State Accused of Failing to Clean Up Boarding Homes

A year after a scathing report called attention to conditions in privately run board-and-care homes for the elderly, mentally ill and retarded, the state Department of Social Services has fallen far short of correcting the problems, witnesses told the Little Hoover Commission on Thursday.

An El Dorado County official told the commission that on a visit to one board-and-care facility, he found a woman strapped to her bed, lying in feces and urine. An official from Napa County described interviewing elderly residents in another home who were covered with ants.

The two officials, who direct volunteers who visit facilities but have no power to take action against them, complained that the Department of Social Services’ community care licensing office is ineffective in revoking licenses or collecting fines that might force changes in conditions.

‘Nobody to Help Them’

“Things haven’t changed,” said the commission’s longtime chairman, Nathan Shapell. He later added, “I’ve been involved with this issue for the last 10 years. We’re dealing with human beings, not objects . . . and there’s nobody out there to help them.”

Last January, the commission, which seeks to promote economy and efficiency in state government, issued a report that found conditions in some homes so deplorable that it would be “unthinkable and immoral for government to allow such facilities to operate.”

The report recommended a long list of changes it thought the state should make in licensing and regulating the 22,000 board-and-care facilities. These homes provide room and board to 150,000 individuals who cannot fully care for themselves but do not require hospitals or nursing homes.

Fred Miller, a branch manager with the department, told the commission of a number of actions that his agency has taken to remedy problems in the facilities.

He testified that the state has added 20 staff members to help evaluate the homes and investigate complaints against them. It also is setting up a 24-hour telephone hot line to field complaints, he said.

Miller complained, however, of complicated procedures required before the state can toughen its regulations and of difficulties in closing an unlicensed home or one that violates the rules.

He also assured the commission that the department does not, as last year’s report contended, warn facilities when they will be inspected. When that policy was violated recently by one of the state’s 290 inspectors, Miller said, the inspector was fired.

Several county officials contradicted Miller’s generally upbeat view of progress being made in cleaning up the board-and-care industry.

Cathy Vaughn, a patient advocate for the Stanislaus County Department of Mental Health, scoffed at Miller’s claim that inspections are always a surprise to home operators.

“They may seem like they’re unannounced, but the operators know they are coming,” Vaughn said.

She also complained that it had taken the state two years to close one notorious board-and-care home where 10 residents had died in six months.

Kristen Casey, a Napa County official, described facilities that were often “dark, gloomy and minimally furnished,” where residents might spend days at a time lying on their beds with their faces turned to the walls. She called for the state to impose standards on home administrators, many of whom do not know what state rules require.

She told of interviewing three elderly home residents who were covered with ants but were too intimidated by administrators to complain. The home has since changed ownership, she said, and is now cleaner.

Doug Nowka, senior services planner for El Dorado County, criticized what he termed the state’s slow and inadequate responses to rule violations.

As an example of violations, Nowka testified that during a visit to one home he discovered a resident bound in her bed lying in her own waste. “She was unable to react to verbal or physical stimulation due to her poor mental health,” Nowka said.

Six months ago, one board-and-care home operator asked permission to increase the number of residents from 5 to 13 but was turned down by the fire marshal. Nowka said the owner went ahead anyway, despite potential fire safety problems.

Fines for Overcrowding

The Department of Social Services has levied fines totaling $4,000 because of the overcrowding, Nowka said, but has not attempted to collect from the operators and the extra residents are still there.

Nowka, however, said he had a simple solution to the problem: close the facility.

In another case, he said, a state inspector found that one home had an inadequate supply of food on hand to feed residents, but the inspector gave the operator 30 days to correct the violation.

“I need to depend on licensing (officials) to do their job,” he said. “I don’t believe they are doing their job.”

Nowka also complained that public agencies that help individuals find homes continue to place people in inadequate or unlicensed facilities. He suggested that the state regularly distribute a list of licensed facilities, along with notations for those that have been cited for violating state rules.

In its report a year ago, the Little Hoover Commission recommended a rating system for board-and-care homes and legislation allowing the immediate dismissal of a public employee who places an individual in an unlicensed home or one under investigation for abuse of residents.

The commission recommended removing responsibility for licensing homes from the Department of Social Services and perhaps turning over the duties to the state attorney general.