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Proposed Inspection Cuts Endanger RCFE Residents
California’s latest budget crisis is triggering damaging cuts to many programs that serve elders, especially to services that help seniors stay at home and out of nursing homes. Needed services and programs are being cut or closed while the number of elders needing care is surging throughout California.
The budget cuts pose a particular danger to the 150,000 elders residing in residential care facilities for the elderly (RCFEs). RCFEs are commonly referred to as assisted living facilities. Most RCFE residents are not losing services because they are already required to pay for their own care. They are, however, being deprived of oversight from the licensing agency that is supposed to monitor their care.
Under the Governor’s proposed budget, most RCFEs would be inspected just once every five to seven years. This extremely low level of oversight defeats the purpose of licensing and would make residents’ rights and care standards almost meaningless.
The proposed cuts to the Department of Social Services’ Community Care Licensing Division diminish oversight at a time when assisted living facility care is growing rapidly in California and the care needs of residents are increasing dramatically. Many residents suffer from dementia and other serious health problems that make them highly vulnerable to abuse. More than 7,770 assisted living facilities for elders are operating in California, an increase of more than 25 percent since 2000.
Once a model for other states, California’s inspection system for assisted living facilities is now one of the weakest in the nation. In the 1970’s and 1980’s, DSS inspected RCFEs twice per year. By the early 90’s, inspections were cut to once per year. In 2004, inspections were slashed to once every five years, with a small number of RCFEs subject to annual inspections. By its own admission, DSS has been unable to comply with the five–year inspection cycle due to lack of resources.
The proposed budget maintains the inadequate five–year inspection cycle, and also cuts the number of RCFEs that are randomly selected for annual inspections by more than half. Currently, 30 percent of RCFEs are supposed to receive random annual inspections. The proposed budget decreases this level to 14 percent.
Increased oversight and enforcement is needed now more than ever. The present oversight system does not ensure the basic care and safety of residents. At the very least, each RCFE should be inspected every two years. Facilities with poor compliance histories should be inspected annually or more often. California should raise licensing fees and increase fines to substandard facilities to help pay for regular inspections.
The proposed cuts also seriously diminish any possibility of the Departments posting information on a centralized web site that would enable consumers to make informed choices about placement in one of the 7,700+ facilities. Information, such as the number and types of complaints, violations, types of enforcement actions, is not available unless consumers visit one of the twelve Community Care Licensing program offices. Even then, consumers are restricted to looking at one facility file at a time, out of hundreds of files.
The cuts are only proposed and are not final, so consumers have an opportunity to notify their state legislators of the importance of increasing oversight of residential care facilities for the elderly, rather than decreasing it, particularly at a time when the growth of these facilities and their residents is at an all time high.