How can I describe the depth of this nothingness?
After a few hours watching the task force assigned to repair the regulatory mess associated with Florida’s assisted living facilities, I’d need a new thesaurus.
The Assisted Living Workforce was born out of a scandal of such unspeakable neglect that it made for a startling juxtaposition against the emptiness of its fix.
It wasn’t as if the task force, which met Friday in Fort Lauderdale, was contemplating mere theoretical problems. Last year, The Miami Herald reported awful instances of neglect and abuse among the elderly and disabled consigned to the state’s ALFs.
They were locked in closets. They were tied up with ropes. Some were controlled with powerful tranquilizers, doped into a zombie state. Others, lost and confused, somehow managed to walk away unnoticed by staffers at ALFs.
And people died. The Miami Herald documented at least 70 deaths of the elderly or mentally disabled from abuse or neglect suffered in Florida’s ALFs, while regulators from the Agency for Health Care Administration seemed to have fallen into a lethargic trance, unwilling or unable to take action against lousy providers. As the deaths mounted, AHCA was carrying out fewer inspections and imposing fewer penalties. Inspectors had reason enough take action against 70 homes for deaths attributed to abuse or neglect in 2008 and 2009, but managed to shut down only seven. In 2009 alone, AHCA could have levied $6 million in fines against ALF operators, but settled for $650,000.
Plainly, regulatory torpor contributed to brutal living circumstances among Florida’s most vulnerable citizens. Great investigative work by The Herald’s Carol Marbin Miller, Mike Sallah and Rob Barry seemed to have provoked considerable anger across the state. So the governor appointed this task force.
It was stacked. Gov. Rick Scott filled most of the seats with ALF industry insiders and advocates and two legislators famously cozy with ALF operators, Republican Sen. Rene Garcia of Hialeah and Republican Rep. Matt Hudson of Naples. Former Secretary of Elder Affairs Bentley Lipscomb warned The Herald last year that the workgroup would hardly do much that might inconvenience ALFs. “Based on what I’ve seen so far, I don’t expect much out of any of this,” he said.
Friday’s meeting made Lipscomb look like a prophet. Only one voice, among the 14 task force members, was an actual resident and he didn’t say much. Meanwhile, Hollywood ALF operator Larry Sherberg was hardly shy about talking down new regulations he considered onerous. He and his fellows sauced the word “onerous” over the proceeding, like pouring Tabasco over Louisiana redfish. He also called a proposal to require some new but rather tepid qualifications for ALF administrators an “unfunded mandate.”
Sherberg read from a U.S. News and World Report guest column by Gov. Rick Scott, explaining why he rejected an expansion of Medicaid under the affordable health care act, citing the potential for future costs for the state. “Substitute this for Medicaid,” Sherberg said. “The state can’t afford it. We can’t afford it,” he said. “We’ve got to look at this from a realistic standpoint.”
His analogy might have been shocking enough, given that the regulations he dismissed were designed to rid the state of shoddy ALF operators who’ve left a trail of real human suffering and death in their wake. Market forces, tired to diminished budgets, might indeed say something about how Florida got itself into this mess, but market forces sure as hell aren’t going to fix the problem. The frail and dependent “consumers” here were not of the kind able to pick and choose among providers. Industry reps even objected to a proposal to protect resident whistle-blowers who alert state inspectors about abuse from being tossed out onto the street by ALFs.
But Sherberg’s objections, even his presence here, was particularly audacious, given that his operation in Hollywood was hit for a $1,000 fine last year for the gut-wrenching neglect of an elderly resident just a few days before Scott appointed him to the task force. His ALF was hit with nearly a dozen violations in the past three years. And as chairman of the Florida Assistant Living Association legislative committee, he has lobbied hard in recent years to undo state regulations. It would be hard to imagine Sherberg, of all people, backing stronger measures.
Sherberg made for as good an explanation as any for what has come out of the task force. Or what hasn’t. Mostly, the members voted to reject new regulatory proposals or table them. Maybe next time. Maybe not.
Not that action would mean much. The group’s first set of proposals died in the Legislature this year. There’s no reason to think that new proposals would do much better in Tallahassee in 2013. Not much will just get trumped, once again, by nothing.