Can We Commit to a Net Zero Loss of Board and Care Beds?
net-zero Definition: resulting in neither a surplus nor a deficit of
something specified when gains and losses are added together.
Soon I will be recording a podcast interview with a delightful couple who have operated a board and care home in the San Fernando Valley for the past 22 years. I visited the home last week and met the residents who would be impacted if this husband-wife team elect to close the facility. The human cost of losing of a stable, family-style living arrangement is something we often don’t touch upon in policy reports but was beautifully conveyed in an LA Times article by Lila Seidman on this topic last year.
As I prepare for this interview, I am pulling down reports from the city and county which underscore that we cannot abandon a sense of urgency to protect these precious beds – or assume that someone else is taking care of this slow-motion train wreck. In this blog, I will focus on board and care beds, which are technically referred to as Adult Residential Facilities (ARF’s), even though we are also seeing a crisis in the inventory of Residential Care for Elderly (RCFE) beds also.
I applaud the city and county for taking seriously this existential need and they are moving faster than I ever expected.
But is it fast enough?
I am posting this blog to subject myself to any push-back from those who would argue that things cannot move more quickly. That this is the best we can do. But I ask: How do we stop closures -- full stop? I am sharing a handful of observations that bubble to the surface as I read these reports.
County of Los angeles
Question: Could the county of Los Angeles could tap into the state of emergency that was adopted in January 2023 to identify funding to shore up ARF facilities in danger of closing until all the remediation strategies are worked out.
As I read it, the state of emergency declaration calls for county departments to “…accelerate timelines for the creation of licensed beds, interim housing and permanent supportive housing….increase funding for local rental subsidies…” I would argue that implicit in the creation of licensed beds would be a commitment to a net-zero loss of existing licensed beds.
In the county’s most recent report, dated June 5, 2023, we continue to see the steady loss of beds and closed Adult Residential Facilities (also known as “board and cares”). The report documents a loss of 134 facilities since the county started to keep track in Q1 2016. This translates into a loss of 1,983 beds over these past seven years. The trend is not reversing.
The county is making heroic efforts to improve the tracking of available beds, support the newly formed association for board and care operators (the Licensed Adult Residential Care Association or LARCA) and create a framework for wisely investing in capital improvements to take advantage of state and county funding. But it would seem that providing an emergency operating “patch” to those operators who are serving people at the basic SSI rate might hold off closures until these other measures take hold? From what I understand, adding $1000 a month to support those residents who are paying the SSI rate ($40/day) could make a huge difference.
And where is the report from The Future Organization that we’ve been waiting for? As described in the most recent county report (page 4), “The Future Organization [has been engaged] to conduct research exploring the services, needs and capability of ARF’s and RCFEs in the County. The results of their comprehensive research study will be released soon and will outline the experiences of operators and residents of licensed residential facilities. The research results can be used to inform nonprofits and government entities about the demographics, experiences and needs of these populations.”
What I worry about is that plans are already underway to consider how the “son of Measure H” might be structured to bring back to the voters in 2027 – and I’m wondering if we are thinking ahead as to the need of non-traditional housing to support more vulnerable people in our community? How could the son of Measure H strengthen our housing stock in this space?
city of los angeles
Question: Could the city of Los Angeles, similarly, tap into the emergency powers associated with Mayor Bass’s declaration of a state of emergency on December 12, 2023.
The city of Los Angeles has also recently released a report (May 12, 2023) that outlines a whole series of measures that are responsive to the direction established by a motion adopted unanimously by the city council on October 20, 2020, “…to fund, preserve, and expand board-and-care facilities to continue to serve the most vulnerable residents.”
At the very least, in this interim time, the city could pledge to provide emergency funding to ensure that the daily SSI rate of $40 be supplemented similar to what is provided by the county through their Enhanced Case Management “patch.” This would amount to $1000 per month per affected resident.
Meanwhile, the city’s report also outlines a robust and creative list of ways to lessen the burden on board/care operators and lower operating costs including: relaxation of zoning barriers, expedited building permits, relaxation of fees or fines, among other items.
The city also recognizes the need to partner with the County in order to forestall more facility closures and advocate in Sacramento for an increase in the SSI/SSP daily rate paid to operators. Bravo!
Of great interest to me was seeing the recommendation that the city hire an official Board and Care liaison. Brilliant idea. Until one person is vested with the responsibility to watch out for this housing resource, it will continue to quietly slip away.
we cannot take these beds for granted
Board and care beds are appropriate placements for people who cannot live a more independent life in the permanent supportive housing (PSH) setting. The residential beds can represent a bridge between hospital and jail back into the community. They are relied upon by the County’s Housing for Health program and the County’s Office of Diversion and Re-entry. They can be supportive options for people with mental health conditions and/or substance use disorders who require care and would deteriorate in the isolation of an apartment. We must begin to preserve and expand this housing resource in the continuum of all that is available for people in the city and county of Los Angeles.