Word To The Wise: Speak Up Or Nothing Changes

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By E.A. Roberts
____________

Recently I had the opportunity to attend the Open House given at Atria Covell Gardens, an assisted living facility for seniors. Its purpose was to showcase the new double occupancy suites, which were created as a result of resident complaints. Rent increases for this residential care facility for the elderly (RCFE) jumped to as much as 16% over a two year period, a drastic spike in price. What ensued is a prime example of democracy in action.

Oddly enough, the Davis Senior Citizens Commission just so happened to have one of their regular off-site meetings at Atria Covell Gardens last winter. Without knowing what was coming, commissioners convening the session were greeted with a firestorm of protest. Atria Covell Garden residents had just received word of an extreme rate hike in rent and services the evening before. This feisty group of seniors were infuriated, and let the commission know just how they felt.

Our advice as a commission was for them to complain long and loudly, with Letters to the Editor of the Davis Enterprise, or to the Davis Vanguard, as a way of obtaining publicity for their cause. We also suggested contacting state and local legislators. There were also talks with the company that managed the facility as well. All avenues were sought for redress, including the state licensing board. Just about anyone who was in any way connected with the situation was contacted by these angry seniors.

The result was not only several different bills now wending their way through the legislature having to do with notification of rent increases at RCFEs. In addition, Atria Covell Gardens has made changes to several single suites to accommodate two persons in a shared arrangement – to cut costs for those of lesser income. More of these units are planned there for the future. Had the seniors in residence at Atria Covell kept quiet about their predicament, then nothing much would have changed.

Instead a private company has been encouraged to make necessary alterations to keep competitive with the current market. The fact of the matter is that Atria Covell Gardens represents the only sole RCFE in the city of Davis. University Retirement Commons is the only Continuum of Care Facility (Independent Living Facility; Assisted Living Facility; Skilled Nursing Facility; Alzheimer’s Unit all in one) within town limits. In consequence, these two facilities have virtually no competition, and have been able to charge prices at a rate that is as high as whatever the market will bear.

However, because of the complaints about the sudden, drastic rent hikes at Atria Covell Gardens, there has been the introduction of new legislation which may warn of perceived price gouging. There has also been talk of building another lower cost assisted living facility, for middle income older folks. Both of these factors surely played into management’s decision to devise a way to create more affordable units at Atria Covell Gardens. High praise goes to the seniors that spoke out against their financial predicament; and to private enterprise for coming up with a creative solution! It may not be the perfect solution, but it is a start in the right direction.

Legislation Pending:

  • AB 2101 Author: Wolk [D]; Title: RCFEs; rate increases

Requires RCFEs to develop emergency plans, give residents advanced notice of rent increases, and give prospective residents information about rate increases over the past 5 yrs.

  • AB 2370 Author: Bass [D]; Title: RCFEs; rate increases

Requires RCFEs to disclose annually to current residents their average monthly rate increases for each of the previous 3 years, to be posted near the entrance to the facility and provided to any prospective tenant upon request.

CA Commission on Aging Public Hearing: Health Access for Older Californians

The California Commission on Aging (CCoA) held a public hearing in Yolo County, on the topic of health access for older Americans in rural areas. CCoA is an advisory body to the governor of CA on senior issues. Its 25 members are appointed by the governor, Senate Rules Committee and Speaker of the Assembly. They serve as volunteers, for up to two three year terms.

Our own Dave Soto, of the Area 4 Agency on Aging, pointed out that his organization encourages:

1. A multi-disciplinary approach;
2. Disease and injury prevention;
3. Home-centered services;
4. Transportation options;
5. Technological innovation.

Dawn Purkey of Yolo Adult Day Health stressed the following:

  • Age distinctions should be made when providing services, because the needs for each age group can be so different, e.g. 65-75, 75-85, 85 and above;
  • Service providers need to be protected with programs like respite care;
  • Caregiver assessment tools should be developed;
  • Nontraditional models of caregiving should be tried;
  • Volunteerism should be encouraged.
Nancy Guenther, the Program Manager of the Office on Disability and Health, CA Dept. of Public Health, Injury Control Section advised as listed below:
  • Transportation networks; more transportation options;
  • Mobile units to dispense healthcare;
  • Use of new technology, e.g. videophones; internet interactions
  • Care calls to check on isolated seniors;
  • Health promotion visits;
  • Universal fund, paid by doctors, for language interpreters
Teri Boughton, Senior Program Officer for State Health Policy, CA HealthCare Foundation advised:
  • Allowing greater independence of nurse practitioners;
  • Align licensing requirements with the military, to encourage retired military medical personnel to practice in rural areas;
  • Raise reimbursement rates for Medicare and Medicaid, to encourage doctors to take more low income patients;
  • Encourage development of telemedicine by remote technological devices
Then questions were invited from commission members and the audience. Suggested solutions for improving access to healthcare in rural areas included:
  • Retail medical clinics, as long as there was integration with more comprehensive care;
  • Great ideas are funded through local, state and federal grants; volunteerism; and operating on a shoestring budget;
  • Recruitment of physicians (especially geriatric physicians) with: debt forgiveness as an incentive; and develop hospital districts;
  • Mobilization of resources to come together to meet senior needs, e.g. use of Fish & Game airplanes to medivac rural patients to urban trauma centers, recruit both Vets with medical experience and retired physicians; physicians should tithe 10% to public clinics; medical networks need to work outside the Medicare/Medicaid system, e.g. by municipalities paying doctors to come back on occasion and provide services;
  • National Health Services Corp – education is paid for if recipient doctor works in rural area for a period of years;
  • Provide more transportation options;
  • Push for universal health coverage;
  • Provide more public education on available services;
  • Have sliding scale with respect to fees charged for accessing services.
In proposing transit mobility training as a possible solution to get seniors to their medical appointments, I was lucky enough to be informed by a commission member that he was aware of Yolo County’s grant application to Caltrans for this teaching project. Transit mobility training instructs seniors how to use public transit, so they are not in fear of getting lost or stranded. It will assist them in using public transit to get to a doctor‘s office or medical clinic, by starting them off with group training for a social event. An out-of-service bus is utilized to take a cadre of willing senior citizens by the hand to the local downtown area for lunch, or the movies.

This program is being developed by the Triad Task Force of which I am Chair. Triad is the action arm of the Yolo County Commission on Aging, chaired by Mariko Yamada. The transit mobility training project is being facilitated in conjunction with a private company. Paratransit Inc. already provides this type of training in Sacramento County, so Davis Senior Citizens Commissioner Tansey Thomas and I asked them if they would be willing to expand their services into Yolo County. JD Culver and Kevin Walch of Paratransit Inc. were delighted to oblige! A pilot project would begin in Davis, and expand to encompass as much of Yolo County as possible.

I also mentioned to the CCoA some other projects in Yolo County that Triad has either completed or is in the works:

  • Rebuilding Together – a nonprofit organization that provides safety devices in the home, such as grab bars, wheelchair ramps, smoke detectors, custom railings, toilet risers, etc., regardless of income status.
  • Caregiver Registry – to provide trained caregivers to those seniors not wealthy enough to afford private pay services, but too wealthy to qualify for gov’t subsidized in-home supportive services.
  • Proposition 63 funded mobile assessment team known as the Yolo County Older Adult Program – to assist seniors in crisis.
  • Triad Task Force, a community-based organization willing to take on projects that assist seniors.
  • Building Bridges – an elder abuse prevention program, which is key to the protection of older adult health. Once a senior has been abused, either physically or financially, it begins a downward spiral that often results in the death of an elderly person.
Finally, I noted the need for elder abuse prevention, as key to the protection of older adult health. It was pointed out by me that once a senior has been abused, either physically or financially, it begins a downward spiral that often results in death.

Lesson to be learned: Speak out, or nothing will change for the better. Volunteerism, creativity, and a willingness to address problems are the solutions to a better life for senior citizens.

Elaine Roberts Musser is an attorney who concentrates her efforts on elder law and aging issues, especially in regard to consumer affairs. If you have a comment or particular question or topic you would like to see addressed in this column, please make your observations at the end of this article in the comment section.

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About The Author

David Greenwald is the founder, editor, and executive director of the Davis Vanguard. He founded the Vanguard in 2006. David Greenwald moved to Davis in 1996 to attend Graduate School at UC Davis in Political Science. He lives in South Davis with his wife Cecilia Escamilla Greenwald and three children.

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16 thoughts on “Word To The Wise: Speak Up Or Nothing Changes”

  1. ERG

    Competition might help–but this is a statewide problem with for-profit assisted living facilities. AB 2101 and AB 2370 would provide residents and prospective residents with information about RCFEs’ track record of rate increases, but wouldn’t directly limit them. (AB 2370 is now in the Sentate. AB 2101 died in Assembly Appropriations; although, it’s possible at least the provsions related to emergency plans may be revived in another bill.)

    A more direct approach was AB 2598 (Leno), which would have enabled rent control jurisdictions to apply rent control ordinances to that part of the RCFE rate that is attributable to rent (as opposed to care and supervision). RCFEs are currently exempt from rent control. Needless to say, opposition to the bill by RCFE providers was zealous and organized. AB 2598 did not make it out of the Assembly. Let’s hope the idea does not die as well. We should be letting our state reps know that this issue won’t be going away and needs to be addressed in next year’s legislative session.

  2. ERG

    Competition might help–but this is a statewide problem with for-profit assisted living facilities. AB 2101 and AB 2370 would provide residents and prospective residents with information about RCFEs’ track record of rate increases, but wouldn’t directly limit them. (AB 2370 is now in the Sentate. AB 2101 died in Assembly Appropriations; although, it’s possible at least the provsions related to emergency plans may be revived in another bill.)

    A more direct approach was AB 2598 (Leno), which would have enabled rent control jurisdictions to apply rent control ordinances to that part of the RCFE rate that is attributable to rent (as opposed to care and supervision). RCFEs are currently exempt from rent control. Needless to say, opposition to the bill by RCFE providers was zealous and organized. AB 2598 did not make it out of the Assembly. Let’s hope the idea does not die as well. We should be letting our state reps know that this issue won’t be going away and needs to be addressed in next year’s legislative session.

  3. ERG

    Competition might help–but this is a statewide problem with for-profit assisted living facilities. AB 2101 and AB 2370 would provide residents and prospective residents with information about RCFEs’ track record of rate increases, but wouldn’t directly limit them. (AB 2370 is now in the Sentate. AB 2101 died in Assembly Appropriations; although, it’s possible at least the provsions related to emergency plans may be revived in another bill.)

    A more direct approach was AB 2598 (Leno), which would have enabled rent control jurisdictions to apply rent control ordinances to that part of the RCFE rate that is attributable to rent (as opposed to care and supervision). RCFEs are currently exempt from rent control. Needless to say, opposition to the bill by RCFE providers was zealous and organized. AB 2598 did not make it out of the Assembly. Let’s hope the idea does not die as well. We should be letting our state reps know that this issue won’t be going away and needs to be addressed in next year’s legislative session.

  4. ERG

    Competition might help–but this is a statewide problem with for-profit assisted living facilities. AB 2101 and AB 2370 would provide residents and prospective residents with information about RCFEs’ track record of rate increases, but wouldn’t directly limit them. (AB 2370 is now in the Sentate. AB 2101 died in Assembly Appropriations; although, it’s possible at least the provsions related to emergency plans may be revived in another bill.)

    A more direct approach was AB 2598 (Leno), which would have enabled rent control jurisdictions to apply rent control ordinances to that part of the RCFE rate that is attributable to rent (as opposed to care and supervision). RCFEs are currently exempt from rent control. Needless to say, opposition to the bill by RCFE providers was zealous and organized. AB 2598 did not make it out of the Assembly. Let’s hope the idea does not die as well. We should be letting our state reps know that this issue won’t be going away and needs to be addressed in next year’s legislative session.

  5. Elaine Roberts Musser

    To ERG: Thanks for the update on pending legislation and where it is (or is not) in the legislative process since I wrote this article. I agree with your assessment that we need to include assisted living (rent portion) within rent control guidelines. However, I very much doubt this will be high on the priority list of most legislators.

    That said, pressure by residents to create options such as shared apartments is the very least we can encourage. Competition can be a great equalizer. Sometimes the pocketbook speaks louder than words. In the case of Atria Covell Gardens, there is now a cheaper alternative – shared suites. In one case, two sisters will be moving in together with each other.

  6. Elaine Roberts Musser

    To ERG: Thanks for the update on pending legislation and where it is (or is not) in the legislative process since I wrote this article. I agree with your assessment that we need to include assisted living (rent portion) within rent control guidelines. However, I very much doubt this will be high on the priority list of most legislators.

    That said, pressure by residents to create options such as shared apartments is the very least we can encourage. Competition can be a great equalizer. Sometimes the pocketbook speaks louder than words. In the case of Atria Covell Gardens, there is now a cheaper alternative – shared suites. In one case, two sisters will be moving in together with each other.

  7. Elaine Roberts Musser

    To ERG: Thanks for the update on pending legislation and where it is (or is not) in the legislative process since I wrote this article. I agree with your assessment that we need to include assisted living (rent portion) within rent control guidelines. However, I very much doubt this will be high on the priority list of most legislators.

    That said, pressure by residents to create options such as shared apartments is the very least we can encourage. Competition can be a great equalizer. Sometimes the pocketbook speaks louder than words. In the case of Atria Covell Gardens, there is now a cheaper alternative – shared suites. In one case, two sisters will be moving in together with each other.

  8. Elaine Roberts Musser

    To ERG: Thanks for the update on pending legislation and where it is (or is not) in the legislative process since I wrote this article. I agree with your assessment that we need to include assisted living (rent portion) within rent control guidelines. However, I very much doubt this will be high on the priority list of most legislators.

    That said, pressure by residents to create options such as shared apartments is the very least we can encourage. Competition can be a great equalizer. Sometimes the pocketbook speaks louder than words. In the case of Atria Covell Gardens, there is now a cheaper alternative – shared suites. In one case, two sisters will be moving in together with each other.

  9. Anonymous

    I was my mother’s caregiver several years ago, and when her Alzheimer’s became so difficult that I felt I couldn’t continue to care for her at home–and still be a wife and mother to my family–I began making “the calls.”
    First, her insurance company told me that Alzheimer’s wasn’t a “skilled nursing condition,” therefore they wouldn’t cover a care facility.

    I began to see what medicare offered, and it’s sad to say, but thank god my mother began to enter into the dying process–she forgot how to eat and swallow. I don’t know if I could have put her in many of the facilities I visited.

    So much needs to be done in this area! I’ve noticed an improvement in the last several years, but there are still too many loopholes, and too much money to be gained as the boomers march into old(er) age.

    ~Carol O’Dell
    Author of Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir
    available on Amazon
    http://www.mothering-mother.com

  10. Anonymous

    I was my mother’s caregiver several years ago, and when her Alzheimer’s became so difficult that I felt I couldn’t continue to care for her at home–and still be a wife and mother to my family–I began making “the calls.”
    First, her insurance company told me that Alzheimer’s wasn’t a “skilled nursing condition,” therefore they wouldn’t cover a care facility.

    I began to see what medicare offered, and it’s sad to say, but thank god my mother began to enter into the dying process–she forgot how to eat and swallow. I don’t know if I could have put her in many of the facilities I visited.

    So much needs to be done in this area! I’ve noticed an improvement in the last several years, but there are still too many loopholes, and too much money to be gained as the boomers march into old(er) age.

    ~Carol O’Dell
    Author of Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir
    available on Amazon
    http://www.mothering-mother.com

  11. Anonymous

    I was my mother’s caregiver several years ago, and when her Alzheimer’s became so difficult that I felt I couldn’t continue to care for her at home–and still be a wife and mother to my family–I began making “the calls.”
    First, her insurance company told me that Alzheimer’s wasn’t a “skilled nursing condition,” therefore they wouldn’t cover a care facility.

    I began to see what medicare offered, and it’s sad to say, but thank god my mother began to enter into the dying process–she forgot how to eat and swallow. I don’t know if I could have put her in many of the facilities I visited.

    So much needs to be done in this area! I’ve noticed an improvement in the last several years, but there are still too many loopholes, and too much money to be gained as the boomers march into old(er) age.

    ~Carol O’Dell
    Author of Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir
    available on Amazon
    http://www.mothering-mother.com

  12. Anonymous

    I was my mother’s caregiver several years ago, and when her Alzheimer’s became so difficult that I felt I couldn’t continue to care for her at home–and still be a wife and mother to my family–I began making “the calls.”
    First, her insurance company told me that Alzheimer’s wasn’t a “skilled nursing condition,” therefore they wouldn’t cover a care facility.

    I began to see what medicare offered, and it’s sad to say, but thank god my mother began to enter into the dying process–she forgot how to eat and swallow. I don’t know if I could have put her in many of the facilities I visited.

    So much needs to be done in this area! I’ve noticed an improvement in the last several years, but there are still too many loopholes, and too much money to be gained as the boomers march into old(er) age.

    ~Carol O’Dell
    Author of Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir
    available on Amazon
    http://www.mothering-mother.com

  13. Elaine Roberts Musser

    Carol,
    I agree with you here. An Alzheimer’s diagnosis can be literally the kiss of death. There are very few options for those of moderate income or higher with Alzheimer’s. This is one of the areas I want to get into in my next column, when I talk again about senior housing options.

  14. Elaine Roberts Musser

    Carol,
    I agree with you here. An Alzheimer’s diagnosis can be literally the kiss of death. There are very few options for those of moderate income or higher with Alzheimer’s. This is one of the areas I want to get into in my next column, when I talk again about senior housing options.

  15. Elaine Roberts Musser

    Carol,
    I agree with you here. An Alzheimer’s diagnosis can be literally the kiss of death. There are very few options for those of moderate income or higher with Alzheimer’s. This is one of the areas I want to get into in my next column, when I talk again about senior housing options.

  16. Elaine Roberts Musser

    Carol,
    I agree with you here. An Alzheimer’s diagnosis can be literally the kiss of death. There are very few options for those of moderate income or higher with Alzheimer’s. This is one of the areas I want to get into in my next column, when I talk again about senior housing options.

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