A state commission facing an August deadline to issue recommendations on how to better regulate assisted living residences voted Wednesday to extend its deadline, citing a need to consider lessons learned from the July 13th fire at a Fall River facility that killed 10 residents.
The commission had been facing a deadline of August 1 to issue its report.
“We were marching toward doing that,” said Robin Lipson, Secretary for the state’s Executive Office of Aging and Independence, who chairs the commission. “But ... there is emerging consensus that we need some time to process what we’re learning from last week. And to make sure that our recommendations incorporate all the best thinking, as new information comes out and as we reflect on what happened.”
The commission gave itself at least 90 more days to hear from safety experts and others as it creates what commissioners say they hope will be actionable recommendations for the Legislature.
“I think one of the things that is clear — and there’s consensus emerging at the commission — is that this situation necessitates that we drill down on safety,” Lipson said. “And so one of things that we will likely focus on in the next month or so is to hear from safety experts and make sure we understand what some of the best practices are from other industries, including the long-term care industry and the healthcare industry.”
The motion to extend the deadline was introduced by state Sen. Mark Montigny who is on the commission. He said meaningful regulations for assisted living residences are long overdue.
“My mission, and I think most would agree, is to use the tragedy for the only thing that might come out of this that’s good,” the New Bedford Democrat said. “And that is to use the ... focus of the legislature and the administration and the media and the advocates to actually get firm recommendations, to finally do what we should have done 20 years ago.”
Commissioners at Wednesday’s meetings raised concerns that assisted living facilities for low-income residents, who mostly pay through the state’s Medicaid program, MassHealth, are less likely to have necessary safety protections.
“The area of affordable assisted living residences needs extra attention. They are different,” said state Rep. Thomas Stanley who is also on the commission. “Only 7 to 10% of assisted living residences are so-called 'affordable,' for lack of a better term. But those are the ones that really need focus.”
“Across every board, affordable versions — from housing to medical facilities — are always not given the same level of attention. That’s a pretty systemic issue,” said Lindsay Mitnik, a commission member and staff attorney at Greater Boston Legal Services. “I think that this is our opportunity to do that, and to make sure that just because something is more affordable does not mean that it is not at the same level of regulation.”
The commission also includes representatives who work in the assisted living industry, including Matthew Salmon, the CEO of SALMON Health and Retirement. Salmon said residents in assisted living facilities have had increasingly complicated medical needs over the last 15 years.
“I think what we need to address is that assisted living in Massachusetts is a social model, not a medical model,” Salmon said. “If you look at the construction regulations for assisted living compared to skilled nursing or a hospital, they’re much different because of the care that’s expected to be provided in those buildings.”
“We need to understand what the upper limit is, for what is acceptable, to be caring for in an assisted living [facility],” Salmon said, “because the level of complexity of the residents you’re taking care of will change how you respond in a disaster.”
