The Options for Senior Living Team is asking for your support on HB2529, the first legislative effort to reach this level of escalation to the Office of the Governor in the State of Arizona.

We are asking for support from the entire senior living industry, especially all agents and assisted living care providers.

Update on HB2529

UPDATE on HB2529 – Assisted Living; Referral Agency Disclosure

HB2529 passed the Senate yesterday, and is now sitting on the Governor’s desk for signature. We are not done. We need your help one last time. We understand that our opposition is working up stories and gathering allies (big ones) to go to the Governor’s office to ask him to veto our bill.

We need you to call AND email the Governor’s office (and cc the Health Policy Advisor, Christina Corieri) to ask the Governor to sign HB2529. Please use all your contacts, and forward this email to colleagues, friends, family, and politically active residents.

Down and View:
Click here to see the Process Flow Chart.

To call: Governor Doug Ducey’s office number: 602-542-4331
To email: Governor Ducey – engage@az.gov

Please cc his Policy Advisor: Ms. Christina Corieri, Policy Advisor, Health & Human Services: CCorieri@az.gov

Here is a sample email (please change up and use your own words):

Dear Governor Ducey,

Please sign HB2529. While there are strict federal requirements that prevent referral fees to nursing homes, that is not the case with assisted living. There is a concern among the senior-living community in Arizona that significant payments are being made to direct residents to various facilities without any disclosure. While payments are being made by assisted living facilities, it is represented to the resident that the referral is “free.”

HB2529 would require disclosure of the referral fee to the resident or resident’s representative. The disclosure would also have to disclose the existence of any business and familial relationships between the referral agency and the assisted living facility.

HB2529 does not encompass regulation, certification, or administrative agency review. It is intended to operate as a consumer protection to allow the consumer to know the level of payment that is being made to refer that resident and whether a business and/or familial relationship exists between the assisted living facility and the referral agency.

Please bring sunshine to an otherwise hidden process that misleads Arizona seniors. I urge you to sign HB2529.

Respectfully,
YOUR NAME

SUMMARY of HB2529:
HB2529, as amended, is a significant reform that will protect Arizona’s seniors. The bill brings sunshine to an otherwise hidden process that can mislead seniors into thinking a referral agency is working only in their best interest to help find the best-assisted living facility for that person.

Rather than creating a regulatory bureaucracy as other states have done, HB2529 simply requires a referral agency to tell its customer or the customer’s representative prior to making a referral that the agency is paid a fee by the assisted living facility for the referral, and to disclose the existence of any business relationship that may create a conflict of interest  (such as the agency is part owner of the facility referred to).

Once that customer becomes a resident at an assisted living facility due to such a referral, the referral agency must close the loop with its customer by sending a second disclosure of the amount of the fee paid or a good faith estimate of the fee to be paid.  These disclosures must be acknowledged by the resident or their representative, and provided to the assisted living facility to be kept on file.

The bill allows for enforcement of these provisions by the Attorney General or the County Attorney, with up to a $1,000 civil penalty per violation.  This bill creates consumer protections for some of Arizona’s most vulnerable residents- we strongly encourage support of HB2529 on final read.

BACKGROUND:
HB 2529 just requires a disclosure to the resident and an acknowledgment by the resident or resident’s representative at the beginning of the relationship with the resident and at the end. It is important to note that none of the local referral agencies, associations of referral agencies or assisted living facilities are opposing this bill.  We would speculate that the two national associations (one more vocally than the other) do not want to alter a national process for an Arizona-specific requirement.

The two national referral agencies refer individuals only to facilities where they have a contract. These contracts set forth a fee, or range. Therefore, when they know that a resident is going to enroll, they know at least the good faith estimate of the fee (as the bill provides).

Further, the national referral agencies, A Place for Mom and Caring.com, can alter their contracts with their facilities in Arizona to require prior notification by the assisted living facility to the referral agency when a resident has indicated that they have decided to move into the facility.  That should be a simple change in their contract. After that change, the referral agencies will be notified prior to the admission of the resident and can, in turn, notify the resident of the estimated fee and receive an acknowledgment from the resident.

The bill imposes no recordkeeping requirement on the referral agency.  That could be done in the future. There are recordkeeping requirements on AL facilities for the residency contract and medical records.  Facilities will likely keep these records with the other resident records.

Most licensing requirements – either in statute or in rule and regulation – have an enforcement penalty, either a fine, a criminal penalty or a civil penalty.  HB 2529 contains the most minimal penalty, discretionary by the Attorney General or County Attorney so that there is at least some threat of penalty if the disclosures are not followed.

I would again stress that none of Arizona assisted living facilities, Arizona assisted living associations, Arizona referral agency associations or local referral agencies have expressed opposition to the bill.  I believe the opposition by the two nationals are because they have a single national model and this legislation would require a modification of that model.

We remain willing and available to provide further changes in the future. However, this is as close as we’ve come to a consumer protection/disclosure requirement in assisted living.

Our Opposition:
Caring. com is the only one in opposition to this bill. A Place for Mom is neutral – at this time. We have attended a stakeholder meeting, and have made concessions to Caring. com and A Place for Mom.

Caring. com is not happy and is actively working to get this bill vetoed. It’s our position that it should be the Referral Agencies responsibility to let the resident/family know of their relationship – upfront, not the Assisted Living Manager.

As a reminder, HB2529 does not require anything new for AL Managers or Assisted Living Homes or Centers. The disclosures requirements and penalties in HB2529 are for Referral Agencies.

We are in the home stretch, but we need your help to get this bill signed by the Governor.

PLEASE CALL AND EMAIL.

If you’d like to help, but this information is confusing, please email me at pkoester@leadingageaz.org

For questions or information:
Arizona LeadingAge
3877 N. 7th St. #240
Phoenix, Arizona 85014
602.230.0026