On Tuesday, 8 April, the Assembly Human Services (AHS) Committee (Stone, Chair) heard many bills under its purview, one of which was AB 1523 - requiring RCFEs to carry and maintain liability insurance as a condition of licensure. The bill, carried by Assembly Speaker-Elect Toni Atkins and Assembly Member Shirley Weber, and sponsored by CARR, was heard at 3pm.
Ms. Atkins addressed the committee, explained the need for RCFEs to carry liability insurance both as a best-practices for facilities, and a necessary tool to allow consumers to obtain accountability when adverse events occur to their loved ones. Chris Murphy, CARR's ED gave testimony also on behalf of the legislation, referring to two local wrongful death actions against two RCFEs.. Faced with large judgments they were unable to pay, both facilities filed for bankruptcy protection; the state lost two facilities, and residents in each had to be relocated. Two additional testimonies on behalf of the bill were heard. Speaking in opposition to the bill was Denise Johnson, Consultant for the Community Residential Care Association of California. She expressed policy affordability issues for those facilities who care for SSI/SSP residents.
The primary focus surrounding California’s RCFE industry is policy reform. In CARR’s view, modification of regulatory language may do little to affect the performance of facilities without accompanying improvements to the oversight and enforcement practices of California’s Department of Social Services (DSS). CARR’s five years spent reviewing the public documents strongly suggests a department significantly weakened by the absence of evidence-based practices.
DSS does not make use of facility compliance data or LPA performance data to inform their policies or practices. CARR’s analysis of this data suggests this is a major shortcoming that impacts departmental operations and jeopardizes safety within RCFEs. The resultant patterns, frequencies and trends reveal current compliance and accountability issues have just as much to do with outdated regulations as does the organizational culture of DSS. This raises questions about the Department’s effectiveness as a regulator. Samples include:
CARR recently offered testimony before the San Diego County Board of Supervisors in support of Chairwoman Jacob and Supervisor Cox’s initiatives to improve the local RCFE industry. CARR also participated in the press conference called by Chairwoman Jacob and District Attorney, Bonnie Dumanis to show our support for the creation of an elder abuse task force within the District Attorney's office. Read Chrisy and Chris' words of support:
C.L. Selder's Statement: "On behalf of CARR, I applaud Chairwoman Jacob and Supervisor Cox for addressing the deficits within San Diego’s long-term care facilities. The initiatives put forth are common sense strategies that will reduce risk for RCFE consumers. CARR strongly supports the development of a rating system for RCFEs that relies on both qualitative and quantitative data; one similar to CMS’s national rating system for skilled nursing facilities.
CARR's advocates Chrisy Selder and Chris Murphy trekked to Sacramento to attend the 11 February oversight hearings called by Joint Chairs of the Human Services Committee: Senator Yee and Assemblyman Stone. The legislators heard from 13 hand-picked individuals across the spectrum of stakeholders.
The genesis of these hearings was a direct result of two events: the constellation of investigative reports ("Deadly Neglect") on assisted living in San Diego published by the UTSanDiego on 9 September 2013, and the October bungled closure of a Castro Valley RCFE where CCL closed the facility but did not provide for the care or relocation of the residents; 48 hours after being abandoned by the licensee and the regulators, 19 residents were found still living in the facility, unattended and in squalor.
Following three and a half hours of testimony by the witnesses, the floor was opened for public comment. Due to shortness of time, each member of the public was limited to about 1 minute, but our comments below were prepared for a total of 4 minutes. Nine organizations and/or individuals spoke, including CARR. CARR's full remarks are provided below:
"Hi, I am Christina Selder, co-founder of Consumer Advocates for RCFE Reform or CARR for short. CARR is a San Diego based 501(c)3 which advocates for consumer protections related to assisted living facilities.