In a brazen attempt to deregulate nursing homes, the Department of Public Health (DPH) presented a legislative proposal today that would gut California’s oversight of nursing home care and destroy countless reforms established by the Legislature over the last 30 years.
The Senate Budget Subcommittee #3 defeated the measure today on a 2-1 vote. On Monday, an Assembly Budget Subcommittee also rejected the proposal on a 3-0 vote. Despite these defeats, it is possible that the Department of Public Health will continue to try to pass this measure.
Links to the DPH proposal, the Senate’s analysis of it, and CANHR’s opposition letter are at the bottom of the page.
The plan would have also cut oversight of hospitals and other health care facilities, but its most far-reaching changes were aimed at deregulating nursing homes. If passed, it would have eliminated all State timelines for investigating nursing home complaints and repealed a California law that required DPH to conduct licensing inspections of nursing homes.
Its most shocking provision would have repealed a longstanding requirement that DPH start investigating nursing home complaints that pose an imminent danger of death or serious bodily harm to a resident within 24 hours. Delaying investigations while residents are dying from neglect and abuse would be a terrible injustice to victims and would send the wrong message to nursing home operators.
Of equal concern, the Department proposed to repeal the requirement that it begin investigating other complaints against nursing homes within 10 working days. This requirement is the subject of a September 2006 San Francisco Superior Court order obtained by CANHR that requires DPH to comply with the 10-day timeline. Prior to the lawsuit, DPH often ignored serious nursing home complaints for months or years and had a huge backlog of complaints. By repealing the investigation timelines, DPH was seeking a return to the days when it wasn’t accountable to anyone.
The Department’s proposal to eliminate state licensing inspections of nursing homes would repeal most of SB 1312, legislation authored by Senator Alquist in 2006 to restore those inspections. The law requires the Department to evaluate compliance with the dozens of California laws and regulations that exceed federal standards. Without this process, the California requirements would be unmonitored, unenforced and meaningless to residents.
The California requirements that DPH seeks to ignore include the right to informed consent, abuse reporting, minimum staffing requirements, family council rights, family visitation rights, bed hold rights during hospitalization, admission agreement standards, protections against theft and loss and many others.
Senator Alquist, who sits on the Senate Budget Subcommittee, expressed anger that DPH sought to undo her legislation and sell-out nursing home residents in the process. In lengthy comments at the hearing, she said that California laws designed to protect residents have little value if they are not enforced. She mocked DPH’s use of the term “deficiency” to describe nursing home violations, saying it did not do justice to the harm suffered by residents who are being mistreated.
Claiming the proposed changes are “efficiency” measures, DPH used the budget process to bypass the Legislature’s normal process to review legislation. Due to this suspect maneuver and DPH’s total failure to give notice of its plan, the measure was heard this week with very little advance notice and even less public awareness about its goal to deregulate nursing homes.
Helpful reviews by the Assembly and Senate Budget Subcommittee staff showed that DPH’s proposal would not save the State any money.
The DPH proposal represents a deep betrayal of its duty to protect California nursing home residents from neglect, abuse and mistreatment. It leaves residents and their families to wonder who they can turn to when they suffer mistreatment in a nursing home. And it leaves us to wonder what it will try next.
The only good news with this development is the outstanding overnight response by CANHR members, consumers, ombudsmen, Disability Rights California and other advocates who rose up against it, and the excellent work of the Assembly and Senate members and staffers who stopped it in its tracks.