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Alameda County: Assisted Living Reform Advocates Hope New Director Will Overhaul State's Licensing Agency
San Jose Mercury News
The California agency criticized for its botched closure of a Castro Valley assisted living home is on the hunt for a new director -- and it must choose from a pool of state workers unless Gov. Jerry Brown appoints an outside figure.
An internal hire is unlikely to satisfy senior advocates demanding a major shake-up at the Department of Social Services' Community Care Licensing Division.
"They need an overhaul of that department," said Patricia McGinnis, director of California Advocates for Nursing Home Reform. "Unless they have a complete change of attitude, unless they have a complete change of guard, I don't see how things are going to be any different."
The agency drew outrage last month for allowing more than a dozen frail residents to be left at Valley Springs Manor without proper care after the state had ordered the home closed. An internal review is now looking into what went wrong.
It was the previous head of the division, Jeffrey Hiratsuka, who initiated formal proceedings in May to revoke the license of the Castro Valley facility and ban its owners from ever running such a home again.
That was after complaints by residents and advocates against Valley Springs and a sister home in Oakland began mounting last year. The complaints led to unannounced state inspections that discovered numerous violations and forced the ouster of the homes' longtime administrator, according to state records.
Hiratsuka, who could not be reached for comment, retired this summer after fours years directing the division and a total of 12 years working in its Sacramento headquarters. A staff newsletter commended the 61-year-old for guiding "the program through some of the worst economic and budget times ever experienced in the state."
The agency posted the job opening on Aug 14. The six-figure salary -- between $108,216 to $122,844 annually -- comes with the responsibility of overseeing a $100 million budget, developing statewide policy and enforcing laws meant to ensure the safety of vulnerable elders and children at 80,000 private care facilities around the state, including more than 7,500 elder care homes such as the one in Castro Valley. Whoever takes the job reports to Will Lightbourne, director of the California Department of Social Services. Lightbourne has authority to make the hire if the candidate is a state government worker or military veteran, but the governor can also select an outside candidate.
"The focus is on finding and hiring the most qualified candidate" regardless of whether that person comes from within or outside, Brown spokesman Evan Westrup said Monday.
In the meantime, a former director, David Dodds, returned Aug. 1 to fill in as interim director.
Through a spokesman, Dodds declined to speak Monday as the internal review continues. He had experience managing emergency closures when he ran the division in the 1990s.
"The worst thing that happens in our program is that we have to take someone's license away," he told the San Francisco Examiner in 1996. "Sometimes, through a temporary suspension order, we show up at the door and close the facility. Those statistically are rare, but in this state, when we need to take that action, we don't hesitate to do it."
Dodds told the newspaper his agency takes special caution after revoking a license because "it risks elders, just moving them. We're very much aware of the transfer trauma."
Indeed, state law dictates precisely what agency workers must do in the event of a sudden closure. State workers must "make every effort to minimize trauma for the residents" living in a home where the license is being revoked, according to California's health and safety code. That effort is supposed to include working with local placement agencies, notifying family members and consulting with medical doctors to help transfer residents safely, all before the final closure notice is posted on the door. A series of new laws passed in recent years strengthened some of those resident protections.
Despite all those rules, "obviously something went wrong" in Castro Valley, said state Sen. Ellen Corbett, D-San Leandro. "This should not be happening in our state."
Corbett is now crafting legislation to require "some sort of transition plan" to keep residents safe after a home is closed for repeated violations.
Nineteen residents were still living in Valley Springs, but most caretakers had stopped working when the state ordered its Oct. 24 closure, citing a long list of health and safety violations. A state worker returned the following day and reported that there was not enough food and problems distributing medicine to the residents still waiting to leave. She filed a report and issued a fine. Not until the next afternoon, two days after the home had closed, did a series of 911 calls alert Alameda County fire officials to the dire conditions inside.
"There may be plans in place but obviously they did not work," Corbett said. "It was closed down and the owners walked away and the people were left behind."
Paramedics began evacuating the last 11 residents on Oct. 26 after realizing only two inexperienced and unpaid workers -- a cook and janitor -- were caring for them.
Corbett said she is still researching the gaps in the state's response but will introduce a bill when the Legislature begins its new session in January. She also wants more frequent inspections of care homes, something that might come at a high cost.
Elder care advocate McGinnis welcomes any new legislation but said lawmakers need to change the "whole system," including the people who run it, "if we want to prevent this kind of thing from happening again."
What state law says:
Section 1569.525 of the California Health and Safety Code dictates what state workers must do after ordering the closure of a residential care home to ensure the safe transition of the displaced residents. "If the director determines that it is necessary to temporarily suspend or to revoke any license of a residential care facility for the elderly in order to protect the residents or clients of the facility from physical or mental abuse, abandonment, or any other substantial threat to health or safety pursuant to Section 1569.50, the department shall make every effort to minimize trauma for the residents. The department shall contact any local agency that may have placement or advocacy responsibility for the residents of a residential care facility for the elderly after a decision is made to temporarily suspend or to revoke the license of the facility and prior to its implementation. The department shall work with these agencies to locate alternative placement sites and to contact relatives responsible for the care of these residents. The department shall use physicians and surgeons and other medical personnel deemed appropriate by the department to provide onsite evaluation of the residents and assist in any transfers. The department may require the licensee to prepare and submit to the licensing agency a written plan for relocation and compliance with the terms and conditions of the approved plans, and to provide other information as necessary for the enforcement of this section." To read more of the code's provisions, including recent amendments, go to: www.leginfo.ca.gov/pub/11-12/bill/asm/ab_2051-2100/ab_2066_bill_20120927_chaptered.pdf