FHCA recently interviewed Doug Adkins, Executive Director of Dayspring Senior Livingin Hilliard, just outside the Jacksonville area. Doug is a member of the Florida Center for Assisted Living Committee (FCAL) and a strong advocate for long term care, specifically assisted living issues. He has been an active member of Florida Health Care Association for over three decades, is a member of both the Reimbursement and Legislative Committees and is a former recipient of FHCA’s Arthur H. Harris Government Services Award.
How did you make the decision to work in long term care? Specifically, an assisted living facility?
After my graduation from University of Evansville in 1986, I moved to Florida where my father had purchased some older motel properties. The property was zoned ACLF at the time. I am a person of faith and at the age of 24 yrs old this was not what I had envisioned. I followed the wise advice of my mother ( Joan) and sought through prayer what God’s will was for me relative to this project. You see, my family worked primarily in the Corporate 500 in everything from aluminum, power engineering, aerospace, etc., so this was a real step outside the comfort zone. My counsel is to be careful in what you ask God to do, it may surprise you when he answers. I have now cared for over 4,000 residents in the last 34 years, and each day my sense of urgency is renewed by the blessing of God’s new day!
As Executive Director of Dayspring Senior Living and Dayspring Village, you oversee see 190 beds collectively. With both being limited mental health and limited nursing facilities, tell us about the uniqueness of you community, staff and the residents.
Our two facilities are unique in the diagnosis and the complexity we serve. We focus on compassion and a love for people when recruiting the staff. This is really a mission rather than a job, and it is important that others share your commitment to the mission. The easiest way to understand the word “compassion” is found in Mark Chapter 5 – You see Jesus did not particularly desire to get in a boat and sail to a place called Gadara. He was obedient to what was asked of him so he went to redeem what belonged to God. The “maniac at Gadara” is a well-known story but embodies tremendous lessons on how we should view our obligation to exhibit “compassion” or “love” for those who are most complex. When you help someone or “redeem” them through mending of the broken spaces in their lives, you truly make a difference. It is not always glorious and you often do not get recognized for the many complex solutions and successes you achieve in mending what is broken, but the impact is life changing, and preserving and improving the lives around is truly what I believe is a worthy use of our time.
How long have you been a member of Florida Health Care Association (FHCA)? What made you choose FHCA over other state long term care organizations?
I have been a member of FHCA since 1989. I remember Grady Snowden was the first FHCA President I served under and I attended all the meetings that I could and got engaged in the Residential Care Committee. I eventually became the Residential Care Vice President, and FHCA made the name change to the [Florida Center for Assisted Living] FCAL while I was the VP. Without question, the committee structure and engagement of members in the serious business of changing the landscape of long term care is a major reason I have stayed with FHCA over all these years. There is a framework that allows for good ideas and talented people to influence the process. I know this first hand, because after getting some important changes made to the ALF laws, I was selected as an Art Harris Award recipient for my legislative work. I consider the Art Harris award as a lifetime achievement award, as it takes hard work and commitment to get things done in the legislative process. To some extent, the understanding of this process allowed my wife Janet to become elected as the 134th woman ever to serve in the Florida House of Representatives from 2009 to 2016 and achieve her many accomplishments. FHCA has the credibility and a process that works, and everyone knows that if FHCA has vetted the issue, it’s good policy and we should move forward.
As an FHCA leader, what are some of the projects that you have supported or worked on that have made you proud?
The list is too numerous to recite all that we have accomplished, but a few highlights include the staffing rule challenge that the Board supported me on, the name change to FCAL, my involvement in SB 1202 (a major long term care reform bill), and ensuring that ALFs were able to benefit from all the tort reforms that continue to make a difference to this very day. I also remember fight for the Cost of Living Adjustment (COLA) pass-through with the optional state supplementation program and recall the day and time that Senator Silver said, “let do it,” when we proposed to creating the Medicaid Assistive Care Services program and leveraging the Optional State Supplements (OSS) dollars to pull down the Medicaid match. I also remember the many legislative workgroups we got passed, how they helped change the course of ALF policy and helped raised the OSS personal needs allowance from $43/month to $54/month.
I am also proud to have supported Governor Ron DeSantis during his Republican Primary. We hosted a fundraiser and he came to Hilliard to campaign with our residents. In May 2020, I filed a petition to commence rulemaking on COVID testing. In June 2020, AHCA denied my petition and a few days later adopted emergency rules to require all staff and third parties to do testing. The reality is that Governor DeSantis has been a strong leader for long term care ,and he understand clearly the “Silver Tsunami” that is headed our way.
In your opinion, please describe how FHCA has changed over the past years?
FHCA has modernized its framework and is now focused on a whole range of issues affecting quality of care and our residents. We have new “titans” of our profession rising to lead in many areas and, even today, the focus on innovation and new ideas continue to be a part of the FHCA culture and focus.
Do you believe that FHCA is able to meet the needs of other assisted living facilities in Florida?
The simple truth is that FHCA is a credible organization that people trust and listen to. I can assure you that absent the support of FHCA, there is very little chance something can get done. When you have this organization supporting the change you need, things will get done and processes begin to work. The reality is we are all a team. We have many shared challenges, and working collaboratively, we are able to be successful.
What are some of the “added benefits” that makes membership in FHCA attractive to your organization as an assisted living facility?
Serving on the FHCA committees, the conference calls and the insight into emerging issues at the state and national level allow us to stay ahead of the curve. Without question, FHCA is engaged in the issues that matter most to owners and administrators.
With the challenges that assisted living facilities face with increasing needs and workforce issues, what do you think FHCA can focus on to help you overcome these challenges?
Right now, we need to focus on modernization of the funding methodology for the low income or middle space market. The creative use of Medicare Advantage Plans and broad use of downward substitution can help us create a braided funding methodology. I have been advocating for a funding methodology workgroup to help get focused on these issues, and I am hopeful we can get this done this year. I also believe the workforce will undergo a realignment and, while this is happening, we need to push for an expansion of the J1 Visas to allow us to bring in, for two years, workers from other nations that can fill these frontline positions while the labor market realigns and we implement the vaccine mandate and adjust to the new work environment.
I am also working on a Med Tech bill that we championed last year, and thanks to Representative James Buchanan (R – Osprey) and Senator Shevrin Jones (D-Miami Gardens), was passed through the House but did not get through the Senate. Frontline experience handling medications translates into knowledge and skills that come to fruition when these talented workers take the nursing exam. With so many struggling to pass the nursing exam, the expanded use of Med Techs on the frontlines will only build practice skills and help grow that next generation of frontline nurses.
As an assisted living member, how do you think FHCA can support other assisted living members as we move forward in the long term care continuum?
Getting more [ALF] members involved on the Legislative, Conference and Reimbursement committee will help expand the focus and conversation. We need to focus on some “Wins” for the ALF communities and help address the funding methodology for the middle space market. The reality is that this is where the vast numbers are and, in order to get investment and construction moving again, we have to create a laser focus on the funding and the workforce issues. I think FHCA is an organization that can pull together the people and the ideas to make this stuff happen. I am going to do my part and help support all ALF projects that help Florida move forward. Let’s get it done!