or on-site. ● Scholarship recipients can choose the degree program best suited to their needs, interests and past experience: » Master of Arts in Senior Living Hospitality (MASLH) » Master of Arts in Aging Services Management (MAASM) » Master of Science in Gerontology (MSG) » Master of Arts in Gerontology (MAG) » Master of Arts in Long-Term Care Administration (MALTCA) » Master of Arts in Medical Gerontology (MAMG) » Graduate Certificate in Gerontology ● The opportunity to apply for the scholarship is available to any CALA member that works in a senior living community

“The Leonard Davis School of Gerontology at USC is a global leader in gerontological education. Its master's programs are unparalleled, showcasing a rich blend of multidisciplinary perspectives. Whether in-person or through its cutting-edge virtual classrooms, students benefit from the wisdom and expertise of the foremost authorities in aging studies. We consistently seek out and hire its graduates, which is a testament to the program's commitment to cultivating professional excellence and propelling career advancement." PATRICIA WILL, FOUNDER & CEO, BELMONT VILLAGE SENIOR LIVING “Stepping into the esteemed multidisciplinary program at USC has been a transformative experience for me. In my role, where I facilitate regular trainings for frontline staff, my enriched perspective has elevated the quality and impact of our sessions and has provided a powerful tool to adeptly guide the managers I mentor through clinical challenges." ALLISON GROVES, DIRECTOR OF CLINICAL OPERATIONS, CARLTON SENIOR LIVING

Seize this golden opportunity to enhance your knowledge and propel your career forward — submit your application today!

CALA Provider Members Only

allison's video

*Admission to the USC School of Gerontology does not guarantee scholarship support. **Scholarship Application Deadline: June 14, 2024 (All required documents, including transcripts, must be received by CALA by this date.) Please note: Full scholarship includes tuition. Student is responsible for books and other fees. Award contingent upon acceptance into graduate school.

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GROWING YOUR WORKFORCE PIPELINE – ONE PARTNERSHIP AT A TIME Looking for creative, collaborative ways to grow your workforce pipeline? Consider partnering with these organizations and programs with broad reach and access to an expansive talent pipeline, and connect with programs and prospective employees near you.

THE ARC CALIFORNIA The Arc California and its numerous chapters throughout the state creates successful relationships with large and small businesses by connecting candidates with developmental disabilities to job opportunities to excel in their professional roles. CALIFORNIA COMMUNITY COLLEGES California Community Colleges provide workforce development in healthcare, human services, and the culinary arts making their graduates perfect employees to fill the workforce gaps in Senior Living communities. THE CA COUNCIL ON GERONTOLOGY & GERIATRICS (CCGG) The CA Council on Gerontology & Geriatrics (CCGG) links academic institutions — including students, educators, researchers, and administrators — to older adults and their families and to legislators, service providers, businesses, and other stakeholders. CSU CAMPUS CAREER CENTERS CSU Campus Career Centers can help you expand your talent pool, simplify your recruitment efforts, and save costs by connecting you with CSU students and alumni who are well prepared to contribute to your organization’s success. CSU HOSPITALITY & TOURISM ALLIANCE The CSU Hospitality & Tourism Alliance offers a passport to the world of hospitality and tourism management. Our graduates prove to be an immediate asset to any employer. They come from a rigorous academic background, with a strong work ethic and real-world experience. EARN & LEARN Earn & Learn is an Education Technology organization that works to effectively scale work-based learning experiences for all learners. We are a funneled point of contact for employers to work with a region’s schools, colleges, and community organizations to develop a local diverse talent pipeline. NURSING SCHOOLS Nursing Schools throughout the state prepare the next generation of professionals with the knowledge, skills and attitudes necessary to continuously improve the quality, safety, and effectiveness of health and human services. Consider partnering with a school to host early-term nursing students for clinical rotations. PROSTART® ProStart® is a career and technical education program that unites the foodservice industry and the classroom to teach high school students culinary skills and restaurant management principles, as well as employability skills such as communication, teamwork, professionalism, and time management. WOUNDED WARRIOR PROJECT – WARRIORS TO WORK Through collaboration and partnerships, Wounded Warriors Project Warriors to Work collaborates with employers to facilitate productive onboarding, identify optimal roles for veterans and provide qualified candidates, and develop practices to help increase retention among veteran employees. CALA’S WORKFORCE DEVELOPMENT WEB PAGES CALA’s Workforce Development website pages include numerous tools and resources developed by and for CALA members to help you build connections, as well as recruit and retain a talented workforce.

Interested in obtaining key contacts or learning more about a particular organization? Contact CALA’s Vice President of Workforce & Professional Development Jan Trifiro at jan@CAassistedliving.org .

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Our CALA membership has provided us with unlimited opportunities for networking and collaboration with other professionals in Assisted Living. This facilitates the exchange of ideas, sharing of experiences and building relationships with peers and experts in the field. Jennifer Sprow, Director of Customer Success, Skilled Nursing Pharmacy

EXCELLENCE EDUCATIONAL

Elevate: CALA's Annual Conference & Expo

We are grateful to the many members, supporters and senior living professionals who graced us with their presence at this year's #CALAElevate. Be it in the state capital in June or the Palm Springs in November, we seized the opportunity to rekindle our connections, reignite our passion and reaffirm our mission. Together, we engaged in many dynamic educational sessions, clinked glasses and savored the moment at the Trade Show Wine Tasting, celebrated the pinnacle of excellence in our field at the Awards Luncheon and forged new alliances at our networking events. We express our sincerest appreciation to all those who were part of this remarkable experience. Your presence and participation enriched CALA's Elevate, making it an unforgettable event. Thank you for elevating our community!

Being a CALA member helps me feel a part of a larger community. I love attending the conferences where I connect with colleagues and am inspired with new ideas and am reminded of best practices! Thank you for all you do to keep us informed! Dawn DeStefani, Executive Director, ActivCare Mission Bay

Being a member of CALA provides me with additional knowledge and training that helps me be a more effective & compassionate Executive Director. The opportunities for engagement with other fellow executives also remind me that I am not alone, when dealing with challenging staffing or resident situations. CALA is such a wonderful, and crucial, organization for senior living.” Sylvia Chu, Executive Director, The Trousdale, Eskaton

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I m P a c t OUR outreach

THIS YEAR WAS ANOTHER EXCITING YEAR FOR CALA’S GRASSROOTS ADVOCACY EFFORTS. GRASSROOTS ADVOCACY IS AN ESSENTIAL ASPECT OF CALA’S EFFORTS TO EDUCATE LEGISLATORS ABOUT ASSISTED LIVING, MEMORY CARE AND CONTINUING CARE RETIREMENT COMMUNITIES, AND DEVELOP IMPORTANT RELATIONSHIPS. GRASSROOTS ADVOCACY

From legislative visits and letter writing campaigns to Day in Your District and Advocacy Day , CALA members used their voices to help shape the future of policy in California. One of the most impactful and important ways to cultivate relationships with your legislators is to invite them to visit your community. With recent elections sending a largely new group of legislators to Sacramento, legislative visits are essential in shaping their perspective of senior living. In fact, 19 CALA member communities welcomed a newly elected state legislator into their community for a visit, tour or townhall. Additionally, CALA members welcomed 21 veteran legislators at their communities while continuing to foster meaningful relationships with their legislators and staff. Member advocacy efforts did not stop with tours and continued as CALA members met with legislators and staff during our annual advocacy events, Advocacy Day and Day in Your District . These advocacy events help policymakers understand the care and services CALA members provide to constituents in their district, along with the large number of jobs created. This year during Advocacy Day , over 70 legislators and staff met with CALA members in Sacramento to discuss the pressing issues facing senior living, from background checks to minimum wage. The conversations and relationships built truly are essential in furthering our voice in the Legislature and impacting the future of senior living policy in California. During the Legislature’s summer recess, 87 CALA members met with legislators in their district offices as part of CALA’s Day in Your District . Many of the connections that members made in

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