CARR Supported the Board of Supervisors' RCFE Initiatives in 2013

In 2013, CARR testified 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.

Despite the high profile of assisted living, quality information on RCFEs remains largely unavailable to consumers.  Seniors, caregivers, family members, conservators, public guardians and social workers all searching for performance and quality–related information are dismayed to discover that their best research efforts produce little beyond ‘telephone directory’ information, amenity menus and a handful of professional websites that rate facilities based on self-reported data.  

So their fundamental questions persist:  What goes on behind closed doors?  Can we trust this facility?  Despite their uncertainty, they must still make a placement decision knowing they are missing the most substantive part of the equation—compliance and quality-of-care information.

CARR observed the need to improve the visibility of facility compliance histories for consumers in 2009.  Recognizing that with compliance history data as part of the evaluation process, consumers could judge for themselves whether the care and services advertised by RCFE facilities agreed with the story told by their public file.  It also granted a window into the oversight practices of the state agency responsible for licensing, inspecting and enforcing Title 22 regulations within the facility.

Because CARR’s primary focus has been San Diego RCFEs, San Diego County has the unique opportunity to have compliance history data as part of its rating system.  No other county in California can currently entertain such a comprehensive rating system.  Furthermore, with the implementation of this program, San Diego County will join an elite group of states that have successfully addressed the information asymmetry within their RCFE industries.

In closing, CARR encourages the board to unanimously support these initiatives that will further protect the health, safety and dignity of local RCFE residents.  Thank you."

Chris Murphy's Statement:     "Members of the Board:  I am Chris Murphy, Executive Director of Consumer Advocates for RCFE Reform (CARR) a local 501(c) 3 grassroots consumer advocacy organization that researches public documents and policy issues on assisted living in California.

CARR strongly supports the restoration of funding to the Long-Term Care Ombudsman program. The Ombudsman’s office provides valuable and much needed advocacy for residents in long-term care facilities (which include both assisted living and skilled nursing).  As the number of assisted living facilities in San Diego grows, the need for Ombudsman will become more acute.

As sponsor of AB 1523, Mandatory Liability Insurance for RCFEs, introduced by Majority Leader Toni Atkins, CARR appreciates Supervisors’ Jacob and Cox’s recommendation to support the major RCFE reform bills pending in the legislature. We caution, however, that in our view, not all bills offer workable or enforceable solutions, despite the best intentions of their sponsors.  Therefore, we encourage a dialogue with the County’s Legislative Program personnel to insure that any piece of RCFE reform legislation supported by the County does more good than harm, and that unintended consequences are minimized. The criteria for lending support should be how well the bill works to protect the health and safety of elders in assisted living.  An overview of our legislative analyses is offered for your consideration.

Lastly, CARR enthusiastically supports the initiative for a multi-disciplinary Special Prosecution Unit in the DA’s office to investigate and prosecute crimes committed in long-term care facilities.  We know that crimes specifically committed in RCFEs are rarely referred to either local law enforcement or to the Department of Justice/BMFEA.  Crimes of abuse, neglect, and sexual assault occurring in assisted living facilities continue to elude exposure, professional investigation, or criminal prosecution - in large part because Community Care Licensing and its in-house Investigations Bureau conduct their work sub rosa, stifling outside agency involvement.  Until crimes are consistently and timely investigated first by local law enforcement and/or the Department of Justice, abusers will continue to go unpunished.  The thoughtful and aggressive implementation of the Special Prosecution Unit could create a model for replication statewide. 

CARR is optimistic these initiatives will improve the lives of frail elders living in long-term care facilities.  And we look forward to the day when San Diego will be known nationwide as a zero-tolerance city for elder abuse in any setting. "

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