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Delaware Senate Democrats

Sen. Mantzavinos, Rep. Johnson file bills to enhance oversight, strengthen workforce of long-term care facilities

February 26, 2024

DOVER – Families would have greater assurance that long-term care facilities in the First State are operating at the highest standards under a package of bills introduced in the General Assembly this week.

The four-bill package filed by Sen. Spiros Mantzavinos and Rep. Kendra Johnson on Monday would provide some of the most meaningful reforms to Delaware’s long-term care industry in decades, resulting in expanded oversight, accountability, and stronger pathways for the recruitment and retention of long-term care workers throughout the First State.

“Families place an immense amount of trust in the caregivers, staff and management at assisted living, long-term, transitional, memory care, and other types of elder care facilities,” said Sen. Mantzavinos, who has helped to lead the General Assembly’s efforts to improve the quality of life for aging Delawareans since he first took office in 2020.

“As elected leaders, we owe it to those families and their loved ones to do everything we can to ensure that their loved ones are safe and properly cared for,” he said. “I am confident this common-sense legislative package will raise the level of care at all of Delaware’s long-term care facilities, hold administrators accountable if they fall short, and give them the resources they need to provide the world-class services that families expect.”

The Long-Term Care package is supported by the Delaware Elder Care Advocacy Coalition, a group of passionate families who united in late 2023 to push for more transparency, accountability, and best-in-class care for Delaware seniors.

“We are grateful for legislation to ensure our residents of long-term care facilities receive quality care and live their life with dignity,” Coalition Founder Candace Esham said. “Transparency and accountability to follow current regulations is critical to resident safety, identifying systemic issues, and empowering families in decision making for choice of facilities. Enabling a workforce to dedicate their service to our most vulnerable population will help current staff and residents, as well as better prepare Delaware for the future.”

The bipartisan Long-Term Care package introduced by Sen. Mantzavinos, Rep. Johnson, and 26 co-sponsors includes:

House Bill 300 would require assisted living facilities currently unregulated by the federal Centers for Medicare & Medicaid Services to maintain accreditation from an independent organization selected by the Delaware Department of Health and Social Services. The legislation also would define dementia care service in Delaware Code for the first time, and require facilities that provide those services to meet independent certification standards. 

Senate Bill 215 would change how often the Division of Health Care Quality is required to conduct in-person inspections of Delaware’s assisted living facilities and nursing homes. While current state law requires “regular” inspections, SB 215 would make clear that in-person inspections of the roughly 80 facilities currently in operation must occur at least once a year.

Failure to maintain accreditation required for a facility or the certification required for a dementia service could lead to civil penalties and a potential suspension or denial of a license to operate in the First State. 

Senate Bill 216 would increase the civil penalties that can be imposed against long-term care facilities, regardless of whether the violations pose a serious threat to the health and safety of residents. Those fines have not been adjusted since 2000. Under SB 216, all fines levied against long-term care facilities would be doubled to account for inflation over the last 24 years.

Senate Bill 217 would both help bolster the long-term care workforce by strengthening the pipeline of healthcare workers graduating from Delaware’s institutions of higher learning.

The legislation would create a career-based scholarship program that incentivizes nursing students and others to pursue careers in Delaware’s long-term care facilities in exchange for financial aid while they earn their degrees.

Modeled after a similar scholarship program created by Speaker Valerie Longhurst in 2022 for speech-language pathologists and mental health professionals. SB 217 would loan students up to $5,000 a year to cover the cost of tuition for a degree in the healthcare field. Students who work at a long-term care facility after graduation would gradually have their loan converted to a grant over the course of four years.

The Long-Term Care legislative package has bi-partisan support from legislators in both the House and the Senate.

“Delaware’s seniors deserve the best care possible and family members should be confident their loved ones are receiving necessary assistance from well-qualified personnel,” said Senate Minority Whip Brian Pettyjohn. “These bills do just that and I am proud to join in this bipartisan effort.”

“As I often talk about, I had the honor of serving as a caretaker for my late grandmother. Those were certainly some of the hardest years, but ones I would not exchange for anything. I learned a lot about long-term care and where improvements were needed within the system,” said Rep. Mike Smith, a co-prime sponsor of all four bills. “One of the bills I am especially proud to co-sponsor is legislation to strengthen the long-term care workforce. We need committed, well-qualified, and properly trained staff to make sure our loved ones are being taken care of in the manner we all expect.”

The introduction of the Long-Term Care legislative package and the formation of the Caucus on Aging follows the work of the Aging-In-Place Working Group in 2022 and the Long-Term Care and Memory Care Task Force (LTCMC) in 2023.

Both task forces were made up of legislators, state regulators and industry professionals. Both task forces also released reports recommending several reforms to strengthen Delaware’s continuum of care to help seniors to live healthy and productive lives well into their senior years – a particularly pressing issue given recent estimates that one in four Delawareans will be 65 or older by 2050.

“Our work on the Long-Term Care and Memory Care Task Force provided us with many valuable insights from seniors, advocates, and industry professionals about the complex challenges faced by long-term care residents and staff alike,” Rep. Johnson said. “HB 300, together with the other measures in our legislative package, will go a long way toward addressing those challenges and improving the safety and well-being of those residing in assisted living facilities, particularly those requiring specialized dementia care.”

After the LTCMC task force issued its final report in late May 2023, Sen. Mantzavinos and Rep. Johnson introduced multiple bills to help address issues commonly encountered by residents of long-term care facilities and their families.

Of those, the Delaware General Assembly passed House Concurrent Resolution 55 directing DHSS to submit a report this spring detailing recommendations for how best to implement a person-centered acuity model of long-term care staffing. Governor John Carney also signed into law Senate Bill 152, which set cultural competency and language accessibility standards for long-term care facilities.

Senate Bill 150, which would strengthen staffing training requirements for long-term care facilities that offer dementia care, and Senate Bill 151, which would help ensure long-term care facilities are giving an honest account of the dementia care services they offer, are both awaiting votes in the Senate.

“Our work to enhance and improve long-term care and memory care services in the State of Delaware did not end on June 30 last year,” Sen. Mantzavinos said.

“We continued to work with the long-term care industry, reform advocates, impacted families and our fellow legislators over the last eight months to put forward additional legislation that will improve the care our parents and grandparents are able to receive here in Delaware,” he said. “I remain committed to advancing all of the bills we have put forward so far, as well as developing new bills that will help ensure our older neighbors are able to enjoy their senior years in safety and comfort.”