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She holds degrees in English and journalism from UC Berkeley (where she got her start in public radio on KALX-FM).\r\n\r\nOutside of the studio, you'll find Rachael hiking Bay Area trails and whipping up Instagram-ready meals in her kitchen.","avatar":"https://secure.gravatar.com/avatar/87bf8cb5874e045cdff430523a6d48b1?s=600&d=blank&r=g","twitter":"rachaelmyrow","facebook":null,"instagram":null,"linkedin":"https://www.linkedin.com/in/rachaelmyrow/","sites":[{"site":"arts","roles":["administrator"]},{"site":"news","roles":["edit_others_posts","editor"]},{"site":"futureofyou","roles":["editor"]},{"site":"bayareabites","roles":["editor"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"food","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"Rachael Myrow | KQED","description":"Senior Editor of KQED's Silicon Valley News 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KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/state-of-health"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal 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FM","link":"/"}},"stateofhealth_21838":{"type":"posts","id":"stateofhealth_21838","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"21838","score":null,"sort":[1412111183000]},"guestAuthors":[],"slug":"brown-signs-package-of-assisted-living-reform-bills","title":"Brown Signs Package of Assisted-Living Reform Bills","publishDate":1412111183,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_21850\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/JerryBrown-e1412110038711.jpg\">\u003cimg class=\"size-large wp-image-21850\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/JerryBrown-640x457.jpg\" alt=\"(Neon Tommy)\" width=\"640\" height=\"457\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Neon Tommy)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Deborah Schoch,\u003c/strong> \u003ca title=\"http://centerforhealthreporting.org/article/brown-boosts-assisted-living-fines\" href=\"http://centerforhealthreporting.org/article/brown-boosts-assisted-living-fines\" target=\"_blank\">Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Gov. Jerry Brown signed into law Monday \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB2236\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB2236\" target=\"_blank\">a bill \u003c/a>imposing a 100-fold increase in the top fine for violations of state regulations at assisted-living homes for the elderly.\u003c/p>\n\u003cp>The top fine will now be $15,000, for violations causing death or serious injury, up from $150.\u003c/p>\n\u003cp>The relatively low fines were highlighted in a \u003ca title=\"http://centerforhealthreporting.org/project/assisted-living-facilities-are-under-microscope-state-legislators-debate-reform-measures\" href=\"http://centerforhealthreporting.org/project/assisted-living-facilities-are-under-microscope-state-legislators-debate-reform-measures\" target=\"_blank\">series of stories produced last year\u003c/a> by the CHCF Center for Health Reporting and the U-T San Diego. The series focused on 27 deaths and hundreds of injuries at homes in San Diego County caused by abuse and neglect.\u003c/p>\n\u003cp>\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\" target=\"_blank\">The bill to increase fines\u003c/a>, co-authored by Assemblyman Brian Maienschein, (R-San Diego), was amended during the legislative process to allow a four-step appeals process. Also, a proposal to boost fines for some lesser offenses to $1,000 from $150 was removed from the bill amid lobbying from smaller assisted living homes.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Brown’s signature on the fine increase came one day after he signed nine other bills tightening state oversight of the more than 7,500 assisted-living homes in California, marking the state’s most sweeping overhaul of the industry in nearly three decades.\u003c/p>\n\u003cp>For the first time, assisted living residents will have a statutory bill of rights like the one protecting nursing home residents.\u003c/p>\n\u003cp>The homes’ staffs also will face stiffer training requirements, and owners will pay higher licensing fees. A staff member with CPR training must be present at homes at all times, and operators will be prohibited from punishing employees who call 911 to get emergency care for sick residents.\u003c/p>\n\u003cp>Brown’s signature on the reform package is a major victory for assisted living residents, said Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, the state’s largest advocacy group for long-term care residents.\u003c/p>\n\u003cp>“We look at it as a good start,” said McGinnis. “But we’re not finished by any stretch of the imagination. And I don’t think the legislators are, either. I think they like the fact that they’re going to be changing people’s lives on an immediate basis.”\u003c/p>\n\u003cp>Many of the assisted-living bills that Brown did sign were backed by McGinnis's group and the California Assisted Living Association, the state’s largest industry association.\u003c/p>\n\u003cp>Both groups had pulled their support of the bill to raise fines after it was, in their view, weakened.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/169949480&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>Four San Diego legislators played key roles in the reform effort: Democratic Assembly Speaker Toni Atkins and Democratic Sen. Marty Block; and Republican Assembly members Brian Maienschein of San Diego and Marie Waldron of Escondido.\u003c/p>\n\u003cp>Brown signed Atkins’ bill last month requiring that all assisted living facilities \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/05/two-women-on-a-mission-to-reform-assisted-living-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/05/two-women-on-a-mission-to-reform-assisted-living-in-california/\" target=\"_blank\">carry liability insurance\u003c/a>. Brown signed Block’s two bills Sunday.\u003c/p>\n\u003cp>Block said he intentionally chose the bill name SB-911 for one of his measures, which will protect facility employees who call for emergency care for sick residents. Some employees have said they fear calling 911 because managers say it reflects badly on a home’s record, he said.\u003c/p>\n\u003cp>The same bill raises the training mandate for administrators to 80 hours from 40. Brown also has signed a parallel bill, authored by Assembly Member Wesley Chesbro, D-Arcata, requiring more training for staff caring for residents, including those with dementia.\u003c/p>\n\u003cp>Sally Michael, president of the industry group California Assisted Living Association -- which, along with McGinnis’ group, supported a number of the reform measures -- said it is pleased by Brown’s actions, particularly his signing of the Chesbro bill and Block’s SB 911.\u003c/p>\n\u003cp>“These bills increase the number of hours required for assisted living caregiver and administrator training. They also improve the administrator testing process by making it more rigorous,” Michael said.\u003c/p>\n\u003cp>Block’s second bill boosts facility licensing fees by 10 percent, which, coupled with the administration’s separate 10 percent increase, will boost fees by 20 percent.\u003c/p>\n\u003cp>Block initially proposed a 30 percent increase. He said Monday that for now, the 20-percent hike is enough to provide much needed funds to the Department of Social Social Services, which regulates assisted living homes.\u003c/p>\n\u003cp>“This will be a game changer in terms of funding more inspections and other services,” Block said.\u003c/p>\n\u003cp>The other assisted living bills that Brown signed Sunday:\u003c/p>\n\u003cul>\n\u003cli>SB 895, mandating that homes fix problems found during state inspections within 10 days of being notified (Sen. Ellen Corbett, D-Hayward).\u003c/li>\n\u003cli>SB 1153, giving state regulators the power to halt new admissions to an assisted living home that has not immediately fixed major violations (Sen. Mark Leno, D-San Francisco).\u003c/li>\n\u003cli>AB 1751, requires residents to be represented on assisted living homes’ governing boards (Richard H. Bloom, D-Santa Monica).\u003c/li>\n\u003cli>AB 1899, requires that if an operator’s license is revoked or given up for abandoning a facility, that operator cannot get the license reinstated (Cheryl R. Brown, D-San Bernardino).\u003c/li>\n\u003cli>AB 2044, mandates that a supervisor or trained substitute be at the home 24 hours a day (Freddie Rodriguez, D-Chino).\u003c/li>\n\u003cli>AB 2171, Establishes a bill of rights for assisted living residents similar to the bill now protecting residents of California nursing homes (Bob Wieckowski, D-Fremont).\u003c/li>\n\u003c/ul>\n\u003cp>Including reform bills previously signed by Brown, the governor has approved all 13 assisted living bills passed by the Legislature.\u003c/p>\n\u003cp>\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" target=\"_blank\">Four other bills failed to muster the needed votes\u003c/a> and get to his desk, including a bill requiring annual inspections of homes – now inspected a minimum of every five years – which foundered in the state Senate. Several legislators predict that a similar bill will be proposed next year. Another bill that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" target=\"_blank\">would have required the state to build an online consumer rating system\u003c/a> so that consumers could compare facilities on quality also failed to get the governor's desk.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The \u003ca title=\"http://centerforhealthreporting.org\" href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Based at the University of Southern California’s Annenberg School for Communication and Journalism, the Center is funded by the nonprofit California HealthCare Foundation.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"For starters, the highest fine regulators could levy for violations was a mere $150. Now it's $15,000.","status":"publish","parent":0,"modified":1412134520,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":true,"iframeSrcs":["https://w.soundcloud.com/player/"],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":1034},"headData":{"title":"Brown Signs Package of Assisted-Living Reform Bills | KQED","description":"For starters, the highest fine regulators could levy for violations was a mere $150. Now it's $15,000.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Brown Signs Package of Assisted-Living Reform Bills","datePublished":"2014-09-30T21:06:23.000Z","dateModified":"2014-10-01T03:35:20.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"21838 http://blogs.kqed.org/stateofhealth/?p=21838","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/09/30/brown-signs-package-of-assisted-living-reform-bills/","disqusTitle":"Brown Signs Package of Assisted-Living Reform Bills","path":"/stateofhealth/21838/brown-signs-package-of-assisted-living-reform-bills","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21850\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/JerryBrown-e1412110038711.jpg\">\u003cimg class=\"size-large wp-image-21850\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/JerryBrown-640x457.jpg\" alt=\"(Neon Tommy)\" width=\"640\" height=\"457\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Neon Tommy)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Deborah Schoch,\u003c/strong> \u003ca title=\"http://centerforhealthreporting.org/article/brown-boosts-assisted-living-fines\" href=\"http://centerforhealthreporting.org/article/brown-boosts-assisted-living-fines\" target=\"_blank\">Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Gov. Jerry Brown signed into law Monday \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB2236\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB2236\" target=\"_blank\">a bill \u003c/a>imposing a 100-fold increase in the top fine for violations of state regulations at assisted-living homes for the elderly.\u003c/p>\n\u003cp>The top fine will now be $15,000, for violations causing death or serious injury, up from $150.\u003c/p>\n\u003cp>The relatively low fines were highlighted in a \u003ca title=\"http://centerforhealthreporting.org/project/assisted-living-facilities-are-under-microscope-state-legislators-debate-reform-measures\" href=\"http://centerforhealthreporting.org/project/assisted-living-facilities-are-under-microscope-state-legislators-debate-reform-measures\" target=\"_blank\">series of stories produced last year\u003c/a> by the CHCF Center for Health Reporting and the U-T San Diego. The series focused on 27 deaths and hundreds of injuries at homes in San Diego County caused by abuse and neglect.\u003c/p>\n\u003cp>\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\" target=\"_blank\">The bill to increase fines\u003c/a>, co-authored by Assemblyman Brian Maienschein, (R-San Diego), was amended during the legislative process to allow a four-step appeals process. Also, a proposal to boost fines for some lesser offenses to $1,000 from $150 was removed from the bill amid lobbying from smaller assisted living homes.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Brown’s signature on the fine increase came one day after he signed nine other bills tightening state oversight of the more than 7,500 assisted-living homes in California, marking the state’s most sweeping overhaul of the industry in nearly three decades.\u003c/p>\n\u003cp>For the first time, assisted living residents will have a statutory bill of rights like the one protecting nursing home residents.\u003c/p>\n\u003cp>The homes’ staffs also will face stiffer training requirements, and owners will pay higher licensing fees. A staff member with CPR training must be present at homes at all times, and operators will be prohibited from punishing employees who call 911 to get emergency care for sick residents.\u003c/p>\n\u003cp>Brown’s signature on the reform package is a major victory for assisted living residents, said Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, the state’s largest advocacy group for long-term care residents.\u003c/p>\n\u003cp>“We look at it as a good start,” said McGinnis. “But we’re not finished by any stretch of the imagination. And I don’t think the legislators are, either. I think they like the fact that they’re going to be changing people’s lives on an immediate basis.”\u003c/p>\n\u003cp>Many of the assisted-living bills that Brown did sign were backed by McGinnis's group and the California Assisted Living Association, the state’s largest industry association.\u003c/p>\n\u003cp>Both groups had pulled their support of the bill to raise fines after it was, in their view, weakened.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/169949480&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>Four San Diego legislators played key roles in the reform effort: Democratic Assembly Speaker Toni Atkins and Democratic Sen. Marty Block; and Republican Assembly members Brian Maienschein of San Diego and Marie Waldron of Escondido.\u003c/p>\n\u003cp>Brown signed Atkins’ bill last month requiring that all assisted living facilities \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/05/two-women-on-a-mission-to-reform-assisted-living-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/05/two-women-on-a-mission-to-reform-assisted-living-in-california/\" target=\"_blank\">carry liability insurance\u003c/a>. Brown signed Block’s two bills Sunday.\u003c/p>\n\u003cp>Block said he intentionally chose the bill name SB-911 for one of his measures, which will protect facility employees who call for emergency care for sick residents. Some employees have said they fear calling 911 because managers say it reflects badly on a home’s record, he said.\u003c/p>\n\u003cp>The same bill raises the training mandate for administrators to 80 hours from 40. Brown also has signed a parallel bill, authored by Assembly Member Wesley Chesbro, D-Arcata, requiring more training for staff caring for residents, including those with dementia.\u003c/p>\n\u003cp>Sally Michael, president of the industry group California Assisted Living Association -- which, along with McGinnis’ group, supported a number of the reform measures -- said it is pleased by Brown’s actions, particularly his signing of the Chesbro bill and Block’s SB 911.\u003c/p>\n\u003cp>“These bills increase the number of hours required for assisted living caregiver and administrator training. They also improve the administrator testing process by making it more rigorous,” Michael said.\u003c/p>\n\u003cp>Block’s second bill boosts facility licensing fees by 10 percent, which, coupled with the administration’s separate 10 percent increase, will boost fees by 20 percent.\u003c/p>\n\u003cp>Block initially proposed a 30 percent increase. He said Monday that for now, the 20-percent hike is enough to provide much needed funds to the Department of Social Social Services, which regulates assisted living homes.\u003c/p>\n\u003cp>“This will be a game changer in terms of funding more inspections and other services,” Block said.\u003c/p>\n\u003cp>The other assisted living bills that Brown signed Sunday:\u003c/p>\n\u003cul>\n\u003cli>SB 895, mandating that homes fix problems found during state inspections within 10 days of being notified (Sen. Ellen Corbett, D-Hayward).\u003c/li>\n\u003cli>SB 1153, giving state regulators the power to halt new admissions to an assisted living home that has not immediately fixed major violations (Sen. Mark Leno, D-San Francisco).\u003c/li>\n\u003cli>AB 1751, requires residents to be represented on assisted living homes’ governing boards (Richard H. Bloom, D-Santa Monica).\u003c/li>\n\u003cli>AB 1899, requires that if an operator’s license is revoked or given up for abandoning a facility, that operator cannot get the license reinstated (Cheryl R. Brown, D-San Bernardino).\u003c/li>\n\u003cli>AB 2044, mandates that a supervisor or trained substitute be at the home 24 hours a day (Freddie Rodriguez, D-Chino).\u003c/li>\n\u003cli>AB 2171, Establishes a bill of rights for assisted living residents similar to the bill now protecting residents of California nursing homes (Bob Wieckowski, D-Fremont).\u003c/li>\n\u003c/ul>\n\u003cp>Including reform bills previously signed by Brown, the governor has approved all 13 assisted living bills passed by the Legislature.\u003c/p>\n\u003cp>\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" target=\"_blank\">Four other bills failed to muster the needed votes\u003c/a> and get to his desk, including a bill requiring annual inspections of homes – now inspected a minimum of every five years – which foundered in the state Senate. Several legislators predict that a similar bill will be proposed next year. Another bill that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/\" target=\"_blank\">would have required the state to build an online consumer rating system\u003c/a> so that consumers could compare facilities on quality also failed to get the governor's desk.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The \u003ca title=\"http://centerforhealthreporting.org\" href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> partners with news organizations to cover California health policy. Based at the University of Southern California’s Annenberg School for Communication and Journalism, the Center is funded by the nonprofit California HealthCare Foundation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/21838/brown-signs-package-of-assisted-living-reform-bills","authors":["8344"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_825","stateofhealth_591"],"featImg":"stateofhealth_21850","label":"stateofhealth"},"stateofhealth_21266":{"type":"posts","id":"stateofhealth_21266","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"21266","score":null,"sort":[1409954586000]},"guestAuthors":[],"slug":"two-women-on-a-mission-to-reform-assisted-living-in-california","title":"Two Women on a Mission to Reform Assisted Living in California","publishDate":1409954586,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_21273\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS11418_photo.jpg\">\u003cimg class=\"size-large wp-image-21273\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS11418_photo-640x480.jpg\" alt=\"Chris Murphy (L) and Christina Selder (R) of Consumer Advocates for RCFE Reform in San Diego conduct their crusade from a modest home office. (Rachael Myrow/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Christina Selder and Chris Murphy of Consumer Advocates for RCFE Reform in San Diego conduct their crusade from a modest home office. (Rachael Myrow/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Many of us dream of starting a revolution. Few of us make it happen. One of the most dramatic stories of the last year belongs to a loose collection of activists, working to reform assisted living oversight in California. Together with lawmakers, these activists launched 17 bills in Sacramento, 12 of which passed, 2 of which have become law, so far.\u003c/p>\n\u003cp>It’s a big story, but let’s break off one piece, involving a couple women in San Diego with a passion for raw data, strong coffee and home-baked muffins.\u003c/p>\n\u003cp>About a decade ago, Chris Murphy’s mom was suffering from Stage 4 ovarian cancer. She couldn't live on her own. Someone suggested Murphy check out an assisted living facility, and so she took a tour.\u003c/p>\n\u003cp>“This is really a cool place,\" Murphy says she thought at the time. \"Maybe my mother would like to live here. I would like to live here. I was sucked in by the chandeliers, and by the garden, and by the apparent appearance of the facility.\"\u003c/p>\n\u003cp>\u003c!--more-->Sitting in her home office today, with a fan going to hold off the summer heat, Murphy declines to go into detail about how, exactly, her mom died. Murphy eventually sued and settled.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But she continued to stew over it.\u003c/p>\n\u003cp>\"I didn’t know that there was a public record that I could review,\" she says. \"I didn’t know that the facility had had a wrongful death lawsuit against it. That was not in the public record, even when I was able to review the public record, after the lawsuit. I figured that because they were licensed that the state had some meaningful oversight of this facility, only to discover that it was haphazard, in my view, at best.\"\u003c/p>\n\u003cp>Murphy was retired from a career in defense contracting, but she decided to go back to school at San Diego State and study gerontology -- the social and psychological aspects of aging. That’s where she met Chrisy Selder. Selder was doing her thesis on the idea that people who don’t need round-the-clock, licensed nursing care would be happier in homier assisted living -- which happens to be significantly less expensive than skilled nursing care. It’s a commonly accepted idea in California, where the number of assisted living facilities has doubled in the last 25 years. But Selder's thesis fell apart after she worked in a few facilities and interned in the local ombudsman’s office. The more research she did, she says, the less she thought that assisted living really was a good alternative to nursing homes.\u003c/p>\n\u003cp>Recognizing a kindred spirit, Selder joined Murphy to launch a non-profit called \u003ca href=\"http://www.rcfereform.org/\" target=\"_blank\">Consumer Advocates for RCFE Reform\u003c/a>, or CARR. (An RCFE is regulator-speak for Residential Care Facilities for the Elderly. Most of us call them \"assisted living facilities.\")\u003c/p>\n\u003cp>\"There were a lot of things that I learned in that process,\" Murphy says, \"that if I had known at the front end, I may have made better placement choices for my mother. And then I decided I had a lot of information that could be leveraged for the consumer.\u003c/p>\n\u003cp>What CARR did was create an online database of facilities and public records to give consumers \"immediate access to a facility's public documents,\" it says\u003ca href=\"http://www.rcfereform.org/About-Us\" target=\"_blank\"> on CARR's website\u003c/a>. Before CARR, this online access did not exist.\u003c/p>\n\u003cp>There are more than 700 facilities on CARR's website today, including about 30,000 public documents \"harvested\" by Murphy, Selder and volunteer student interns from San Diego State's programs in criminal justice, gerontology, social services, and public health.\u003c/p>\n\u003cp>Except for the website administrator, everyone at CARR is a volunteer. It’s going to take them a long time to get the whole state catalogued. So far, they’ve got San Diego and Imperial Counties, parts of Orange County, and several small, rural counties in Northern California. They've also got \u003ca href=\"https://www.calvet.ca.gov/VetHomes/Pages/Residential-Care.aspx\" target=\"_blank\">CalVet\u003c/a> facilities. Given their non-existent public relations department, the database was a bit of a trade secret, until the day a health reporter named Deborah Schoch did a Google search and turned up CARR’s site. Schoch is with the \u003ca href=\"http://centerforhealthreporting.org/\" target=\"_blank\">Center for Health Reporting\u003c/a> at USC, and she spotted the raw material for a series of investigative reports.\u003c/p>\n\u003cp>\"They went in and hand scanned thousands and thousands of documents,\" Schoch says. \"We were able to use those to detect certain homes and then went in and scanned our own records, and found more homes like that. But (CARR) gave us an entry point. I have to tell you, some of these folders are 3 inches thick, and there may be two of them, and they’re very difficult to navigate. You just have to go through it page by page by page. There’s nothing that says right up front 'somebody died here.'\"\u003c/p>\n\u003cp>Schoch joined forces with \u003ca href=\"http://www.utsandiego.com/news/2013/Sep/09/deadly-neglect-assisted-living-homes-san-diego/\" target=\"_blank\">\u003cem>UT San Diego\u003c/em>\u003c/a> to detail 27 deaths in San Diego County assisted living -- deaths caused by neglect and abuse. The series they published, “\u003ca href=\"http://centerforhealthreporting.org/topics/elderly-care\" target=\"_blank\">Deadly Neglect\u003c/a>,” was one of several media exposes that inspired those 17 bills in Sacramento.\u003c/p>\n\u003cp>You might think it odd CARR collects the same data the state does, but if you want to get at state data, you have to call your local \u003ca href=\"http://www.cdss.ca.gov/cdssweb/PG12.htm\" target=\"_blank\">Department of Social Services\u003c/a> office, and wait for staffers to pull the data on the facilities you're interested in. Murphy says people don’t realize how hard it is to research -- until time is tight and the stakes are high.\u003c/p>\n\u003cp>\"You’re going to take off three days worth of work,\" Murphy says. \"You’re going to make a California records act request. The state of California is going to tell you when you can come in and look at that file.\" Meanwhile she says, your dad is leaving the gas on after he cooks. Or the facility he’s living in now has issued a discharge notice with a deadline.\u003c/p>\n\u003cp>That, and the files are edited to remove data considered \"non-public\" by somebody in Sacramento. Schoch, who put in a Public Records Act request for some facility files, discovered some of the records removed included those detailing injuries and deaths.\u003c/p>\n\u003cp>CARR’s database makes all the inspection, complaint, and civil penalty reports it collects available online for a small fee ($25 a month). Murphy says they have about 30 subscribers at any given time, including placement agencies and attorneys, as well as families looking to place their parents.\u003c/p>\n\u003cp>\"We needed a little bit of revenue. And a little bit of revenue is all we’re getting!\" Murphy says and explodes into laughter.\u003c/p>\n\u003cp>Over the years, Murphy and Selder’s jaundiced opinions have only hardened. From their vantage point, elbow deep in documents, the profit motive leads managers to cut corners. Regulations are enforced unevenly. The problems afflict facilities of all sizes, not just the big, corporate ones. Lobbyists in Sacramento will argue small facilities shouldn’t be regulated as tightly as large ones. Selder disagrees. \"There’s no cluster. [Facilities with] 6 beds are having just as much problems as the125 beds.\"\u003c/p>\n\u003cp>Murphy and Selder don’t rate facilities, because, they say, individual needs are so different. They prefer to upload raw data. This year, they did something they've never done before: sponsor a bill. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1523\" target=\"_blank\">AB 1523\u003c/a>, now signed into law by Gov. Jerry Brown, mandates all assisted living facilities carry liability insurance. While some owners of small facilities protested they won’t be able to afford the coverage, there’s wide agreement consumers have little recourse to address serious concerns given what many describe as light oversight from state regulators.\u003c/p>\n\u003cp>In a statement CARR issued after the governor signed AB 1523 into law, Murphy and Selder wrote that they hope the law encourages insurance companies to “weed out the poor performers” the state hasn’t managed to, and lead to the closure of facilities that are “un-insurable.”\u003c/p>\n\u003cp>The legislation was co-authored by \u003ca href=\"http://asmdc.org/speaker/\" target=\"_blank\">State Assembly Speaker Toni Atkins\u003c/a>, who represents San Diego.\u003c/p>\n\u003cp>\"I was absolutely shocked to learn that facilities didn’t carry liability insurance,\" Atkins says. \"I had a hard time understanding how any business, in this day and time, and particularly a business that deals with frail, elderly people, could not have liability insurance.\"\u003c/p>\n\u003cp>Speaker Atkins says the evidence presented by “the Chrises” helped build a data-driven case in Sacramento for substantive reform. \"Typically, as a legislator, you want to see the data,\" Atkins says. Murphy and Selder, she says, \"Set about compiling that data, and putting it front of people.\"\u003c/p>\n\u003cp>For those who wanted to see substantive reform of assisted living facilities in California, it's not clear yet how many of the original 17 measures will make it into law, how many were de-fanged in 11th hour rewrites. Schoch has drawn up a handy \u003ca href=\"http://centerforhealthreporting.org/article/bill-bill-assisted-living-reform-package\" target=\"_blank\">scorecard\u003c/a>.\u003c/p>\n\u003cp>\"A lot of it had to do with cost,\" Speaker Atkins says about what killed or altered reform bills in the waning days of the legislative session. She offers up \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1454\" target=\"_blank\">AB 1454\u003c/a> by Assemblymember Ian Calderon (D-Whittier) as an example. It would have mandated annual, unannounced inspections of all licensed community care facilities, including assisted living homes. This would require more staff at the Department of Social Services, and thus, more money in the agency's budget. The Brown Administration did approve a bigger budget for DSS this year, but it's not a given it would be enough to guarantee annual visits. Atkins holds out hope for future budget boosts, though. \"California's making a turnaround as it relates to health and human service issues, but it's taking awhile,\" she said.\u003c/p>\n\u003cp>Murphy worries about how those bills that do make it into law will be interpreted by regulators. \"If it’s not clearly stipulated within the bill, then it’s left to the regulators, and then the regulators are going to come up with whatever they come up with.\" She wants to see the California Department of Social Services set up stakeholders meetings across the state, to ask what families and activists want to see happen next.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/268203311\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\n","blocks":[],"excerpt":"Two women started what the state would not: online access to unfiltered information about assisted living facilities.","status":"publish","parent":0,"modified":1465490735,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":32,"wordCount":1790},"headData":{"title":"Two Women on a Mission to Reform Assisted Living in California | KQED","description":"Two women started what the state would not: online access to unfiltered information about assisted living facilities.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Two Women on a Mission to Reform Assisted Living in California","datePublished":"2014-09-05T22:03:06.000Z","dateModified":"2016-06-09T16:45:35.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"21266 http://blogs.kqed.org/stateofhealth/?p=21266","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/09/05/two-women-on-a-mission-to-reform-assisted-living-in-california/","disqusTitle":"Two Women on a Mission to Reform Assisted Living in California","path":"/stateofhealth/21266/two-women-on-a-mission-to-reform-assisted-living-in-california","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_21273\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS11418_photo.jpg\">\u003cimg class=\"size-large wp-image-21273\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/09/RS11418_photo-640x480.jpg\" alt=\"Chris Murphy (L) and Christina Selder (R) of Consumer Advocates for RCFE Reform in San Diego conduct their crusade from a modest home office. (Rachael Myrow/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Christina Selder and Chris Murphy of Consumer Advocates for RCFE Reform in San Diego conduct their crusade from a modest home office. (Rachael Myrow/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Many of us dream of starting a revolution. Few of us make it happen. One of the most dramatic stories of the last year belongs to a loose collection of activists, working to reform assisted living oversight in California. Together with lawmakers, these activists launched 17 bills in Sacramento, 12 of which passed, 2 of which have become law, so far.\u003c/p>\n\u003cp>It’s a big story, but let’s break off one piece, involving a couple women in San Diego with a passion for raw data, strong coffee and home-baked muffins.\u003c/p>\n\u003cp>About a decade ago, Chris Murphy’s mom was suffering from Stage 4 ovarian cancer. She couldn't live on her own. Someone suggested Murphy check out an assisted living facility, and so she took a tour.\u003c/p>\n\u003cp>“This is really a cool place,\" Murphy says she thought at the time. \"Maybe my mother would like to live here. I would like to live here. I was sucked in by the chandeliers, and by the garden, and by the apparent appearance of the facility.\"\u003c/p>\n\u003cp>\u003c!--more-->Sitting in her home office today, with a fan going to hold off the summer heat, Murphy declines to go into detail about how, exactly, her mom died. Murphy eventually sued and settled.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But she continued to stew over it.\u003c/p>\n\u003cp>\"I didn’t know that there was a public record that I could review,\" she says. \"I didn’t know that the facility had had a wrongful death lawsuit against it. That was not in the public record, even when I was able to review the public record, after the lawsuit. I figured that because they were licensed that the state had some meaningful oversight of this facility, only to discover that it was haphazard, in my view, at best.\"\u003c/p>\n\u003cp>Murphy was retired from a career in defense contracting, but she decided to go back to school at San Diego State and study gerontology -- the social and psychological aspects of aging. That’s where she met Chrisy Selder. Selder was doing her thesis on the idea that people who don’t need round-the-clock, licensed nursing care would be happier in homier assisted living -- which happens to be significantly less expensive than skilled nursing care. It’s a commonly accepted idea in California, where the number of assisted living facilities has doubled in the last 25 years. But Selder's thesis fell apart after she worked in a few facilities and interned in the local ombudsman’s office. The more research she did, she says, the less she thought that assisted living really was a good alternative to nursing homes.\u003c/p>\n\u003cp>Recognizing a kindred spirit, Selder joined Murphy to launch a non-profit called \u003ca href=\"http://www.rcfereform.org/\" target=\"_blank\">Consumer Advocates for RCFE Reform\u003c/a>, or CARR. (An RCFE is regulator-speak for Residential Care Facilities for the Elderly. Most of us call them \"assisted living facilities.\")\u003c/p>\n\u003cp>\"There were a lot of things that I learned in that process,\" Murphy says, \"that if I had known at the front end, I may have made better placement choices for my mother. And then I decided I had a lot of information that could be leveraged for the consumer.\u003c/p>\n\u003cp>What CARR did was create an online database of facilities and public records to give consumers \"immediate access to a facility's public documents,\" it says\u003ca href=\"http://www.rcfereform.org/About-Us\" target=\"_blank\"> on CARR's website\u003c/a>. Before CARR, this online access did not exist.\u003c/p>\n\u003cp>There are more than 700 facilities on CARR's website today, including about 30,000 public documents \"harvested\" by Murphy, Selder and volunteer student interns from San Diego State's programs in criminal justice, gerontology, social services, and public health.\u003c/p>\n\u003cp>Except for the website administrator, everyone at CARR is a volunteer. It’s going to take them a long time to get the whole state catalogued. So far, they’ve got San Diego and Imperial Counties, parts of Orange County, and several small, rural counties in Northern California. They've also got \u003ca href=\"https://www.calvet.ca.gov/VetHomes/Pages/Residential-Care.aspx\" target=\"_blank\">CalVet\u003c/a> facilities. Given their non-existent public relations department, the database was a bit of a trade secret, until the day a health reporter named Deborah Schoch did a Google search and turned up CARR’s site. Schoch is with the \u003ca href=\"http://centerforhealthreporting.org/\" target=\"_blank\">Center for Health Reporting\u003c/a> at USC, and she spotted the raw material for a series of investigative reports.\u003c/p>\n\u003cp>\"They went in and hand scanned thousands and thousands of documents,\" Schoch says. \"We were able to use those to detect certain homes and then went in and scanned our own records, and found more homes like that. But (CARR) gave us an entry point. I have to tell you, some of these folders are 3 inches thick, and there may be two of them, and they’re very difficult to navigate. You just have to go through it page by page by page. There’s nothing that says right up front 'somebody died here.'\"\u003c/p>\n\u003cp>Schoch joined forces with \u003ca href=\"http://www.utsandiego.com/news/2013/Sep/09/deadly-neglect-assisted-living-homes-san-diego/\" target=\"_blank\">\u003cem>UT San Diego\u003c/em>\u003c/a> to detail 27 deaths in San Diego County assisted living -- deaths caused by neglect and abuse. The series they published, “\u003ca href=\"http://centerforhealthreporting.org/topics/elderly-care\" target=\"_blank\">Deadly Neglect\u003c/a>,” was one of several media exposes that inspired those 17 bills in Sacramento.\u003c/p>\n\u003cp>You might think it odd CARR collects the same data the state does, but if you want to get at state data, you have to call your local \u003ca href=\"http://www.cdss.ca.gov/cdssweb/PG12.htm\" target=\"_blank\">Department of Social Services\u003c/a> office, and wait for staffers to pull the data on the facilities you're interested in. Murphy says people don’t realize how hard it is to research -- until time is tight and the stakes are high.\u003c/p>\n\u003cp>\"You’re going to take off three days worth of work,\" Murphy says. \"You’re going to make a California records act request. The state of California is going to tell you when you can come in and look at that file.\" Meanwhile she says, your dad is leaving the gas on after he cooks. Or the facility he’s living in now has issued a discharge notice with a deadline.\u003c/p>\n\u003cp>That, and the files are edited to remove data considered \"non-public\" by somebody in Sacramento. Schoch, who put in a Public Records Act request for some facility files, discovered some of the records removed included those detailing injuries and deaths.\u003c/p>\n\u003cp>CARR’s database makes all the inspection, complaint, and civil penalty reports it collects available online for a small fee ($25 a month). Murphy says they have about 30 subscribers at any given time, including placement agencies and attorneys, as well as families looking to place their parents.\u003c/p>\n\u003cp>\"We needed a little bit of revenue. And a little bit of revenue is all we’re getting!\" Murphy says and explodes into laughter.\u003c/p>\n\u003cp>Over the years, Murphy and Selder’s jaundiced opinions have only hardened. From their vantage point, elbow deep in documents, the profit motive leads managers to cut corners. Regulations are enforced unevenly. The problems afflict facilities of all sizes, not just the big, corporate ones. Lobbyists in Sacramento will argue small facilities shouldn’t be regulated as tightly as large ones. Selder disagrees. \"There’s no cluster. [Facilities with] 6 beds are having just as much problems as the125 beds.\"\u003c/p>\n\u003cp>Murphy and Selder don’t rate facilities, because, they say, individual needs are so different. They prefer to upload raw data. This year, they did something they've never done before: sponsor a bill. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1523\" target=\"_blank\">AB 1523\u003c/a>, now signed into law by Gov. Jerry Brown, mandates all assisted living facilities carry liability insurance. While some owners of small facilities protested they won’t be able to afford the coverage, there’s wide agreement consumers have little recourse to address serious concerns given what many describe as light oversight from state regulators.\u003c/p>\n\u003cp>In a statement CARR issued after the governor signed AB 1523 into law, Murphy and Selder wrote that they hope the law encourages insurance companies to “weed out the poor performers” the state hasn’t managed to, and lead to the closure of facilities that are “un-insurable.”\u003c/p>\n\u003cp>The legislation was co-authored by \u003ca href=\"http://asmdc.org/speaker/\" target=\"_blank\">State Assembly Speaker Toni Atkins\u003c/a>, who represents San Diego.\u003c/p>\n\u003cp>\"I was absolutely shocked to learn that facilities didn’t carry liability insurance,\" Atkins says. \"I had a hard time understanding how any business, in this day and time, and particularly a business that deals with frail, elderly people, could not have liability insurance.\"\u003c/p>\n\u003cp>Speaker Atkins says the evidence presented by “the Chrises” helped build a data-driven case in Sacramento for substantive reform. \"Typically, as a legislator, you want to see the data,\" Atkins says. Murphy and Selder, she says, \"Set about compiling that data, and putting it front of people.\"\u003c/p>\n\u003cp>For those who wanted to see substantive reform of assisted living facilities in California, it's not clear yet how many of the original 17 measures will make it into law, how many were de-fanged in 11th hour rewrites. Schoch has drawn up a handy \u003ca href=\"http://centerforhealthreporting.org/article/bill-bill-assisted-living-reform-package\" target=\"_blank\">scorecard\u003c/a>.\u003c/p>\n\u003cp>\"A lot of it had to do with cost,\" Speaker Atkins says about what killed or altered reform bills in the waning days of the legislative session. She offers up \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1454\" target=\"_blank\">AB 1454\u003c/a> by Assemblymember Ian Calderon (D-Whittier) as an example. It would have mandated annual, unannounced inspections of all licensed community care facilities, including assisted living homes. This would require more staff at the Department of Social Services, and thus, more money in the agency's budget. The Brown Administration did approve a bigger budget for DSS this year, but it's not a given it would be enough to guarantee annual visits. Atkins holds out hope for future budget boosts, though. \"California's making a turnaround as it relates to health and human service issues, but it's taking awhile,\" she said.\u003c/p>\n\u003cp>Murphy worries about how those bills that do make it into law will be interpreted by regulators. \"If it’s not clearly stipulated within the bill, then it’s left to the regulators, and then the regulators are going to come up with whatever they come up with.\" She wants to see the California Department of Social Services set up stakeholders meetings across the state, to ask what families and activists want to see happen next.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/268203311&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/268203311'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/21266/two-women-on-a-mission-to-reform-assisted-living-in-california","authors":["251"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_186","stateofhealth_825","stateofhealth_591"],"featImg":"stateofhealth_21273","label":"stateofhealth"},"stateofhealth_20825":{"type":"posts","id":"stateofhealth_20825","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"20825","score":null,"sort":[1408382135000]},"guestAuthors":[],"slug":"the-assisted-living-reform-bills-that-died","title":"The Assisted Living Reform Bills That Died","publishDate":1408382135,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cstrong>By Polly Stryker\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_20831\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11379_photo-scr.jpg\">\u003cimg class=\"size-large wp-image-20831\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11379_photo-scr-640x480.jpg\" alt=\"Taking some fresh air in the courtyard at Westchester Villa, an assisted facility in Inglewood. (Rachael Myrow/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Taking some fresh air in the courtyard at Westchester Villa, an assisted facility in Inglewood. (Rachael Myrow/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Last Thursday, August 14, was the day that bills still in the state Senate Appropriations Committee sank or swam. The Senate Appropriations Committee is where bills costing $150,000 or more go for consideration. If bills make it out of this committee, then bills are still in play and could make it to the governor’s desk, albeit with potential amendments along the way. If not, they die.\u003c/p>\n\u003cp>Going into the home stretch of this legislative session, 16 bills were on the table that, altogether, constituted the first major overhaul of the assisted living industry in nearly 30 years.\u003c/p>\n\u003cp>Two have already made it to the governor’s desk. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1523\" target=\"_blank\" rel=\"noopener\">AB1523\u003c/a> mandates liability insurance for all assisted living facilities. Advocates say liability insurance is one of the best ways to improve conditions in the industry. Operators whose violations make buying insurance too expensive will be simply forced out of business. The industry group \u003ca href=\"http://caassistedliving.org/\" target=\"_blank\" rel=\"noopener\">California Assisted Living Association\u003c/a> supported AB1523. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1572\" target=\"_blank\" rel=\"noopener\">AB1572\u003c/a> mandates facility operators allow and support resident and family councils at assisted living facilities. CALA supported that one as well.\u003c/p>\n\u003cp>Most of the rest of the bills are still swimming. But what about the bills that died?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1571\" target=\"_blank\" rel=\"noopener\">AB1571\u003c/a> (Eggman D-Stockton) would have created a more robust online consumer information system than \u003ca href=\"https://secure.dss.ca.gov/CareFacilitySearch/home/selecttype/\" target=\"_blank\" rel=\"noopener\">the one currently offered\u003c/a> by the Department of Social Services.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/05/online-information-about-assisted-living-facilities-hard-to-come-by/\" target=\"_blank\" rel=\"noopener\">Online Information About Assisted Living Facilities Hard to Come By\u003c/a>]\u003c/p>\n\u003cp>“It is very disappointing,\" says Pat McGinnis, executive director of \u003ca href=\"http://www.canhr.org/\" target=\"_blank\" rel=\"noopener\">California Advocates for Nursing Home Reform\u003c/a>, one of the key advocacy organizations sponsoring legislation this year. McGinnis says that there are more than 7,500 licensed facilities in California, \"and absolutely no way for consumers to compare one facility with another. It will be impossible for consumers to try to look up 348 [facilities] in Alameda County, for example, to try to see what violations, deficiencies, et cetera, they might have.”\u003c/p>\n\u003cp>\"I am not at all finished with this issue,” says the bill’s author, Assemblywoman Susan Eggman (D-Stockton). Though she says the DSS has already made changes to its website in response to AB1571, Eggman says she is considering reintroducing similar legislation in the next session. The DSS declined to comment.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1454\" target=\"_blank\" rel=\"noopener\">AB1454\u003c/a> (Calderon D-Industry) would have required every facility licensed by the Department of Social Services to be subject to annual, unannounced inspections. DSS licenses many different types of facilities, not just assisted living facilities. Currently, state law requires DSS to visit a facility every five years, barring a complaint which generates a separate visit. The agency says in practice it has an investigator visit about every 2 and a half years.\u003c/p>\n\u003cp>Bill watchers say two concerns appear to have spiked this bill. For one thing, AB1454 would have changed the inspection frequency for \u003cem>every\u003c/em> type of facility DSS visits. For another, that would cost a pretty penny: $20 million, by one state estimate.\u003c/p>\n\u003cp>In a written response, Assemblyman Ian Calderon said, “Although the Legislature provided an increase in funding to the Department of Social Services in the 2014-2015 Budget to protect our children and elderly, annual inspections continue to be urgently needed as part of the oversight process. Without increasing the frequency of unannounced visits, our state will continue to put our most vulnerable populations – children and elderly – at risk.”\u003c/p>\n\u003cp>But there's another bill that addresses this issue, in part. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB895\" target=\"_blank\" rel=\"noopener\">SB895\u003c/a> (Corbett D-Alameda) would phase in unannounced annual visits for assisted living facilities only, by July 1, 2018. That passed out of the Senate Appropriations Committee with amendments.\u003c/p>\n\u003cp>Finally,\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1554\" target=\"_blank\" rel=\"noopener\"> AB1554\u003c/a> (Skinner D-East Bay) would have required the DSS to investigate complaints that alleged physical or sexual abuse, or imminent physical danger, at assisted living facilities within one working day, instead of 10 -- and report to the complainant promptly.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\" target=\"_blank\" rel=\"noopener\">Crime in Assisted Living: What Happens After\u003c/a>\u003c/strong>]\u003c/p>\n\u003cp>Assemblywoman Skinner remarks the bills that made it out of the Senate Appropriations Committee put the onus on the industry itself, as opposed to the DSS.\u003c/p>\n\u003cp>“My frustration is, if we have higher expectations on the facilities, if we don’t have responsibility of the agency to enforce, then how are we going to feel assured that these facilities are complying?” Skinner is termed out, so she won’t introduce a similar bill next legislative session. But she adds, note how many legislators were involved in trying to reform assisted living facilities. This issue, Skinner says, isn’t going to go away.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Rachael Myrow contributed to this report.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Bills that made it out of the Senate Appropriations Committee put the onus on assisted living industry.","status":"publish","parent":0,"modified":1525451712,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":783},"headData":{"title":"The Assisted Living Reform Bills That Died | KQED","description":"Bills that made it out of the Senate Appropriations Committee put the onus on assisted living industry.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"The Assisted Living Reform Bills That Died","datePublished":"2014-08-18T17:15:35.000Z","dateModified":"2018-05-04T16:35:12.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"20825 http://blogs.kqed.org/stateofhealth/?p=20825","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/08/18/the-assisted-living-reform-bills-that-died/","disqusTitle":"The Assisted Living Reform Bills That Died","path":"/stateofhealth/20825/the-assisted-living-reform-bills-that-died","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Polly Stryker\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_20831\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11379_photo-scr.jpg\">\u003cimg class=\"size-large wp-image-20831\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11379_photo-scr-640x480.jpg\" alt=\"Taking some fresh air in the courtyard at Westchester Villa, an assisted facility in Inglewood. (Rachael Myrow/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Taking some fresh air in the courtyard at Westchester Villa, an assisted facility in Inglewood. (Rachael Myrow/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Last Thursday, August 14, was the day that bills still in the state Senate Appropriations Committee sank or swam. The Senate Appropriations Committee is where bills costing $150,000 or more go for consideration. If bills make it out of this committee, then bills are still in play and could make it to the governor’s desk, albeit with potential amendments along the way. If not, they die.\u003c/p>\n\u003cp>Going into the home stretch of this legislative session, 16 bills were on the table that, altogether, constituted the first major overhaul of the assisted living industry in nearly 30 years.\u003c/p>\n\u003cp>Two have already made it to the governor’s desk. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1523\" target=\"_blank\" rel=\"noopener\">AB1523\u003c/a> mandates liability insurance for all assisted living facilities. Advocates say liability insurance is one of the best ways to improve conditions in the industry. Operators whose violations make buying insurance too expensive will be simply forced out of business. The industry group \u003ca href=\"http://caassistedliving.org/\" target=\"_blank\" rel=\"noopener\">California Assisted Living Association\u003c/a> supported AB1523. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1572\" target=\"_blank\" rel=\"noopener\">AB1572\u003c/a> mandates facility operators allow and support resident and family councils at assisted living facilities. CALA supported that one as well.\u003c/p>\n\u003cp>Most of the rest of the bills are still swimming. But what about the bills that died?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1571\" target=\"_blank\" rel=\"noopener\">AB1571\u003c/a> (Eggman D-Stockton) would have created a more robust online consumer information system than \u003ca href=\"https://secure.dss.ca.gov/CareFacilitySearch/home/selecttype/\" target=\"_blank\" rel=\"noopener\">the one currently offered\u003c/a> by the Department of Social Services.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/05/online-information-about-assisted-living-facilities-hard-to-come-by/\" target=\"_blank\" rel=\"noopener\">Online Information About Assisted Living Facilities Hard to Come By\u003c/a>]\u003c/p>\n\u003cp>“It is very disappointing,\" says Pat McGinnis, executive director of \u003ca href=\"http://www.canhr.org/\" target=\"_blank\" rel=\"noopener\">California Advocates for Nursing Home Reform\u003c/a>, one of the key advocacy organizations sponsoring legislation this year. McGinnis says that there are more than 7,500 licensed facilities in California, \"and absolutely no way for consumers to compare one facility with another. It will be impossible for consumers to try to look up 348 [facilities] in Alameda County, for example, to try to see what violations, deficiencies, et cetera, they might have.”\u003c/p>\n\u003cp>\"I am not at all finished with this issue,” says the bill’s author, Assemblywoman Susan Eggman (D-Stockton). Though she says the DSS has already made changes to its website in response to AB1571, Eggman says she is considering reintroducing similar legislation in the next session. The DSS declined to comment.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1454\" target=\"_blank\" rel=\"noopener\">AB1454\u003c/a> (Calderon D-Industry) would have required every facility licensed by the Department of Social Services to be subject to annual, unannounced inspections. DSS licenses many different types of facilities, not just assisted living facilities. Currently, state law requires DSS to visit a facility every five years, barring a complaint which generates a separate visit. The agency says in practice it has an investigator visit about every 2 and a half years.\u003c/p>\n\u003cp>Bill watchers say two concerns appear to have spiked this bill. For one thing, AB1454 would have changed the inspection frequency for \u003cem>every\u003c/em> type of facility DSS visits. For another, that would cost a pretty penny: $20 million, by one state estimate.\u003c/p>\n\u003cp>In a written response, Assemblyman Ian Calderon said, “Although the Legislature provided an increase in funding to the Department of Social Services in the 2014-2015 Budget to protect our children and elderly, annual inspections continue to be urgently needed as part of the oversight process. Without increasing the frequency of unannounced visits, our state will continue to put our most vulnerable populations – children and elderly – at risk.”\u003c/p>\n\u003cp>But there's another bill that addresses this issue, in part. \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB895\" target=\"_blank\" rel=\"noopener\">SB895\u003c/a> (Corbett D-Alameda) would phase in unannounced annual visits for assisted living facilities only, by July 1, 2018. That passed out of the Senate Appropriations Committee with amendments.\u003c/p>\n\u003cp>Finally,\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1554\" target=\"_blank\" rel=\"noopener\"> AB1554\u003c/a> (Skinner D-East Bay) would have required the DSS to investigate complaints that alleged physical or sexual abuse, or imminent physical danger, at assisted living facilities within one working day, instead of 10 -- and report to the complainant promptly.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\" target=\"_blank\" rel=\"noopener\">Crime in Assisted Living: What Happens After\u003c/a>\u003c/strong>]\u003c/p>\n\u003cp>Assemblywoman Skinner remarks the bills that made it out of the Senate Appropriations Committee put the onus on the industry itself, as opposed to the DSS.\u003c/p>\n\u003cp>“My frustration is, if we have higher expectations on the facilities, if we don’t have responsibility of the agency to enforce, then how are we going to feel assured that these facilities are complying?” Skinner is termed out, so she won’t introduce a similar bill next legislative session. But she adds, note how many legislators were involved in trying to reform assisted living facilities. This issue, Skinner says, isn’t going to go away.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Rachael Myrow contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/20825/the-assisted-living-reform-bills-that-died","authors":["8344"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_186","stateofhealth_825","stateofhealth_2829","stateofhealth_3245","stateofhealth_591"],"featImg":"stateofhealth_20831","label":"stateofhealth"},"stateofhealth_20618":{"type":"posts","id":"stateofhealth_20618","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"20618","score":null,"sort":[1407847856000]},"guestAuthors":[],"slug":"are-the-proposed-assisted-living-reforms-in-california-enough","title":"Are The Proposed Assisted Living Reforms in California Enough?","publishDate":1407847856,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_20634\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11410_photo-hpf.jpg\">\u003cimg class=\"size-full wp-image-20634\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11410_photo-hpf.jpg\" alt=\"CAPTION COMING (Rachael Myrow/KQED)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11410_photo-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11410_photo-hpf-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11410_photo-hpf-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A \"crime book\" maintained by the San Diego advocacy group Consumer Advocates for RCFE Reform. (RCFE is short for Residential Care Facility for the Elderly.) This book contains cases of what CARR calls \"egregious neglect\" at San Diego assisted living facilities. (Rachael Myrow/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Over the last 25 years, the number of assisted living facilities in California has nearly doubled. The homes are intended to care for relatively independent, healthy seniors, but that doesn’t describe a lot of the people living in them today.\u003c/p>\n\u003cp>\"There’s been a seismic shift in the population they serve,\" says Deborah Schoch of the California HealthCare Foundation\u003ca href=\"http://centerforhealthreporting.org/project/medical-errors-weaker-rules-signal-safety-problems-ca-assisted-living-homes\" target=\"_blank\" rel=\"noopener\"> Center for Health Reporting\u003c/a>. Schoch says the system was set up to meet the needs of people who could use some extra help with the tasks of daily living –- and it does. But many of those people need a lot of help.\u003c/p>\n\u003cp>The system, she says, is caring for people \"who are frail, who may have dementia, who may be wheelchair bound, who may not be able to turn on their own in bed.\"\u003c/p>\n\u003cp>\u003c!--more-->Assisted living facilities are not designed to deliver skilled nursing care, and they do not typically have people with those qualifications on staff. There are no staff-to-resident ratios or many of the other rules that govern nursing homes. While many assisted living facilities do a fine job of delivering care, others are overwhelmed –- or worse. Schoch was the lead reporter for \u003cspan style=\"color: #20497d\">a \u003c/span>series called “\u003ca href=\"http://centerforhealthreporting.org/project/medical-errors-weaker-rules-signal-safety-problems-ca-assisted-living-homes\" target=\"_blank\" rel=\"noopener\">Deadly Neglect\u003c/a>” that detailed 27 deaths in San Diego County assisted living facilities from abuse and neglect.\u003c/p>\n\u003cp>\"I worked with \u003ca href=\"http://www.utsandiego.com\" target=\"_blank\" rel=\"noopener\">UT San Diego\u003c/a>, and we were able to get access to a lot of inspection reports: deaths, injuries, elder abuse, people left on the floor for 48 hours in assisted living facilities in San Diego County.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She's since come out with more stories detailing more troubling incidents, but that first series had a politically explosive effect. In San Diego, Supervisors voted to fund a special unit in the District Attorney’s office to target crime in the facilities.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related: \u003c/strong>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\">Crime in Assisted Living: What Happens After\u003c/a>]\u003c/p>\n\u003cp>In Sacramento, where regulations haven’t changed much in close to 30 years, lawmakers held hearings featuring reform advocates like Aaron Byzak, who started a group called “\u003ca href=\"https://www.facebook.com/HazelsArmy\" target=\"_blank\" rel=\"noopener\">Hazel’s Army\u003c/a>” after his grandmother Hazel died in assisted living. \"If somebody parked in my grandmother’s disabled parking lot illegally, they’d be fined $450,\" he told reporters in the state capitol. \"But they kill her, and it’s $150.\"\u003c/p>\n\u003cp style=\"color: #20497d\">\u003cspan style=\"color: #333333\">Lawmakers were also keenly aware of recent headlines from Castro Valley, where 14 bed-ridden residents were \u003ca href=\"http://www.sfgate.com/bayarea/article/Castro-Valley-care-home-patients-abandoned-4929583.php\" target=\"_blank\" rel=\"noopener\">discovered abandoned\u003c/a> after the state ordered the facility closed. It turned out the operators had a long list of violations.\u003c/span>\u003c/p>\n\u003cp>You’ll get no argument from the agency charged with oversight of these facilities that it’s time for a revamp. A number of recommendations made in its last annual budget proposal mirror reform bills now pending in the legislature, such as raising the $150 maximum fine to $15,000, and upgrading the online database available to the public. That’s not all. Pat Leary is the Chief Deputy Director of the California Department of Social Services.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/162846042\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>\"They’re going to create a medical expertise unit, with a nurse,\" Leary said. \"We’re establishing a corporate accountability unit. There are a number of these facilities that are owned by corporations that are making decisions on a statewide basis. But the way that we track facilities is on a one-facility-at-a-time basis -- we’ve been missing trends.\"\u003c/p>\n\u003cp>Two women in San Diego were so frustrated with the lack of data and analysis, they created their own non-profit, and their own database for roughly 700 assisted living facilities in San Diego and Imperial Counties, as well as rural Northern California. CARR, the \u003ca href=\"http://www.rcfereform.org\" target=\"_blank\" rel=\"noopener\">Consumer Advocates for RCFE Reform\u003c/a>, (RCFE stands for residential care facility for the elderly) has managed to do what the state hasn’t yet - build a publicly accessible online database with 30,000 documents\u003ci>, \u003c/i>including inspection, complaint, and civil penalty reports. Their documents formed the basis of \"Deadly Neglect.\"\u003c/p>\n\u003cp>CARR co-founder Christina Selder echoes a sentiment heard commonly among consumer advocates. \"We find that they’re more of a facility protection agency than a consumer protection agency.\"\u003c/p>\n\u003cp>\"There are a number of cases where facilities will have repeat noncompliance meetings for atrocious activities,\" Selder said.\u003c/p>\n\u003cp>Without providing its name, she mentions a facility CARR uses as an example.\u003c/p>\n\u003cp>\"This particular facility had one resident who was left on the floor in their apartment for more than 24 hours and bled to death,\" she said. \"Same facility, a dementia resident who was unable to consent to have sexual relations with another resident but that repeatedly went on. There was a culture of fear among the staff, and so they weren’t cooperating during the investigation with Department of Social Services. That was the third one for this facility. Now, this facility remains open today. There’s no caution tape on the door.\"\u003c/p>\n\u003cp>Her partner in CARR, Chris Murphy, chimes in. \"I mean it’s almost like 'what do you have to do to get closed?'\"\u003c/p>\n\u003cp>They've developed some strong opinions after reviewing so many DSS reports. For instance, despite the claims of some that the worst abuses are likely to be more common in big facilities, especially those owned by corporate chains, Selder and Murphy say small homes are just as likely to fail their residents.\u003c/p>\n\u003cp>Both Murphy and Selder have degrees in gerontology. Both say they’re heartened by all the legislation in Sacramento, especially \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1523\" target=\"_blank\" rel=\"noopener\">the bill they sponsored\u003c/a>, AB 1523, requiring all facilities to carry liability insurance. [UPDATE: That bill passed, and Governor Jerry Brown signed it into law.] But Murphy worries about the fine print on all the legislation. \"If it’s not clearly stipulated within the bill, then it’s left to the regulators, then the regulators are going to come up with whatever they come up with. So I would hope that they get serious about having stakeholders meetings, using all of the expertise that’s available in this state.\"\u003c/p>\n\u003cp>Selder worries lawmakers are tweaking a system that is fundamentally dysfunctional. If a growing number of elderly need medical care, Selder says, maybe they shouldn’t be in assisted living. Or maybe assisted living should deliver tiered levels of care, with tiered levels of regulation. But that’s not the discussion on the table in Sacramento - at least, not this year.\u003c/p>\n\u003cp>\"We are behind the curve,\" Selder says. \"Other states have rating systems. Other states have assisted living regulated under the Department of Public Health. We’re not there. We’re not even talking about it in the right way yet.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Polly Stryker contributed to this report.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"\"We are behind the curve. Other states have rating systems. Other states have assisted living regulated under the Department of Public Health. We’re not there. We’re not even talking about it in the right way yet.\"","status":"publish","parent":0,"modified":1525451423,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":1216},"headData":{"title":"Are The Proposed Assisted Living Reforms in California Enough? | KQED","description":""We are behind the curve. Other states have rating systems. Other states have assisted living regulated under the Department of Public Health. We’re not there. We’re not even talking about it in the right way yet."","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Are The Proposed Assisted Living Reforms in California Enough?","datePublished":"2014-08-12T12:50:56.000Z","dateModified":"2018-05-04T16:30:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"20618 http://blogs.kqed.org/stateofhealth/?p=20618","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/08/12/are-the-proposed-assisted-living-reforms-in-california-enough/","disqusTitle":"Are The Proposed Assisted Living Reforms in California Enough?","path":"/stateofhealth/20618/are-the-proposed-assisted-living-reforms-in-california-enough","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20634\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11410_photo-hpf.jpg\">\u003cimg class=\"size-full wp-image-20634\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11410_photo-hpf.jpg\" alt=\"CAPTION COMING (Rachael Myrow/KQED)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11410_photo-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11410_photo-hpf-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11410_photo-hpf-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A \"crime book\" maintained by the San Diego advocacy group Consumer Advocates for RCFE Reform. (RCFE is short for Residential Care Facility for the Elderly.) This book contains cases of what CARR calls \"egregious neglect\" at San Diego assisted living facilities. (Rachael Myrow/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Over the last 25 years, the number of assisted living facilities in California has nearly doubled. The homes are intended to care for relatively independent, healthy seniors, but that doesn’t describe a lot of the people living in them today.\u003c/p>\n\u003cp>\"There’s been a seismic shift in the population they serve,\" says Deborah Schoch of the California HealthCare Foundation\u003ca href=\"http://centerforhealthreporting.org/project/medical-errors-weaker-rules-signal-safety-problems-ca-assisted-living-homes\" target=\"_blank\" rel=\"noopener\"> Center for Health Reporting\u003c/a>. Schoch says the system was set up to meet the needs of people who could use some extra help with the tasks of daily living –- and it does. But many of those people need a lot of help.\u003c/p>\n\u003cp>The system, she says, is caring for people \"who are frail, who may have dementia, who may be wheelchair bound, who may not be able to turn on their own in bed.\"\u003c/p>\n\u003cp>\u003c!--more-->Assisted living facilities are not designed to deliver skilled nursing care, and they do not typically have people with those qualifications on staff. There are no staff-to-resident ratios or many of the other rules that govern nursing homes. While many assisted living facilities do a fine job of delivering care, others are overwhelmed –- or worse. Schoch was the lead reporter for \u003cspan style=\"color: #20497d\">a \u003c/span>series called “\u003ca href=\"http://centerforhealthreporting.org/project/medical-errors-weaker-rules-signal-safety-problems-ca-assisted-living-homes\" target=\"_blank\" rel=\"noopener\">Deadly Neglect\u003c/a>” that detailed 27 deaths in San Diego County assisted living facilities from abuse and neglect.\u003c/p>\n\u003cp>\"I worked with \u003ca href=\"http://www.utsandiego.com\" target=\"_blank\" rel=\"noopener\">UT San Diego\u003c/a>, and we were able to get access to a lot of inspection reports: deaths, injuries, elder abuse, people left on the floor for 48 hours in assisted living facilities in San Diego County.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She's since come out with more stories detailing more troubling incidents, but that first series had a politically explosive effect. In San Diego, Supervisors voted to fund a special unit in the District Attorney’s office to target crime in the facilities.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related: \u003c/strong>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/11/crime-in-assisted-living-what-happens-after/\">Crime in Assisted Living: What Happens After\u003c/a>]\u003c/p>\n\u003cp>In Sacramento, where regulations haven’t changed much in close to 30 years, lawmakers held hearings featuring reform advocates like Aaron Byzak, who started a group called “\u003ca href=\"https://www.facebook.com/HazelsArmy\" target=\"_blank\" rel=\"noopener\">Hazel’s Army\u003c/a>” after his grandmother Hazel died in assisted living. \"If somebody parked in my grandmother’s disabled parking lot illegally, they’d be fined $450,\" he told reporters in the state capitol. \"But they kill her, and it’s $150.\"\u003c/p>\n\u003cp style=\"color: #20497d\">\u003cspan style=\"color: #333333\">Lawmakers were also keenly aware of recent headlines from Castro Valley, where 14 bed-ridden residents were \u003ca href=\"http://www.sfgate.com/bayarea/article/Castro-Valley-care-home-patients-abandoned-4929583.php\" target=\"_blank\" rel=\"noopener\">discovered abandoned\u003c/a> after the state ordered the facility closed. It turned out the operators had a long list of violations.\u003c/span>\u003c/p>\n\u003cp>You’ll get no argument from the agency charged with oversight of these facilities that it’s time for a revamp. A number of recommendations made in its last annual budget proposal mirror reform bills now pending in the legislature, such as raising the $150 maximum fine to $15,000, and upgrading the online database available to the public. That’s not all. Pat Leary is the Chief Deputy Director of the California Department of Social Services.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/162846042&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/162846042'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"They’re going to create a medical expertise unit, with a nurse,\" Leary said. \"We’re establishing a corporate accountability unit. There are a number of these facilities that are owned by corporations that are making decisions on a statewide basis. But the way that we track facilities is on a one-facility-at-a-time basis -- we’ve been missing trends.\"\u003c/p>\n\u003cp>Two women in San Diego were so frustrated with the lack of data and analysis, they created their own non-profit, and their own database for roughly 700 assisted living facilities in San Diego and Imperial Counties, as well as rural Northern California. CARR, the \u003ca href=\"http://www.rcfereform.org\" target=\"_blank\" rel=\"noopener\">Consumer Advocates for RCFE Reform\u003c/a>, (RCFE stands for residential care facility for the elderly) has managed to do what the state hasn’t yet - build a publicly accessible online database with 30,000 documents\u003ci>, \u003c/i>including inspection, complaint, and civil penalty reports. Their documents formed the basis of \"Deadly Neglect.\"\u003c/p>\n\u003cp>CARR co-founder Christina Selder echoes a sentiment heard commonly among consumer advocates. \"We find that they’re more of a facility protection agency than a consumer protection agency.\"\u003c/p>\n\u003cp>\"There are a number of cases where facilities will have repeat noncompliance meetings for atrocious activities,\" Selder said.\u003c/p>\n\u003cp>Without providing its name, she mentions a facility CARR uses as an example.\u003c/p>\n\u003cp>\"This particular facility had one resident who was left on the floor in their apartment for more than 24 hours and bled to death,\" she said. \"Same facility, a dementia resident who was unable to consent to have sexual relations with another resident but that repeatedly went on. There was a culture of fear among the staff, and so they weren’t cooperating during the investigation with Department of Social Services. That was the third one for this facility. Now, this facility remains open today. There’s no caution tape on the door.\"\u003c/p>\n\u003cp>Her partner in CARR, Chris Murphy, chimes in. \"I mean it’s almost like 'what do you have to do to get closed?'\"\u003c/p>\n\u003cp>They've developed some strong opinions after reviewing so many DSS reports. For instance, despite the claims of some that the worst abuses are likely to be more common in big facilities, especially those owned by corporate chains, Selder and Murphy say small homes are just as likely to fail their residents.\u003c/p>\n\u003cp>Both Murphy and Selder have degrees in gerontology. Both say they’re heartened by all the legislation in Sacramento, especially \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1523\" target=\"_blank\" rel=\"noopener\">the bill they sponsored\u003c/a>, AB 1523, requiring all facilities to carry liability insurance. [UPDATE: That bill passed, and Governor Jerry Brown signed it into law.] But Murphy worries about the fine print on all the legislation. \"If it’s not clearly stipulated within the bill, then it’s left to the regulators, then the regulators are going to come up with whatever they come up with. So I would hope that they get serious about having stakeholders meetings, using all of the expertise that’s available in this state.\"\u003c/p>\n\u003cp>Selder worries lawmakers are tweaking a system that is fundamentally dysfunctional. If a growing number of elderly need medical care, Selder says, maybe they shouldn’t be in assisted living. Or maybe assisted living should deliver tiered levels of care, with tiered levels of regulation. But that’s not the discussion on the table in Sacramento - at least, not this year.\u003c/p>\n\u003cp>\"We are behind the curve,\" Selder says. \"Other states have rating systems. Other states have assisted living regulated under the Department of Public Health. We’re not there. We’re not even talking about it in the right way yet.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Polly Stryker contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/20618/are-the-proposed-assisted-living-reforms-in-california-enough","authors":["251"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_186","stateofhealth_825","stateofhealth_2829","stateofhealth_3245","stateofhealth_591"],"featImg":"stateofhealth_20634","label":"stateofhealth"},"stateofhealth_20500":{"type":"posts","id":"stateofhealth_20500","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"20500","score":null,"sort":[1407156636000]},"guestAuthors":[],"slug":"a-walk-through-assisted-living-facilities-in-california","title":"A Walk Through Assisted Living Facilities in California","publishDate":1407156636,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_20515\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11381_photo-hpf.jpg\">\u003cimg class=\"size-full wp-image-20515\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11381_photo-hpf.jpg\" alt=\"TV lounge at Westchester Villa, an assisted living facility in Inglewood, near Los Angeles. (Rachael Myrow/KQED)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11381_photo-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11381_photo-hpf-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11381_photo-hpf-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">TV lounge at Westchester Villa, an assisted living facility in Inglewood, in Los Angeles County. (Rachael Myrow/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>This week, lawmakers in Sacramento \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/01/down-to-the-wire-lawmakers-have-4-weeks-to-act-on-assisted-living-reforms/\" target=\"_blank\">get busy\u003c/a> on 15 bills that together constitute the most comprehensive overhaul of assisted living facility regulation in three decades. But for many Californians, it's not even clear what an assisted living facility is. People often ask if assisted living is the same thing as a nursing home. It's not.\u003c/p>\n\u003cp>In nursing homes, people get round-the-clock medical care from licensed nurses. Assisted living comes in because not everyone who needs help also needs that level of care. Sometimes that assistance doesn't even involve a facility. Sometimes people can receive assistance and remain living in their own homes.\u003c/p>\n\u003cp>Say you've noticed your mother is walking with a new shuffle and dropping things, or that dad is mixing up his medications -- and getting argumentative when you bring it up. Something is going on that must be addressed, even though your parent is still physically healthy and wants to be independent.\u003c!--more-->\u003c/p>\n\u003cp>Heather Angel-Collin is deeply familiar with this scenario. A 25-year veteran social worker, she runs a couple senior-focused programs for \u003ca href=\"http://www.jfsla.org/page.aspx?pid=213\">Jewish Family Service for Los Angeles\u003c/a>, a non-profit social service agency that serves 100,000 people a year, regardless of religion or ability to pay.\u003c/p>\n\u003cp>\"It’s a slow progression of, you know, becoming more frail, or becoming more forgetful.\" she says. \"And those things can be very subtle, especially if you’re not seeing that person on a day-to-day basis.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Angel-Collin says it helps to think of tiers of care. Few people want to move out of their homes. They may not have to -- ever -- if domestic or medical support can be arranged.\u003c/p>\n\u003cp>\"Maybe they need to have medications given every day,\" she says. \"Maybe they need some assistance with taking a shower or bath or getting dressed.\" In California, \u003ca href=\"http://www.cdss.ca.gov/agedblinddisabled/pg1296.htm\" target=\"_blank\">In-Home Supportive Services\u003c/a> provides in-home support for several hours a week, and there are people older than 100 drawing on the services to continue living at home, mostly independently and significantly less expensively than a nursing home would be.\u003c/p>\n\u003cp>Still, there may come a time when your parent's care needs are no longer feasible with continuing to live at home. California has more than 7,500 licensed facilities you can choose from, but where do you start?\u003c/p>\n\u003cp>\u003cstrong>Finding the Right Assisted Living Facility\u003c/strong>\u003c/p>\n\u003cp>There's no one right answer as to the kind of assisted facility you choose. What's available in your area? What can you afford? Does size matter? Many people prefer something small and homey, but larger facilities may offer more services and activities. Your parent may feel more comfortable in a facility that makes a special effort to make people of a certain cultural or career background feel at home. For example, Angel-Collins notes there's a waiting list of Armenian-Americans keen to live at \u003ca href=\"http://ararathome.org/\">Ararat Home of Los Angeles\u003c/a>.\u003c/p>\n\u003cp>Remember that assisted living facilities -- unlike nursing homes -- do not provide skilled medical care. What they can offer includes services like meals and housekeeping, as well as supervised pill distribution, extra attention for patients with dementia, and transportation to the doctor’s office. In California, most families pay for assisted living out-of-pocket.\u003c/p>\n\u003cp>While most assisted living facilities are small, serving six people or less, most Californians who choose assisted living, especially in urban areas, live in large facilities, like \u003ca href=\"http://www.westchestervilla.com/public/\" target=\"_blank\">Westchester Villa\u003c/a>, a 174-bed residential care facility for the elderly in Inglewood, south of Los Angeles.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/01/down-to-the-wire-lawmakers-have-4-weeks-to-act-on-assisted-living-reforms/\" target=\"_blank\">Lawmakers Have 4 Weeks to Act on Assisted Living Reforms\u003c/a>]\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/161679382&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Westchester Villa is centrally located -- just down the street from Inglewood High School, within easy driving distance to restaurants, shopping malls and LAX. It's a modest neighborhood, and the facility reflects that. From the lobby, Westchester Villa looks a lot like a Best Western.\u003c/p>\n\u003cp>Matthew Chinichian is the chief administrator, a soft-spoken, amiable man who is one of three administrators at this facility. That in itself marks Westchester as a cut above many facilities in Los Angeles serving lower income populations, but there are other ways this place stands out. The first thing he notes about Westchester Villa is that it was purpose-built. More commonly, assisted living facilities are in retrofitted apartment buildings or smaller facilities are re-purposed single-family homes.\u003c/p>\n\u003cp>The cafeteria is huge. There are several lounges, not just one, featuring comfortable couches, big screen TVs, book collections, pianos and pool tables. For anybody who's lived in communal situation, the appeal is obvious. If you want a quiet space to think outside your bedroom, you'll find one. If you don't like what's on one TV, you can find another with nobody hogging the remote control.\u003c/p>\n\u003cp>Westchester caters to African-Americans. You don’t have to be black, but three out of four residents are, reflecting the neighborhood and positive word-of-mouth from local churches. In a community room for Bible study, local pastors from various denominations lead sessions \"at least four times a week,\" Chinichian says. \"Actually, our residents enjoy that more than any other type of activity. We have Bible study going all the time.\"\u003c/p>\n\u003cp>If you have the money, there are some fabulous places in California -- with breathtaking views, heated indoor swimming pools, and more. Those can cost $4,000-10,000 a month. A private room at Westchester is more modest: $2,340 a month. A double is $1,750. While most residents cover their own costs, there are some beds available for residents who rely on government support.\u003c/p>\n\u003cp>\u003cstrong>Regulation Lacking\u003c/strong>\u003c/p>\n\u003cp>So let’s imagine you are trying to decide on a place for your mom or dad. How can you be confident in the quality of care? Who regulates assisted living facilities? Critics like Angel-Collin's colleague, Nancy Volpert, say oversight from the state is nowhere near as robust as it needs to be. Volpert is director of public policy at Jewish Family Service of LA, which is co-sponsoring eight of the bills pending in Sacramento. Volpert supports all 15 bills pending.\u003c/p>\n\u003cp>\"We need to have regular inspections,\" Volpert says. \"We need to have a robust complaint process. We need to have staffing sufficient to meet the need. We need to have training. These are facilities that serve all of us and all of our families. Neglect doesn’t know an income bracket.\"\u003c/p>\n\u003cp>Neglect can mean all sorts of things: from simple disorganization to willful failure to protect against injury, or follow up after injury. A series of reports last year from multiple media outlets – \u003ca href=\"http://ww2.kqed.org/news/2013/09/09/whos-protecting-the-abused-elderly/\" target=\"_blank\">KQED/Center for Investigative Reporting\u003c/a>, \u003ca href=\"http://www.utsandiego.com/news/2013/Sep/09/deadly-neglect-assisted-living-homes-san-diego/\" target=\"_blank\">San Diego Union Tribune/Center for Health Reporting\u003c/a> and the \u003ca href=\"http://www.sfgate.com/bayarea/article/Castro-Valley-Janitor-saw-elderly-become-weak-4944795.php#photo-5400480\" target=\"_blank\">San Francisco Chronicle\u003c/a> – all found abuse and neglect, sometimes leading to death, at assisted living facilities around the state.\u003c/p>\n\u003cp>Advocacy groups like \u003ca href=\"http://www.canhr.org/\" target=\"_blank\">California Advocates for Nursing Home Reform\u003c/a> and \u003ca href=\"www.rcfereform.org\" target=\"_blank\">Consumer Advocates for RCFE Reform\u003c/a> seized the momentum these reports created in Sacramento to \u003ca href=\"http://www.californiareport.org/archive/R201401140850/c\">push for reform\u003c/a>. The question now is whether there's enough momentum to carry most of the reforms all the way through and change the laws.\u003c/p>\n\u003cp>Already, Governor Jerry Brown has signed one bill into law, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1572&search_keywords=\">AB 1572\u003c/a> which requires every assisted living facility, at the request of just two or more residents, to assist in establishing and maintaining a resident council that could bring in family members, advocates, long-term care ombudsmen and others. The new law requires facilities to respond in writing within 14 calendar days regarding any action or inaction taken in response to written concerns or recommendations.\u003c/p>\n\u003cp>While many of the bills sailed through initial hearings and votes uncontested, arguments are \u003ca href=\"http://www.utsandiego.com/news/2014/aug/01/assisted-living-bills-hurdles/?Watchdog\" target=\"_blank\">heating up\u003c/a> over the details as those who back them fight to get the bills through the legislature and on to Gov. Brown's desk for signature.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Polly Stryker contributed to this report.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"California legislators are considering 15 bills to overhaul regulation of the state's 7,500 assisted living facilities.","status":"publish","parent":0,"modified":1407256356,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":true,"iframeSrcs":["https://w.soundcloud.com/player/"],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":1343},"headData":{"title":"A Walk Through Assisted Living Facilities in California | KQED","description":"California legislators are considering 15 bills to overhaul regulation of the state's 7,500 assisted living facilities.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A Walk Through Assisted Living Facilities in California","datePublished":"2014-08-04T12:50:36.000Z","dateModified":"2014-08-05T16:32:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"20500 http://blogs.kqed.org/stateofhealth/?p=20500","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/08/04/a-walk-through-assisted-living-facilities-in-california/","disqusTitle":"A Walk Through Assisted Living Facilities in California","path":"/stateofhealth/20500/a-walk-through-assisted-living-facilities-in-california","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20515\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11381_photo-hpf.jpg\">\u003cimg class=\"size-full wp-image-20515\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11381_photo-hpf.jpg\" alt=\"TV lounge at Westchester Villa, an assisted living facility in Inglewood, near Los Angeles. (Rachael Myrow/KQED)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11381_photo-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11381_photo-hpf-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11381_photo-hpf-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">TV lounge at Westchester Villa, an assisted living facility in Inglewood, in Los Angeles County. (Rachael Myrow/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>This week, lawmakers in Sacramento \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/01/down-to-the-wire-lawmakers-have-4-weeks-to-act-on-assisted-living-reforms/\" target=\"_blank\">get busy\u003c/a> on 15 bills that together constitute the most comprehensive overhaul of assisted living facility regulation in three decades. But for many Californians, it's not even clear what an assisted living facility is. People often ask if assisted living is the same thing as a nursing home. It's not.\u003c/p>\n\u003cp>In nursing homes, people get round-the-clock medical care from licensed nurses. Assisted living comes in because not everyone who needs help also needs that level of care. Sometimes that assistance doesn't even involve a facility. Sometimes people can receive assistance and remain living in their own homes.\u003c/p>\n\u003cp>Say you've noticed your mother is walking with a new shuffle and dropping things, or that dad is mixing up his medications -- and getting argumentative when you bring it up. Something is going on that must be addressed, even though your parent is still physically healthy and wants to be independent.\u003c!--more-->\u003c/p>\n\u003cp>Heather Angel-Collin is deeply familiar with this scenario. A 25-year veteran social worker, she runs a couple senior-focused programs for \u003ca href=\"http://www.jfsla.org/page.aspx?pid=213\">Jewish Family Service for Los Angeles\u003c/a>, a non-profit social service agency that serves 100,000 people a year, regardless of religion or ability to pay.\u003c/p>\n\u003cp>\"It’s a slow progression of, you know, becoming more frail, or becoming more forgetful.\" she says. \"And those things can be very subtle, especially if you’re not seeing that person on a day-to-day basis.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Angel-Collin says it helps to think of tiers of care. Few people want to move out of their homes. They may not have to -- ever -- if domestic or medical support can be arranged.\u003c/p>\n\u003cp>\"Maybe they need to have medications given every day,\" she says. \"Maybe they need some assistance with taking a shower or bath or getting dressed.\" In California, \u003ca href=\"http://www.cdss.ca.gov/agedblinddisabled/pg1296.htm\" target=\"_blank\">In-Home Supportive Services\u003c/a> provides in-home support for several hours a week, and there are people older than 100 drawing on the services to continue living at home, mostly independently and significantly less expensively than a nursing home would be.\u003c/p>\n\u003cp>Still, there may come a time when your parent's care needs are no longer feasible with continuing to live at home. California has more than 7,500 licensed facilities you can choose from, but where do you start?\u003c/p>\n\u003cp>\u003cstrong>Finding the Right Assisted Living Facility\u003c/strong>\u003c/p>\n\u003cp>There's no one right answer as to the kind of assisted facility you choose. What's available in your area? What can you afford? Does size matter? Many people prefer something small and homey, but larger facilities may offer more services and activities. Your parent may feel more comfortable in a facility that makes a special effort to make people of a certain cultural or career background feel at home. For example, Angel-Collins notes there's a waiting list of Armenian-Americans keen to live at \u003ca href=\"http://ararathome.org/\">Ararat Home of Los Angeles\u003c/a>.\u003c/p>\n\u003cp>Remember that assisted living facilities -- unlike nursing homes -- do not provide skilled medical care. What they can offer includes services like meals and housekeeping, as well as supervised pill distribution, extra attention for patients with dementia, and transportation to the doctor’s office. In California, most families pay for assisted living out-of-pocket.\u003c/p>\n\u003cp>While most assisted living facilities are small, serving six people or less, most Californians who choose assisted living, especially in urban areas, live in large facilities, like \u003ca href=\"http://www.westchestervilla.com/public/\" target=\"_blank\">Westchester Villa\u003c/a>, a 174-bed residential care facility for the elderly in Inglewood, south of Los Angeles.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/01/down-to-the-wire-lawmakers-have-4-weeks-to-act-on-assisted-living-reforms/\" target=\"_blank\">Lawmakers Have 4 Weeks to Act on Assisted Living Reforms\u003c/a>]\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/161679382&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Westchester Villa is centrally located -- just down the street from Inglewood High School, within easy driving distance to restaurants, shopping malls and LAX. It's a modest neighborhood, and the facility reflects that. From the lobby, Westchester Villa looks a lot like a Best Western.\u003c/p>\n\u003cp>Matthew Chinichian is the chief administrator, a soft-spoken, amiable man who is one of three administrators at this facility. That in itself marks Westchester as a cut above many facilities in Los Angeles serving lower income populations, but there are other ways this place stands out. The first thing he notes about Westchester Villa is that it was purpose-built. More commonly, assisted living facilities are in retrofitted apartment buildings or smaller facilities are re-purposed single-family homes.\u003c/p>\n\u003cp>The cafeteria is huge. There are several lounges, not just one, featuring comfortable couches, big screen TVs, book collections, pianos and pool tables. For anybody who's lived in communal situation, the appeal is obvious. If you want a quiet space to think outside your bedroom, you'll find one. If you don't like what's on one TV, you can find another with nobody hogging the remote control.\u003c/p>\n\u003cp>Westchester caters to African-Americans. You don’t have to be black, but three out of four residents are, reflecting the neighborhood and positive word-of-mouth from local churches. In a community room for Bible study, local pastors from various denominations lead sessions \"at least four times a week,\" Chinichian says. \"Actually, our residents enjoy that more than any other type of activity. We have Bible study going all the time.\"\u003c/p>\n\u003cp>If you have the money, there are some fabulous places in California -- with breathtaking views, heated indoor swimming pools, and more. Those can cost $4,000-10,000 a month. A private room at Westchester is more modest: $2,340 a month. A double is $1,750. While most residents cover their own costs, there are some beds available for residents who rely on government support.\u003c/p>\n\u003cp>\u003cstrong>Regulation Lacking\u003c/strong>\u003c/p>\n\u003cp>So let’s imagine you are trying to decide on a place for your mom or dad. How can you be confident in the quality of care? Who regulates assisted living facilities? Critics like Angel-Collin's colleague, Nancy Volpert, say oversight from the state is nowhere near as robust as it needs to be. Volpert is director of public policy at Jewish Family Service of LA, which is co-sponsoring eight of the bills pending in Sacramento. Volpert supports all 15 bills pending.\u003c/p>\n\u003cp>\"We need to have regular inspections,\" Volpert says. \"We need to have a robust complaint process. We need to have staffing sufficient to meet the need. We need to have training. These are facilities that serve all of us and all of our families. Neglect doesn’t know an income bracket.\"\u003c/p>\n\u003cp>Neglect can mean all sorts of things: from simple disorganization to willful failure to protect against injury, or follow up after injury. A series of reports last year from multiple media outlets – \u003ca href=\"http://ww2.kqed.org/news/2013/09/09/whos-protecting-the-abused-elderly/\" target=\"_blank\">KQED/Center for Investigative Reporting\u003c/a>, \u003ca href=\"http://www.utsandiego.com/news/2013/Sep/09/deadly-neglect-assisted-living-homes-san-diego/\" target=\"_blank\">San Diego Union Tribune/Center for Health Reporting\u003c/a> and the \u003ca href=\"http://www.sfgate.com/bayarea/article/Castro-Valley-Janitor-saw-elderly-become-weak-4944795.php#photo-5400480\" target=\"_blank\">San Francisco Chronicle\u003c/a> – all found abuse and neglect, sometimes leading to death, at assisted living facilities around the state.\u003c/p>\n\u003cp>Advocacy groups like \u003ca href=\"http://www.canhr.org/\" target=\"_blank\">California Advocates for Nursing Home Reform\u003c/a> and \u003ca href=\"www.rcfereform.org\" target=\"_blank\">Consumer Advocates for RCFE Reform\u003c/a> seized the momentum these reports created in Sacramento to \u003ca href=\"http://www.californiareport.org/archive/R201401140850/c\">push for reform\u003c/a>. The question now is whether there's enough momentum to carry most of the reforms all the way through and change the laws.\u003c/p>\n\u003cp>Already, Governor Jerry Brown has signed one bill into law, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1572&search_keywords=\">AB 1572\u003c/a> which requires every assisted living facility, at the request of just two or more residents, to assist in establishing and maintaining a resident council that could bring in family members, advocates, long-term care ombudsmen and others. The new law requires facilities to respond in writing within 14 calendar days regarding any action or inaction taken in response to written concerns or recommendations.\u003c/p>\n\u003cp>While many of the bills sailed through initial hearings and votes uncontested, arguments are \u003ca href=\"http://www.utsandiego.com/news/2014/aug/01/assisted-living-bills-hurdles/?Watchdog\" target=\"_blank\">heating up\u003c/a> over the details as those who back them fight to get the bills through the legislature and on to Gov. Brown's desk for signature.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Polly Stryker contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/20500/a-walk-through-assisted-living-facilities-in-california","authors":["251"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_186","stateofhealth_825","stateofhealth_591"],"featImg":"stateofhealth_20515","label":"stateofhealth"},"stateofhealth_20449":{"type":"posts","id":"stateofhealth_20449","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"20449","score":null,"sort":[1406915697000]},"guestAuthors":[],"slug":"down-to-the-wire-lawmakers-have-4-weeks-to-act-on-assisted-living-reforms","title":"Down to the Wire: Lawmakers Have 4 Weeks to Act on Assisted Living Reforms","publishDate":1406915697,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_2438\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Alzheimers0404-e1406915625176.jpg\">\u003cimg class=\"size-full wp-image-2438\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Alzheimers0404-e1406915625176.jpg\" alt=\"A woman, suffering from Alzheimer's Disease, in a retirement home corridor. (Sebastien Bozon/AFP/Getty Images)\" width=\"640\" height=\"426\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/01/Alzheimers0404-e1406915625176.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2012/01/Alzheimers0404-e1406915625176-400x266.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2012/01/Alzheimers0404-e1406915625176-320x213.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Sebastien Bozon/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Polly Stryker\u003c/strong>\u003c/p>\n\u003cp>The assisted living industry in California is big business: More than 7,500 licensed facilities provide care for more than 175,000 people statewide. Starting Monday, and over the next two weeks, \u003cem>The California Report\u003c/em> will bring stories about \u003ca href=\"http://www.ccld.ca.gov/PG543.htm\" target=\"_blank\">assisted living facilities\u003c/a> in the state.\u003c/p>\n\u003cp>Assisted living is an alternative to more expensive -- and often more institutional -- care in a skilled nursing facility. In assisted living, staff help seniors with daily needs, such as meals, medicine-taking and bathing. The homes range from small mom-and-pop places with six beds to corporate chains with over 100 beds. A growing number offer dementia care.\u003c/p>\n\u003cp>But while these facilities are licensed, the laws regulating them have not had a major update since 1985, and California has lagged behind other states in updating its rules.\u003c!--more-->\u003c/p>\n\u003cp>A series of reports last year from multiple media outlets -- \u003ca href=\"http://ww2.kqed.org/news/2013/09/09/whos-protecting-the-abused-elderly/\" target=\"_blank\">KQED/Center for Investigative Reporting\u003c/a>, \u003ca href=\"http://www.utsandiego.com/news/2013/Sep/09/deadly-neglect-assisted-living-homes-san-diego/\" target=\"_blank\">San Diego Union Tribune/Center for Health Reporting\u003c/a> and the \u003ca href=\"http://www.sfgate.com/bayarea/article/Castro-Valley-Janitor-saw-elderly-become-weak-4944795.php#photo-5400480\" target=\"_blank\">San Francisco Chronicle\u003c/a> -- all found abuse and neglect, sometimes leading to death, at assisted living facilities around the state.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These reports, combined with advocacy momentum, coalesced to spur legislators to try and create the first major update of assisted living facility laws in nearly 30 years.\u003c/p>\n\u003cp>And an update is desperately needed. For example, if someone in an assisted living facility dies from abuse or neglect, the law allows for a meager fine of $150. The main regulatory agency for the industry, the Department of Social Services, is only required to inspect facilities every five years unless there is a complaint.\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>[Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/11/5-things-to-remember-when-choosing-a-nursing-home/\" target=\"_blank\">5 Things to Remember When Choosing A Nursing Home\u003c/a>]\u003c/p>\n\u003cp>Fifteen bills are making their way through the state Legislature, and the month of August is key. The Legislature has until Aug. 29 to move bills to the governor's desk. If passed, the package of legislation would bring changes that include: increasing possible fines from $150 to $15,000; mandating annual inspections; creating a Resident Bill of Rights; mandating liability insurance; and creating a better online database for consumers. You can read summaries of all the bills from the\u003ca href=\"http://caassistedliving.org/advocacy/legislation/legislative-update/\" target=\"_blank\"> California Assisted Living Association\u003c/a>, the \u003ca href=\"http://www.canhr.org/legislation/rcfe_reform_act.html\" target=\"_blank\">California Advocates for Nursing Home Reform\u003c/a> or the \u003ca href=\"http://rcfereform.org/CARRs_Advocacy_Platform\" target=\"_blank\">Consumer Advocates for RCFE Reform\u003c/a>.\u003c/p>\n\u003cp>Here's our take on three of the bills:\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1571\" target=\"_blank\">AB1571\u003c/a>, introduced by Assemblywoman Susan Eggman (D-Stockton), would create a better online consumer information system. Right now, if you want to compare assisted living facilities, there's no easy way to do so, The DSS website doesn't include specifics of violations. If this bill passes, improvements, including a rating system, would be online by 2019. The California Advocates for Nursing Home Reform (CANHR) is one of the bill’s sponsors.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB2171\" target=\"_blank\">AB2171\u003c/a>, from Assemblyman Bob Wieckowski (D-Fremont), would create a residents' bill of rights, giving people rights similar to those that people in nursing homes have. Sponsors include CANHR and the Consumer Attorneys of California. They say it would give residents of assisted living facilities rights they could protect in court with an injunction proactively -- like the right to live in a safe environment and to be free from neglect or exploitation -- instead of having to show proof of injury after the fact. CALA, the assisted living industry group, sees things differently. It fears the bill would open the floodgates for “shakedown lawsuits” by trial lawyers to sue assisted living facilities. It is the only bill the group opposes.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1523\" target=\"_blank\">AB1523\u003c/a>, from Speaker of the Assembly Toni Atkins (D-San Diego), would require assisted living facilities to carry liability insurance. It's sponsored by \u003ca href=\"http://www.rcfereform.org\" target=\"_blank\">Consumer Advocates for RCFE Reform\u003c/a>. If citations and legal actions equal higher insurance rates, the thinking goes that the bad places will be weeded out by the high cost of insurance. CALA, the industry group, supports this bill and says its members carry liability insurance already.\u003c/p>\n\u003cp>Ultimately, it’s up to Gov. Jerry Brown to sign or veto the bills that make it to his desk by the time the Legislature wraps up its session Aug. 29. Stakeholders say the governor’s office has given little indication as to what he will do. Pat McGinnis, executive director of CANHR says, “I know he doesn’t think of himself as elderly, but he is at an age where he would be eligible for (assisted living) care, so he ought to be thinking about that. Or think if his mother was in one of these places.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Rachael Myrow and April Dembosky contributed to this report.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"The current regulations were passed in 1985. ","status":"publish","parent":0,"modified":1407188640,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":767},"headData":{"title":"Down to the Wire: Lawmakers Have 4 Weeks to Act on Assisted Living Reforms | KQED","description":"The current regulations were passed in 1985. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Down to the Wire: Lawmakers Have 4 Weeks to Act on Assisted Living Reforms","datePublished":"2014-08-01T17:54:57.000Z","dateModified":"2014-08-04T21:44:00.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"20449 http://blogs.kqed.org/stateofhealth/?p=20449","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/08/01/down-to-the-wire-lawmakers-have-4-weeks-to-act-on-assisted-living-reforms/","disqusTitle":"Down to the Wire: Lawmakers Have 4 Weeks to Act on Assisted Living Reforms","path":"/stateofhealth/20449/down-to-the-wire-lawmakers-have-4-weeks-to-act-on-assisted-living-reforms","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_2438\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Alzheimers0404-e1406915625176.jpg\">\u003cimg class=\"size-full wp-image-2438\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Alzheimers0404-e1406915625176.jpg\" alt=\"A woman, suffering from Alzheimer's Disease, in a retirement home corridor. (Sebastien Bozon/AFP/Getty Images)\" width=\"640\" height=\"426\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/01/Alzheimers0404-e1406915625176.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2012/01/Alzheimers0404-e1406915625176-400x266.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2012/01/Alzheimers0404-e1406915625176-320x213.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Sebastien Bozon/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Polly Stryker\u003c/strong>\u003c/p>\n\u003cp>The assisted living industry in California is big business: More than 7,500 licensed facilities provide care for more than 175,000 people statewide. Starting Monday, and over the next two weeks, \u003cem>The California Report\u003c/em> will bring stories about \u003ca href=\"http://www.ccld.ca.gov/PG543.htm\" target=\"_blank\">assisted living facilities\u003c/a> in the state.\u003c/p>\n\u003cp>Assisted living is an alternative to more expensive -- and often more institutional -- care in a skilled nursing facility. In assisted living, staff help seniors with daily needs, such as meals, medicine-taking and bathing. The homes range from small mom-and-pop places with six beds to corporate chains with over 100 beds. A growing number offer dementia care.\u003c/p>\n\u003cp>But while these facilities are licensed, the laws regulating them have not had a major update since 1985, and California has lagged behind other states in updating its rules.\u003c!--more-->\u003c/p>\n\u003cp>A series of reports last year from multiple media outlets -- \u003ca href=\"http://ww2.kqed.org/news/2013/09/09/whos-protecting-the-abused-elderly/\" target=\"_blank\">KQED/Center for Investigative Reporting\u003c/a>, \u003ca href=\"http://www.utsandiego.com/news/2013/Sep/09/deadly-neglect-assisted-living-homes-san-diego/\" target=\"_blank\">San Diego Union Tribune/Center for Health Reporting\u003c/a> and the \u003ca href=\"http://www.sfgate.com/bayarea/article/Castro-Valley-Janitor-saw-elderly-become-weak-4944795.php#photo-5400480\" target=\"_blank\">San Francisco Chronicle\u003c/a> -- all found abuse and neglect, sometimes leading to death, at assisted living facilities around the state.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These reports, combined with advocacy momentum, coalesced to spur legislators to try and create the first major update of assisted living facility laws in nearly 30 years.\u003c/p>\n\u003cp>And an update is desperately needed. For example, if someone in an assisted living facility dies from abuse or neglect, the law allows for a meager fine of $150. The main regulatory agency for the industry, the Department of Social Services, is only required to inspect facilities every five years unless there is a complaint.\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>[Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/11/5-things-to-remember-when-choosing-a-nursing-home/\" target=\"_blank\">5 Things to Remember When Choosing A Nursing Home\u003c/a>]\u003c/p>\n\u003cp>Fifteen bills are making their way through the state Legislature, and the month of August is key. The Legislature has until Aug. 29 to move bills to the governor's desk. If passed, the package of legislation would bring changes that include: increasing possible fines from $150 to $15,000; mandating annual inspections; creating a Resident Bill of Rights; mandating liability insurance; and creating a better online database for consumers. You can read summaries of all the bills from the\u003ca href=\"http://caassistedliving.org/advocacy/legislation/legislative-update/\" target=\"_blank\"> California Assisted Living Association\u003c/a>, the \u003ca href=\"http://www.canhr.org/legislation/rcfe_reform_act.html\" target=\"_blank\">California Advocates for Nursing Home Reform\u003c/a> or the \u003ca href=\"http://rcfereform.org/CARRs_Advocacy_Platform\" target=\"_blank\">Consumer Advocates for RCFE Reform\u003c/a>.\u003c/p>\n\u003cp>Here's our take on three of the bills:\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1571\" target=\"_blank\">AB1571\u003c/a>, introduced by Assemblywoman Susan Eggman (D-Stockton), would create a better online consumer information system. Right now, if you want to compare assisted living facilities, there's no easy way to do so, The DSS website doesn't include specifics of violations. If this bill passes, improvements, including a rating system, would be online by 2019. The California Advocates for Nursing Home Reform (CANHR) is one of the bill’s sponsors.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB2171\" target=\"_blank\">AB2171\u003c/a>, from Assemblyman Bob Wieckowski (D-Fremont), would create a residents' bill of rights, giving people rights similar to those that people in nursing homes have. Sponsors include CANHR and the Consumer Attorneys of California. They say it would give residents of assisted living facilities rights they could protect in court with an injunction proactively -- like the right to live in a safe environment and to be free from neglect or exploitation -- instead of having to show proof of injury after the fact. CALA, the assisted living industry group, sees things differently. It fears the bill would open the floodgates for “shakedown lawsuits” by trial lawyers to sue assisted living facilities. It is the only bill the group opposes.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1523\" target=\"_blank\">AB1523\u003c/a>, from Speaker of the Assembly Toni Atkins (D-San Diego), would require assisted living facilities to carry liability insurance. It's sponsored by \u003ca href=\"http://www.rcfereform.org\" target=\"_blank\">Consumer Advocates for RCFE Reform\u003c/a>. If citations and legal actions equal higher insurance rates, the thinking goes that the bad places will be weeded out by the high cost of insurance. CALA, the industry group, supports this bill and says its members carry liability insurance already.\u003c/p>\n\u003cp>Ultimately, it’s up to Gov. Jerry Brown to sign or veto the bills that make it to his desk by the time the Legislature wraps up its session Aug. 29. Stakeholders say the governor’s office has given little indication as to what he will do. Pat McGinnis, executive director of CANHR says, “I know he doesn’t think of himself as elderly, but he is at an age where he would be eligible for (assisted living) care, so he ought to be thinking about that. Or think if his mother was in one of these places.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Rachael Myrow and April Dembosky contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/20449/down-to-the-wire-lawmakers-have-4-weeks-to-act-on-assisted-living-reforms","authors":["8344"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_825"],"featImg":"stateofhealth_20482","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. Plus, KQED’s Bianca Taylor brings you the local KQED news you need to know.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Consider-This-Podcast-Tile-703x703-1.jpg","imageAlt":"Consider This from NPR and KQED","officialWebsiteLink":"/podcasts/considerthis","meta":{"site":"news","source":"kqed","order":"7"},"link":"/podcasts/considerthis","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1503226625?mt=2&at=11l79Y&ct=nprdirectory","npr":"https://rpb3r.app.goo.gl/coronavirusdaily","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM1NS9wb2RjYXN0LnhtbA","spotify":"https://open.spotify.com/show/3Z6JdCS2d0eFEpXHKI6WqH"}},"forum":{"id":"forum","title":"Forum","tagline":"The conversation starts here","info":"KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.","airtime":"MON-FRI 9am-11am, 10pm-11pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED Forum with Mina Kim and Alexis Madrigal","officialWebsiteLink":"/forum","meta":{"site":"news","source":"kqed","order":"8"},"link":"/forum","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz","npr":"https://www.npr.org/podcasts/432307980/forum","stitcher":"https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast","rss":"https://feeds.megaphone.fm/KQINC9557381633"}},"freakonomics-radio":{"id":"freakonomics-radio","title":"Freakonomics Radio","info":"Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. 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One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.","airtime":"MON-FRI 7pm-8pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Fresh-Air-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/fresh-air/","meta":{"site":"radio","source":"npr"},"link":"/radio/program/fresh-air","subscribe":{"npr":"https://rpb3r.app.goo.gl/4s8b","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/Fresh-Air-p17/","rss":"https://feeds.npr.org/381444908/podcast.xml"}},"here-and-now":{"id":"here-and-now","title":"Here & Now","info":"A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.","airtime":"MON-THU 11am-12pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Here-And-Now-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"http://www.wbur.org/hereandnow","meta":{"site":"news","source":"npr"},"link":"/radio/program/here-and-now","subsdcribe":{"apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=426698661","tuneIn":"https://tunein.com/radio/Here--Now-p211/","rss":"https://feeds.npr.org/510051/podcast.xml"}},"how-i-built-this":{"id":"how-i-built-this","title":"How I Built This with Guy Raz","info":"Guy Raz dives into the stories behind some of the world's best known companies. 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