OF OUR MOST VULNERABLE ADULTS
THOSE WHO ARE AGED- THERE'S THE
MENTAL ILL OR DISABLED LAST
FALL STOP COMMITTEE AND OTHER
LEGISLATIVE. DEPARTMENT OF
SOCIAL SERVICES COMMUNITY CARE
LICENSING STAFF TO LOOK MORE
ABOUT HOW CCL AND DUCKS ITS
OVERSIGHT OF LICENSED
FACILITIES. WHAT THE START
FORCED BE IMPORTANCE PERFORMED
BY TCL. DURING THE UNANNOUNCED
INSPECTIONS OF BOARD AND CARE
FACILITIES ONE OPERATOR WAS
FOUND TO HAVE HE SOLD A LIFE.
RESIDENTS VOICED CONCERNS ABOUT
THE MANAGEMENT OF A LARGE
FACILITY THAT HAD A HIGH
TURNOVER TURN OVER A FACILITY
ADMINISTRATORS. AND ONE
FACILITY WAS FOUND TO BE IN
DESPERATE THIS THIS REPAIR WHAT
IN A VEHICLE OLD WATER HEATERS
AND EVEN A RABBIT. SCATTERED
AROUND THE YARD WITH THE
INCREASING NUMBER OF HORRIBLE
PEOPLE LIVING IN OUR
COMMUNITIES RISING HEALTHCARE
AND HOUSING COST AND SOCIETAL
DESIRE TO LOVE PEOPLE TO RESIDE
IN A LOCATION OF THEIR OWN IN
STATE ROLE IN ENSURING LICENSE
FIRST THESE ARE MEETING MINIMUM
FIFTIES IT'S BECOMES
INCREASINGLY IMPORTANT. HOW THE
TENSION BETWEEN BRECHT FORSMAN
TORY STANDARDS CLUB LINES MUST
BE KNOWLEDGE. IN THIS HEARING
WE WILL HEAR STATE REGULATORS
AT THE CCL THE STATE LONG TERM
CARE. OMBUDSMAN REPRESENTATIVES
OF OPERATORS OF BOARD AND
FACILITIES ADVOCATES FOR
RESIDENTS THE DEPARTMENT OF
AGING AND COUNTY
REPRESENTATIVES WAS CLIENTS
RESIDE IN THE SERVICE. I LIKE
TO CALL MEMBERS FIRST PANEL.
AND ANGELA SHORT AND PAM
DEFAULTS F. YOU CAN PLEASE COME
UP AND WE STAGE NAME AND.
GERMANIZATION REPRESENT. I'D.
SO PLEASE STATE YOUR NAME AND
AFFILIATION WE'RE GOING TO
ALLOW OUR- PALACE TO COMPLETE
THEIR TESTIMONY AND THEN OPEN
FOR QUESTIONS IF THAT'S
ALRIGHT- WITH THE MEMBERS OF
THE COMMITTEE WHICH WE YOU
PAUL- HAVE THEM. COME IN AS A
THE WATCHES OF THANK YOU. GOOD%
AFTERNOON I'M ANGELES SHORT
WITH THE LEGISLATIVE ANALYST'S
OFFICE- I'VE BEEN ASKED TO
PROVIDE A HIGH LEVEL OVERVIEW
OF COMMUNITY CARE LICENSING AND
BOARDED CARE FACILITIES AND
I'LL BE SPEAKING TODAY FROM THE
HANDOUT WHICH I BELIEVE ARE
RECEIVED FROM THE. REALLY CARE
LICENSING OR CCL IS A DIVISION
WITHIN THE DEPARTMENT OF SOCIAL
SERVICES RESPONSIBLE FOR
DEVELOPING AND FOURTH AND
ENFORCING REGULATIONS. TO
PROTECT THE HEALTH AND SAFETY
OF INDIVIDUALS IN VARIOUS TYPES
OF CARE. FACILITIES LICENSED BY
CCL REP PROVIDE SERVICES FOR A
RANGE OF INDIVIDUALS FROM THE
VERY ON TO THE ELDERLY. AS OF
TWENTY NINE BELT MONITORED
ROUGHLY SEVENTY ONE THOUSAND
LICENSED FACILITIES AND A
BOTTLE OF THESE FACILITIES. BY
THE THIRD SAYS FOR NEAR ONE
POINT FOUR MILLION AGAINST. AS
YOU'LL SEE FROM THE CHART ON
PAGE ONE TYPES OF FACILITIES
INCLUDE CHILD CARE ADULTS AND
SENIOR CARE AND CHILDREN'S
RESIDENTIAL CHILDCARE
ACCOUNTING FOR OVER HALF ADULT
AND SENIOR KERR ACCOUNTING FOR
ABOUT TWENTY PERCENT. AND THEN
CHILDREN DONE SHOAL BY. SAYING
ANOTHER 20% SINCE AND
CHILDREN'S RESIDENTIAL INCLUDES
BOTH AUSTER FAMILY HOMES AND
GROUP HOPE FOR FOUGHT WITH.
OVERSIGHT OF ITS FACILITIES AS
PRIME WE PROVIDED BY A
LICENSING PROGRAM ANALYSTS. AS
OF TWENTY EIGHTEEN NINETEEN
ROUGHLY SIX HUNDRED OF THESE
LICENSING PROGRAM ANALYSTS WERE
LOCATED AND AROUND- IN EXCUSE
ME IN THIRTY OFFICES. AND IS A-
ARE THOSE EARLY RESPONSIBLE FOR
CONDUCTING FACTIONS AND
INVESTIGATING COMPLAINTS.
TURNING TO PAGE TWO HOUSE
SPEAKER A BIT MORE DETAIL ABOUT
SEE SALES ROLES AND
RESPONSIBILITIES AND OVERSEEN
FACILITIES. THOUGH ROLES AND
RESPONSIBILITIES FALL INTO
THREE MAJOR CATEGORIES
PREVENTION COMPLIANCE AND
ENFORCEMENT. IN TERMS OF
PREVENTION CCL AIMS TO PREVENT
NON COMPLIANCE BY CONDUCTING
PRE LICENSING FACILITY VISITS
BACKGROUND CHECKS FOR STAFF AND
PROVIDING TECHNICAL ASSISTANCE
AND OTHER INFORMATION ON LAWS
REGULATIONS TO LICENSEES AMONG
OTHER ACTIVITIES. IN TERMS
COMPLIANCE CCL INSURES THAT
FACILITIES ARE IN COMPLIANCE
WITH ALL LICENSING LAWS AND
REGULATIONS BY CONDUCTING
REGULAR INSPECTIONS BOTH
MANDATE AND ANNOUNCED AS WELL
AS INVESTIGATING ALL
COMPLAINTS. IN TWENTY EIGHTEEN
CCL CONDUCT FOR THIRTY THOUSAND
OF THESE ANNUAL VISITS AND
INVESTIGATED ROUGHLY FOURTEEN
THOUSAND COMPLAINTS. AS YOU'LL
SEE IN THE TABLE ON PAGE TWO
THE FREQUENCY OF INSPECTIONS
VARIES BY THE TYPE OF FACILITY.
FOR DON SENIOR SENIOR CARE
FACILITY INSPECTIONS ARE
MANDATED ANNUALLY WHEREAS FOR
CHILDREN'S RESIDENTIAL
FACILITIES INSPECTIONS OCCUR
EVERY TWO YEARS. HEALTHCARE
FACILITIES AT THE END OF THE
YEAR BY THE END OF TWENTY
TWENTY INSPECTIONS WILL ALSO BE
OCCURRING ON AN ANNUAL BASIS.
FINALLY IN TERMS. MENTAL CCL
HAS SEVERAL ENFORCEMENT TOOLS
IT MAY USE. WHEN IT FINDS- A
FACILITY IS OUT OF COMPLIANCE
WITH LICENSING STANDARDS THESE
TOOLS INCLUDE CREATING AND
ENFORCING CORRECTIVE ACTION
PLANS. ISSUING CITATIONS AND
FINANCIAL PENALTY IS REVOKING
ARE SPENDING A FACILITY LICENSE
AS WELL AS APPOINTING A
TEMPORARY FACILITY MANAGER IF A
LIFE- IF OF FACILITIES LICENSE
IS SUSPENDED OR REVOKED. MOVING
ON PAGE THREE I'LL SPEAK
BRIEFLY ABOUT SOME CHANGES TO
SEE SALES FUNDING AND STAFFING
OVER THE PAST SEVERAL YEARS. AS
YOU'LL SEE HERE ON PAGE THREE.
THE SALES FUNDING HAS VARIED
OVER TIME BUT HAS BEEN
INCREASING STEADILY SINCE
TWENTY THIRTEEN FOURTEEN WITH
TOTAL FUNDING REACHING OUT A
HUNDRED AND FIFTY FIVE BILLION
DOLLARS. SIX NINE MILLION
DOLLARS OF THAT COMING FROM THE
GENERAL FUND AS OF TWENTY
SEVENTEEN EIGHTEEN. AND YOU'LL
NOTICE THAT TOTAL FUNDING A
CHANGE IN TOTAL FUNDING IS
REALLY DRIVEN BY CHANGE IN
GENERAL FUND FUNDING WHEREAS
FUNDING FROM FEDERAL
REIMBURSEMENTS AND FUNDS AS AS
REVENUES FROM FEET HE IS A
EXCUSE ME FEET AND PENALTY.
HAVE REMAINED STEADY THE TIME.
AND TURNING TO PAGE FOR. YOU'LL
SEE THAT SEE SEALS TOTAL
AUTHORIZED POSITIONS HAVE ALSO
VARIED OVER TIME BUT HAVE BEEN
INCREASING GRADUALLY SINCE
TWENTY FOURTEEN FIFTEEN AND
TOTAL AUTHORIZED POSITIONS
REACHED AROUND ONE THOUSAND
THREE HUNDRED AS OF TWENTY
EIGHTEEN NINETEEN. LICENSING
PROGRAM ANALYST WITH A STAFF
PRIMARILY RESPONSIBLE FOR
CONDUCTING INVESTIGATIONS-
EXCUSE ME INSPECTIONS AND
INVESTIGATING COMPLAINTS MAKE
UP ROUGHLY HALF OF THOSE
AUTHORIZED POSITIONS. WE KNOW
THAT ALL THESE ARE AUTHORIZED
POSITIONS THEY ARE NOT ALWAYS
FILLED AS OF FEBRUARY TWENTY
NINETEEN CECILE STAFFING
VACANCY RATE WAS AROUND 10% AND
THIS IS ON PAR WITH HISTORICAL
AVERAGES OF STAFFING VACANCY
RATE. CCL MOVING ON TO PAGE
FIVE ON NOW SHIFT MY FOCUS TO
BOARD AND CARE FACILITIES WHICH
ARE THE PRIMARY TOPIC OF YOUR
HEARING TODAY. IN GENERAL
BOARDING CARE FACILITIES ARE
PRIVATE RESIDENTIAL FACILITIES
SERVING ADULTS AND SENIORS WHO
CANNOT LIVE SAFELY ON THEIR OWN
WITHOUT PERSONAL CARE
ASSISTANCE AND NON MEDICAL CARE.
TODAY MY COPS WILL FOCUS ON THE
BOARDING CARE FACILITIES
LICENSED BY CCL WHICH ARE
ADULTS RESIDENTIAL FACILITIES
OR ARTS AND RESIDENTIAL CARE
FACILITIES FOR THE ELDERLY OR
ARE SEE IF YOU. THIS WAS ONLY
BOTH SERVE INDIVIDUALS WITH
VARYING NEEDS INCLUDING PERSONS
WITH DISABILITIES COGNITIVE
IMPAIRMENTS AND MENTAL AND
BEHAVIORAL HEALTH NEEDS. THE
DIFFERENCE BETWEEN THEM IS
REALLY THAT ARTS ARE SERVING
ADULTS OF THOSE AGED EIGHT
FIFTY NINE WHERE'S OUR SEE IF
HE IS OUR SURVEY ELDERLY
CALIFORNIANS EIGHT SIXTY- WE'LL
SEE FROM THE TABLE PAGE FIVE.
THAT THERE WERE OVER TWELVE
THOUSAND ARTISTS AND OUR SEE IF
USED AS OF TWENTY EIGHTEEN
NINETEEN WITH A TOTAL CAPACITY
TO SERVE MORE THAN TWO HUNDRED
TWENTY FIVE THOUSAND
CALIFORNIANS. THIS WAS ALL REAL
RANGE IN SIZE FROM SMALLER
RESIDENTIAL HOMES WITH AROUND
SIX BEDS TO LARGER ASSISTED
LIVING FACILITIES CAPABLE OF
SERVING ONE HUNDRED RESIDENTS
ARE MORE. HOW MUCH BURDEN CARE
FACILITY CAN CHARGE VARIES BY
THE INDIVIDUAL RESIDENTS MANY
RESIDENTS MAY PAY OUT OF POCKET
WHILE FOR OTHERS FACILITIES CAN
RECEIVE A MONTHLY REIMBURSEMENT
THROUGH PUBLIC ASSISTANCE
PROGRAMS SUCH AS THE
SUPPLEMENTAL SECURITY INCOME
STATE SUPPLEMENTARY PAYMENTS
PROGRAM OR THE SS I SS P.
PROGRAM. AS OF TWENTY TWENTY
THE SS I AS AS AS AS P.
REIMBURSEMENT RATE IS JUST OVER
ONE THOUSAND DOLLARS PER
PRESIDENT PER MONTH. AND
TURNING TO PAGE SIX I'LL SPEAK
BRIEFLY ABOUT SOME COMMON
DEFICIENCIES AND BOARDING CARE
FACILITIES. AS I NOTED EARLIER
SEE SALES ROLES AND
RESPONSIBILITIES INCLUDE
COMPLIANCE AND ENFORCEMENT WHEN
CCL FINDS A FACILITY IS OUT OF
COMPLIANCE. IT MAY SITE THAT
FACILITY FOR A DEFICIENCY. AS
OF TWENTY EIGHTEEN THE CCL
CITED AROUND TWENTY FOUR
THOUSAND DEFICIENCIES ACROSS
OUR FACE AN RCF USE AND AS
YOU'LL SEE FROM THE TABLE ON
PAGE SIX THE MOST COMMON TYPE
OF DEFICIENCY IS A BOTH ACROSS
BOTH FACILITY TYPES WERE THE
LATEST OF THE FACILITY BEING IN
SAFE SANITARY AND COULD REPAIR.
ALL TIMES. BUT I WILL MY
COMMENTS AND I'M HAPPY TO
ANSWER ANY QUESTIONS. AND SEVEN
OUT TO MEET OUR HAVE THE NEXT
TO. PLEASE ENTER. YOUR NAME AND
YOUR ORGANIZATION SURE HI GOOD
AFTERNOON MY NAME SCANDIC
FOSSUM THE DEPUTY DIRECTOR FOR
COMMUNITY CARE LICENSING AT THE
DEPARTMENT OF SOCIAL SERVICES.
SO I'M I'M GRATEFUL TO COME
TOGETHER TO AS A COMMUNITY TO
TALK ABOUT PRESERVING BEDS AS
WE'VE BEEN IDENTIFYING THIS
ISSUE FOR THE PAST FEW YEARS
WHEN I CAME TO THIS POSITION IN
TWENTY FOURTEEN. THE BEGINNING
OF SEE OF THE ROOF. YOU LAWS
WERE IN AN AND- RANK IN THE
ACTION IN THOSE A OF NON OF
COMPROMISE HEALTH AND SAFETY-
OF ARE VULNERABLE RESIDENTS.
THE CALIFORNIA DEPARTMENT OF
SOCIAL SERVICES HAS PRIMARILY
HAS PRIMARY RESPONSIBILITY FOR
ENSURING OVER SEVENTY THOUSAND
LICENSE COMMUNITY CARE
FACILITIES PROVIDE A SAFE
SUPPORTIVE AND HEALTHY SETTING
FOR THE ONE POINT FOR ME AND
CALIFORNIANS. EACH OF THESE
INDIVIDUAL THEIR FAMILIES RELY
ON THE STATE TO OVERSEE THE
HEALTH AND SAFETY OF LICENSED
FACILITIES THROUGH FOCUSED
PREVENTION EFFECTIVE MONITORING
AND CONSISTENT FAIR INSURANCE
FOR ENFORCEMENT CARRIED OUT BY
APPROXIMATELY FOURTEEN HUNDRED.
STAFF WITH CLOSE TO FOUR
HUNDRED AND THAT DON'T SENIOR
CARE PROGRAM. SO THEY DON'T
SENIOR KERR PROGRAM HAS
APPROXIMATELY FOURTEEN THOUSAND
FACILITIES WE HAVE ABOUT FOUR
HUNDRED STAFF THAT ARE
RESPONSIBLE FOR DOING ANNUAL
INSPECTIONS AND COMPLAIN
INVESTIGATIONS AS WELL AS
OTHER- ACTIVITIES THAT THEY'RE
REQUIRED TO DO. AND FOURTEEN
FIFTEEN THE STATE HAD EMERGED
FROM THE GREAT RECESSION CCL
LIKE MANY PROGRAMS IN THE
SAFETY NET SERVING BOWL
CALIFORNIA HAD BEEN DECIMATED.
WE THE CARRYING OUT THE BARE
MINIMUM CRITICAL ACTIVE.
SECTIONS OF LIFE THE LEASE A-
BACK FOR ANNUAL TO EVERY YEARS
USING TOOLS THEY DEVELOP TO
JUST TRIAGE FACILITIES HERE
ACTUALLY JUST DOING A QUICK YOU
KNOW WALK AROUND THE FACILITY
TO IDENTIFY THINGS- IN AND
PROVIDE A FULL PICTURE OF THE
OPERATIONS OF THE FACILITY.
THAT'S WHEN THEY HAD DEVELOPED
THE KEY AND- TOLD CALLED THE
KIT. FOR DON'T SENIOR CARE THE
NUMBER OF COMPLAINING VESTED
CATIONS TAKING OVER NINETY DAYS
DURING THREE YEARS IN THIS TIME
DOUBLED FROM EIGHT HUNDRED AND
FIFTY OVER NINETY SIX TO
SIXTEEN HUNDRED- ACTIVITY AIMED
AT HELPING- AND- THE FACILITIES
MAINTAIN. COMPLIANCE AND
PROVIDING INFORMATION LIKE
TECHNICAL SUPPORT WERE EITHER
TOTALLY ELIMINATED OR SEVERE
CUT. PRIOR TO THE RECESSION THE
CITY HAD ITS GOALS. ANALYSTS
EVERY REGION OFFICE. THAT HAD
THAT MONITORED RESIDENTIAL
CARE. THE DATE WE HAVE FOUR FOR
THE ENTIRE STATE BUT WE'VE
TRIED TO IMPLEMENT THAT
TRAINING WITH OUR LIKE OUR L.
PA'S TO ACTUALLY PROVIDE THAT
TECHNICAL ASSISTANCE WHY
THEY'RE ALL RIGHT DOING AN
INSPECTION. SO THE INSPECTIONS
NOW TAKING LONGER BECAUSE OF
THAT BUT IF WE SEE THAT AS
BEING VERY FRUITFUL FOR HELPING
THESE FACILITIES BEEN COMPLY.
I'LL TALK TO LITTLE MORE
FURTHER DOWN. STILL IN FOR AND
FISCAL YEAR FOURTEEN FIFTEEN AS
I SAID WHEN I FIRST CAME ON
BOARD IT WAS AN IMPORTANT YEAR
FOR CCL IT MARKED THE BEGINNING
REBUILDING OUR WHOLE DIVISION.
THE NEEDS OF THE POPULATION
WERE CHANGING THE RESIDENTS
WERE OLDER AND MORE DIVERSE
THAT THE RESIDENTS HAD MORE
COMPLEX BEHAVIORAL MENTAL
HEALTH AND ANY MEDICAL
CONDITIONS WITH CO MORBIDITIES.
SOMETHING THAT WE HAVE BEEN IN
THE PAST AND FACILITY HE'S WITH
HIS PARENTS IS CHANGING THEM
MEANT CTL NOW RESPONSE I'D
SPREAD DEVASTATING DISASTERS
THE FIRES WE REACH OUT TO EVERY
SINGLE- ASSISTED LIVING OUR CFE
ARE FOR. CHILD CARE GROUP HOME
FACILITY IN THE VICINITY OF THE
FIRE TO. OUT TO SEE IF THEY
NEED ANY US AND SO WE'VE ADDED
ON. MUCH MORE COLLABORATION
WITH OUR FACILITIES TO PROVIDE
MORE OF A ASSISTANCE. TO BETTER
MEET THE NEEDS OF THE RESIDENTS
OVER THE PAST FIVE YEARS WE
HAVE ENGAGED IN THE EVOLUTION
OF CHANGE MODIFY IN OUR
DIRECTION TO INCLUDE A MORE BUS
ROBUST PREVENTION AND TECHNICAL
ASSISTANCE FOCUS. TO PRESERVE
THE CAPACITY AND ASSURE QUALITY
OF COMMUNITY CARE. THAT WERE
ANGELA MENTIONED THAT AND WEEK
WE CALL IT THE THREE LEGGED
STOOL WHICH IS PREVENTION
COMPLIANCE AND ENFORCEMENT THAT
WE TRIED TO GIVE A MORE ROBUST
TRAINING TO OUR R. L. P. A.'S
WHEN I GO IN TO DO AN AND-
INVESTIGATION IN A FACILITY.
THE INCREASED FREQUENCY OF
LICENSING INSPECTIONS FROM-
FROM LESS THAN FIVE YEARS TO
ANNUALLY FOR DON'T SENIOR CARE.
IMPROVE THE QUALITY OF THE
REFUSE TO ALLOW COMPREHENSIVE
EVALUATION NOW IN THE
FACILITIES. THROUGH TECHNICAL
ASSISTANCE WE WOULD REDUCE OUR
COMPLAINT BACKLOG- BY EIGHT
HUNDRED THIRTY CASES IN THREE
YEARS. WE ESTABLISHED A QUALITY
ASSURANCE UNIT THE PROVIDES
ACTIONABLE PERFORMANCE DATA AND
PROMOTES DATA IT LITERACY. WE
CREATED A CALL CENTER TO
CENTRALIZE AND STANDARDIZED
COMPLAIN INTAKE AND GIVE THE
PUBLIC WHAT SOME NUMBER. FOUR
COMPLAINTS AND GET THEM. IN
ABOUT MY- OUT THEY HAVE ALL
EVERY SINGLE REGIONAL OFFICE
APPARENTLY AND IT WILL IT WAS.
WE HAD KNOWS OR DOES. IN OF
WHAT PLANES WERE COMING UNLESS
WE DIDN'T. ALTHOUGH OUR FOR ARE
SOCIAL MODEL MANY OF OUR
RESIDENTS HAVE MENTAL
BEHAVIORAL MEDICAL NEEDS
NECESSITY NECESSITATING THE
INTERVENTION OF CLINICAL
PRACTITIONERS IN TWENTY FIFTEEN
WE RECRUITED IN OUR AND TWO
FROM THE PROPS A MINUTE THEIR
FOR THE SYSTEM THIS FILM SENIOR
CARE PROGRAM. AND IN TWENTY
SIXTEEN WE HIRED FIVE READ
REGISTERED NURSES TO ACTUALLY-
PROVIDE EXPERT CONSULTATION ON
A LOW OF THE COMP MEDICAL
SOCIAL ISSUES THAT WE WERE
FINDING ON THESE. MONDAYS IS
THE MOST. THE PRESENT TENSE
BASED COMMUNITY CARE PRACTICES
THEY WERE DEVELOPED FOR BOTH
INTERNAL CCL STAFF AS WELL WELL
AS OUR LICENSEES- THE INCLUDED
IDENTIFYING CHANGES OF
CONDITION BECAUSE THAT WAS ONE
THING THAT WE IDENTIFIED THAT
THE LICENSEE AND THERE'S MORE
NOT TRYING TO KNOW. YOU KNOW A
CHANGE IN CONDITION LED TO
PRESSURE ULCERS- WE HAD. FALL
AWARENESS- PREVENTION OF
PRESSURE INJURIES AND
ALTERNATIVES THE PSYCHOTROPIC
MEDICATIONS BECAUSE I WAS
ANOTHER AREA OF CONCERN. WITH
THE CLINICAL TECHNICAL
ASSISTANCE THE SEALS FOSTERING
RESIDENT CENTERED CARE
RESIDENTS AND CARROTS A
PERTAINS TO THE COMMUNITY
RESIDENTIAL FACILITIES MEANS
STAFF KNOW THE RESIDENT AND
CARE AND SUPERVISION IS REALLY
PROFOUND AROUND WHAT THAT
RESIDENTS PRESIDENT ARE AND NOT
JUST THE HOUSE THAT THEY HAVE
TO DO. RESIDENT COMES INTO A
FACILITY AND THAT USED TO BE
NOT A AND SLEEPING TELL TAN AND
HELP AND BREAKFAST LEVEL WHEN
THEY COME INTO OFFICE THEY MAY
HAVE SER BRECK AT EIGHT THIRTY
EVERY DAY THEY DON'T. PAY AT TO
WHAT THE NEEDS ARE THE OF THE
REPRESENTS THE WAY TO PROMOTE
RESIDENTS THAT ARE. UP IT IS AN
ALL POINT IN. TO ENSURE AS AS
THEIR- REFERENCES. IT CAN I TO
THAT. AS EIGHT PROCESS NEW A
SENSE THE CLUB FACILITIES ABLE
TO MEET REST NEEDS USING OUT
AGENCIES LIKE HOME HEALTH OR
HOSPICE WE HAVE A- PARTNERSHIP
WITH THE PRO IT VRY. KEEN OF
THE TALENTED CLOSE IS THAT WE
IN THE NATURAL DISASTERS NUMBER
THESE THAT. HOW WITH BOOTS ON
THE- FACE THERE'S A VERY CLOSE
PARTNER WITH. ACROSS THE STATE
OMBUDSMAN OR IN THESE
FACILITIES AND WILL COMMUNICATE
TO US THERE'S HEALTH AND SAFETY
ISSUES AND- HOW US IN
ASSISTANCE ONE ARE IS A CLOSER
OF FINDING AVAILABLE BAD.
CLOSER TO CRITICAL TO THIS TO
MANY OF THE IN. WRITTEN
INITIATIVES ENGAGE IN OR TO
HELP PREVENT THE CLOSURES AND
WHEN THEY HAVE- LESSEN THE
IMPACT ON THE RESIDENTS. WE
IDENTIFIED FACILITY CLOSERS A-
THE RISING COST OF HOUSING AND
OTHER BUSINESS COSTS A PLEA
AMONG PLEASE OPERATE IN SMALLER
MARGINS AND SERVING LOW INCOME.
CALIPHATE IN. SO BURNS BECAUSE
THERE WERE THERE TO FOR THE OUR
FEET LIED BILLION AND EVER
SINCE WE WERE USED HOW WE-
IMPLEMENT THE- PARENTS THEY
WERE. ALL OF THE SITE ARE LESS
ON THE WEB AND THERE'S A- AN
ANTI CON. THAT HAPPENED A
ENSURE COMPANY USE. I AS TO
INCREASE THE RATES FOR THE A
LOT OF THESE FACILITIES AND SO
THEY WERE UNABLE TO AFFORD
THEIR LIFE ELAINE AND WHICH IS
A REQUIREMENT THAT WE CHECK
EVERY TIME WE GO INTO A
FACILITY. SO THAT IS THAT IS
WHAT THE CONCERNS. ONE OF THE
IT IS WITH HOUSING. I WANT SIZE
THESE ARE THE RESIDENTS HOME IN
A WAY THAT WERE WE TALK ABOUT
IN BEGINNING. HOW THE CAN DO OF
SO OF THESE HOMES. WE ALLOW THE
SOME OF THAT THAT'S CONSULTANTS
TO ACTUALLY GO AND SHADOW AN
INVESTIGATOR AND INSPECTION
THAT THERE ARE FACILITIES I
WILL SAY THAT HOW THAT ARE NOT
IN GOOD REPAIR- WERE IN THERE
ONCE A YEAR AND THIS WELL WITH
COMPLAIN INVESTIGATIONS. WE USE
OUR TECHNICAL ASSISTANCE AS
MUCH AS WE CAN WHEN WE FAIL. IF
THERE'S HEALTH AND SAFETY
ISSUES WE WAY THAT DIDN'T. WHAT
THE ISSUES ARE AND THAT AND THE
TO SEE IF HEALTH AND STATE IS
WEAK WEAK- ASSIST WITH A
VIOLATIONS WE HAVE. AN OF
ANGELA IN THE DIFFERENT OPTIONS
THAT WE HAVE FOR VIOLATION. ON
SO. ANYWAY THEY THE SSI THERE
WHEN YOU WALK AND SOMETIMES
IT'S A SHOCK SOME OF THE
CLIENTS THAT ARE IN THOSE
FACILITIES THEY HAVE YOU KNOW
BEHAVIORS OF FOURTEEN AND THESE
ARE ISSUES THAT THE LICENSEES
HAVE TO DEAL WITH AND SO IT
DOES IMPACTS SOMETIMES WHAT THE
PHYSICAL PLANT LOOKS LIKE
THAT'S WHAT WE TRY TO PROVIDE
TECHNICAL ASSISTANCE WITH THEM
AND NOT JUST SHUTTING ON DOWN.
LAST YEAR WE HAD APPROXIMATELY
TWELVE HUNDRED ADULTS SENIOR
CARE FACILITY CEASE OPERATION
FOR A VARIETY OF REASONS THAT
SIGNIFICANT WE STILL HAVE
ENOUGH BEDS IN THE STATE WE
HAVE NEVER CLOSE TO FACILITY
AND NOT HAVE A PLACE TO
RELOCATE A RESONANT. BUT IT IS
IT IS CONCERNING THAT THE
NUMBER THAT ARE CLOSING. I'M
MORE NOTIFIED OF A POTENTIAL
CLOSER WE CONDUCT THE VISIT OF
THE FACILITY WE HAD TO WE
REQUIRE THAT THE LICENSEE TO
ATTEND A MEETING HELD AT THE
REGIONAL OFFICE. TO TALK ABOUT
THEIR CLOSER PLAN AND WHAT ARE
THE NEXT STEPS- WE CONTACT OUR
PARTNERS SUCH AS THE REGIONAL
CENTERS BEHAVIORAL HEALTH
OMBUDSMAN PUBLIC GUARDIAN TO
HELP US LOCATE BEDS APPROPRIATE
BEDS FOR THE RESIDENTS. AFTER
RELOCATION WE CONDUCT THE
WELFARE VISIT WITHIN THE NEXT
MONTH OF ALL RELOCATED
RESIDENTS TO ASSURE THEIR
HEALTH AND SAFETY. THE
PARTNERSHIPS WE HAVE WITH OUR
STAKEHOLDERS INCLUDING THE
ADVOCATES FOR THE RESIDENTS IN
THE PROVIDER ASSOCIATIONS FOR
THE FACILITIES CANNOT BE
UNDERSCORED ENOUGH. WE WORK
CLOSELY ON A VARIETY OF ISSUES
THAT IMPACT THE QUALITY OF LIFE.
THIS INCLUDES UPDATING
REGULATIONS WHERE WE'RE
CURRENTLY WORKING ON DEMENTIA
INCIDENTAL MEDICAL AND DENTAL
UNIFORMS TESTAMENT TOOL AND
BROWN'S- STAFFING RATIOS. AND
IDENTIFYING PRIORITIES FOR
SYSTEM IMPROVEMENT WITH ALL OF
THESE CONCERNS IT REALLY. IS
IMPORTANT THAT WERE ALL AROUND
THE TABLE AND LOOKING AT THE
BEST AND- ENVIRONMENT FOR THESE
RESIDENTS. IN CLOSING OVER THE
LAST SEVERAL YEARS OF LICENSING
HAS BEEN WORKING WITH AND
CURRENT RESOURCE TO BUILD A
STRONG FRAMEWORK TO SUPPORT OUR
MISSION. NOW IN THE FUTURE THE
CURRENT ISSUE OF CCL HAS
ENGAGED IN THE AREAS OF
STATUTORY REGULATORY REFORM. US
REMEMBER GAGE WAS STAKEHOLDERS
COMPREHENSIVE PROCESS
IMPROVEMENTS INFRASTRUCTURE
REBUILDING STAFF DEVELOPMENT
AND EMPOWERMENT FOSTERS THE
FULL OF COOPERATION PREVENT
DISTANCE A STEP BACK. THE BACK
IN MEN. THE END OF A- AND- FOR.
ALL CAN COMMITTEE READ.
FACILITIES WE I HAVEN'T ABOUT
THE INS TOLL THAT WE THE THAT
IS MUCH OF A MUCH MORE WERE.
TOOL TO REALLY ABOUT THE
MEASURE OF THE FACILITY THAT
MEETS ALL OF THE REGULATIONS SO
I PROVIDED YOU WITH A LITTLE
HAND OUT- TO TERROR AND THAT
SHE CAN KIND OF SHOW THIS IS
WHAT THE TOOL- INCLUDES SO IT
INCLUDE. WE GO THROUGH INSTEAD
OF. JUST LIKE A WALK THROUGH
THIS IS SOMETHING THAT HITS ALL
OF THEM STORY OF THE REGULATORS
OR AT LEAST A PIECE OF ALL THE
REGULATIONS SO WE'RE LOOKING AT
ALL I'LL ASK. THE SOUL. IF YOU
HAVE QUESTIONS. LANCE THANK YOU
ALL FOR START UP THE-
QUESTIONS- WILL GO AHEAD AND
START FIRST AND ASKED TWO
QUESTIONS OF THE PANEL THE
FIRST ONE I KNOW THAT YOU JUST
TO BRIEFLY TOUCHED ON THE
INSPECTION THE NEW INSPECTION
TOLD TO UP WHAT IS IT. WHAT IS
THE STAFF SPONSOR THAT TODAY
TOOL I'M THE STAFF- YOU KNOW
IT'S STILL NEW TO THEM IT'S
JUST BEEN IMPLEMENTED FOR
SENIOR CARE AND ADULT CARE WILL
BE AND IMPLEMENTED- IN. MARCH
SO. WE HAD A LOT OF THAT THE
ACTUALLY THE LPS THAT DO THE
INSPECTIONS WORK WHEN WE WERE
DEVELOPING THE TOOLS SO THEN WE
WOULD HAVE THEM TESTED ME WOULD
GET FEEDBACK FROM THEM IS THERE
THAT THE SUBJECT MATTER EXPERT.
EVERYBODY KNOWS THE LICENSEES
NO AND OUR STAFF KNOW IT TAKES
LONGER SO IT TAKES LONGER BUT
YOU'RE GETTING YOUR GETTING A
SENSE OF THE QUALITY CARE NOW
WE COULD GO IN THERE AND COME
IN AND OUT CHECK OUT THE BOX
THAT WE DID OUR ANNUAL
INSPECTION THE KIT. I'M NOT WE
WERE LESS TYPE OF. IT'S GOING.
YOU KNOW EVERY TIME WE WOULD GO
BACK GET A COMPLETE LIKE THEY
DIDN'T UNDER THAT THE
REGULATIONS SO THE WAY THE TOOL
IS DEVELOPING IS THE LPA
ACTUALLY GOES OVER THE
REGULATION SO THEY UNDERSTAND
THEY HAVE AN OPPORTUNITY TO ASK
QUESTIONS SO- WE GOT WE DID A
SURVEY A WEEK LEFT TO SURVEY
WITH THE LICENSEE FOR EVER THAT
WE DID WE DID A SURVEY IN THE
PILE. SO WE GOT FEEDBACK FROM
THE LICENSEES. SO WE TOOK THAT.
CAN WE CAN'T MODIFY MODIFY
MODIFY. AND WE FINALLY YOU KNOW
PUT PENS DAY IN THIS IS THE
START. SO WE HAD TO DEVELOP A-
TOOL FOR ALL EVERY FACILITY
TIED IN ARM IN ARM THE VISION.
SO WE JUST WE DON'T HAVE THE
RESOURCES TO DO EVERYONE AT ONE
TIME BECAUSE IT'S IT TAKES A
LOT OF THE POLICY STAFF TO LOOK
GO TO ALL OF THE REGULATIONS
AND- BECAUSE WE DEVELOP. I
DON'T WANT TO GO INTO THE WEEDS
BUT THERE'S DOMAINS THROUGHOUT
THE TOOL THAT ARE THAT ARE. AT
THAT ARE REAL TO REBELS ELATION
SO YOU'RE BEING. YOU ALL OF THE
CALLS IN THE REGULATE IN THE
STOOL. SO WHERE CONSTRUCT. BACK
FROM THE LAB AND THE AND OURS.
OUR STAFF YOU ARE STILL BE USED
TO IT IT'S TAKEN LONGER WE FEEL
AFTER THEY'VE USED IT FOR A
WHILE THIS IS NEW TO THEM. THAT
WE'RE GONNA BE MORE EFFICIENT
WITH IT SINCE WE'VE JUST
STARTED THIS IN NOVEMBER WITH.
WAS SENIOR KERR WE'RE WATCHING
IT VERY CLOSELY TO SEE AND YOU
KNOW IF FOR IDENTIFYING AND
EFFICIENCIES. THANK AND THEN
THE SECOND QUESTION THAT I KNOW
YOU TOUCHED ON A TECHNICAL
ASSISTANCE IN THE IN THE YOU
HAVE. HE TELLS BUT MORE BY THE
FIRST THESE ARE ARE WAS SENT
OUT- PREFERRED OVER TO YOUR NET
SO THEY'RE ACTUALLY REFERRED
THEY CAN'T SELF. SUBSCRIBE TO
THE LICENSE SO IT ACTUALLY. TO
BE- SUBMITTED FROM THE L. P.
A.'S AFTER THEY'VE BEEN IN THE
FACILITY AND IT'S SOMETHING
THAT'S BEYOND. WHAT THE EPA HAS
TIME TO DO BECAUSE WHAT WE'RE
TEACHING THE LPS ACTUALLY GIVE
THAT TECHNICAL ASSISTANCE WHEN
THEY'RE THERE ON SITE WHEN THEY
CAN. IF IT'S SOMETHING THAT'S
MORE ADVANCED- THEN THEY THEY
RECRUIT THE TECHNICAL
ASSISTANCE YOU KNOW BUT LIKE I
SAID WE ONLY. FOR THE STATE AND
IT MAKE VERY BUSY. WHAT A- BAD.
WELL IF LIKE WE- OF. SAMPLE ONE
CASE A OF THE- AND- STOCKTON.
WAS JUST COULD NOT GET RID OF
BED BUGS AND THERE'S BED BUGS
AND A LOT OF THE LOWER INCOME
FACILITIES. IT'S NOT THAT YOU
CAN JUST BROKE OUT PEST CONTROL
AND GET RID OF IT SOMETHING
THAT YOU CONTINUALLY HAVE TO
WORK ON. WHEN THE RESIDENTS ARE
FREE TO COME AND GO- INTO AN
ADULT RESIDENTIAL FACILITIES
YOU KNOW THEY COME BACK AND SO.
OUR TECHNICAL ASSISTANCE
ANALYST ACTUALLY WENT OUT THERE
AND DID SOME RESEARCH AND FOUND
THESE THEY'RE CALLED HOT BOXES
THAT THEY COULD PUT LIKE THEIR
SHOES AND THEIR- SOCKS AND WHEN
THEY CAME BACK. SO THE AND THEY
WERE FAIRLY INEXPENSIVE FOR
THE- THE SILLY SO I MEAN THAT
THEY DID THAT- THEY THEY- THEY
LOOK AT WHATEVER THE VIOLATIONS
ARE AND- THEM UNDERSTAND THIS
IS WHAT. WE DO TO REMEDY TO
ASIAN LOT OF THE LEAST OF THE-
IS THE COULD ROUGH NEEDS WERE.
THE KEEP PASS UP THE REALLY
NEED WHOLE NEW THEY DO DON'T
HAVE FINANCE FOR IT BUT- IT
THEY CALLED AND- TRAINING OF
MEDIC. THEY THEY HOW THEY OF.
STORE MEDI I'M DEPENDS ON WHAT
ISSUE IS IN THERE HAVE WE GUY
THAT ARE TECHNICAL UNIT DRAFT
THAT WE PUT ON OUR WEBSITE FOR
OUR PROVIDERS AND- THE
TECHNICAL SYSTEMS ANALYST
ACTUALLY GO OUT THERE WITH THE
RESOURCE GUIDE GIVE IT TO THEM
AND SHOW THEM THIS IS WHAT HOW
YOU CAN DO IT IF THEY THEY HAVE
A PROBLEM WITH THE RECORDS HOW
THEY THEY- THE DOOR THEIR
EFFORTS FOR THEIR STAFF OR
THEIR OR THEY'RE AND MET THEIR-
RESIDENT. THEY HELP JENNIFER
THIS IS YOU CAN SEE THAT YOU
KNOW THE ACTUALLY WORK WITH
THEM TO SET IT UP CORRECTLY.
WELL THANK YOU I DO A MEMBERS
OF THE COMMITTEE HAVE ANY
QUESTIONS AND I SAW. A CENTER
PAN FOR FREE AND. RIGHT THANK
YOU VERY MUCH I APPRECIATE YOUR
PRESENTATION- SO IN TERMS OF.
THE BOARDING CARE FACILITIES
THANK YOU MADE REFERENCE THAT
ACTUALLY ARE WE LOSING NUMBER A
DECREASING YOU SAID YOU THERE
ARE SEVERAL BECAUSE I AM TRYING
GET SENSE OF LIKE. CLOSER
VERSES OPENINGS. OKAY SO WE'RE-
WE'RE TRYING TO FIGURE OUT
EXACTLY- WHICH- TO PUT IT. I'LL
JUST PUT IT REALLY THINK WE
THAT OUR BY OUR CAPACITY IS
VERY MUCH THE SAME IN THE LAST
FOUR YEARS OKAY TO THE LETTER
BUT BASS CITY WERE NOT BUT THE
SSI BEDS WERE SEEN OUR BEING
THOSE OF THE FACILITIES THAT
ARE SHUTTING DOWN IT'S GETTING
THE COST OF LIVING THE RANTS.
OF THE COST OF INSURANCE OF
THAT OUR ART IN SO WE'RE REALLY
DOING AN ANALYSIS RIGHT NOW TO
REALLY FIGURE OUT WE'VE SENT
SURVEYS OUT TO THOSE THAT
CLOSED IN THE LAST YEAR TRYING
TO GET A SENSE OF YOU KNOW WHY
THEY CLOSED AND YOU KNOW
BECAUSE WE DO TALK TO THEM BUT
WE HAD WE DON'T HAVE THAT WE
HAVE A CAPTION THAT IN THE DAY
THIS IS. SO WE'RE LOOKING AT
THAT CLOSELY BUT BUT THE OF THE
SIDE BAD ONES THERE SUFFERING
AND TRYING TO OPEN SO IF. A
LOOK AT THE- THERE. CLOSE TO
FIND A CHANGE OF OWNERSHIP.
THERE YOU KNOW THEY WORK FOR
CHANGE OF ON. YOU KNOW IF YOU
SIXTY BEDS THAT THAT'S- THAT.
AND SMALL. AND SO WE'RE
WATCHING IT VERY CLOSELY WE
CANNOT IDENTIFY BASED ON OUR
DATA SYSTEM BUT WE'RE STILL
WORKING ON IT HOW MANY SSI
CLIENTS WE HAVE WERE WERE WE
GET DATA FROM DEPARTMENT OF
HEALTH CARE SERVICES OF EVERY
CLIENT THAT THEY'RE PAYING
CLAIMS ON WITH SSI AND WE MATCH
OUR ADDRESSES SAUDIS BUT YET
STAFF OR THAT ARE LIVING
FACILITIES THE OWNER SO THESE
THEY COULD BE THERE YOU KNOW.
COUNTING THEM BECAUSE THEY'RE
COLLECTING US AS THE- AND IT
COULD BE STAFF SO WE DON'T HAVE
A SOLID NUMBER ON IT WE JUST
HAVE A BALL PARK BUT WE'RE
WORKING TO SEE HOW WE CAN
REFINE THAT. A AND THEN. SO
BASICALLY WE'RE LOSING SSI BAGS
I USE THAT AS A MASTER RACE
OKAY SO THAT THE BIGGER PRIVATE
FACILITIES ARE OPENING UP SO
THE BEDS ARE LIKE CAPTURED WHEN
YOU LOOK HURDLE CAPACITY IN THE
STATE IT'S NOT SHOWING THE
UTTERANCE BUT IS ESSENTIALLY
IT'S BEEN LEVEL FOR THE LAST
FOUR. HAVE PASS THE RIGHT. OKAY
I'M AND I WOULD MAKE NO THAT
PART AND OUR POPULATION'S AGING
SO THE THAT. SO YOU THINK THAT
THE ACTUAL DEMAND FOR THESE IS
ACTUALLY EVEN THOUGH OUR
CAPACITY IS THE SAME AS
ACTUALLY GOING UP IS THAT. AND
IT'S I MEAN I DON'T WANNA STAYS
EXACTLY THE SAME IT KIND OF
GOES FLUCTUATES GOES UP A
LITTLE BIT THIS YEAR AND THEN
DOWN WELL AND SO I GUESS MY
CONCERN IS THAT IS IF YOU LOOK
OUT TEN YEARS TWENTY YEARS
YEAH. ARE YOU YEARS. WHAT WHAT
WERE WE IN TURN OF OUR- TO
PROVIDE CARE. AND WHAT HAPPENS
TO THOSE PEOPLE THEY CAN'T FIND
A- THE BAD THAT'S THAT'S
EXACTLY WHAT WE'RE LOOKING AT
IT VERY CLOSELY WHERE WE ARE
NOT CLOSE TO THAT YEAH THAT
WILL IT IS SOMETHING WE'RE
LOOKING OUT BECAUSE OF THE-
BREVITY OF HOW MANY ARE CLOSING
OKAY SO RIGHT NOW WE DON'T HAVE
A PROBLEM WITH THAT. FIND IN A
BAD FOR ADDRESS AYE CLIENT BUT
IT IS SOMETHING THAT WE IS
WE'RE WATCHING VERY CLOSELY AND
SEE WHAT WE CAN TO PRESERVE
THESE FANS TO HELP THEM FROM
CLOSING. OKAY I APPRECIATE.
MONITORING BUT I ALSO HOPE THAT
THERE ARE SOME. OBJECTION IN
PLANNING FOR THE FUTURE SO WHEN
IT'S SO I KNOW WE HAVE A MASTER
PLAN ON AGING GOING ON THIS
THIS IS THIS SOMETHING THAT
YOU'RE AGENCIES BEEN ASKED TO
PROVIDE INPUT TO ARE NOT JUST
IN. THE FLIGHT DATA FOR. YEAH
THEY'VE ASKED US FOR DATA BUT
WE'RE ALSO LOOKING AT HOW WE
CAN FIND OTHER AVENUES TO
INCREASE THE NUMBER OF THAT
SAID THEY WERE LOOKING AT
OTHER. YOU KNOW I DO WE NEED TO
THE STATUTE WE'RE LOOKING AT
DIFFERENT OPPORTUNITIES FOR THE
WIND WHEN CAN WE IS THE
LEGISLATURE EXPECT SOME SORT OF.
BROOKE BUT OUR WHATEVER T. IN
TERMS OF THE THINGS THAT YOU'RE
AGENCIES LOOKING AT SO I
APPRECIATE YOUR LOOKING AT AND
STUDYING AT I LIKE TO HAVE A
SENSE AND TIME LINE AS TO WHEN
WE SHOULD BE AT YEAH BECAUSE
YOU KNOW BY THERE AND WE DO AT
THE MOMENT BUT WHAT THE WHEN
SHOULD BE ABLE TO ACT. I DON'T.
FROM YOUR TO. AS FAR AS SOME
ANSWERS AS TO WHAT YOU WOULD
SUGGEST IN TERMS OF HOW WE
EXPERIENCE YEAH WHAT HAVE BEDS
WE NEED AND HOW WE GET THERE.
I'LL HAVE TO GET BACK TO YOU ON
A TIME LINE I MEAN WE CAN
PROVIDE. INFORMATION WE DON'T
HAVE A REAL ROBUST DATA SYSTEM
BUT WE HAVE WE KNOW WHAT OUR
CAPACITY IS BECAUSE WE'VE- WE
ARE WE ARE WE ARE WE TALKING
ABOUT MONTHS EARLY TALKING
ABOUT THE- HOW LONG WILL IT
TAKE. I MEAN WHEN SOMEONE SAYS
THEY'RE LOOKING AT OUT WHAT
WHAT'S WHEN. I SAID I KNOW YOU
I GIVE ME A PARTICULAR I DON'T
BUT EATS AYE AYE WHY SAID THE
SCALE OF THE TALK ABOUT NEXT
YEAR WE TALKING ABOUT I WOULD.
BUDGET AND I'M ON OF NEXT YEAR
BECAUSE THERE'S A LOT OF
FACTORS THAT INCLUDE THAT WE
DON'T GO OUT AND RECRUIT PEOPLE
TO APPLY THAT WE PROVIDE DATA
THAT SAID. IS WHAT MORE WE'RE
GOING TO WHAT WE NEED. OKAY
WHAT WHAT ARE ROLE IS TO
MONITOR THE FACILITIES FOR THE-
COMPLIANCE WITH HEALTH AND
SAFETY AND TO HELP THEM FROM
GOING. OUT OF BUSINESS AND-
STAND THE MASTER PLAN THEY'RE
SUPPOSED TO COME OUT WITH A
REPORT IN OCTOBER RIGHT. I GET
FRANKLY EVERY GUY SHOULD WE
DEAL EXPECT SOMETHING BY
OCTOBER. WE'LL HAVE TO GET BACK
TO YOU ON THAT BECAUSE THE
MASTER PLAN IS NOT PART OF US
THE MASTER PLAN IS SOMETHING
THAT. IT WAS THE A PROPOSAL. BY
THE ADMINISTRATION FOR THE TASK.
RIGHT RIGHT BUT I WOULD THINK
THAT THIS IS WILL YOU TELL ME
IS IT IS IT IS IT IS A CRITICAL
SOURCE OF. SERVICES FOR SENIORS
IS A- WARNING AREA DEFINITELY
OKAY ALL RIGHT SO I HERE
DEFINITELY I WOULD AGREE WITH
THAT THEN WOULDN'T THAT
SHOULDN'T PROJECTIONS ABOUT
WHAT WE SHOULD DO IN THE FUTURE
BE INCORPORATED INTO THE MASTER
PLAN WHICH IS FIRST COME OUT
OCTOBER I WOULD THINK SO. OKAY
SO THAT MEANS OR AGENCY
HOPEFULLY IS PROVIDING
INFORMATION TO THE COMMISSION.
AND THIS WOULD AND HOPEFULLY
SOME RECOMMENDATIONS TO THE
COMMISSION BECAUSE AFTER ALL
YOU'RE CLOSER TO THE DATA THAN
ANYONE ELSE- IS TO HAVE WHAT
KIND OF RECOMMENDATIONS THEY
WOULD MAKE.IN OCTOBER ATTRACT
TIED. OKAY SO I WOULD HOPE THAT
BY THE TIME THE MASTER PLAN
CAME OUT. AT YOUR AGENCY WOULD
HAVE. RECOMMENDATIONS THAT THEY
WITH NOW WHETHER ACCEPTED BY
NOT BY THE COMMISSION THAT'S
ABOUT A WHOLE DIFFERENT ISSUE
BUT- CERTAINLY BEFORE OCTOBER
CERTAINLY BY THE TIME OF
OCTOBER. HOPEFULLY THE WORK
THAT YOU'VE BEEN DOING IS GOING
TO BE BOTH INFORMING THE MASTER
PLAN BUT YOU COULD ALSO PERHAPS
REPORT INDEPENDENTLY AS TO WHAT
YOU WOULD SUGGEST TO TAKE CARE
AT. IN TERMS OF PROJECTIONS AS
TO WHAT I DEMANDS AND NEEDS ARE
FOR. THE CARE HOMES CORRECT I
COULDN'T AGREE WITH YOU MORE
BUT I WILL SAY THAT THESE ARE
JUST THESE RECOMMENDATIONS I
BELIEVE THE HOUSE. OVER AT THAT
TIME THAT YOU KNOW ONCE THAT.
COMES OUT OF THAT ITEM WE HAVE
SEEN THEN I IT BUT I MEAN I
WOULD EXPECT. YOUR EIGHT. I'M
SORRY SERVICE. WOULD HAVE. THIS
IS YEAH. THERE IS. OF THE
MASTER PLAN OR A AT THE TIME.
OF IS YOUR SUCH AND- PART OF IT.
THAT YOU COULD RELATE TO.
ABSOLUTE BY OCTOBER. CENTER
PANEL I JUST WANT TO DROP TO WE
DO HAVE THAT A DIRECTOR UP FOR
A DEPARTMENT OF AGING THAT
MAYBE OKAY ABLE TO ANSWER. UP
SOME OF THE QUESTIONS THAT YOU
HAVE HERE OKAY WELL THIS IS
THIS IS THE CIVIC THE SERVICE.
YEAH THAT'S RIGHT SO I KNOW I
WILL OKAY WELL I. WILL GET BACK
THANK YOU AYE AYE WOULD EITHER
APPRECIATE YOU GETTING BACK TO
MY ON THAT AND- BUT I AM VERY
VERY YOU KNOW I'M JUST ALSO
LOOKING AT OTHER TIMELINES AND
I WANTED. TO HEAR THAT- WERE
WERE ON TOP OF THIS AND- I.
LITTLE BIT. SURE THANK YOU. CAN
JOHNSON AT DIRECTOR OF THE PART
AND SOCIAL SERVICES THANK YOU.
I WE ARE ABSOLUTELY LOOKING AT
THIS ISSUE I WANT TO SHARE WITH
YOU PART OF THAT GOVERNOR'S
PROPOSAL IN THE JANUARY BUDGET
FOR THE CALIFORNIA ACCESS TO
HOUSING SERVICES FUND IS. AT IN
PART- A PROPOSAL TO STABILIZE.
THESE PARTICULAR RESOLUTELY
TYPES. ABSENCE ABSOLUTELY OUR
COMMITMENT WITH THAT IT'S A
PROPOSED TO BE DONE THROUGH
REGIONAL ADMINISTRATORS AND SO
THE REGIONAL AT THE REGION'S
WOULD PROPOSE TO ACCESS. THE
ALLOCATION THAT'S GOOD. AT
DEDICATED TO THAT READ AND HOW
THE WHOLE SPECIFICALLY USED
PLAYERS THAT CATER TO. PRESENT
CARE. THE CONCERT. IS SINCE.
ODD THE BOARDING CARE
FACILITIES. BOTH WITH POTENTIAL
IT MIGHT BE. FORMATS FOR
RESOURCES PARTICULARLY FOR. THE
FIVE. SINCE THAT ARE THERE- I'M-
EVEN SOME OF THE HERD ADD TO
DIRECTOR DICK SMITH GEN AS HE
ACTION CAN DO. OF A PERSON TYPE
SO IF WE WERE TO. OR REGIONAL
ADMINISTRATOR WAS TO STOP THAT
PARTICULAR. LET'S SAY THE ROOF
EXIT THAT WE PROVIDED. THAT
WOULD BE DONE IN EXCHANGE FOR
RENTAL CREDITS AND SUPPORTS
AFTER THAT POPULATION SO WE
ABSOLUTELY AS AN ADMINISTRATION
ARE APT ARE DEDICATED AND
COMMITTED TO SUPPORTING AS
SUSTAINABLE. OPTIONS FOR THIS
FACILITY TYPE IN LOOKING AT
THAT AS A CONTINUUM OF CARE FOR
THE POPULATION AND IT CERTAINLY
APPRECIATE THAT AND LOOK
FORWARD TO HEARING MORE ABOUT.
THE GOVERNOR'S PROPOSAL IN OUR
BUDGET SUB. WHICH I KNOW BOTH
OUR TITLE I SIT ON AND BUT I
ALSO WANT TO AS AN AND THIS.
MAN TERMS OF YOUR ANALYSIS OF
WHAT'S GOING ON RIGHT SO I
APPRECIATE ACTUALLY THE FUNDING
HELPS THIS DRESS THESE ISSUES
OUT HAVING BEEN OUT. BUT THE
NEEDS ARE FOR BOARD CAN'T ERROR
IS THE LADIES AND BAD BECAUSE
IT'S YOU KATE AND I APPRECIATE
YOU SHARING WITH US. YOU KNOW
WHERE. HE BASICALLY. YES OF THE
STATE FOR THE LAST FOUR YEARS
WITH INCREASING AGING PA. SO
YOU GET A THERE'S A- CENTRAL
GAP THAT'S WHY EVERY THAT USED
NOW YOU FIND AT THAT FOR
EVERYBODY BUT- SUPPLY STAYS
HERE. THE MAN DOES THIS TO
BASED ON THE- ALONE. WE GET A
WE IT WILL WE WOULD LIKE TO OF
THESE ISSUES THEN TRY TO HANDLE
THEM AS A CRY. SO RIGHT SO I
APPRECIATE THAT I'M JUST TRYING
TO GET A BETTER. OF AND I AM DO
YOU AT THAT TIMELINE WHEN WE
EXPECT SOME ANSWERS- ON SOME OF
THOSE QUESTIONS AND AGAIN
THAT'S BECAUSE I HAVE A
TREMENDOUS FAITH IN YOUR
DEPARTMENT AND THE- AND THE TO.
HELP US PROVIDE THAT ANALYSIS.
IT WE ABSOLUTE CAN SHARE BOTH
THE AND- IF THE MASTER PLANNING
AN AGING EFFORT OBVIOUSLY
THERE'S A NICE SOLID OVERVIEW
THE DEMOGRAPHICS THE TRAINS
THAT YOU'RE REFERENCING AND SO
WE CAN ABSOLUTELY CARE THAT
KIND OF WHAT WE'RE SEEING IN
TRENDS OF THIS CARE. AND LOOK
AT A PROJECTION WE CAN WE CAN
SAY THAT ARE THANK YOU SO VERY
MUCH MAY I ASK ONE MORE
QUESTION THANK YOU. SO THE
OTHER ONE IT. LATER THE
INSPECTION PROCESS. AND THE
AND- I KNOW THAT. BUDGET JUST
CLEAR FACTS AND EX I KNOW YOU
TRANSFER SWITCH FROM THE WHAT
WAS THAT FIT. HE ENDED YET AND
THEY FELL RIGHT THE KEY
INDICATOR TO SO IS THE NEW
PROCESS ALSO SORT OF. A
STANDARD COMPREHENSIVE IS THAT
ALSO USING KEY INDICATORS
PARTICULAR DOMAINS ARE. YES YES
OKAY YES ALL RIGHT AND SO
BASICALLY SIR BILLS I KNOW IT'S
NOT AND IT BUILDS A LITTLE BIT
ON THAT YES THAT THE DOLLAR YET
RIGHT. AND I GUESS THE JUST THE
QUESTION ABOUT SO CERTAINLY WE
HAVE THE INDICATORS AT IF
THERE'S A PROBLEM AND THEN
TREAT. FOR THAT. AT THE END
ENTER INSURING THE IN THE- HAVE
ARE SUFFICIENT TRIGGER. FOR
FURTHER INVEST HAVE YOU CAN FOR
DUE A SAM. OF FACILITIES WHERE
YOU DO GET OUT A SUBSET WHAT
YOU MIGHT DO A MORE
COMPREHENSIVE AND THAT SAY HEY
DID THOSE TRIGGERS ACTUALLY
FIND THE THINGS WE FOUND OUT A
MORE COMPREHENSIVE. THOSE IT'S
DOING ITS JOB THESE ARE THE
METHODOLOGY IS- IS SUFFICIENT
TO DO RECKON WHATEVER NOT
EVERYONE BUT MAYBE IT'S NOT
LIKE ANY WE ACTUALLY GOT IT DID
THREE TAXES UNFORTUNATELY THAT
MAY NOT BE THE BEST ALLERGY
BUT- TRYING TO FIGURE OUT LIKE
YOU KNOW WHAT THE- PATTERNS
ARE. WE ACTUALLY OUR PILOTS
INCLUDED THE CONFERENCE
PRETENCE OF TRIPLE SO THAT OKAY
GOT DONE IF I THE TRIGGERS IF
THIS IS THIS IS IDENTIFIED AS
THE VIOLATE THAT USUALLY. SOME
OVER HERE THIS CALL MAY. THE WE
ACTUALLY WILL COME. FULL
ALRIGHT PILOTS SO THAT.
MISSIONARIES. OKAY SO I WOULD
DISTANCE THINKING ABOUT THAT ON
A MORE ON. YEAH THE PILOTS BUT
TO BE SHE THAT THE WI STILL YES
OKAY WE PLAN ON DOING DANIEL
AND OKAY THE HAND OUT I DO SOME
OF THE TRIGGER BUT AND THAT AND
THEN. THE FORMER FOR IT SO THAT
THAT IS GOING TO CALL IMPROVE
IT'S SO. LAWS ARE CHANGED TOOLS
UPDATE THAT THEY'RE CONTINUALLY
ANALYZING THE DATA- SO IT'S NOT
SOMETHING THAT'S GOING TO BE
STATIC ALL OF THE TIME WE'RE
GOING TO CONTINUE TO MANAGE TO
MAKE SURE THAT THESE TRIGGERS
ARE ACTUALLY- NOT. CHANGING DUE
TO YOU KNOW OTHER FACTORS AND
THE FACILITIES THAT ARE TAKING-
TAKE PLACE ALL RIGHT IN APRIL.
THE TENSION BETWEEN YOU COME IN
AND YOU FIND A FACILITY THINGS
ARE. BUT UP. IN MUCH OF ITS
RELATED SO. TIMES IT'S THE WHO
MAY CERTAIN. NEEDS OR SOMETHING
THAT MAY MAKE IT MORE
CHALLENGING AND SO FORTH AND WE
DON'T JUST CLOSE BECAUSE OF A
LOSS WHEN WE SURE PEOPLE ARE IN
SAFE YOU KNOW. HEALTHY
FACILITIES SO. I APPRECIATE
THAT AND- CERTAINLY LOOKING
FORWARD TO HEARING SOME OF THE
OTHER THE FUTURE PANELS WHO
MAY. HAVE SOME IDEAS ABOUT THAT
AS WELL OKAY RIGHT WELL THANK
YOU VERY MUCH AFTER. SENATE
JACKSON YEAH VERY BRIEFLY I
THINK- I SHARE OBVIOUSLY DOCKED
PAN HEADS IS SUBCOMMITTEE IN IS
RIGHT ON TOP OF THE NUTS AND
BOLTS OF IT BUT- I JUST WANT TO
REITERATE. THIS IS A PROBLEM
THE DAM IS ABOUT TO BREAK ON
THIS ISSUE AND- WE CANNOT
AFFORD ANY LEVEL OF COMPLACENCY
HERE AS WE- AGAIN WE CAN ME
WHAT WE HAVE TODAY BUT WITH
THE- SENIOR POPULATION EXPECTED
TO DOUBLE BY THE END OF TWENTY
THIRTY- THERE IS AN URGENCY
HERE AND I JUST WANT TO.
REINFORCE OF MY SENATE AND I
THINK THE SHARED BY THOSE OF US
IF YOU JUST LOOK AT THE
NUMBERS. THIS IS WE NEED SOME
VERY VERY PROACTIVE ADVOCACY.
OF FROM THE AGENCIES THAT ARE
GOING TO BE TASKED WITH THIS-
AND WE NEED TO DO MORE PENSION
SIMPLY. SO I BUT THERE IS TODAY.
THERE IS HOLES I DON'T WANT SAY
TSUNAMI BECAUSE I KNOW THAT TO
ADVERSE WORD OR NEGATIVE FOR IT
ACCORDING TO THOSE WHO. ARE
PART OF THIS TSUNAMI MYSELF
INCLUDED SO I WILL FEEL
COMFORTABLE. SAYING THAT BUT
BUT I THINK WE REALLY NEED TO
BE. A VERY WHERE WE'RE GONNA
HAVE A EIGHT MILLION SENIORS
NOT ALL OF THEM ARE GOING TO
HAVE A PLACE- WITH FAMILY OR-
OF CONTAINED- GENERAL
OPPORTUNITY SO YOU WERE GOING
TO BE A MAJOR PLAYER AND I JUST
HOPE THAT. AS WE GO FORWARD WE
CAN HEAR SOME. SOME LEVEL OF.
ENTHUSIASM OR- URGENCY AS WE
DISCUSS THESE ISSUES. THEY
CANNOT CAN I JUST ANSWER THAT I
DON'T WANT TO YOU KNOW IF I
PROVIDED YOU WITH THE
IMPRESSION THAT WERE JUST
SITTING BACK AND GIVING NUMBERS
WERE NOT THAT'S WHY WE CHANGED
TO PREVENTION AND TECHNICAL.
ASSISTANCE BECAUSE WE SAW THE
MAIN AND WE PULLED IN ON OUR
PARTNERS ALL THE STAKEHOLDERS
AND TO SEE WHAT WE COULD DO TO
REALLY. FACES HAT ON AND NOT
JUST COMMAND THAT THE PREVIOUS.
MISSION IS TO JUST WHEN YOU SEE
IT YOU CITED PEOPLE WERE
SHUTTING DOWN SO WE REALLY
PULLED TOGETHER STAKEHOLDERS WE
TAKE THIS AS A VERY- HIGH
PRIORITY WE UNDERSTAND WHAT'S
COMING AND- YOU KNOW THE MASTER
PLAN OF AGING YOU KNOW WORKING.
WITH US IT'S ALL MOVING
TOWARDS- THAT POPULATION THAT
YOU JUST SPOKE TO SO IF YOU GOT
IMPRESSION THAT WERE JUST
SITTING BACK AND MY- WHAT WERE
NOT. AND CERTAINLY A I DON'T
THINK THAT ARE IMPRESSION IS
THAT SOCIAL SERVICES AND A
LOOKING AT THESE ISSUES AND
PROACTIVE MANNER BUT- I THINK I
DO THINK THAT. IN ADDITION TO
AND I REALIZE MY YOUR MAIN JOBS
IS TO LICENSE AND BE SURE AS I
AM ALSO THINKING ABOUT YOU
BECAUSE YOU'RE THE ONES WHO ARE
IN THE FIELD TO DOING THIS. WE
ALSO NEED SOME HELP FROM YOU
BECAUSE YOU'RE ON THE GROUND TO
UNDERSTAND WHAT DO WE NEED TO
DO. TO ACTUALLY INCREASE THE
NUMBER OF BEDS BECAUSE WHEN YOU
TOLD ME AND I FEEL THAT YOU
KNOW WE'RE CENTURY LEVEL GOES
UP AND DOWN PERCENT FROM LAST.
YEAR THE LOWER SOME BECAUSE I
DON'T SEE A LINE THAT. SO THE
QUESTION IS WHAT DO WE DO TO
CHANGE THE TREND LINE SO DO WE
HAVE MORE I APPRECIATE THERE'S
YEAH WE HAVE SOME OTHER
PROPOSAL SO WE'LL BE HEARING
ABOUT THOSE- BUT YOU KNOW WE
GOT FIGURE OUT WHAT. THE
TRAJECTORY IS IN OUR LOSING US
IF THAT'S ASIDE BEDS ARE GOING
DOWN WELL WHAT IS IT ABOUT THAT
NO SOME PEOPLE MAY SAY WE NEED
MORE MONEY OR SOMETHING LIKE
THAT- MAYBE THERE'S OTHER
THINGS WE NEED TO DO AS WELL.
AND THEN IF BUT THAT THE NET IS
THAT WE'RE SOURCE. SAME THAT
LOW WILL RUN NOT WORK AND SO WE
NEED MORE. SUGGESTIONS AND
FEEDBACK. INFORMATION REGIS
WHICH IS WHY. ALONG THAT LINE.
AND WHY AS TO HOW. WE CAN GET
SOME HELP AND TO FIGURE OUT WHY
TOGETHER TO COME UP WITH A WAY
TO. TRY TO GET AN UP TICK. A
SUSTAINED UPTICK IN THE NUMBER
OF BEDS. AS WELL. TOTALLY
UNDERSTAND THINK YEAH. DO YOU
HAVE ANY ADDITIONAL QUESTIONS
FROM COMMITTEE MEMBERS. NOW
WELL THANK YOU THANK YOU BOTH
FOR YOUR TESTIMONY- ALL- AM I
UNDERSTAND YOU'LL PLEASE JOIN
US FOR THE THIRD PANEL PANEL SO
WE WILL SEE YOU AGAIN LATER
THIS AFTERNOON BOB BUT FOR NOW
LET'S CALL IT THE NEXT PANEL.
AS AND IF YOU CAN PLEASE COME
ON UP AND STATE YOUR NAME AND
AFFILIATION. I WANT TO GIVE UP
WE WILL HOLD OFF ON QUESTIONS
AND TO ALL OF OUR PANELISTS
HAVE HAD AN OPPORTUNITY TO
SPEAK. WE HAVE. GOOD AFTERNOON
MADAM CHAIR TOO MANY NUMBERS
I'M JOE RODRIGUEZ I'M THE
CALIFORNIA STATE LONG TERM CARE
OMBUDSMAN. KAREN LARSEN
DIRECTOR OF HEALTH AND HUMAN
SERVICES REAL COUNTY GEORGE
CANARIUM SIX BEDS. HEATHER
HARRISON WITH THE CALIFORNIA
ASSISTED LIVING ASSOCIATION.
MADAM CHAIR COMMITTEE MEMBERS
I'VE HAD THE PRIVILEGE OF
SERVING AS THE CALIFORNIA STATE
LONG TERM CARE OMBUDSMAN SINCE
TWO THOUSAND TWO AND I HAD THE
OFFICE OF THE STATE LONG TERM
CARE OMBUDSMAN WHICH IS
ESTABLISHED IN THE OLDER
AMERICANS ACT AND THEN THE
OLDER CALIFORNIANS ACT AS AN
INDEPENDENT. PERSON CENTERED
COMPLAINT RESOLUTION AN
ADVOCACY PROGRAM FOR RESIDENTS
OF LONG TERM CARE FACILITIES.
THE MISSION OF THE OFFICE IS TO
IDENTIFY INVESTIGATE AND
RESOLVE COMPLAINTS. THAT ARE
MADE BY OR ON BEHALF OF
RESIDENTS. THAT MADE PERSONALLY
AFFECT THE HEALTH SAFETY
WELFARE OR RIGHTS OF THE
RESIDENCE. THE OFFICE ANALYZES
COMMENTS ON AND MONITORS THE
DEVELOPMENT AND IMPLEMENTATION
OF FEDERAL STATE AND LOCAL LAWS
REGULATIONS AND OTHER
GOVERNMENTAL POLICIES AND
ACTIONS THAT PERTAIN TO THE
HEALTH SAFETY WELFARE AND
RIGHTS OF RESIDENTS WITH
RESPECT TO THE ADEQUACY OF LONG
TERM CARE FACILITIES AND
SERVICES IN THE STATE. THE
OFFICE RECOMMENDS ANY CHANGES
IN SUCH LAWS REGULATIONS
POLICIES AND ACTIONS AS THE
OFFICE DETERMINES TO BE
APPROPRIATE. IN CALIFORNIA
LOCAL OMBUDSMAN ENTITIES
RECEIVE REPORTS OF SUSPECTED
ABUSE AND NEGLECT THAT OCCUR IN
FACILITIES. THE OFFICE HAS NO
REGULATORY OVERSIGHT OF LONG
TERM CARE FACILITIES. COMMUNITY
CARE LICENSING AND SPECS AND
LICENSED FACILITIES AS YOU'VE
ALREADY HEARD. THEY SANCTION
THEM FOR VIOLATIONS OF STATE
LAWS AND REGULATIONS. IN
CONTRAST OMBUDSMEN
REPRESENTATIVES WORK TO RESOLVE
THE PROBLEMS OF RESIDENTS AND
IMPROVE THE LONG TERM CARE
SYSTEM. IN FISCAL YEAR NINETEEN
TWENTY LOCAL OMBUDSMAN PROGRAMS
RECEIVED AN APPROXIMATELY A
HUNDRED AND 25% INCREASE IN
GENERAL FUND SUPPORT. THIS
BUILDS UPON PREVIOUS
INCREMENTAL INCREASES IN
FUNDING. WITH THIS NEW FUNDING
LOCAL OMBUDSMAN PROGRAMS REPORT
BEING ABLE TO HIRE THIRTY SIX
NEW FULL TIME EQUIVALENTS.
NINETEEN NEW PART TIME STAFF.
NINE EXISTING STAFF THAT WENT
FROM PART TIME TO FULL TIME.
AND TWELVE EXISTING PART TIME
STAFF WHO SAW AN INCREASE IN
HOURS. THIS FUNDING AND THESE
POSITIONS ALLOW THE LONG TERM
CARE OMBUDSMAN PROGRAM TO VISIT
EVERY LONG TERM CARE FACILITY
IN THE STATE ON A QUARTERLY
BASIS NOT IN RESPONSE TO A
COMPLAINT. THIS EQUATES TO
APPROXIMATELY ONE THOUSAND TWO
HUNDRED AND THIRTY SKILLED
NURSING FACILITIES. AND SEVENTY
THREE HUNDRED RESIDENTIAL CARE
FACILITIES FOR THE ELDERLY. WE
ALSO RECEIVED REPORTS OF ABUSE
NEGLECT IN ADULT RESIDENTIAL
FACILITIES WE DON'T VISIT THEM
ON A QUARTERLY BASIS. IN
FEDERAL FISCAL YEAR NINETEEN
CALIFORNIA OMBUDSMEN
REPRESENTATIVES INVESTIGATED
ELEVEN THOUSAND EIGHT HUNDRED
AND TWENTY NINE COMPLAINTS IN
RESIDENTIAL CARE FACILITIES FOR
THE ELDERLY. THE MOST COMMON
COMPLAINTS INVESTIGATED WERE
RESIDENT CONFLICTS. ACCIDENTAL
OR INJURIES OF UNKNOWN ORIGIN
FALLS IMPROPER HANDLING. GROSS
NEGLECT. PHYSICAL ABUSE AND
RESIDENT TO RESIDENT PHYSICAL
OR SEXUAL ABUSE. LONG TERM CARE
OMBUDSMAN PROGRAM AS A POSITIVE
AND COLLEGIAL WORKING
RELATIONSHIP WITH COMMUNITY
CARE LICENSING. LICENSING IS
RESPONSIVE TO OMBUDSMEN
CONCERNS. IF THE SITUATION IS
BROUGHT TO MY ATTENTION LOCAL
GOVERNMENT WHEN MY LOCAL
PROGRAMS. I CAN BRING TO
LICENSING AND I KNOW THEY WILL
RESPOND. LET ME SHORT SHARE A
STORY WITH YOU SOMETHING THAT
HAPPENED A FEW MONTHS AGO. I
RECEIVED A CALL FROM OUR AFTER
pSERVICE. IT WAS A SUNDAY
AFTERNOON. THEY TAKEN A CALL
FROM A DEPUTY. DOWN IN THE EAST
BAY. WHO WAS RESPONDING TO A
NINE ONE ONE CALL. THE NINE ONE
ONE CALL WAS FROM A RESIDENT IN
A FACILITY WHO FELT SHE WAS IN
DANGER AND NEEDED HELP THE
STAFF WERE AND RESPONSIVE. THE
DEPUTY YOU WENT TO THE FACILITY.
AND FOUND A KITCHEN TABLE FULL
OF. MEDICATIONS MEDICATIONS
THAT WERE DISORGANIZED WAS
UNCLEAR WHO WAS SUPPOSED TO BE
RECEIVING THESE MEDICATIONS
THEY WEREN'T SORTED THEY
WEREN'T PROPERLY- BEING
MAINTAINED. THERE WAS A
RESIDENT WHO THE OFFICER FELT
WAS IN DISTRESS AND NEEDED TO
BE SEEN BY PROFESSIONALS. THE
CARE GIVER WHO IS PRESENT. I
DIDN'T SPEAK ENGLISH VERY WELL
AND WAS HAVING DIFFICULTY
COMMUNICATING WITH THE DEPUTY.
THE DEPUTY FELT SOMEBODY NEEDED
TO STEP IN. I CALLED LICENSING
ONE OF THE PROGRAM MANAGERS
FROM THE EAST BAY WHO HAS
OVERSIGHT FOR FACILITIES IN
THAT PART OF THE STATE. THIS IS
ABOUT FOUR O'CLOCK ON ON SUNDAY
AFTERNOON. SHE UNDERSTOOD WHAT
WAS GOING ON AND SAID I WILL
GET A LICENSING PROGRAM ANALYST
OUT THERE THIS AFTERNOON. IF I
CAN'T FIND ONE I'LL GO OUT
MYSELF. THE MANAGER ENDED UP
GOING TO THE FACILITY. SHE
STAYED UNTIL ABOUT TEN THIRTY
THAT NIGHT AND KEPT IN
COMMUNICATION WITH ME THE WHOLE
EVENING SO I KNEW WHAT WAS
GOING ON ONE RESIDENT WAS
TRANSFERRED. STAFF DID HELP THE
CARE GIVER ORGANIZE THE
MEDICATIONS AND CLEAN THINGS UP.
LICENSING KEEPS ME INFORMED OF
THEIR ACTIONS AND COORDINATES
WITH OUR LOCAL PROGRAMS. I KNOW
THAT IF I MAKE A CALL. IT'S
GOING TO BE RESPONDED TO.
LICENSING INVITES US TO
PARTICIPATE IN THEIR TRAINING
FOR NEW LICENSING PROGRAM
ANALYSTS SO THAT THEY WILL
UNDERSTAND THE MISSION GOALS
AND PROCESSES OF THE OMBUDSMAN
PROGRAM. LICENSING STAFF
REGULARLY ATTEND OUR TRAINING
FOR LOCAL OMBUDSMAN
COORDINATORS SO THEY'RE AWARE
OF WHAT. WHAT WE'RE DOING. AS
THE ADVOCATE FOR RESIDENTS WE
BRING CONCERNS AND ISSUES TO
LICENSE THINGS THAT TENSION.
ALL FACILITIES NEED OVERSIGHT
AND ATTENTION FROM LICENSING.
THE ON BUTTON IS THERE AS
PROBLEM SOLVERS AND WORK WITH
LICENSING TO PROMOTE QUALITY
CARE NO MATTER THE SETTING.
THANK YOU. FROM A GOOD
AFTERNOON MADAM CHAIR AND
MEMBERS MY NAME IS GEORGE COULD
HEAR AND I'M HERE WITH SIX BEDS
WHICH IS A STATE WIDE TRADE
ASSOCIATION THAT REPRESENTS
APPROXIMATELY TWO THOUSAND
RESIDENTIAL CARE FACILITIES FOR
THE ELDERLY AN ADULT
RESIDENTIAL FACILITIES SERVING
SIX OR FEWER PERSONS- COMMONLY
REFERRED TO AS BOARDING CARE
HOMES ARE CURRENTLY BOARDING
CARE HOMES REPRESENTS
APPROXIMATELY 73% OF THE ALMOST
FIVE HUNDRED RCF EASE AND
APPROXIMATELY SO SIX OF THE
MORE THAN FIVE AND HE ARE
ABSENT. YEAH REPRESENTS
SIGNATURE PHONE AND OF THE TENT
ERIN ARE. I LIKE THIS I THINK
IN THE DEPARTMENT AND ITS
LEADERSHIP THEIR HARD WE SEEN
POSITIVE CHANGES OVER THE LAST
HANDFUL OF YEARS AND A NUMBER
OF AREAS. INCLUDING MORE
FREQUENT INSPECTIONS. STRONGER
LICENSEE APPEAL RIGHTS FASTER
PROCESSING OF NEW LICENSE
APPLICATIONS NEW L. P. A.
TRAINING. THE REEMERGENCE OF
THE TECHNICAL SUPPORT UNIT. AN
OVERALL SHIFT IN CULTURE THAT
AS PRIORITIZE PREVENTION
CONSULTATION AND COLLABORATION
AS PART OF ITS TOOL KIT FOR
ENGAGING PROVIDERS. WE ALSO
RECOGNIZE THE DEPARTMENT'S
EFFORTS TO CREATE MORE
CONSISTENT EXPERIENCES IN THE
FIELD. AND A TWO THOUSAND
SURVEY AT TWO THOUSAND FIFTEEN
SURVEY TO PROVIDERS ONLY 47% OF
RESPONDENTS SAID THEY WERE
HAPPY WITH COMMUNITY CARE
LICENSING. AND OUR MOST RECENT
SURVEY HERE IN 20002072% OF OUR
RESPONDENTS SAID THAT THEY WERE
HAPPY WITH COMMUNITY CARE
LICENSING. A SIGNIFICANT
IMPROVEMENT. NOT WITHSTANDING
SOME OF THESE POSITIVE
DEVELOPMENTS ARE IN THE MARKET
PLACE MANY PROVIDERS ARE ALSO
EXPERIENCING SIGNIFICANT
OPERATIONAL AND ECONOMIC
CHALLENGES. FOR ONE PROVIDERS
ARE STRUGGLING TO FIND CARE
GIVERS. WE EXPECT THERE TO BE A
DECREASING SUPPLY A FAMILY CARE
GIVERS AS A RACIAL FAMILY CARE
GIVERS TO THOSE OVER EIGHTY IS
EXPECTED TO SHRINK. FROM SEVEN
A ONE IN 200-017-2421 IN TWO
THOUSAND THIRTY AND JUST THREE
TO ONE BY TWO THOUSAND FIFTY.
THIS DYNAMIC SUGGEST A
SIMULTANEOUS INCREASE IN DEMAND
FOR RESIDENTIAL CARE IS THERE
WILL BE LESS FAMILY CARE GIVERS
TO RELY ON. AND ALSO A SHORTAGE
OF PROFESSIONAL CARE GIVERS AS
A GENERATION OF CARE GIVERS ARE
EXITING THE WORK FORCE. A
DOUBLE WHAMMY OF SORTS. IN A
RECENT SURVEY OF PROVIDERS CARE
GIVER SHORTAGE WAS IDENTIFIED
AS THE SECOND GREATEST
CHALLENGE THEY FACE. IN THE
SAME SURVEY. ARISING MINIMUM
WAGE LIABILITY INSURANCE COSTS
WORKERS COMP COSTS AND THE
OVERALL COST OF REGULATION
RIGHT IN A FIGHT AS BEING AMONG
THE TOP FIVE GREATEST OPERATING
CHALLENGES. IN PARTICULAR THE
STATE INCREASING MINIMUM WAGE
TO FIFTEEN DOLLARS PER HOUR WAS
IDENTIFIED AS THE GREATEST
CHALLENGE ESPECIALLY SINCE
MINIMUM WAGE HAS A MAGNIFIED
EFFECT ON OPERATING COSTS AS A
DIRECTLY IMPACT OVER TIME A
REAL TAXES AND WORKERS. BORN
CARE PROVIDERS SIMPLY UNABLE TO
ADEQUATELY SPREAD THESE RISING
COSTS ACROSS SIX BEDS PER
FACILITY. DESPITE THE LARGE
NUMBER OF THESE HOMES IT'S A
HIGHLY FRAGMENTED INDUSTRY
SEGMENT WITH MOST OWNERS
OPERATING BETWEEN ONLY ONE IN
THREE HOMES. THEY FRANKLY LACK
ECONOMIES OF SCALE.
HISTORICALLY BOARDING CARE
PROVIDERS HAVE PLAYED A VITAL
ROLE IN HOUSING IN CARING FOR
CALIFORNIA'S MOST VULNERABLE
POPULATIONS INCLUDING JEWEL SS.
AS WELL AS OTHER LOW AND-
MIDDLE INCOME SEGMENTS OF THE
POPULATION DEALING WITH
PHYSICAL DISABILITIES COGNITIVE
IMPAIRMENTS AND BEHAVIORAL
HEALTH ISSUES. HOWEVER WITH THE
BACKDROP OF THESE OPERATING
CHALLENGES AN INCREASING NUMBER
OF PROVIDERS ARE UNABLE TO
DELIVER KAREN HOUSING AT THE SS
I SS P. NON MEDICAL OUT OF HOME
CARE RATE. WHICH IS CURRENTLY
JUST ONE THOUSAND SIXTY NINE
DOLLARS PER MONTH. THIS IS LESS
THAN THIRTY SIX DOLLARS PER DAY
OR LESS THAN ONE DOLLAR FIFTY.
PER HOUR. AREAS WITH HIGH
PROPERTY COST TO SAN FRANCISCO
LOS ANGELES HAVE BEEN HIT
PARTICULARLY HARD WITH FACILITY
CLOSURES. THE ECONOMIC
CHALLENGE HOWEVER IS HARDLY
ENDEMIC TO AREAS SUCH AS SAN
FRANCISCO AND LA OR FACILITIES
A SERVE ONLY SS I SS P.
RECIPIENTS. THEY REPRESENT THE
LEADING EDGE OF THE PROBLEM AND
ARE A SIGN OF THINGS TO COME.
BASED ON OPERATING DATA
COLLECTED AT A STATEWIDE
MINIMUM WAGE OF FIFTEEN DOLLARS
PER HOUR AND IF THE SWIMMING
FULL OCCUPANCY WE PROJECT AT
THE FACILITY BREAK EVEN RATE
PER RESIDENT IN CALIFORNIA.
WILL BE APPROXIMATELY THIRTY
SIX HUNDRED DOLLARS FROM. WITH
JUST ONE VACANT UNIT THE BREAK
EVEN INCREASES THE FORTY THREE
HUNDRED DOLLARS PER MONTH.
WE'RE TALKING ABOUT A MONTHLY
BREAK EVEN RATE THAT WILL BE AT
LEAST TWENTY FIVE HUNDRED
DOLLARS PER MONTH HIGHER THAN
THE CURRENT S. S. S. S. P. NON
MEDICAL OUT OF HOME CARE RATE.
ABSENT IN PREVENTION WE WILL.
PASS THE FINE WITHIN THREE
YEARS A SIGNIFICANT SEGMENT OF
THE STATE'S BOARDING CARE
INDUSTRY TO BE ECONOMICALLY
CHALLENGED. IN FACT THE
STAGGERING 44% OF PROVIDERS
THAT RESPONDED TO OUR MOST
RECENT SURVEY. INDICATED THAT
THEY PLAN TO CLOSE THE FACILITY
WITHIN ONE TO THREE YEARS.
COMPARED TO ONLY 26% THAT
INDICATED THEY PLAN TO OPEN A
FACILITY WITHIN THE SAME TIME
FRAME. WHAT'S AT STAKE HERE IS
THE FOR OF THE MOST VULNERABLE
MEMBERS OF OUR SOCIETY.
BOARDING CARE HOME STAND AT THE
VERY INTERSECTION OF HOUSING
AND CARE. AND THAT'S A VERY
POWERFUL CONCEPT. THEY ALSO
REPRESENT THE MOST EFFICIENT
USE OF CALIFORNIA'S EXISTING
HOUSING SUPPLY. BUT ONCE I
SUPPLY IS LOST TO AN
ALTERNATIVE USE IT'S EXTREMELY
DIFFICULT IF NOT IMPOSSIBLE TO
BRING BACK. IT'S MORE IMPORTANT
THAN EVER THE MEMBERS OF THE
LEGISLATURE IN THE
ADMINISTRATION WORK CLOSELY
WITH REGULATORY AGENCIES
PROVIDER REPRESENTATIVES
CONSUMER ADVOCATES. LOCAL
GOVERNMENT AGENCIES AND OTHER
STAKEHOLDERS TO COME UP WITH
SOLUTIONS TO SYSTEMIC PROBLEMS
FACING THE MORNING HERE HOMES.
THEY'RE OPERATING SERVICE THE
MOST VULNERABLE MEMBERS OF OUR
COMMUNITIES HAPPY TO ANSWER ANY
QUESTIONS. GOOD AFTERNOON MADAM
CHAIR AND MEMBERS OF HEATHER
HARRISON WITH THE CALIFORNIA
ASSISTED LIVING ASSOCIATION I'M
HAPPY TO BE HERE TODAY I WAS
ASKED TO TALK A LITTLE BIT
ABOUT THE PROVIDERS CALIBER
PRESENTS. THE RESIDENTS THEY
SERVE AND SHARE OUR THOUGHTS ON
THE SS OVERSIGHT IN GENERAL AND
THE INSPECTION PROCESS IN
PARTICULAR. CALORIE PRESENTS
MORE SIX HUNDRED FIFTY LICENSED
RESIDENTIAL CARE FACILITIES FOR
THE ELDERLY THROUGHOUT
CALIFORNIA INCLUDING ASSISTED
LIVING MEMORY CARE AND
CONTINUING CARE RETIREMENT
COMMUNITIES. IN TOTAL OUR
MEMBERS ARE LICENSED TO SERVE
APPROXIMATELY EIGHTY FOUR
THOUSAND RESIDENTS. OUR MEMBERS
RANGE IN SIZE FROM SMALL SIX
BUT COMMUNITIES TO LARGE
PURPOSE BUILT COMMUNITIES THAT
SERVE A HUNDRED OR RESIDENTS.
AND THAT ALSO INCLUDES
DEDICATED MARIE CARE
COMMUNITIES. THE RANGE OF
SETTING FROM SIZE AND FEATURES
AN APPROACH TO CARE ALL HELPS
PROVIDERS- OFFER CHOICE SO
OLDER. HAVE OPTIONS OF THE
ENVIRONMENTS TO MEET THEIR
NEEDS WHAT UNITES OUR MEMBERS
IS THEIR COMMITMENT TO THIS
MODEL OF- AND SHARING ITS ROLE
FOR RESIDENTS TODAY AND IN THE
FUTURE. JUST AS THERE IS A
RIGHT OF ASSISTANCE. PROVIDERS
THE COMMUNITIES OUT THERE
THERE'S ALSO RANGE OF RESIDENTS
SERVED. RESIDENTS ARE MOST
OFTEN IN OUR COMMUNITIES- WE
FIND IN THEIR EIGHTIES SOME
NEED LITTLE HANDS ON CARE THEY
MIGHT STILL DRIVE IN ARE VERY
ACTIVE IN THE GREAT COMMUNITY
INDEPENDENTLY. SIGN ACT PRESS.
ARE MORE FOR SOCIAL REASONS AND
THE HEALTH CARE ON HAND SHOULD
THEY NEED IT. MOST RESIDENTS
THOUGH NEED HELP WITH
ACTIVITIES OF DAILY LIVING LIKE
DRESSING BATHING GROOMING
MEDICATION ASSISTANCE. MANY
HAVE DEMENTIA OR MILD COGNITIVE
IMPAIRMENT AND SUMMER RECEIVING
HOSPICE CARE AT THE END OF LIFE.
AT RESIDENTS NEEDS IN. THEIR
LEVEL OF INCREASES THE SERVICES
THEY REQUIRE INCREASED AND THAT
ALSO LEADS TO AN INCREASE IN
COSTS AS WELL. ONE OF THE
FOUNDATIONS OF SUCCESS OF
ASSISTED LIVING AND REALLY OF
ANY LICENSE CARE PROGRAM IS THE
INTEGRITY OF THE LICENSING AND
OVERSIGHT SYSTEM ITSELF
COMPLIANCE MATTERS AND
APPROPRIATE OVERSIGHT CAN HELP
RESULT OF- ISSUES BEFORE THEY
BECOME PROBLEMS. THIS AND
CALIFORNIANS THE DECLINE IN
INSPECTIONS AND THE REDUCTIONS
NDSS STAFF HE FOUGHT WITH MANY
OF IF YOU OF AND MANY OTHERS
HERE IN THE ROOM TODAY TO
RESTORE ON SECTIONS HERE BUT WE
ARE VERY PLEASED. ANNUAL
INSPECTIONS WERE FULLY ACHIEVED
IN THE NINETEEN AND WE WILL
CONTINUE TO MAKE SURE THAT THE
STAND IS MAINTAINED. NO NEW.
TOOL IN THE NEW SECTION
PROCESSES STILL BEING PULLED
OUT WE DON'T HAVE A LOT OF
EXPERIENCE WITH IT YET BUT IF
IT MEETS EXPECTATIONS WHICH IS
A MORE THOROUGH. INSPECTION
THAT STILL HAPPENS ANNUALLY I
THINK THAT SOMETHING WE WOULD
ALL BE PLEASED WITH WE'VE HEARD
THAT IT DOES TAKE LONGER- SETS
HAVE. IS OKAY ISN'T GET MORE
EXPERIENCE WITH IT AND MARK
MILLER WITH THE TOOL ITSELF IN
THE PROCESS THAT WOULD SPEED UP
SOME. IT'S NOT ONLY. AND IT THE
PLANE PROCESSING PROCESSING
APPEALS REVIEWING- AND VETTING
LICENSE APPLICATIONS SO THAT
NEW PROVIDERS TO CAN COME INTO
THIS FIELD BOB AND PROCESSING
CRIMINAL THESE ARE ALL
IMPORTANT FUNCTIONS THAT THE
DEPARTMENT OF SOCIAL SERVICES
REALLY REFOCUSED ON IN RECENT
YEARS AND THEY'RE BEEN I'M OUR
PERSPECTIVE. TICKET MEN'S IN
REDUCING SOME OF THE BACKLOG
IMPROVING THOSE LINES. OUR
PEOPLE IN IS FOCUSED ON L. A.
TRAINING- IT'S VITAL THAT THE
INSPECTORS ARE FULLY PREPARED
TO DO THEIR JOB- WITH THESE NEW
TOOLS AND WITH THE CHANGING
REGULAR AND. AND I HAVE- ONE OF
CALLOUS TOP PRIORITIES WILL BE
TO MAINTAIN THESE ANNUAL
INSPECTIONS REALLY THE BEST
WAY. FOR DSS TO KNOW WHAT IS
HAPPENING IN THE COMMUNITIES
THEY LICENSE IS TO VISIT THE
COMMUNITIES THEY LICENSE- WHEN
THEY'RE OUT THERE EVERY YEAR
WHAT THE COMMUNITIES TALKING TO
RESIDENTS TALKING TO STAFF-
BEING AWARE OF THE ENVIRONMENT
OF THE- WE HAVE AN OPPORTUNITY.
MAKE AN IMPACT. IT CAN ON THE
SIDE. TO AVOID ALARMS AND THEN
TO TAKE QUICK AT. FIND ANY
ISSUE THEY FACE FIELD. OF YOU
KNOW I ALSO WILL AT YOUR HOUSE
AS WE'RE SITTING HERE TODAY-
IT'S IMPORTANT TO THINK OF THE
BAKER THE BROADER LONG TERM
LONG TERM SERVICES AND SUPPORT
SYSTEM THAT WERE OPERATING
WITHIN AND THAT THERE IS A
PATIENT EARLIER ABOUT THE
MASTER PLAN FOR AGING. YEAH
WE'RE REALLY IN. TO SEE THE
FOCUS BEIJING A LONG TERM CARE
ISSUES JUST IN GENERAL AND IN
PARTICULAR WITH THE MASTER PLAN
BECAUSE THE- THE- THE
DEMOGRAPHICS BEING WHAT THEY
ARE THIS IS SOMETHING THAT IS
REALLY GOING TO COME TO. HAD
AND WE ARE- ARE HOPEFUL THAT
WITH THIS RENEWED ATTENTION WE
WILL BE ABLE TO WORK
COLLABORATIVELY TO IDENTIFY.
WAYS TO SOLVE SOME OF THE
PROBLEMS THAT ARE BEING
DISCUSSED HERE IN THIS ROOM
TODAY BUT ALSO LOOK FOR
CREATIVE WAYS TO MEET THE
CHANGING NEEDS. OF OLDER ADULTS
AND THE- THE CHANGING LARGER
ENVIRONMENT THAT WE'RE ALL
OPERATING WITHIN HI THIS IS
RELEASED I HOPE. I THINK WE ALL
HOPE WE CAN LOOK FOR AS WE AGE.
WITH A CERTAIN COST. GOOD
AFTERNOON I THANK YOU FOR THE
OPPORTUNITY TO SPEAK ABOUT OUR
LOCAL EXPERIENCE AS IT RELATES
TO BOARDING CARE FACILITIES AND
THE EXPERIENCE OF OTHER COUNTY
STATEWIDE MY NAME'S KAREN
LARSON I'M THE DIRECTOR AND
HUMAN SERVICES FOR YOLO COUNTY
IN MY ALL I OVERSEE LIKE HEALTH
AND MENTAL HEALTH DIRECTOR A
GUARD CONSERVATIVE- WEALTH. IF
YOU AT. AND EVERYONE IS ROLES
I'M FACED WITH THE CHALLENGES
OF POVERTY UNLIMITED HOUSING
OPTIONS FOR OUR MOST VULNERABLE
RESIDENTS I YOLO COUNTY IS WHAT
I LIKE TO CALL A GOLDILOCKS
COUNTY WE'RE NOT TOO BIG WE'RE
NOT TOO SMALL I WOULD JUST
ABOUT THE RIGHT SIZE WE HAVE
JUST OVER TWO HUNDRED THOUSAND
REST WERE GEOGRAPHICALLY
ETHNICALLY AND SO. HONESTLY TO
ABOUT 30% POPULATION LIVING
POVERTY. WE SERVE APPROXIMATELY
TWENTY ONE HUNDRED CLIENTS IN
OUR SPECIALTY MENTAL HEALTH
SERVICES AND APPROXIMATELY 20%
OF THOSE ARE AN INPATIENT OUR
HOSPITAL SETTINGS. BUT AREN'T
THERE INDEPENDENT BOARDING CARE
FACILITIES ARE CRITICAL PIECE
OF THE HOUSING CONTINUUM FOR
OUR CLIENTS COMING HOME FROM
THE SETTINGS AS WELL AS THOSE
WHO ARE AT RISK FOR
HOMELESSNESS WITHOUT THE
SUPPORTS PROVIDED TO THAT.
FACILITY CALIFORNIA. BOARDING
CARE CRISIS NOW I WANT TO MAKE
THAT CLEAR FOR OUR CLIENTS THAT
I'M TALKING ABOUT. WE HAVE A
CRISIS NOW FOR THOSE THAT ARE
RECEIVING SSI AND STRUGGLING
WITH MENTAL HEALTH CONDITIONS
THAT ARE IN NEED OF A BOARDING
A LEVEL OF SUPPORT. AND THIS IS
SERIOUSLY COMPROMISING OUR
STATE'S ABILITY TO ADEQUATELY
SERVE THE NEEDS OF OUR
INDIVIDUALS WITH SERIOUS MENTAL
ILLNESS WITHOUT. FIVE WHEN CARE
FACILITIES WE HAVE CLIENTS
WAITING TOO LONG. IN EMERGENCY
ROOMS FOR A TO GO OR STAY FAR
TOO LONG IN MORE EXPENSIVE.
SETTINGS WHILE OTHERS AWAIT
THOSE SEPARATELY DID IMPAIR
THAT. AND A LOT FACILITY.
PERHAPS TURNING IS THAT DON'T
ACT QUICKLY WHERE IS FOR ADDING
YOUR- CHRONICALLY. MENTALLY ILL
POPULATION. BROKE YOLO COUNTY
OUR LOCAL BOARDING CARE NEED IS
MORE THAN THREE TIMES THAT OF
OUR CAPACITY AS A RESULT MANY
OF OUR CLIENTS END UP LIVING IN
SURROUNDING COUNTIES. COUNTIES
FACILITIES THIS IS AN OPTIMAL
BECAUSE IT TAKES OUR CLIENTS
AWAY FROM THEIR NATURAL
SUPPORTS FROM THEIR COMMUNITY
FROM THEIR CARE PROVIDERS AND
IT ALSO TAKES AWAY FROM OUR
NEIGHBORING COUNTIES. THE PLACE
I AM LOCAL. IN A DAY AND WHAT
HAVE COUNTY CLERK. THEY'RE JUST
GET A CALL WILL TRAVEL VISITING
THAT'S BECAUSE OUT OF THE AIR
AND TRANSFER THEIR MEDIC HOW
AND OTHER BENEFITS BACK AND
FORTH BETWEEN COUNTY. IN TWO
THOUSAND SEVENTEEN YOLO COUNTY
USE OUR MENTAL HEALTH SERVICES
ACT INNOVATION DOLLARS TO HIRE
AN EVALUATOR TO CONDUCT A STUDY
AN OFFER SUGGESTIONS ON BEST
PRACTICES ON THIS ISSUE WHAT WE
LEARNED IS REFLECTIVE OF THE
PICTURE I JUST DESCRIBED. ALONG
WITH A NEW ONE SPECIFIC TO THE
INDIVIDUALS THEMSELVES THOSE
WITH THE HIGHEST NEEDS. ARE OFF
WITHOUT OF OUR LOCAL LOW.
OPPORTUNITIES AS PROVIDERS GET
IN MULTIPLE REFER AND ARE ABLE
TO THOSE THAT ARE A LITTLE
EASIER TO DEAL WITH. THIS MEANS
THAT OUR CLIENTS WITH THE
HIGHEST NEEDS OFTEN STAY LOCKED
FACILITIES LONGER THAN THEY
SHOULD. OR ARE FORCED INTO. CAN
HELP US. THREE THE
DISPROPORTIONATE IMPACT LEAD TO
AN INCREASE NUMBERS OF INTO.
WITH NEEDS LIVING FAR AWAY FROM
THEIR COMMUNITY AND WHILE
WAITING FOR THE BOARD OF CARE
LEVEL OF SUPPORT. TO SUSTAIN
OUR THIRTY SEVEN LOCAL BEDS
WHICH IS ALL WE HAVE. AND WE
ARE INVESTING OVER A MILLION
DOLLARS IN SUPPORTING ONGOING
OPERATIONAL COSTS AND
MAINTENANCE OF THE HOMES THE
OPERATORS FOR THESE HOME
SACRIFICE MUCH OF THEMSELVES
FOR OUR CLIENTS MANY OF WHOM
HAVE LIVED IN THOSE FACILITIES
FROM YEARS. YET THEY'RE NOT
PAID A LIVING WAGE THEY DON'T
HAVE HEALTH INSURANCE AND
THEY'RE UNABLE TO PAY RENT OR
UTILITIES. ADDITIONALLY AND IN
LINE WITH THE STATEWIDE GROWING
NUMBERS OF AGING ADULTS AND OF
SERVICES AND SPECIALIZED CARE.
THESE BOARD AND CARE OPERATORS
HAVE BECOME THE PRIMARY SUPPORT
FOR SOME OF OUR MOST VULNERABLE
RESIDENTS WITH AGING SPECIFIC
NEEDS. BUT WITHOUT ADDITIONAL
RE. AND TRAINING TO MATCH THOSE
NEEDS. ONE IN FOUR YOLO COUNTY
RESIDENTS EXPERIENCE SEVERE
HOUSING PROBLEMS WE EXPERIENCED
A 40% INCREASE AND PEOPLE
LIVING HOMELESS IN OUR LAST
POINT IN TIME COUNT AND SOME OF
OUR CITIES HAVE A HOUSING
VACANCY RATE OF LESS THAN ONE
PERCENT. YOLO COUNTY CANNOT
AFFORD TO LOSE THESE HOMES AND
THIS LEVEL OF CARE LOCALLY. IN
FACT WE NEED MORE. STATEWIDE
THE NUMBER A BOARDING CARE
FACILITIES HAS DECLINED AT AN
ALARMING RATE LARGELY DUE TO
INADEQUATE FUNDING AND RISING
HOUSING COSTS. LA HAS LOST OVER
TWO HUNDRED BEDS JUST WITHIN
THE LAST YEAR. NAPA REPORTED
THAT BETWEEN TWO THOUSAND
FIFTEEN AND TWO THOUSAND
NINETEEN THERE WAS A 20%
REDUCTION IN RESIDENTIAL CARE
FACILITIES FOR THE ELDERLY. AND
SINCE TWO THOUSAND. FRANCISCO
HAS LOST MORE THAN A THIRD OF
THEIR LICENSE RESIDENTIAL
FACILITIES THAT SERVE PEOPLE
UNDER THE AGE OF SIXTY. THE
REMAINING BOARDING CARE
FACILITIES ARE FACING RAPIDLY
INCREASING OPERATING COSTS AND
ARE UNABLE TO AFFORD NEEDED
REPAIRS TO MAINTAIN THEIR
FACILITIES. AND OUR EXPERIENCE
THROUGHOUT THE STATE ONCE A
BOARDING CARE FACILITY CLOSE IS
THAT SAUDI AN OPERATOR ARE GONE
AND NOT REPLACE. THE LOSS OF
ABOUT BORN CARE FACILITY
PERMANENTLY REDUCES THE STATE
PASSIVITY TO HOUSE VULNERABLE
POPULATIONS. OF PERSONS WHO ARE
AGE DISABLED OR HAVE A MENTAL
ILLNESS. ALL OF THIS THE EIGHT.
BECOME HOMELESS ABOUT HALF OF
OUR STATE HOMELESS POPULATION
IS OVER THE AGE OF FIFTY AND OF
THOSE HALF ENTERED FOR
HOMELESSNESS FOR THE FIRST TIME
AFTER THE AGE OF FIFTY.
CURRENTLY THE DEVELOPMENT OF.
THESE ARE ABLE TO PAY HIGHER
RATES DID A LEGISLATURE'S
SIGNIFICANT INVESTMENT AND
SUPPORTED SIX STABLE HOUSING
OPTIONS. FOR INDIVIDUALS WITH
DEVELOPMENTAL DISABILITIES WE
FEEL STRONGLY THAT RECTIFYING
THAT SEVERITY AND SS I RATES
FOR THOSE STRUGGLING WITH
MENTAL HEALTH CONDITIONS.
AMELIORATE MANY OF THE PROBLEMS
WAS STANDING AND QUALITY. THESE
DIFFERENTIAL RATES ARE ARE PAID
IN THE SAME FACILITIES FOR THE
SAME LEVEL OF CARE AND SERVICE
CREATING AN ISSUE OF PARITY IN
TERMS OF POLICY. REGARDLESS OF
THE SOLUTION WE CAN TO THERE'S
NO DOUBT THAT OUR CURRENT MODEL
FOR BOARDING CARES IS NEITHER
SUSTAINABLE NOR SAFE IN MANY
CASES. WE MUST COME TOGETHER
AND DEVELOP A NEW MODEL FOR THE
FACILITIES WILL HELP THEM
THRIVE AND GROW AND THAT WILL
DO THE SAME FOR THE RESIDENTS
THAT LIVE IN. THANK YOU. THANK
YOU AT THIS TIME- WANTED TO GO
AHEAD AND ASK. AND IF YOU CAN'T
SPELL A BIT MORE ON AT THE OUT
OF COUNTY PLACEMENTS AND THE
DOMINO EFFECT IS IT HAVING ON-
ON ON THE RECEIVING I'M A
COUNTIES BUT ALSO ARE YOU AWARE
OF OTHER COUNTIES THAT MAY BE.
MAKING OUT OF COUNTY PLACEMENT
I THINK IT'S HAPPENING
THROUGHOUT THE STATE I'M IN.
JUST OVER THE RIVER SO A LOT OF
OUR CLIENTS. SACRAMENTO AM I
WOULD SAY WE HAVE LIKE I SAID
THIRTY SEVEN BEDS LOCALLY WE
HAVE CLOSE TO SIXTY CLIENTS
PASTE PLACE OUT OF COUNTY AND
OTHER SETTINGS. AND THAT'S JUST
LITTLE YOLO I THINK WE'RE A
MICROCOSM OF WHAT'S HAPPENING
STATEWIDE FOR SURE. CAN AT THIS
TIME I WANT TO GO AHEAD AND
OPEN UP FOR QUESTIONS FOR
COMMITTEE MEMBERS. IN A PATH
THANK YOU AND- PROUD TO
REPRESENT YOLO COUNTY MY
DISTRICT. SO WE WHAT SO WHAT DO
YOU SEE S. SOME OF THE
SOLUTIONS TO THIS PARTICULAR
ISSUE THE CLIENT CARE LIKE WE
JUST HAD A CONVERSATION WITH
FARM SOCIAL SERVICES OUT THERE
FAST THE AND SO FORTH FROM YOUR
PERSPECTIVE WHAT DO YOU SEE IS-
THINGS THAT WE MIGHT CONSIDER
DOING TO CHANGE JUST THREE ON-
THE NUMBER BORN. AIRBEDS WE
HAVE. I THINK IF WE GET AWAY TO
BRING THAT IRATE FOR PEOPLE
STRUGGLING WITH MENTAL HEALTH
ISSUES IN LINE WITH THE SAME AS
THOSE STRUGGLING WITH
DEVELOPMENTAL DISABILITIES.
THAT WOULD AMELIORATE THE PROP
IT WOULD DOUBLE THE REVENUE THE
BORN CARE PROVIDERS COULD
RECEIVE FOR THOSE CLIENTS.
ADDITIONAL QUESTIONS FROM
COMMITTEE MEMBERS. I HAVE ONE
ONE MORE- JUST WANTED TO. ALSO
ASK HOW MANY OF YOUR MEMBERS
FOR THIS FOR GEORGE- HOW MANY
REMEMBERS RESPONDED TO THE
SURVEY THAT THE STATE IN A
DECEPTIVE ESTA CYRUS-
RECIPIENTS WHAT EXCLUSIVELY OR
A MIX- DO YOU HAVE ANY NUMBERS
FOR THEY HAVE. MOST RECENT
SURVEY WE DID WHICH- AFTER
ABOUT FIVE HUNDRED BEDS OF
CAPACITY WHICH IS THAT THE
SURVEY IN THE DAYS LEADING UP
TO THIS- 11% RESPONDED THAT
THEY EXCLUSIVELY CARED FOR SS I
SS BE AND THOSE ARE ALMOST
EXCLUSIVELY ADULT RESIDENTIAL
FACILITIES THAT RESPOND TO
THAT. ARE AND 30% OF RISK THAT
AND THAT THEY USED TO ACCEPT SS
I SS PEOPLE NO LONGER DO. SO
YOU KNOW AS ON ONGOING BASES
WERE GOING TO WORK TO TRY TO
COLLECT MORE DATA. ON ON SOME
OF THAT. PARTICULAR ALSO ON THE
KIND OF THE MIXED PPULATIONS
OF THEIR FACILITIES EXCLUSIVELY
EXCEPT SS I SS P. THERE'S ALSO
FACILITIES THAT HAVE A MIX OF.
MAYBE PRIVATE PAY AND SOME SS I
SS. THOSE SS I SS BEES ARE NOT
ALWAYS TIED IN WITH THE COUNTY
SYSTEM- SO WE'RE- GONNA TRY TO
BE MORE AND MORE. YOUNG MORE
DATA GATHERING ON THAT. OR WELL
THANK YOU SO MUCH TO OUR PANEL
FOR TWENTY NECESSARY AFTERNOON
AND FRAZIER. ON STATEMENTS OUT
AT THIS. TIME I'D LIKE TO CALL
UP. THE NEXT PANEL GOING
FORWARD. WHEN YOU'RE READY
PLEASE FEEL FREE TO BEGIN
PLACED US START BY STATING YOUR
NAME AND AFFILIATION. YOU KNOW
ONCE AGAIN WILL HOLD OFF ON
QUESTIONS UNTIL ALL OUR
PANELIST HAVE HAD AN
OPPORTUNITY TO SPEAK.
GOOD
AFTERNOON. I'M CHEMICALLY WAY
AND THE DIRECTOR OF THE
DEPARTMENT OF AGING AND HAVE
THE PRIVILEGE OF BEING THE
CONVENER OF THE MASTER PLAN FOR
AGING FOR SECRETARY HEALTHY
HUMAN SERVICE THANK YOU FOR THE
INTEREST IN ATTENTION TO THAT
THANK YOU SENATOR HER DAUGHTER
FOR KICKING OFF HER FIRST
COMMUNITY ROUNDTABLE IN
SEPTEMBER ON OLDER WORKERS
SENATOR PAN YOUR UP NEXT A
LITTLE CENTER BILLS FRIDAY SO
JUST AHEAD OF YOU. SENATOR
WIENER WE'RE SCHEDULING FOR
APRIL SO THANK YOU TO ALL OF
YOU WHO ARE COMING OUT TO
LISTEN TO THE COMMUNITY AND WE
WORK SECRETARIES WITH HANNAH
BEST UNDER JACKSON ON FRIDAY
SO- GOALS ARE THE SENATE HEALTH
COMMUNITY COMMITTEE FOR FULL
ENGAGEMENT THANK YOU VERY MUCH
ANNOUNCED NOTHING TO BE TODAY
FOR YOUR LEADERSHIP IN THIS
AREA AND PARTNERSHIP ACT WHICH
TO GET THE PLAN RIGHT OVER THE
NEXT TEN YEARS OF SOLVING THESE
PROBLEMS DRESSED THESE GOALS.
UPDATE YOUR SO. OF THE MAP PLAN
TO HAVE THE GOVERNOR'S EXACT
ORDER JUNE CALLING FOR A TEN
YEAR MASTER PLAN TRIP EXACT.
UPON MY YES INDEED I JUST.
LEADERS IN YOUR ABSENCE YOU
MUST AT HERE'S MY BEEN BURNT IT
AND THE TEN YEAR IS FOR MUCH
DRIVEN BY THE CHANGE
DEMOGRAPHICS THAT THERE ARE
MORE OF US LIVING LONGER BUT
ALSO THAT AGING IS CHANGING IN
MANY IMPORTANT WAYS THE
DIVERSIFICATION THE INCREASE
LIVING ALONE THE INCREASE IN
POVERTY- AND THAT WE'RE LIVING
THROUGH MANY STAGES OF AGING SO
THAT IS A GREAT CHALLENGE FOR
OUR STATE. YOUR PLANS A GREAT
OPPORTUNITY COME TO. WE HAVE A
LISTING- OF BUT WE HAVE A
RECORD NUMBER OF COMMENTS
COMING IN ON OUR MASTER PLAN
DOING WEBSITE WHICH IS ENGLISH.
I NEED WITH LAUNCHER EQUITY
LAST MONTH MAKES THAT THE PLAN
IS RELEVANT ALL CALIFORNIANS-
AND IS ABLE TO ADDRESS
TERMINATION DISPARITY ALSO
GREAT FOR ALL AT. AS THE WHEN
YOU'RE. TWO IN THE MIDST.
PLEASE THE WEAPON ARE WEDNESDAY
BUT YOU'RE UP LOT COMMENDATIONS
FIRST I IN THIS AND OTHER HOUSE
TO ENJOY. POVERTY HUNGER IN
HOME RIGHT TO. IS OUR WAY THIS
WEEK AS I SAW AND OR SO LOTS OF
TOPICS BEING AND LOTS OF YOUR
LOCAL LEADER ARE BE FEATURED AS
WELL. SO WITH ALL THAT
ENGAGEMENT WE ARE NOW TURNING
THE CORNER AND STARTING TO HEAR
RECOMMENDATIONS CUT JUST
BEGINNING OF RECOMMENDATIONS ON
THE FIRST- DELIVERABLE IN THAT
IN THAT AREA IS OUR
STAKEHOLDERS ARE- POLISHING A
REPORT ON LONG TERM SERVICES
AND SUPPORTS A DRAFT IS OUT
NOW. THAT HAS A HUNDRED AND
FORTY RECOMMENDATION COMMEND
YOU- AND IT DOES TOUCH ON MANY
OF THE ISSUE HERE IT TOUCHES ON
THE SUPPLY FORCE SENTENTIAL
QUE- OVERSIGHT COMMITTEE. IT
DEFINITELY BUT WORKFORCE OF THE
NEED FOR THE WORK FORCE THE
RATIO TO DEMAND CAPABLE
CULTURALLY CAPABLE WORK FORCE-
THERE'S ALSO SOME CROSSOVER
WITH TAPPING COURSE IN A MEDI
CAL- AND WHAT THE OPPORTUNITIES
PRESENTED BY THE CAL AIMED.
PROCESS TO INCLUDE HOUSE
SUPPORT THIS. ARE THERE ARE ARE
CALLS FOR F. SITE OTHER BASIC
INCOME SO. AND ONE THAT'S A IS
COGNITIVE HOW WHETHER ITS ALL
TIME DEMENTIA IS BEHAVIORAL
HEALTH AND THAT COMPARISON TO
THE DEVELOPMENTS ABILITY SYSTEM
YOU HEAR THAT IN ALMOST EVERY
FORM SO YOU WILL SEE THAT IN
THE STAKEHOLDER REPORT COMING
OUT- THE GOAL OF THE
STAKEHOLDERS TO FINALIZE IT IN
MARCH. TO BE CLEAR THAT IS NOT
THE MASTER PLAN THAT IS THE
STAKEHOLDERS REPORT- AND THEN%
IN MAY YOU WILL SEE MORE OF THE
RECOMMENDATIONS ON HEALTH AND
WELL BEING. LIVABLE COMMUNITIES
PURPOSE ECONOMIC SECURITY
SAFETY AND EMERGENCY
PREPAREDNESS AND THEN IT'S ALL
GONNA COME TOGETHER IN AUGUST I
THINK THAT HI ALL JUST TO ECHO
THAT WE HAVE BEEN LISTENING AND
PARTNERING UP TO THE BOAT TO
SEE HOW. CONTACT GATHER
PARTNERSHIP WITH OUR AND I
LEADERS ARE CONSUMER
STAKEHOLDERS THANK. JOHN
SHEERAN FROM LOS ANGELES COUNTY
DEPARTMENT ABOUT HEALTH. IT'S
REALLY GREAT TO BE HERE ND AYE
AYE THANK YOU WE ARE NOT A
GOLDILOCKS COUNTY AND YOU KNOW
I GOT TO SAY THIS IS THIS. THIS
EFFORT- IS ONE THAT'S REALLY- I
THINK GALVANIZING A LOT OF
MOMENTUM AND I'M SO THANKFUL
I'M THANKFUL- TO THE STATE
AMOUNTS OF THANKFUL TO MY
MEMBERS SUPERVISORS WHICH
REALLY. GOT BEHIND THIS. AND
YOU KNOW FOR ME- IN MY ROLE
THIS IS ABOUT- FOLKS WITH
SEVERE PERSISTENT MENTAL
ILLNESS. HOMELESSNESS AND
INCARCERATION OF PEOPLE WHO ARE
SICK. AND I WILL I AM A
PSYCHIATRIST SO I COME AT YOU
WITH TO REAL QUICK SCENARIOS I
DO- I DO ST PSYCHIATRY ST
MEDICINE IN SKID ROW- AND I
SPEND TIME WITH PEOPLE WHO ARE.
WHO ARE DEVASTATED AND THEY'RE
LIVING IN HORRENDOUS
CONDITIONS. BUT THERE PEOPLE
THEY'RE LOVELY PEOPLE WHO IN
THE AREA IN THE RIGHT CONTEXT
FOR EXAMPLE BEING IN A BOARDING
CARE. WILL THRIVE IN THEIR OWN
WAY. AND THAT'S WHAT- I TAKE
WITH ME THE OTHER THING IS THAT
WE HAVE YOU KNOW THESE WE HAVE
LOCKED FACILITIES PEOPLE CALL
THEM I AM THESE. AND WE HAVE
YOU KNOW INDIVIDUALS WERE READY
TO GO BUT THEY DON'T HAVE THE
PROPER SUPPORTS AND LIVING
ENVIRONMENTS. AND IT'S VERY
COSTLY IS ALSO IN MY OPINION.
NOT THE LEAST RESTRICTIVE
ENVIRONMENT AND THAT'S- THAT'S
SOMETHING THAT REALLY REALLY
BOTHERS ME. THE THING ABOUT
BURNING CARE FOR ME IS THAT IN
A BOARDING CARE. IS TYPE OF
SHARED OR COLLABORATIVE
HOUSING. AND IT'S A IT'S A IT'S
A RESOURCE. THAT IS REALLY
SOMETHING THAT- THAT THAT I
THINK IS NOT. RECOGNIZED IN THE
WAY THAT IT COULD BE. AS
INFRASTRUCTURE THAT WE MUST
LEVERAGE. IN OTHER WORDS WE
SPENT A TREMENDOUS AMOUNT OF
TIME A TREMENDOUS AMOUNT OF
MONEY DEVELOPING. NEW
INFRASTRUCTURE WHICH TAKES A
LOT OF TIME AT THE SAME TIME
THAT THIS KIND OF COLLAPSE OF A
SYSTEM IS HAVE IT IS OCCURRING.
THE OTHER THING ABOUT ABOUT
BOARDING. BUT I'M A I'M A SICK
A MENTAL HEALTH GUY AND
BOARDING CARE MEANS A CERTAIN
THING TO ME BUT IN THE PROCESS
OF LEARNING ABOUT THE REST OF
THE ARE SEE IF YOU CAN ARE FOR
OLD. THERE'S A LOT OF DIFFERENT
THINGS LOTS OF TYPES SO HE'S
OUT TO DIFFERENT TO POPULATION
AND I THINK AS WE MOVE FORWARD
WE NEED TO KATE NICE THAT WE
NEED AS IT IS NOT. ONE THING-
FOR MY PEOPLE. IT'S OFTEN THE
PURPOSE. THE PLACE AND THE
PEOPLE IN THEIR ENVIRONMENT AS
MUCH AS IT IS THE CARE. AND WE
CAN'T LOSE SIGHT OF THAT IT'S
BURNING CARE IS A VERY RARE
ENTITY. I FOLLOW BECAUSE THE
BUSINESS MODEL- OKAY IN IS
ACTUALLY ARE BREAKING AND IT'S
WHY I THINK I YOU KNOW
CERTAINLY WE'RE WE'RE ALL HERE
FOR DIFFERENT VULNERABLE
POPULATIONS BUT- OPTED TO SEE
THIS HAPPENING IN LOS ANGELES
COUNTY AN ALARMING RATE I MEAN
IT. IS IT'S MARCH. EVEN
FEBRUARY. YOU KNOW I'M SAYING
IT'S THIS IS A PROCESS THAT IS
EXHILARATING IT IT DOESN'T STOP
AND WE'RE USING HUNDREDS AND
HUNDREDS AND HUNDREDS OF BEDS
SINCE I TOOK OVER THIS ROLE
THREE YEARS AGO. AND WITH THE
FIX TO THE BUSINESS MODEL ISN'T
CLEAR THERE'S A LOT OF
INTERESTING- POSSIBILITIES
NOTHING. SEVERAL OF THEM HAVE
BEEN REYES INCLUDING THE SS I
RATE. BUT THE THING ABOUT THE
LOSS OF A BOARDING CARE BAD IS
IT'S NOT JUST THAT YOU'RE
LOSING A UNIT. YOU LOSING US.
AND WE LIVE IN WE HAVE IT WITH
THE NIMBY. NIGHTMARE FOR THOSE
OF US ARE TRYING TO SAY
PROJECTS. AND YOU KNOW LOSING
TEN BEDS AND A SITE WHEN WE'RE
TRYING TO PROMOTE INCLUSION.
AND REINTEGRATION IS REALLY
REALLY UNACCEPTABLE AND I DON'T
THAT'S OF THE VALUE OF A SITE
CANNOT BE LOST. AS WE- PUSH
THIS EFFORT SO FOR ME IT'S NOT
JUST ABOUT SAVING AND RESTORING
THE BOARDING CARE NETWORK IT'S
ABOUT GROWING IT. AND YES THE
RATE IS ONE THING THAT WOULD BE
FANTASTIC RIGHT HOUSING THAT.
PORTING CARES HAVE GOTTEN A BAD
NAME. IN TERMS OF THE KEY
ISSUES WELL THE CONDITIONS ARE
NOT GREAT BECAUSE IT'S BEEN FUN.
SO THERE EASIER BUT ALL THERE'S
BEEN DEFERRED MAINTENANCE
BECAUSE THERE HAVEN'T HAD THE
RATES HAVEN'T HAD. CAPITAL TO
INVEST. THE THING THAT UP HEY.
AT WHAT UP IT IS THE. FORTY ME
AS I WAS IS A CERTAIN TYPE. HOW
PERMANENT OUT SHARED COLLAB.
HOUSE AND- AS CAN WE FIGURE OUT
A WAY TO GET SO. FOR BOARDING
CARE YOU KNOW I THINK SEX EIGHT
VOUCHER A LOT I THINK OF NO
PLACE LIKE HOME CAN WE THINK
ABOUT HOW WE BRING IN FUNDING
THAT IS EXCLUDED BECAUSE
THERE'S A LICENSING COMPONENT
AND I THINK THAT IF WE REFER
AROUND THE FACT THAT FOR
CERTAIN POPULATIONS IT IS
HAPPENING WE TO BE FIGURED OUT
OF BE ABLE TO FIGURE OUT A WAY
TO BRING IN HOUSING SUBSIDY
THANKS VERY MUCH. THANK YOU. I
WANT TO THANK YOU FOR THIS
OPPORTUNITY TO TESTIFY IN THIS
VERY IMPORTANT ISSUE AND I
WANTED PARTICULAR THANK THE
STAFF OF THE SENATE HUMAN
SERVICES COMMITTEE FOR PUTTING
THIS HEARING TOGETHER HI MY
NAME'S PAT MCGINNIS AND I'M THE
EXECUTIVE DIRECTOR OF
CALIFORNIA ADVOCATES FOR
NURSING HOME REFORM THAT WERE
BASED IN SAN FRANCISCO AND FOR
OVER THIRTY FIVE YEARS WE HAVE
PROVIDED ADVOCACY AND SUPPORT
FOR LONG TERM CARE CONSUMERS
INCLUDING NURSING HOMES
RESIDENTIAL CARE OF REASON
CONTINUING CARE FACILITIES.
OBVIOUSLY WE NEED BEDS AND SO
FOR AGING DISABLED ADULTS AND
NOT JUST TO PREVENT
HOMELESSNESS BUT TO ENSURE THAT
THE SAFETY OF THOSE INDIVIDUALS
AND TO PREVENT HARM TO THEM
HOWEVER WHEN WE TALK ABOUT
BURDEN CARE FACILITIES WE NEED
TO BALANCE THE NEED FOR BANDS.
NEED FOR QUALITY CARE AS WELL-
EVERY DAY WE BEGAN TWO HUNDRED
AND FORM IN HOT ARE ON OUR
HOTMAIL THANKS I'D EVERY MONTH
FROM PEOPLE WHO COMPLAIN ABOUT
CARE BUT ALSO LOOKING FOR BANDS
AND ALSO AN AWFUL. PULLING
THEIR RESIDENTIAL THEY PLACE IN
SOME PLACE BUT THERE IS RUN OUT
IF YOU LIVE LAW ENOUGH. AND
YOU'RE NOT RICH YOU MONEY GONNA
RUN WHEN YOU IN A NURSE HOME OR
IN A RED. CARE AND THE- TO THAT
ARE VERY VERY FEW. LICENSE CARE
HOMES ALSO BE A MAJOR PROBLEM
IN CALIFORNIA I DO THINK THAT
E NEED TO SEPARATE THE IT IS
THE IDEA OF BOARD WHICH IN ONE
SENSE YOU'RE TALKING ABOUT. IN
THE AIR WHICH IS A NOT SENSE
THAT THEY BOARDED THERE ARE
FACILITIES THAT. CORD I. PRICES
CITIES IN THE PROVIDE BOARD
CARE WE MORE NURSING HOMES IN
ACUTE CARE HOSPITALS DUMPING
PEOPLE INTO THESE CHEAP
ALTERNATIVES- WHY. BECAUSE
THEY'RE CHEAPER BECAUSE IT
DOESN'T COST THEM AS MUCH SO WE
NEED TO TAKE A LOOK IF WE ARE
GOING TO. HUSBAND FUNDS TO HAS
POOR ILL ON HOUSE TO MENTALLY
CHALLENGED INDIVIDUALS WE NEED
TO MAKE SURE THAT THEY'RE NOT
HOUSE. IN IF THEY NEED OTHER
CARE IN UNLICENSED FACILITIES-
I THINK SOME OF THE ANSWERS ARE
PRETTY OBVIOUS WE NEED MORE
FUNDING WE NEED TO INCREASE THE
SS I SS P. RATES- THERE FOR LOW
INCOME RESIDENTS TO ALLOW.
THOSE FACILITIES AND ACTUALLY
ACCEPT SS I SS P. OUGHT TO BE
ABLE TO BE FINDING A
SUSTAINABLE AND ALSO TO PREVENT
EVEN MORE HOMELESS. NEED TO
SPEAK ON THE IS LIVING FOR
PROGRAM WE'VE TALKED. FOR YEAR.
BUT WHEN CALL US TONIGHT I HAVE
TO ASK YOU WHAT COUNTY ARE YOU
IN YOU'RE NOT IN THE RIGHT
HONEY OR IF. THE PAY PROGRAM
NOT IN THE DESERT. IS A
LUDICROUS THAT WE'VE DEAL A LOT
TERM CARE IS AND- ON YOUR WE BY
DOING THIS FOR ON TIME. I'M
GONNA WASHINGTON HAVE ABOUT FOR
YOU. HAVE HAD A AND- LIVING
WAIVER PROGRAM WHERE THEY'RE
UNDER THE MEDICAID WAIVER SO
THAT THEY CAN FUND THESE KINDS
PROGRAM. PEOPLE GET DEEP THINK.
I WE THINK THAT THESE. I DON'T
ANSWER. THAT. CARE FACILITIES
FOR THE ELDERLY ACT- IN THIS
WAS AMENDED IN NINETEEN NINETY
ONE. WHERE THEY RECOGNIZE THE
NEED FOR A TIERED LEVEL OF CARE
THAT WOULD REPRESENT THE RANGE
OF CARE NEEDS BY FOR THE
ELDERLY RESIDENTS INCLUDING
BASIC CARE AND SUPERVISION
WHICH IS ONE LEVEL- NON MEDICAL
PERSONNEL. PERSONAL CARE WHICH
IS ANOTHER LEVEL AND HEALTH
ASSISTANCE RIGHT NOW WE HAVE A
ONE SIZE FITS ALL. RESIDENTIAL
CARE FACILITY REGULATIONS AND
STATUTES AND IT DOESN'T MAKE
SENSE IT HAS NEVER MADE SENSE
EVEN BECAUSE WE'VE NEVER FUNDED
IT- I WOULD SAY THAT TO BE
SYSTEM IT WOULD TO BE
SUSTAINABLE WE HAVE TO PROVIDE
MENTAL. MENTAL AND BEHAVIORAL
SERVICES MEDICAL SERVICES
SOCIAL SUPPORT AND FINANCIAL
SUPPORT. SO IT'S ABOUT TIME
THAT WE FUND THIS LEVELS OF
CARE AND THAT WE IMPLEMENT THE
TIERED LEVEL OF CARE SYSTEM.
AND FINALLY I WANT TO TALK
ABOUT. FOR CC WE TALK ABOUT ALL
THESE. THE CARE LICENSING TO
ACTUALLY OVERSEE THE KINDS OF
THINGS THAT THEY NEED TO
OVERSEE IN THAT THEY'RE MORE
THAN WILLING TO OVERSEE-
THEY'VE REGULATE OVER SEVENTY
THOUSAND DIFFERENT FACILITIES
STATE RIDE ARE DIFFERENT
PROGRAMS STATEWIDE- YOU KNOW
WHEN I STARTED MY ORGANIZATION
THIRTY FIVE YEARS AGO. WE USED
TO DO THEY USED TO DO
EVALUATIONS EVERY TWICE A YEAR
AND THEN IT WENT TO- ONCE A
YEAR AND THEN IT WENT TO EVERY
FIVE YEARS AND I HAVE BEEN
THERE I HAVE WATCHED THEIR BUT-
BEING CUT. CUT CUT CUT AND THE
KINDS OF SERVICES OVERSIGHT
THEY'RE ABLE TO PROVIDE ALSO
BEING CUT. SO TO PRETEND THAT
WE'VE ACTUALLY FULLY FUNDED
THEM IS A JOKE WE KNOW THAT WE
HAVEN'T- WITH IT ANYONE SPECS
SHINS AN INCREASE IN LICENSE
THE APPLICATIONS. STOP ALLIES
DOWN CATION POLICY. THE
DEPARTMENT HAS STRUGGLED TO
MEET ITS GOALS THAT THERE'S
GOING TO INSURE QUALITY OF CARE.
WHY OF THE REASONS THE THANK.
THE PART THAT CLEARLY IS THE A
PAY FOR THE L. A.'S DON'T GET
ENOUGH MONEY. IN IT'S ALWAYS MY
WE KNOW WHAT THE ANSWERS ARE
IT'S WHERE YOU THAT MONEY IT'S
CERTAINLY A SWITCH FOR CANDOR
TO BE PRAISING AND ENFORCEMENT
AGENCY RATHER THAN COMPLAINING-
BUT I THINK CCL HAS PROVIDED A
COMMITMENT AND SHOWN THEIR
COMMITMENT TO CALIFORNIA
CONSUMERS. AND DESERVES TO HAVE
THE FUNDING NEEDED TO DO THE
JOB THAT THEY ARE SO CLEARLY
EAGLE TO EAT YOUR TO DO. AS A
CONSUMER PROTECTION AGENCY WE
CAN'T JUST THROW MONEY AT
BOARDING CARE FACILITIES AND
THINK THE PROBLEM IS SOLVED. WE
HAVE TO PROVIDE THE KIND OF
OVERSIGHT AND GUIDANCE AND
TECHNICAL ASSISTANCE THEY NEED.
IF WE DON'T PROVIDE ADEQUATE
FUNDING TO DO THE TRAINING THE
A TECHNICAL ASSISTANCE TO
UNDERSTAND THE LAWS TO
ADEQUATELY VET LICENSE THE
APPLICATIONS- TO MAKE SURE THAT
THESE FOLKS ARE FIT TO OPERATE
A FACILITY IN THE FIRST PLACE.
STOP UNLICENSED OPERATORS TO
ABOUT A VALUE. TAKE THE TIME
THIS IS NEW THE VALUE. FOR A
NEW. TIME TO BE A TO DO IT BOB.
I'M ALL DOING IS PER FUN TO BE
PEOPLE IF WE DON'T FULLY FUND
THE OVERSIGHT AGENCY. L. IT
WOULD LEAD. FOR THE- WERE
TRYING TO PROTECT. AN AND ALSO
THIS SIGHTEDNESS WILL SHIP COME
BACK TO HER US. THANK YOU. I'M
SORRY NO THAT'S OKAY- I JUST
WILL JUST ADD THAT WERE JUST
READY TO INFORM AND BE INFORMED
BY THE MASTER PLAN FOR EIGHTEEN
AND- WE LOOK FORWARD TO
RECEIVING THE TASK FORCE
RECOMMENDATIONS TO GIVE OUR-
OUR INSIDE. SENATE JACKSON YES
I DID THE CHECK A QUESTION A
JUST THROW OUT- I DIDN'T HEAR
THIS AN APOLOGETIC GOT A LITTLE
LATE. YOU KNOW ONE OF THE
PROBLEMS AS WE DID LIKE WITH
OUR HOUSING SHORTAGE I'M NOT
SURE WE'RE GOING TO BE ABLE TO
BUILD OUR WAY OUT OF THIS
PROBLEM. AND SO AS WE LOOK AT
SOME OF THE ALTERNATIVES YOU
KNOW IT USED TO BE AND I WAS
READING AN ARTICLE BUT I THINK
DAVID BROOKS CAME OUT WITH THE
SAID YOU KNOW THE NUCLEAR
FAMILY HAS BEEN AT THE FASTER
FOR. AND I IT. ABOUT I CHAU AND
MY MOTHER CHILDHOOD AND CAN OF
THE FAMILY GRANDMA AND THE AT
THE AUNTS AND UNCLES HALL LIVE
RELATIVELY CLOSE BY AND YOU
KNOW GOD HELP US ON
THANKSGIVING EVERYBODY A
MERCHANT GRANDMA'S HOUSE IT WAS
CHAOS BUT RIGHT NOW- AS WE SEE
WHAT'S HAPPENING WITH OUR AGING
POPULATION IS THERE ANY
DISCUSSION ABOUT THINGS LIKE
THE HOUSING I THINK OF GRANNY
FLAT I THINK OF EIGHTY USE I
THINK OF OUR EFFORTS TO TRY TO.
THE FIFTH AT HE WILL PART MAYBE
SEE PUT THE FAMILY BACK
TOGETHER AGAIN- SO THERE SO THE
FAMILIES CAN PROVIDE CARE
GRANDMA CAN PROVIDE SOME CHILD
CARE ON OCCASION FOR THE LITTLE
ONES AND THEN WHEN GRANDMA
NEEDS CARE THAT THE FAMILIES
THERE TO HELP GRANDMA OR
GRANDPA I MEAN. IT'S TIME. THE
ONLY UNIT. IS I THINK PART OF
THE ANSWER TO THIS PROBLEM- DO
YOU HAVE ANY THOUGHTS ON THAT
THAT YOU MIGHT SHARE HOW CAN WE
ENCOURAGE IS I MENTION YOU KNOW
HAVING HOUSING BEING CLOSER
TOGETHER WHEN I USED TO WALK
PRECINCTS- I'D COME UPON HOMES
WHERE THERE'S THE GARAGE IN THE
HOUSE AND LO AND BEHOLD THE
KIDS IN THEIR FAMILY OR IN THE
HOUSE AND GRANDMA AND GRANDPA
MOVED INTO THE GARAGE LIVE
THERE THIRTY FORTY YEARS IN
THE- THAT IN. A UNIT OF.
HAPPENED A YOU KNOW TO THE
EXTENT THAT PEOPLE DO HAVE
FAMILIES AND DON'T NECESSARILY
HAVE TO LIVE IN ISOLATION. ARE
THERE THINGS THAT WE CAN DO I
AND SHOULD BE TALKING ABOUT IS
A WAY TO. SORT OF TRY TO
REPAIR. IN THAT KIND OF
SOCIOLOGICAL PHENOMENA THAT
THAT USED TO HELP FAMILIES
DURING THOSE KIND OF INTER
GENERATIONAL CHALLENGES SO
WE'RE NOT GOING TO DO IT BY
BUILDING MORE FOR. YOU KNOW OR
BUILDING OUR WAY OUT OF THIS
WITH WITH SENIOR HOMES ALTHOUGH
THOSE ARE WE'RE GOING TO NEED
TO DO THAT TOO BUT I JUST THROW
THIS OUT. WHAT ARE YOUR
THOUGHTS ON THAT. I HAVE SOME
THOUGHTS ON IT BECAUSE MY MOM
JUST DIED LAST APRIL IT NINETY
SEVEN YEARS OLD AND WE
PROVIDING CARE FOR HER TO BE
ABLE TO STAY AT HOME I WAS BACK
EAST. PROBABLY THREE OR FOUR
TIMES A YEAR BUT I WAS LUCKY.
AJ WE'RE IRISH SHEET WE HAVE
SEVEN KIDS IN THE FAMILY SO WE
COULD TAKE TURNS. HOWEVER AND I
AGREE WEEK I GREW UP THE SAME
WAY EVERYBODY HAD AN AUNT AND
UNCLE AND ANY NINETY YEAR NOW
ON OUR GRANDMOTHER SOMEBODY
LIVING WITH THEM WE TOOK CARE
OF MY AUNT. WHAT I HEAR FROM
PEOPLE TODAY ARE ON THE PHONE
WE GET HUNDREDS OF PHONE CALLS
EVERY MONTH WHAT I HEAR IS THE
GAS FOR A OF KIDS THEY'RE NOT
HERE. THEY GO TO WASHINGTON DC
TO GET A JOB WE GET CALLS FROM
ALL OVER THE COUNTRY FROM
PEOPLE MY MOM'S IN CAL. AND
SHE'S SECOND I DON'T KNOW WHAT
TO DO. I DON'T KNOW HOW TO
BRIDGE THAT PARTICULAR GAP BUT
DO THINK THAT. YOU KNOW WE
CERTAINLY CAN A- JET AND A LOT
OF PEOPLE THEIR KIDS DON'T GET.
SO THAT DATA WANT TO DEAL WITH
I WOULD SUSPECT MORE THAN HALF
DON'T BUT THAT'S NOT THE POINT.
YEAH AT. WELL WE'RE NOT. HAVING
INNER CHANNEL. FAMILIES IS NOT
THE PAM. I'M SURE THINKING IT
MIGHT BE IT IT'S ONE OF THOSE.
THAT PERHAPS WE NEED TO THINK
ABOUT MORE WHEN PEOPLE DO
CHOOSE TO LIVE IN THE SAME
WORSE OR CLOSE. THEIR SHARED
HOUSING- PROJECTS IT WHERE YOU
ARE YOU MATCH. COLLEGE STUDENTS
WITH AN ELDERLY PERSON WHILE
THEY ARE LIVING THERE. I THINK
HONESTLY THAT IT STOPS WHEN
THAT PERSON'S NEEDS BECOME TOO
HOT- AND THAT'S WHEN IT STOPS.
AND THAT'S WHEN PEOPLE END UP
GOING INTO A BOARDING CARE
RESIDENTIAL CARE FACILITY AND
THAT'S ONE OF THE ISSUES I
AGREE PEOPLE. WE NEED TO DO
THAT WOULD HAVE BEEN A LOT OF
THOSE KINDS OF PROGRAMS OVER
THE YEARS IN CALIFORNIA- I
GUESS I DON'T HAVE ANY ANSWERS.
IF I COULD JUST A BRIEFLY WE'RE
WE'RE WORKING NOT ME ON- ON A
PROGRAM THAT WILL- YOU KNOW
REUNITE FAMILIES- PARTICULARLY
WITH THOSE WHO ARE SUFFERING
FROM SERIOUS MENTAL ILLNESS AND
HAVE BEEN IN ON OFF THE STREETS
AND AN IN AND OUT OF JAIL- ONE
OF THE BIG PROBLEMS THAT I
THINK IS IT. IS ILLNESS
FRACTURES FAMILIES AND WE HAVE
TO MAKE SURE THAT WE HAVE
BETTER ACCESS TO TREATMENT ON
THE OTHER THING I'M JUST YOU
KNOW JUST SAY IT THE YOU KNOW-
HIPPA. AND OTHER THINGS THAT WE
ARE CHALLENGED BY WHICH ARE
FEDERAL DON'T HELP BECAUSE THEY
REALLY DON'T ALLOW FAMILIES TO
COMMUNICATE ABOUT CORE ISSUES
AND THAT'S A BIG BIG PROBLEM.
YEAH I WILL JUST ADD THAT IN
ALL OF OUR HOUSING
CONVERSATIONS YOU'RE ACTUALLY
RIGHT THE FIRST UP THE FEEDBACK
IS MORE HOUSING BUT THE SECOND
IS MORE INNOVATION AND JUST
THREE THINGS THAT WE'VE HEARD
AROUND THE STATE I'M SAN DIEGO
A COUNTY HAS PRE APPROVED FIVE
EIGHTY YOU MODELS SO IF YOU USE
ONE OF THOSE FIVE EIGHTY USE IT
WILL BE APPROVED YOUR SAME THE
PLANNING COSTS YOU SAVE SOME
TIME THERE NEVADA COUNTY AT THE
ROUND TABLE UP THERE THEY SAID
WE HAVE PLENTY OF SQUARE
FOOTAGE IS JUST WITH THE WRONG
PEOPLE IN THE WRONG. CAN I
SUBDIVIDE MY HOUSE CAN I CAN I
DO THAT PUT A KITCHEN IN THE
BACK AND HOW DO WE HELP LOCAL
ZONING AND LOCAL REGULATION
MOVED TO THAT HUGE HOUSE
BECOMING A TRIPLEX OR A MULTI
PLEX- AND THEN MY OWN
NEIGHBORHOOD A NEW AFFORDABLE
HOUSING UNIT HAS GONE UP THAT
IS HALF SENIORS AND HALF OF
FOSTER YOUTH AGING OUT THE
SYSTEM AND SO AGAIN THAT MIX
GENERATIONAL CROSS- NOT JUST
SENIOR CENTER SENIOR HOUSING
BUT CROSS GENERATIONAL SO I
THINK WE'RE LOOKING FOR
EXAMPLES OF THAT AND HOW WE CAN
HELP SCALE AND SPEED. THIS IS
SAM DISCO THEY MADE A VERY VERY
DIFFICULT TO BUILD IN LOS UNITS
AND ALSO I WAS AT A HEARING
FOR- SOMEBODY'S TAXES THIS
ELDERLY COUPLE THEY BUILT OF
DID YOU KNOW AS THE BATHROOM IN
THEIR HOUSE AND TAXES WERE
INCREASED TO THOUGHT DOLLARS A
YEAR. WHICH IS. THAT'S JAMES.
WE MAY. I THE AND YOUR TAX GO
UP YOU BUILD IN LOS. IN
PARTICULAR PLACE LIKE. THIS TAX
ARE PRETTY ALREADY SO. WELL I
WOULD JUST SUGGEST THAT WE ARE
THIS TO THE DESERT OF A ENERGY.
RELATIONSHIPS AND THE THAT THEY
CAN BE A WIN WIN WHEN YOU'RE
DEALING WITH MENTAL ILLNESS
OBVIOUSLY THAT'S A CHALLENGE
WHEN YOU'RE DEALING WITH
COGNITIVE ISSUES THAT CAN BE A
CHALLENGE. BUT PUTTING PEOPLE
IN THESE OTHER FACILITIES ISN'T
IT HI IT JUST ISN'T THE PANACEA
THERE MAY BE INSTANCES WHEN WE
HAVE TO DO THAT BUT- I JUST
WONDER IF WE COULD START
THINKING ABOUT. TAKING
ADVANTAGE OF FAMILIAR OF FAMILY
RELATIONSHIPS A LITTLE BIT MORE
RECOGNIZING THEIR VALUE I MEAN
THEY'VE BEEN A THEY'VE BEEN
AROUND AS LONG AS HUMANKIND IN
AND AS THEY GET MORE AND MORE
ATTENUATED THERE IS THAT
GREATER ISOLATION THAT GREATER
LOSS AND ALL ALL THOSE THINGS
SAID. WHICH IS NOT GOING TO
BUILD OUR WAY OUT OF SO I WOULD
JUST LIKE TO SUGGEST THAT IT
AND HOPE THAT- WE SEE SOME
DISCUSSION AGAIN IT'S NOT THE
ANSWER BUT IT COULD BE PART OF
THE- JACK. I HAVE QUESTION FOR.
I WONDERED IF THERE'S I KNOW
THERE'S A LOT GOING ON IN TCL
BUT CAN YOU YOU JUST. GIVE ME
MAYBE LIKE THE TOP PRIORITIES A
BIT DID YOU TO. ARE LOOKING AT.
WELL RIGHT NOW OUR PRIORITY IS
TO- IMPLEMENTED TOOL THE
INSPECTION TOOL FOR FOUR
PLANNING ON ROLLING THAT OUT TO
ALL OF OUR ALL THREE FACILITY
TYPES ARE PROGRAM TYPES CHILD
CARE CHILDREN'S RESIDENTIAL
ADULTS SENIOR SO THAT THAT'S
ONE OF OUR PRIORITIES- REVISE
IN OUR REGULATIONS RIGHT NOW
WE'RE WORKING ON THE DEMENTIA
RAGS- AND THE COME. THAT THE
PLAN IS TO PROVIDE TRAINING TO
OUR LICENSEES TO SO IT'S LIKE
WE'RE WORKING ON SEVERAL HIGH
PRIORITIES AND BECAUSE ITIT
REALLY TAKES IT'S SO COMPLEX
THAT IT TAKES. A VILLAGE TO GET
THIS COMPLETED HAND. WE TAKE
THE RESPONSES THAT WE GET FROM
OUR L. PAYS OUT IN THE FIELD TO
SEE WHAT WHAT THE NEED IS AS
WELL AS FROM LIKE THE OMBUDSMAN
PROGRAM THAT'S OUT IN THE- IN
THE FACILITIES. MORE FREQUENTLY.
THANK YOU SO MUCH I WANT TO
THANK OUR OUR FINAL PANEL AND
EVERYONE ELSE THAT PARTICIPATED
IN TODAY'S HEARING I ALSO
WANTED A THINKER HUMAN SERVICES
COMMITTEE TEAM OF FOR ALL THEIR
HARD WORK ON TRYING TO GET
TOGETHER THIS THIS AT THIS
HEARING TODAY- I THINK FIFTY WE
HAVE A LOT OF A THERE'S A LOT
OF YOU KNOW WORK BEING DONE BY
CC ALLEN AND- WE COMMEND THE
LEADERSHIP OF THE DEPARTMENT
FOR ALL THE HARD WORK DONE IN
RECENT YEARS TO REBUILD THE
DIVISION. AFTER DUSTED BUDGET
CUTS OF THE COMBINATION OF
SEARCHING POPULATION OF ELDERLY
CALIFORNIANS IN A WIDENING GAP
BETWEEN THE HAVES AND HAVE NOTS
MEANS HE FEEL OVERSIGHT IN THE
RESIDENTIAL FACILITIES
FACILITIES WILL CONTINUE TO BE
OF PRIME IMPORTANCE ARE WE MUST
DO EVERYTHING WE CAN TO ENSURE
OUR SENIORS ARE PEOPLE SERIOUS
MENTAL HEALTH ILLNESS AND
PEOPLE WITH DISABILITIES ARE
SAFE AND A PROPERLY CARE FOR
WHILE RESIDING IN LICENSED
FACILITIES. I LOOK FOR TO
CONTINUE TO WORK WITH ALL OF
YOU IN THIS CAPACITY OF THIS
CONCLUDES TODAY'S HEARING OF
THE SENATE HUMAN SERVICES
COMMITTEE WE ARE ADJOURNED.
THANK YOU. PUBLIC COMMENTS. SO
AT THIS WELL THAT'S OKAY AT
THIS POINT GO HEAD TO TAKE
PUBLIC COMMENT OKAY. FOOD NO.
IT'S MONDAY IT'S OUR FIRST
HEARING RIGHT. YOU'RE JUST
GETTING STARTED- I'M NOT APRIL
FIRST I PROMISE. I'M THERESA
COMSTOCK I'M EXECUTIVE DIRECTOR
FOR CALIFORNIA ASSOCIATION OF
LOCAL BEHAVIORAL HEALTH BOARDS
AND COMMISSIONS WE SUPPORT THE
WORK OF CALIFORNIA'S FIFTY NINE
A MENTAL AND BEHAVIORAL HEALTH
BOARDS AND COMMISSIONS AND
WE'RE PASSING OUT OUR ISSUE
BRIEF THIS IS- THIS IS AN ISSUE
THAT WE'VE BEEN LOOKING AT FOR
A FEW YEARS NOW AND HOPING TO
CALL ATTENTION TO SO THANK YOU
SO MUCH FOR THIS THEM. A
MEETING TODAY- THIS IS A ISSUE
BRIEF THAT SUMMARIZES WHAT WHAT
WE SEE IS AS THE KEY
CHALLENGES- WHAT KIND OF COSTS
ARE WE INCURRING BECAUSE WE
DON'T HAVE ENOUGH BOARDING
CARES FOR INDIVIDUALS WITH
SERIOUS MENTAL ILLNESS- WE-
HAVE DATA THAT I'M POINTS TO
HUNDREDS OF BEDS LOST. AND
FOUND ALSO IF YOU PULL THIS UP
ONLINE YOU'LL SEE THAT THE
SCHEDULE THAT'S AVAILABLE FOR
FUNDING FOR INDIVIDUALS WITH
DEVELOPMENTAL DISABILITIES AND-
AND THEY'RE ABLE TO DROP BY AS
MUCH AS NINE THOUSAND TWO
HUNDRED EIGHTY EIGHT DOLLARS
PER MONTH RIGHT NOW DEPENDING
ON WHAT THEIR NEEDS ARE.
ALTHOUGH PEOPLE WITH SERIOUS
MENTAL ILLNESS ARE ONLY DRAWING
THAT ONE THOUSAND SIXTY NINE
DOLLARS PER MONTH- SO WE'RE-
PLEASE THAT YOU'RE CALLING A
TEN TO THIS ISSUE AND WE
SUPPORT. THE GOVERNOR'S BUDGET
ON IN TERMS OF FUNDING AND
HOPING TO SEE FUNDING AROUND
FIVE HUNDRED MILLION DOLLARS TO
BOLSTER THE BOARDING CARRIES
YOU BECAUSE IT IS AN IMMEDIATE
NEED. THANKS. AFTERNOON LEASE A
COMMON WITH THE CALIFORNIA LONG
TERM CARE OMBUDSMAN ASSOCIATION
AB I I'D CONTINUE THE LOVE FAST
FOR CC OUT THE LOCAL PROGRAMS
TALK ABOUT THE BENEFITS OF
HAVING THE QUARTERLY
STAKEHOLDER MEETINGS WITH THEIR
LOCAL ON MANAGING REGIONAL. OF
THAT KIND OF COMMUNICATION
THAT'S GOING ON BETWEEN THE
LOCAL OMBUDSMAN MCC L. IS
REALLY BENEFICIAL IT IT HELPS
THE OMBUDSMAN TO BE DIRECTED.
YOU KNOW YOU HAVE A HOT SPOT
HERE IT HELPS NGUYEN LICENSING
HEARS FROM THE OMBUDSMAN THIS
IS WHAT WE'RE SEEING. AB I WANT
TO POINT OUT- ONE OF THE THINGS
SENATOR PAN TALKED ABOUT WAS
THE- IT SEEMS TO BE A STABLE
BAD. IN THE ASSISTED LIVING.
THERE WE HAVE ACTUALLY HAD A
TEN THOUSAND- BED COUNT
INCREASE IN THE LAST. FEW YEARS
IN AND THAT'S INCLUDED IN THIS
DOCUMENTATION FROM C. C. L.
WHAT'S CHANGED IS THE NUMBER OF
LICENSES SO WE'VE HAD A
DECREASE IN THE NUMBER OF
LICENSES AND INCREASE THE
NUMBER OF BEDS. THAT INCREASE
IN THE NUMBER OF BEDS IS NOT
SUFFICIENT TO RECOGNIZE YOUR
CONVERSATION EARLIER ABOUT THE
GROWING NUMBER OF SENIORS THAT
NEED THE CARE. BUT WHAT OUR
MEMBERS ARE SAYING IS PEOPLE
ARE ENTERING INTO ASSISTED
LIVING LATER WHEN THEY'RE
SICKER. WHEN THEY HAVE HIGHER
NEEDS AND SO THEY'RE STAYING AT
HOME LONGER THEY'RE TRYING TO
PATCH THINGS- WITH LOCAL
SERVICES FOR LONGER BEFORE THEY
GO INTO ASSISTED LIVING. THAT
PUTS GREATER PRESSURE ON THE
ASSISTED LIVING STAFF THEN ALSO
PUTS A MORE PEOPLE WHEN THEY DO
RUN OUT OF FUNDS. IF YOU'RE IN
AN ASSISTED LIVING FACILITY AND
YOU'RE PAYING FOR AND FIVE
THOUSAND DOLLARS A MONTH WHEN
YOU RUN OUT OF FUNDS YOU
PROBABLY ARE NOT GOING TO
BECOME ELIGIBLE THE BULK OF
THEM ARE NOT GONNA BE ELIGIBLE
FOR THE SS I SS BE RATE.
BECAUSE THEIR MONTHLY INCOME IS
OVER THAT POVERTY LIMIT. SO
THOSE ARE THE FOLKS THAT I
REALLY WORRY ABOUT THEY'RE NOT
ELIGIBLE CURRENTLY FOR SS I SS
P. THE ASSISTED LIVING WAIVER
PROGRAM WAS REFERENCE THAN THAT
PROBABLY WOULD BE THE EASIEST
WAY. TO ADDRESS THAT- INCOME
PERSON AS LONG AS YOU ADDED A
SHIPPER OF COST. NO THE PERSON
CAN APPLY FOR THE ASSISTED
LIVING WAIVER IF THEIR MONTHLY
INCOME IS TOO HIGH. I THINK
THERE ARE LOTS OF THINGS WE CAN
DO. WELL AS AS THE INNER CENTER
JACKSON SAID WE CAN'T BUILD OUR
WAY OUT OF THIS. BUT THESE
HEARINGS ARE A GOOD START AS A
PERSON WHO LIVES WITH OUR-
MOTHER LIVES WITH THEM ALL FOR
INTERGENERATIONAL HOUSING. AND
MY YOUNGEST AND MY SON WAS ABLE
TO BUY HIS FIRST HOME BECAUSE
HE LIVED WITH A GRANDPARENT FOR
A YEAR PROVIDING CARE AND SAVED
RENT. THERE ARE OPTIONS THANK
YOU. GOOD AFTERNOON THANK YOU-
TEAR HER TITLE FOR HOLDING THIS
I'M JANE ADCOCK WITH THE
CALIFORNIA BEHAVIORAL HEALTH
PLANNING COUNCIL. BACK IN
TWENTY SEVENTEEN ACTUALLY STAFF
FROM COMMUNITY CARE LICENSING
REACHED OUT TO US BECAUSE THE
NUMBER OF THE OWNER OPERATORS
WERE STRUGGLING SERVING FOLKS
WITH SERIOUS MENTAL ILLNESS.
THAT CAUSED US TO EMBARK ON
THIS PROJECT WE ISSUED A REPORT
IN TWENTY EIGHTEEN I WILL SEND
IT TO YOUR STAFF. IT DOES TALK
ABOUT FOR THE THIRTY I THINK IS
ABOUT THIRTY THREE COUNTIES IT
RESPONDED- IT SHOWS THE NUMBER
OF BEDS THAT ARE NEEDED THAT
THEY AREN'T AVAILABLE AND HOW
MANY THEY'RE PAYING FOR OUT OF
COUNTY. WE ARE NOW APPROACHING
THIS ISSUE KIND OF A HIERARCHY
OF NEEDS IN THE VERY FIRST ONE
IT IT'S ALL FINANCIAL WE NEED
TO STOP THE LOSS OF THE BED
SAYS DR SHARON MENTION YOU AND
YOU LOSE A FACILITY YOU'RE
NEVER GOING TO GET IT BACK- SO
THERE NEEDS TO BE A FINANCIAL
SUPPLEMENT TO. BRING THAT AND
DOLLAR AMOUNT EACH MONTH CLOSER
TO THE ACTUAL COST WHEN PEOPLE
ARE ON AS A SIDE THAT YOU'VE
HEARD THAT THOUSAND DOLLARS.
THOSE OWNER OPERATORS ARE
OPERATING AT SUCH A DEFICIT
THEY ARE OVERWHELMED AND THEY
ARE NOT ABLE TO PARTICIPATE IN
A LOT OF TA. THEY CAN'T
PARTICIPATE IN STAKEHOLDER
CALLS AND THEY CAN'T GO OUT AND
PURCHASE A LITTLE SMALL. BOX TO
DEAL WITH THE BED BUGS. THE
SECOND IS YOU SEEN ON THE
PAPERWORK TODAY THE BIGGEST
REASON FOR. SITE BY CCL IS THE
FACILITY ITSELF IS AN UP TO
SNUFF WE NEED TO CALL. A ONE
TIME PART. THE FOR EGGS OFFICE.
TO MAY THE WHOLE ON BUT ALL
ALLOW THE OVER CCA A MAN
BECAUSE THEY KNOW BUT. LIFE IS
ME IT IS IT WILL GIVE US
FUNDING TO FIRST. WILL CAN FOR
THEIR PROP. INCOME IT'S A ONE
KERR. AND THEM AS THEY MADE
WHOLE MONTH IT WOULD BE A TERM.
THE AFTER WE DONE THE THEY WE
CAN GO INTO BETTER SUPPORT AND
QUALITY PROGRAMMING FOR
OPERATORS THANK. GOOD AFTERNOON
MADAM CHAIR AND COMMITTEE I'M
TYLER IN THE WITH THE COUNTY
BEHALF OR CONTRACTORS
ASSOCIATION FIRST OF ALL I'D
LIKE TO SAY THANK YOU FOR IT
YOU KNOW HOLDING THIS HEARING
ON THIS VERY IMPORTANT- TOPIC
AROUND THE IN A VULNERABLE
POPULATIONS THAT ARE WITHIN
IMPORTING CARE FACILITIES- AND
I'D ALSO LIKE TO THINK THAT.
COMMITTEE FOR ALLOWING HER TO
MEMBERS DR SHARON AND I'M KAREN
OURS FOR BEING ABLE TO SPEAK
ABOUT YOU KNOW OUR PERSPECTIVE
ON BOARDING CARE FACILITIES WE
DO KNOW THAT- FOR INDIVIDUALS
THAT ARE ON THE ACCESS I RATE
TO THAT THE REPEAT IS NOT- DOES
NOT MEET THE- NEEDS OF THE I'M
FACILITIES TODAY THE RATE. IS
ABOUT HALF OR LESS WHAT THE
ACTUAL COST OF PROVIDING
BOARDING CARE FOR OUR
RESIDENTS- WITH YOURS MENTAL
ILLNESS. AND WE SEE THAT WITH
THIS- INADEQUACY WITHIN THE
RATES- AND THE RATE STRUCTURE
THAT IT LEADS TO THE LOSS OF
PHAM SSI BATS ACROSS THE-
ACROSS THE STATE AND- THIS IS
LEADING TO AN AND BURDEN
OUTCOMES AND STOP FOR WE HAVE
MORE INDIVIDUALS THAT ARE AN
INPATIENT SETTINGS AND
INSTITUTIONAL CARE. I'M A LOT
OF INDIVIDUALS THAT WOULD BE
ABLE TO TRANSITION OUT OF AND-
ON THE STREETS. THAT ARE
EXPERIENCING HOMELESSNESS THIS
WOULD BE A GREAT- SPOT. YOU AT
HAVE GREAT OKAY AN ABORT
OFFICER. A I'M WILL BE BREAKING
FOR A TO THE BUDGET COMMITTEE A-
BY RICK. THAT WE CLOSE BOND
ALONG THE FEINBERG INSTITUTE
AND OUR COUNTY ARE. YOU KNOW
INCREASE IN. FOR BOARDING SO.
TO ADDRESS. RATE SADDAM ADDRESS
THE FIFTH MADE AND OTHER NEEDS
OF THE FACILITIES TO THE
FACILITIES CAN PROVIDE. GOOD
CARE TO THE RESIDENTS THANK YOU.
IF WE HAVE NO ADDITIONAL
COMMENT AT THIS. POINT OF THIS
WILL END OUR FIRST HEARING
THANK YOU SO MUCH MEETING IS
ADJOURNED.