Editorial: Lax protection for the vulnerable

Anyone who abuses, mistreats or neglects an occupant of an assisted living facility, foster home, nursing home or child care center in California is unlikely to ever face penalties, according to disturbing testimony at two recent legislative hearings.

Last week the nonpartisan Legislative Analyst’s Office testified before an Assembly Budget Subcommittee that the state Community Care Licensing Division, which is responsible for inspecting California’s approximately 90,000 nonmedical care facilities, does not consistently impose fines for repeated violations and has no system for tracking whether fines are imposed or collected.

Similar testimony about the state Health Services Licensing and Certification Division in March resulted in a legislative audit committee unanimously ordering an audit of California’s nursing home inspection system. The Legislative Analyst charged that Health Services Licensing fails to detect existing violations, has poor follow-up and consistently fails to meet state standards for timely investigation.

“These are the only two enforcement agencies authorized to provide protection for hundreds of thousands of California’s most defenseless citizens and they are failing in their duty,” said Patricia McGinnis, executive director of the San Francisco-based watchdog organization California Advocates for Nursing Home Reform.

In October 2005, CANHR and surviving relatives of deceased nursing home residents filed suit in San Francisco Superior Court to compel the Department of Health Services to investigate all nursing home safety complaints within 10 days, as required by state law.

The lawsuit charged that investigation is delayed in 60 percent of the cases, which means evidence is gone, staff and witnesses cannot be found and all too often the nursing home patient is already dead.

Officials of the two enforcement agencies insist that their oversight efforts have been weakened in recent years due to cutbacks stemming from California’s budget crisis, which is now easing.
The Schwarzenegger administration is proposing $6.7 million to reform the Community Care Licensing Division, including hiring 80 more inspectors. McGinnis counters that four times as much money is needed to accomplish basic reform.

Community Care Licensing Director Jo Fredrick testified that her inspectors would make twice as many onsite visits this year. However, that is still not enough to assure that every facility would be visited at least once in five years.

California owes its most vulnerable residents and their families effective oversight of the state’s tax-subsidized care facilities. This requires the hiring of at least enough inspectors to fully enforce California’s legal requirements.

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