Straight Talk

CARR Initiates Petition To Require Mandatory Liability Insurance for RCFEs

Today's Concern, Tomorrow's Reality: Make Sure CARR Continues

By now, we all know someone contending with the needs of an aging family member.  And while aging and dependency are not synonymous, there does come a point in time (be it brief or extended) where reliance on others will enter the picture.  Sound familiar:

“I am worried about my aging mother continuing to live alone.  Her memory-loss is becoming more apparent.  Her ability to drive herself to the store and appointments is diminishing.  Her overall health and functioning seem to be declining.   I feel she would be safer with more assistance and supervision.”

           “I do not know what to do about my aging father.  Since my mother passed, I worry about him being alone.  He can no longer keep up the house.  His medication regimen is quite complicated.  And his gait has changed, I worry he may fall as a result and I will not be there to help him.  I feel he would be more comfortable with some additional help and prompting.”

And so, the search for support is triggered. 

Nowadays, most families start with the Internet using search engines to generate potential leads.  Typically, they are overwhelmed and find themselves inundated with choices, providers, articles and organizations.  And their hearts sink as they discover they have no easy, reliable way of distinguishing the increasingly common entrepreneur from the knowledgeable provider committed to seniors themselves. 

MEET OUR INTERNS: Matthew M. & Micah Wroten

While earning our degrees (2007), Chris and I (Chrisy) met in a long-term care policy class. Both of us were conducting research on the assisted living care option for our thesis project.  Ongoing, we shared our concerns about how little information was available on this long-term care option and individual facilities.  But, it was not until we began reviewing the state's public files that we truly understood the scope of the problem and became motivated to do something.

With this inspiration in mind, CARR developed an internship program.  For the last 3 years,  CARR has provided a unique internship experience that allows students to learn about assisted living through the lens of the public document.  Having worked and volunteered in facilities myself, this is truly a perspective that imparts more than a familiarity with resident needs and standard operations (though interns learn that too). Our interns come from various academic backgrounds (i.e. gerontology, social work, public health, criminal justice) but all are interested in making a difference in the world of senior care, and all leave more motivated than when they first came.

CARR Urges YES Vote on Prop 42

Access to the public record is vital to Consumer Advocates for RCFE Reform. Proposition 42 strengthens California's Public Record Act (CPRA), and will require all public entities to comply with the CPRA - compliance will no longer be discretionary. CARR is a firm and ardent supporter of public transparency law, and urges your YES vote on this important tool to keep government transparent. 

In fairness and for full disclosure of information, Ballotpedia offers pros and cons of the legislation.  

UPDATE 6/14/14: AB 1523 Passes out of Senate Human Services Committee on Consent

        UPDATE:  6/14/2014.  On 5/15/14 AB 1523 received the full support of the Assembly, with a vote of 77 ayes to 0 nays.  The bill moved on to the Senate's Human Services Committee where it was passed through on consent.  CARR is proud to have worked with Speaker Tony Atkins Office to create a common-sense piece of legislation that has received bipartisan support.  

AB 1523 was voted out of Assembly Appropriations Committee with unanimous support as well.  

During the initial proceedings 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 is carried by Assembly Speaker-Elect Toni Atkins and Assembly Member Shirley Weber, and sponsored by CARR.  

CARR Contributes to California Healthcare Foundation Think Tank

California Healthline recently asked CARR and other experts in the field "How should California regulate its growing RCFE industry?".  Provided here is CARR's submission.  You can read all of the submissions by visiting http://www.californiahealthline.org/think-tank/2014/how-should-california-regulate-growing-changing-assisted-living-industry.

The Need for Data-Driven Practices

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's Support for the San Diego County Board of Supervisors' RCFE Initiatives

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 Public Comment at the Joint Human Services Committee Oversight Hearing

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. 

THANK YOUS & KUDOS to our Volunteers and Donors

HOW DO WE SAY THANKS?

WOW!  This year CARR has received help, encouragement and money from a wonderful group of volunteers and donors who have identified with CARR's mission and the work we do.   Individuals have stepped up to the plate offering us donations, time, great ideas, and new strategies for our continued work.  Thank you! Thank you! 

Special Thanks to the members of our Board; without you we could not function. 

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ProPublica Article Spotlights Nationwide Risks to Assisted Living Residents

Visitors to CARR's site, and our Twitter and Facebook followers are encouraged to read the ProPublica article "Elderly, At Risk and Haphazardly Protected" by AC Thompson and Jonathan Jones.  The article is a litany of inadequate consumer protections and lack of meaningful state oversight for assisted living facilities throughout the US.    

Thanks in large part to the focus on CCLD failures in San Diego, covered by the collaborative investigative series between Center for Health Reporting and UT San Diego  "Deadly Neglect" (9/9/13), the time has never been better for consumers  to urge state legislators to "step up to the plate", "to do the heavy lifting", to "work for the little people" to develop meaningful and widespread reform to both Title 22 RCFE regulations,  and to the insular and opaque CCLD.  

CARR urges you to write your local state assembly member, and your state senator demanding much needed, long overdue, and totally necessary reform to how residents of assisted living care cared for, and to provide for meaningful reforms in the areas of accountability and criminal prosecution of elder abuse, including neglect that occurs in state RCFEs.

Facility Shopping? Take Along Your IPAD!

All you web-savvy users can now easily access www.rcfereform.org using your ipad.  And because your ipad defaults to Safari as the browser, you will optimally see the site and all its contents.  So now, while you are out and about, taking tours of the RCFEs of interest to you, you are now able, with a login, to access the public documents on our site, in real time while.  Use our public documents to inform the questions you ask the facility administrator or licensee.