CARR's advocates Chrisy Selder and Chris Murphy trekked to Sacramento to attend the 11 February 2014 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.
"We have traveled here to bring attention to the insularity of Community Care Licensing (CCL). CCL treats crimes occurring in RCFEs as regulatory deficiencies rather than as crimes to be prosecuted under the CA penal code 368. Rather than refer these cases to outside law enforcement, they are handled internally within CCL's regional offices or by CCL’s Investigations Bureau. While increasing civil penalties, training, transparency and oversight are critical, so too is the criminal prosecution of elder abuse & neglect inside RCFEs. Here are examples taken directly from the public documents:
"2005 – "Resident admitted to hospital with pressure sores, skin damage, scrotum/eyes/ears dry and raw." This was the 2nd violation for this, nurse-owned facility, that resulted in a resident’s death. Criminal charges were never filed. The maximum civil penalty of $150 was assesed. This facility remains open.
"2006 – "Caregiver groped an elderly resident’s breast, upper thighs and vaginal area against the resident’s will. Resident sustained bruising." The caregiver was fired, but remains in the job market ready to work for another facility. Criminal charges were never filed. No civil penalty was issued, as sexual abuse is not among the deficiencies that receive a civil penalty. This facility remains open.
"2010 – "Facility administrator embezzled money from resident, and sold her belongings." Outside law enforcement did not investigate, and criminal charges were never filed. A civil penalty was not assessed, as financial elder abuse is also not among the deficiencies that carry a civil penalty. This facility remains open.
"I am Chris Murphy, Executive Director and co-founder of CARR.
"2010 – "Resident was taken to the hospital with major dehydration and severe sepsis which resulted in her death." Outside law enforcement did not investigate, and criminal charges were never filed. The facility received a $150 Civil Penalty. This facility remains open.
"A 2011 complaint mentions ‘questionable death’ & failure to call 911; several residents had multiple decubitus ulcers in two of the licensee’s facilities. Neither the questionable death, nor the neglect were investigated by outside law . The facility received a $150 civil penalty and This facility remains open.
"2011 – Death by neglect: A bedridden resident died from his multiple wounds - stage 3, 4 and unstagable pressure ulcers - wounds so deep his coccyx bone was exposed. This death did not receive a criminal investigation nor were criminal charges filed. No civil penalty was found in the public file, and yes, this facility remains open.
"Also in 2011 a caregiver assaulted an elderly dementia resident. As stated in the Accusation, ". . . the caregiver restrained, struck, pushed, pulled and threatened the resident." CCL called this a Personal Rights Violation – CARR calls it elder abuse and assault. The Investigations Bureau, by its own admission, did not refer this case to San Diego police, to San Diego County District Attorney’s office, nor to the California Department of justice, BMFEA. But as this Stipulation & Waiver indicates, DSS considered the caregiver’s conduct to be so reprehensible that it warranted a “lifetime ban” on the caregiver ever working in a California licensed facility.
"If any of these crimes were committed in a personal home, a full investigation would occur by local law enforcement, and likely, charges would be brought. Yet because these crimes occurred in a state licensed RCFE, perpetrators of criminal elder abuse get a pass on prosecution under California Penal Code 368.
"On behalf of California consumers, we implore you to investigate the Investigations Bureau to determine why these and other apparent crimes, have gone uninvestigated, and/or unprosecuted. And why these crimes are routinely not referred to outside local law enforcement agencies?
"Our research over the last five years in over 16,000 public documents leads CARR to conclude that CCL, in collaboration with its Investigations Bureau, is not a consumer-protection agency, but is rather, a provider-protection agency and on many occasions, a criminal-protection agency.
"Thank you for your time today."