By Amita Sharma, KPBS, May 6 2020
The Newsom Administration has approved a plan to pay assisted living communities to take in COVID-19 patients — a move that doctors, nurses and other advocates for elderly people say is unnecessary and dangerous.
The California Department of Social Services is offering to pay assisted living facilities with six or fewer residents $1,000 a day from the time the first coronavirus patient is placed, according to a May 1 notice issued by the agency. Rates for communities with more than six beds will be set on a case-by-case basis.
State officials made plain in the notice that the offer was driven by California’s growing numbers of coronavirus cases and hospitalizations.
“There is an urgent need to provide housing and care for adult and senior care residents that, while positive for COVID-19, do not require hospitalization, while at the same time ensuring that hospital capacity can meet the anticipated demand for COVID-19 positive patients requiring acute care,” the notice says.
Some medical practitioners said they were dumbfounded by the state’s willingness to send people infected with COVID-19 to assisted living communities.
“It’s naive and it’s ignorant,” said physician Michael Wasserman, who is president of the California Association of Long Term Care Medicine. “If I’m a resident of a family member of a resident, I’d be calling my county and state and government officials and screaming at the top of my lungs, asking them why they are doing this and whether they want to be elected again.”
Most vulnerable population
Senior care facilities have borne the brunt of COVID-19 here and throughout the world. Elderly people, especially those with underlying health conditions, are far more likely to get seriously ill and die from the virus than other age groups. In San Diego County, congregate facilities make up 22 percent of the region’s COVID-19 cases and account for nearly half of the deaths.
Wasserman said he doesn’t know of one assisted living facility in the state that is prepared to handle COVID-19 infected people.
“They are not hospitals,” Wasserman said. “They are not medically structured. This virus is absolutely deadly to this vulnerable population. And so one of the things that this edict potentially creates is the ability for a hospital to send someone with covid into an assisted living facility where they could infect other residents. That sort of approach will get more people killed. ”
UC San Francisco nursing professor emeritus Charlene Harrington said unlike nursing homes, assisted living facilities aren’t required to have registered nurses onsite.
Caregivers at these facilities usually don’t have medical training and assist residents with bathing, grooming, feeding and taking medication.
“I have no idea whatsoever how they [the state] could have made that decision,” Harrington said. “I think it’s criminal. It’s horrible. They can’t provide care to residents who are sick.”
Only for mild cases
Governor Gavin Newsom’s office referred a KPBS request for comment to the department of social services.
Department of social services spokesman Scott Murray wrote in an email that the state’s plan only applies to COVID-19 patients who have “minimal or no symptoms and do not require acute, hospital” care.
“To reduce the possibility of transmission, these residents are to be housed on separate floors or in separate wings or buildings from residents who are not COVID-positive – and cared for by separate staff (with sufficient protective equipment) to reduce the possibility of transmission,” Murray said. “It is also possible to create a COVID-only facility.”
The California Association of Assisted Living made it clear that it did not request or endorse the state’s decision.
“We don’t believe the state ever envisioned this proposal as something that would apply to a large number of providers,” said Sally Michael, president and CEO of the association in a statement to KPBS. “Fortunately, the need for surge capacity in hospitals has not been an issue to date. This means that the anticipated crisis response of moving COVID 19 patients into isolated areas of Assisted Living appears unnecessary.”
Peter Look of Carlsbad hopes that’s true. His 92-year-old mother-in-law lives in a Sacramento assisted living facility, which he said is preparing to accept COVID-19 patients.
“It’s a crazy thing to do,” Look said. “The coronavirus is highly infectious. The fatality rate among seniors is so high. The people who live there are so fragile. They’re so vulnerable. All it takes is one error and the infection could go flying through that facility.”