How Should California Regulate Growing, Changing Assisted-Living Industry? – California Healthline.
A joint hearing of the Senate and Assembly Human Services Committees last month examined the growing and changing assisted-living industry in California.
The hearing included testimony from witnesses who contend California’s oversight has not kept pace with the evolving industry which promises to grow faster as aging baby boomers lose the ability to care for themselves.
Dozens of deaths and injuries have been attributed to sub-standard care at California residential care facilities for the elderly — known as RCFEs — in the past six years. In San Diego County alone, 27 assisted-living residents died since 2008 as a result of injuries or neglect stemming from poor care, advocates said.
Some experts contend California’s oversight of the assisted-living industry was less-than-robust even before funding cutbacks in recent years reduced the state’s ability to monitor the facilities.
Some stakeholders contend that state regulations need strengthening to give health officials sufficient clout to protect consumers. They point out that under current regulations neglect or abuse are punishable by a maximum fine of $150.
The assisted-living industry is overseen in California by the state Department of Social Services under legislation passed in 1985. However, in the years since the Residential Care Facilities for the Elderly Act was signed into law, the industry has changed considerably, growing in scope and taking in residents with greater health care needs.
According to a new report from the National Senior Citizens Law Center — “Best Practices in Assisted Living: Considering Potential Reforms for California” — California regulations are about two decades behind the changes in the industry.
We asked experts and stakeholders how California should regulate and stay abreast of the growing, changing assisted-living industry. We got responses from:
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Will Lightbourne | Director, California Department of Social Services
Strengthening Regulatory Foundation
The landscape of care for the aging has markedly evolved. For many reasons, many people who used to be cared for by family at home now rely on the care of others, often in licensed facilities. That cultural shift coincides with a significant shift in the delivery of health care, which is now primarily “managed” as outpatient care.
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Margaret Griffin | President, California Continuing Care Residents Association
First, Most Important Step: Involve Residents
There is widespread agreement that the state of California’s assisted living facilities and the oversight provided by the Department of Social Services together represent a dysfunctional system. Recent news stories and attention from the Legislature in the form of public hearings have helped to bring this sorry situation of care deficiencies and ineffective regulation to the attention of the public.
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Eric Carlson | Directing attorney, National Senior Citizens Law Center
California 20 Years Behind Times, Residents at Risk
California’s assisted living system is decades out of date. As a result, the state’s assisted living residents — elderly and generally vulnerable — are increasingly at risk from substandard care.
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Anthony Chicotel | Staff attorney, California Advocates for Nursing Home Reform
Legislature Responding with Array of Bills
The California Legislature is providing some long overdue scrutiny to residential care for the elderly following increased media attention in 2013. The media reports explored dozens of outrageous cases of poor care leading to resident abandonment, injury and death, all enabled in part by insufficient state oversight.
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Jim Gomez | CEO/President, California Association of Health Facilities
Care Should Be Delivered in Most Appropriate Setting
Aging people — and their right to obtain quality care in the most appropriate setting — should be at the center of any discussion surrounding the regulation of residential care facilities for the elderly. It’s important that seniors who are mentally and physically able have the choice to live in a community-based setting where they receive non-medical care, with limited supervision.
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Sally Michael | President, California Assisted Living Association
Training, Regular Inspections Are Key
Assisted living is a vital part of the state’s system of long-term services and supports, providing needed housing, care, and supervision to as many as 175,000 elders each day. Assisted living communities offer the support and access to health-related services that enable elders to remain as independent as possible in the least restrictive setting possible. Resident satisfaction is high as consumers seek a model of care that promotes choice, independence, and flexibility.
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Joseph Rodrigues | California State Long-Term Care Ombudsman
More Oversight, Real Penalties for Infractions
I truly believe in the importance of strong safeguards and protections for residents of long-term care facilities. In the early days of the Long-Term Care Ombudsman Program, Arthur Fleming, the first commissioner on aging at the U.S. Administration on Aging said, “Our nation has been conducting investigations, passing new laws and issuing new regulations relative to nursing homes at a rapid rate during the past few years.
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Chrisy Selder | Co-founder, Consumer Advocates for RCFE Reform
Need for Data-Driven Practices
The primary focus surrounding California’s RCFE industry is policy reform. We at Consumer Advocates for RCFE Reform (CARR) believe 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.
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