How Should California Regulate Growing, Changing Assisted-Living Industry?

A joint hearing of the Senate and Assembly Human Services Committees last month examined the growing and changing assisted-living industry in California.

The hearing included testimony from witnesses who contend California’s oversight has not kept pace with the evolving industry which promises to grow faster as aging baby boomers lose the ability to care for themselves.

Dozens of deaths and injuries have been attributed to sub-standard care at California residential care facilities for the elderly — known as  RCFEs — in the past six years. In San Diego County alone, 27 assisted-living residents died since 2008 as a result of injuries or neglect stemming from poor care, advocates said.

Some experts contend California’s oversight of the assisted-living industry was less-than-robust even before funding cutbacks in recent years reduced the state’s ability to monitor the facilities.

Some stakeholders contend that state regulations need strengthening to give health officials sufficient clout to protect consumers. They point out that under current regulations neglect or abuse are punishable by a maximum fine of $150.

The assisted-living industry is overseen in California by the state Department of Social Services under legislation passed in 1985. However, in the years since the Residential Care Facilities for the Elderly Act was signed into law, the industry has changed considerably, growing in scope and taking in residents with greater health care needs.

According to a new report from the National Senior Citizens Law Center — “Best Practices in Assisted Living: Considering Potential Reforms for California” — California regulations are about two decades behind the changes in the industry.

We asked experts and stakeholders how California should regulate and stay abreast of the growing, changing assisted-living industry. We got responses from: