Stop CCLD From Making Angie & Jessie Homeless or Institutionalized-This could be your MOM

Stop CCLD From Making Angie & Jessie Homeless or Institutionalized-This could be your MOM

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Elena Merchand started this petition to Melissa Melendaez and

California Community Care Licensing (CCLD) is forcing 2 poor, disabled ladies from their home and forcing them to be put into a nursing home before Christmas.

Please help us stop CCLD from forcing Jessie & Angie from their home. CCLD will force them into a Skilled Nursing Facility right before Christmas - Dec 12th.

CCLD is forcing the LandLord of their shared home to discriminate against them as older adults with disabilities.  By fining the LandLord $400 a day if Jessie & Angie stay in their home CCLD is forcing the landlord to unlawfully evict them.  Currently the ladies are paying rent of $30 & $38 dollars a day. Clearly the agencies that are supposed to advocate for poor older adults are actually victimizing them. 

The sole fact that poor, disabled, older adults share a home does not make it a “facility/institution”.  Older low income, unrelated adults of full capacity who have chosen to share a home and their resources does not constitute a community care facility.

The complaint alleges that the home is providing “unlicensed care” substantiated by the fact that resident 1 & 2 require assistance with “activities of daily living” such as bathing, toileting, dressing and medication management.  


The complaint fails to report that both resident 1 & 2 are receiving services authorized through In Home Support Services (IHSS) such as housecleaning, meal preparation, laundry, grocery shopping, personal care services (such as bowel and bladder care, bathing, grooming and paramedical services), accompaniment to medical appointments, and protective supervision for the mentally impaired.


Please see:  Attachment 1 -  a full list of authorized tasks for resident #1 based upon the assessment of social worker XXX and later, social worker XXX from the State of California Health and Human Services/California Department of Social Services.  A full list of authorized tasks for resident #2 based upon the assessment of social worker XXXX and later, social worker XXXX from the State of California Health and Human Services/California Department of Social Services.

The residents of the shared home are all members of the California Community Transitions Project with the guiding  principles being:

  • U.S. Supreme Court’s Olmstead Decision (1999)
  • Centers for Medicare & Medicaid Services (CMS) offers the “Money Follows The Person” (MFP) Demonstration Grants enabling states to align Medicaid long-term care services with the Olmstead Act. MFP provides states flexibility in how Medicaid dollars are spent
  • All individuals have the right to self-determination, independence, and choice
  • Public entities must provide services to eligible individuals in the setting of their choice

The residents actively participated in their integration back into the community, and underwent a “person centered planning” (PCP) transitional care plan to assist them as they discharged from Skilled Nursing Facilities (SNF).  As members of the CCT project, each resident has extensive case management to assist in the coordination of community services. These services include IHSS, Home Health, transportation, CBAS, MSSP programs and all local community services available. The goals of the project is to prevent readmission, successful assimilation back into the community, lower or neutral cost to the state compared to the SNF.  Most importantly, the project asserts PCP builds upon the individual’s strengths to engage in activities in the community and honors the individual’s preferences, choices, and abilities.


Ideally all older adults with disabilities and in need of assistance with activities of daily living could have the financial wherewithal to live in a Residential Care Facility for The Elderly (RCFE).  Please see Attachment 3. Here you will see the monthly rates for both shared and private rooms for 158  RCFE’s in Riverside County. Currently Riverside County has 432 RCFE’s with 20 facilities enrolled in the Assisted Living Waiver (ALW) Program as of this writing there is approximately a year and half waiting list for MediCal recipients, and sadly many of the waiver enrollee’s die before their slot becomes available. Without an ALW waiver the average shared room rate in Riverside County is $2,847 and a private room is $3718.  Compelling the tenants to move into an RCFE would be an impossible financial hardship and would either force them into a Skilled Nursing Facility or into homelessness. At this time none of the residents have a skilled need, increasing the risk of homelessness or a substandard living environment.


According to the Riverside County Office on Aging area plan 2016 -2020, by the year 2020, Riverside County will experience a 200% increase in persons over the age of 60 and will make up approximately 25% of the County’s total population.


Based on the Office on Aging report that means 802,106 (36%) of Riverside County citizens could potentially benefit from a safe, alternative to the cost prohibitive senior services currently available. More alarming is the 267,368 (12%) Riverside County’s oldest citizens 65+ and disabled desperately need safe, compassionate, cost effective alternatives to institutionalization.


The financial savings of a shared home with proper case management, healthcare integration and social support cannot be ignored. The current tenants at the Bradshaw home have access to weekly visits from a Medical Doctor/ Physician Assistant, quarterly Podiatry services, weekly visits from a Chaplain, nutritious food supplied by the food bank and prepared by their personal caregivers. Additionally, home health provides physical therapy, occupational therapy and behavioral therapy regularly promoting their health.  Molina & IEHP provide transportation to all medical and dental appointments. All of these services and more are all available in the community for older adults that are NOT institutionalized.  


The tenants currently pay rents of $910 to $1130 per month, a dramatic savings compared to $3718 of a comparable RCFE.


“Over the next ten years, the number of households aged 65-74 with “severe” rent burdens (where expenditures on housing account for above ½ of household income) are projected to rise by 42% (Housing America’s Older Adults, Harvard Joint Center for Housing Studies, 2014). Increasing homelessness among older adults is one consequence of this trend; the number of homeless older adults is estimated to increase by 33% from 2010 to 2020 (Healthy Aging Begins at Home, Bipartisan Policy Center, 2016). Another crisis that home sharing directly addresses is the increasing isolation that older adults can experience, particularly when they can no longer drive or their mobility becomes limited in other ways, which directly impacts both their physical and mental health.” this is a direct quote from The U.S. Department of Housing and Urban Development's (HUD's) Office of Policy Development and Research (PD&R) which supports the Department's efforts to help create cohesive, economically healthy communities.


The tenants in the Bradshaw home have developed a family bond, regardless of the fact that they are disabled and not related. Forcing 2 of the 3 housemates to relocate poses tangible risks to all of their wellbeing. By unnecessarily forcing these adults who have their full mental capacity to relocate from an abode of their choosing, the Department of Social Services exposes them to transfer shock and relocation stress syndrome (RSS).

It is well documented that transfer shock and RSS can create physiologic and psychologic disturbances in the elderly.  The syndrome is particularly impactful when the relocation is without the residents involvement or consent. Symptoms of relocation stress syndrome include exhaustion, sleep disturbances, anxiety, grief and loss, depression and disorientation.

Resident #2 being very cognizant of the matter at hand has exhibited severe agitation and anxiety, multiple bouts of diarrhea and difficulty with her appetite and eating. She has valid deep seated concerns of becoming homeless or living in a less than desirable location.

Older adults of average to lower income who may need some assistance with activities of daily living and housing are not going away. These people need some help with activities of daily living (ADL's) but do not need the level of care provided by a skilled nursing facility or other higher levels of care. They often need only a few hours of assistance per day, which can be provided by a personal caregiver or a In Home Support Service (IHSS) provider. Most do not need consecutive hours of care, but need a few hours of care interspersed throughout the day, ie; thirty minutes of assistance in the morning with bathing, thirty minutes of assistance in the afternoon, and an hour of assistance in the evening with incontinence and getting ready for bed. Living alone creates a financial burden for them, as it is virtually impossible to get a quality caregiver to come for an hour and then return again in a few hours. Most caregivers need to work at least a 4 hour shift, this makes shared homes very appealing for the caregivers/ IHSS Provider giving them the ability to work with multiple clients throughout the day within the same location.

The financial issues facing California and our nation’s aging population are massive in scale. Many of the policy and procedures currently in place do not reflect the reality of the elderly and disabled in our community.  With this appeal you are deciding how and where people are able to live their lives. A negative response to this appeal will ultimately mean your agency is taking away a choice and deciding on the quality of life and freedom of choice for these and 1000’s of other people affected by you and your agency.

Conclusion

It is my hope that greater collaboration and innovation can be explored with The Department of Social Services, Community Care Licensing, Adult Protective Services, In Home Support Services and the County of Riverside. It is imperative that we as a society develop a solution. Shared homes with like “type” tenants offers the ability to integrate healthcare services and housing which can positively impact thousands of struggling seniors and their families as they attempt to navigate the complex aging process.

 

 

 

 

 

 

 

 

 

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