ATLANTA — If you have a loved one in memory care, this is your chance to speak up.
There’s a public comment period happening until December 13 before the Georgia Department of Community Health (DCH) officially changes a rule reducing staffing requirements in memory care.
Current law requires at least two direct care workers “on-site” in each memory care unit. The Senior Care Reform Act, House Bill 987, created that requirement and other training mandates when it was passed into law in 2020.
Originally, the Georgia Senior Living Association (GSLA) sponsored and supported the legislation, but now the group argues language in the law has caused unintended consequences.
President and CEO Catie Ramp wrote a letter to DCH making a case for “industry-wide inefficiencies . . . where Georgia staffing is in a crisis” because of the minimum staffing mandate.
In a rare move, the Department of Community Health accepted the external petition to reconsider the rule. In a November meeting, the DCH board voted to adopt a new rule no longer requiring two direct care workers in memory care units. It does not become official until they vote again in January.
The crux of the change centers around the definition of “on-site.” As the law is currently written, two direct care workers must staff a memory care unit at all times, even if it exists within an assisted living community. That means a facility must employ more staff to care for those in the assisted living wings. The care workers cannot serve both.
Beth Cayce, CEO of CaraVita Senior Care Management, which owns several assisted living and memory care communities in the metro, says it all comes down to which care workers can go through a certain door.
“Logistically, it makes a whole lot more sense for them to be able to provide care on both sides of the door within the staffing needs and ratios the residents have,” she says.
Most memory care units are locked for the safety of its residents. The new rule would require only one person in the memory care unit at all times and allow a second person to float around the building as needed.
“Do I think it’s a safety issue? No, I think it’s a cost issue and an affordability issue. It increases prices,” Cayce said. “You take double staffing plus maybe a $3 an hour work rate, and all of a sudden, a family could be looking at having to pay anywhere from $50 to $200 more a month for no difference really in the care.”
On the other side of the argument, some advocates, like those with the Alzheimer’s Association and the Georgia Council on Aging (GCOA), are concerned reducing minimum staffing requirements could cause unsafe conditions and “potentially place residents at risk for injury, abuse, and neglect.”
In a statement released December 11, the Georgia Council on Aging publicly opposed the changes:
“In response to the growing number of cases of elder abuse, the Georgia Legislature felt the need for new staffing requirements in Assisted Living Communities, Personal Care Homes, and Memory Care Centers, and passed HB 987 into law on 2020. HB 987 set appropriate requirements for on-site staff-to-patient ratios. GCOA feels that the proposed rules changes would undermine the existing laws.”
The legal question is legitimate but remains in limbo. Minimum staffing requirements are Georgia law and the DCH promulgates rules facilities must follow based on the law.
Nancy Pitra, Director of Government Affairs for the Alzheimer's Association Georgia chapter, say this change would create a rule at odds with current law.
“If there’s going to be a new definition in the rules, it should also be in the code section and really should go through the General Assembly process,” she said. “[Changing the rule through the Department of Community Health] feels like a little bit of an end run.”
When questioned about the legal concerns, the Department of Community Health replied, “all concerns and issues raised during the public comment period will be carefully reviewed and considered by the department.”
Written public comments to Public.Comment@dch.ga.gov will be accepted up until 5:00 p.m. Wednesday, December 13, 2023. They held a public hearing on Zoom on Monday, December 11 for oral arguments.
The DCH board will meet again in January to make a final decision.