U.S. Assisted Living Residence Smoke-free Regulations: A 50-State Summary Chart The following chart is a snapshot of the U.S. landscape of state smoke-free regulations in assisted living residences, including adult foster care homes and facilities, as of January 2016.* This information was based on a 50-state (plus Washington, D.C.) survey of current state statutes and administrative rules and regulations pertaining to the use of tobacco products in adult foster care homes and related assisted living residences.† Because states vary in the terms they use for these homes and facilities, efforts were made to include those assisted living residences that most resemble adult foster care – licensed living arrangements that provide mentally or physically impaired, elderly or ailing adults around-the-clock support, including food, lodging, supervision and household services, both in corporate adult foster care facilities and in private residences. Whenever possible, hyperlinks to online resources containing the cited authority are included. * This chart was prepared as part of a research project funded by ClearWay MinnesotaSM, Grant Number RC-2014-0017. Please note that the information contained in this document is not intended to constitute or replace legal advice. † For additional information about specific residential care programs and regulations, see U.S. Dep’t of Health & Human Services, Compendium of Residential Care and Assisted Living Regulations and Policy:2015 Edition (2015). Public Health Law Center 875 Summit Avenue, Saint Paul, MN 55105-3076 www.publichealthlawcenter.org 651.290.7506 1 U.S. Assisted Living Residence Smoke-free Regulations: A 50-State Summary Chart State “Assisted Living Residences” / “Adult Smoking Prohibited in Smoking Prohibited in Administrative Additional Foster Care” Descriptions Assisted Living Assisted Living Body Information Residences under State Residences under Other Regulating Smoke-free Law?‡ State Laws or Assisted Living Regulations? Residences Alabama Assisted living facilities are individuals or No. Ala. Code 22-15A-1 Not specified. Smoking Alabama Social Specialty Care entities that provide or offer to provide provisions are not Services Assisted Living: residence and personal care to two or more specified in state rules for Division, “Unless prohibited individuals who need assistance with adult foster care. The Department of by a facility’s own activities of daily living. Specialty care state’s minimum standards Human policies, . a assisted living facilities are assisted living for foster care homes state Resources cognitively intact facilities specially licensed and staffed to that “The services and resident who uses care for residents with a degree of cognitive facilities of the foster lighter fluid to fill a impairment that would ordinarily make them home shall be such that the personal cigarette ineligible for admission or continued stay in person in foster care is not lighter, . may an assisted living facility. Alabama licenses taken advantage of and the store small three categories of assisted living facilities emotional and physical quantities of those based on the number of residents: needs of the person in materials in a safe Family assisted living facilities are foster care are met in a and secure manner authorized to care for 2 to 3 adults way that will protect and within his or her Group assisted living facilities are promote the client's health, own room.” authorized to care for 4 to 16 adults. safety, comfort, and well- (Emphasis added) Congregate assisted living facilities are being.” (Emphasis added.) Rules of Alabama authorized to care for 17 or more adults. Ala. Admin. Code R. 660- State Board of Rules of Alabama State Board of Health, 5-42-.01 (1999) Health, Chap. 420- Chapter 420-5-4. Assisted Living Facilities; 5-20, Health Supp. Alabama Dept. of Human Resources, In rules for Assisted 9/30/15 5-4-2, Minimum Standards for Foster Care Homes Living Facilities Food Specialty Care Handling, no smoking or Assisted Living “other use of tobacco Facilities products” is permitted by staff, residents, and Health Care visitors. Rules of Facilities: Alabama State Board of Smoking is Health, Chapter 420-5-4. prohibited except in ‡ This term includes all state Clean Indoor Air Acts and similar legislation. Public Health Law Center 875 Summit Avenue, Saint Paul, MN 55105-3076 www.publichealthlawcenter.org 651.290.7506 2 U.S. Assisted Living Residence Smoke-free Regulations: A 50-State Summary Chart State “Assisted Living Residences” / “Adult Smoking Prohibited in Smoking Prohibited in Administrative Additional Foster Care” Descriptions Assisted Living Assisted Living Body Information Residences under State Residences under Other Regulating Smoke-free Law?‡ State Laws or Assisted Living Regulations? Residences Assisted Living Facilities. designated enclosed and well- ventilated areas in most health care facilities. Smoking by patients in a chemical dependency treatment program or mental health program may be allowed in a separated and well- ventilated area. ALA. CODE § 22- 15A-1 et seq. (2003) Alaska Typical residents in assisted living homes are No. Alaska Stat. §§ Not specified. Smoking is Alaska Smoking is also elderly persons and persons with mental 18.35.300 et seq. (2004) restricted to designated Department of restricted in any health, developmental, or physical areas in residential health Health and Alaska Pioneers' disabilities. Licensure is not required for care institutions or Social Services, Home or Alaska adult foster homes that serve one or two facilities, and public or Division of Veterans' Home. persons, but these homes may apply for private mental health Health Care Alaska Pioneers’ licensure as an assisted living facility, which facilities. Alaska Admin. Services, and Homes are homes allows them to participate as a Medicaid Code, Title 7, § 10.1085 the Department designated for waiver program service provider. Assisted (2006) of Alaskan residents living rules apply to all adult foster homes Administration age 65 or older who that serve three or more residents. Alaska have been Admin. Code, Title 7, § 10.1085 (2006) physically present in the State of Alaska for a minimum of twelve consecutive months Public Health Law Center 875 Summit Avenue, Saint Paul, MN 55105-3076 www.publichealthlawcenter.org 651.290.7506 3 U.S. Assisted Living Residence Smoke-free Regulations: A 50-State Summary Chart State “Assisted Living Residences” / “Adult Smoking Prohibited in Smoking Prohibited in Administrative Additional Foster Care” Descriptions Assisted Living Assisted Living Body Information Residences under State Residences under Other Regulating Smoke-free Law?‡ State Laws or Assisted Living Regulations? Residences prior to application. Alaska Stat. §§ 18.35.300 et seq. (2004) Arizona Adult foster care homes are considered part No. Ariz. Rev. Stat. § 36- Not specified. State law Arizona of an “assisted living facility”: a residential 601.01 & Ariz. Admin. prohibits smoking in a Division of care institution that provides or contracts to Rules §§ R9-2-101 to R9-2- private residence licensed Licensing provide supervisory care, personal care, or 112 (2007) or certified by the Services, Office directed care on a continuing basis and one to Department or in areas of of Assisted four residents are permitted in each home. a private residence Living These facilities include adult foster care licensed or certified by the Licensing; homes, where care is provided for up to four Department as a health Department of people in the home in which the caregiver care institution other than Health Services lives; assisted living homes, which provide an adult day care. Ariz. care for up to ten people; and assisted living Admin. Code § R9-2-106 centers, which provide care for eleven or (2013) (private residence more people. Arizona Department of Health smoking restriction) Services Assisted Living Guide Arkansas An adult family home is a single family No. Ark. Code. Ann. §§ 20- Not specified. The state, Arkansas residence that provides 24-hour care for no 27-1801 et seq. (2006) however, does allow Department of more than three adults with physical smoking in areas within Human Services disabilities, dementia, or other conditions, long-term care facilities who are not related to the operator. The that are designated by the Arkansas Department of Human Services facility as a smoking area licenses and regulates assisted living or for supervised patient facilities as either Level 1 or Level II, both of smoking only. Ark. Code which provide services in a home-like setting R. § 016.06.61-705 (2010) for elderly and disabled persons. Family Homes 1 and II serve developmentally disabled persons. A "Family Home I" means a community-based residential home licensed by the division that provides room and board, Public Health Law Center 875 Summit Avenue, Saint Paul, MN 55105-3076 www.publichealthlawcenter.org 651.290.7506 4 U.S. Assisted Living Residence Smoke-free Regulations: A 50-State Summary Chart State “Assisted Living Residences” / “Adult Smoking Prohibited in Smoking Prohibited in Administrative Additional Foster Care” Descriptions Assisted Living Assisted Living Body Information Residences under State Residences under Other Regulating Smoke-free Law?‡ State Laws or Assisted Living Regulations? Residences personal care, habilitation services, and supervision in a single-family environment for not more than eight (8) developmentally disabled persons. A "Family Home II" means a community-based