CALA News & Views | Issue 48 | Impact

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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