Getting tough on adult family homes

A SYSTEMIC overhaul of Washington's adult family home industry must lead to tougher regulations. The urgency is heartbreakingly illustrated by the specter of 236 deaths over five years that may have involved neglect or elderly abuse.

Credit a Seattle Times investigative series, "Seniors for Sale," for shedding light on a burgeoning industry operating with impunity. Times reporter Michael J. Berens painstakingly documents deaths from suspicious falls, choking and infections related to bed sores. The series rightly amplifies calls for a pointed policy conversation.

Adult family homes are a popular alternative to nursing homes and other institutionalized care. State oversight has failed to keep up with rapid growth of the industry from a few hundred homes in the early 1990s to nearly 3,000 today.

Most home operators provide a valued service. There should be no mistaking their role, however. These are profitable businesses in need of regulatory scrutiny. The state Department of Social and Health Services has a basic responsibility here. But it needs the tools and resources to perform regular inspections and keep abreast of the homes and vulnerable residents within.

Fees on adult family home licenses must be raised. Operators pay a paltry $100 a year for a license, just 4 percent of the cost of the regulatory burden. Taxpayers subsidize the rest of the cost. A $1,000-per-year fee increase proposed by Gov. Chris Gregoire went nowhere in the state Legislature.

State Sen. Karen Keiser, chair of the Health and Long Term Care Committee, plans to push the fee increase again. Hopefully, the Democrat from Des Moines gets better results.

Other proposed changes to the industry include:

• Raising the required hours of caregiver experience to 1,000 from the current 320, for prospective home operators;

• Reducing the number of adult family homes owned by a single operator to three;

• Requiring a 36-month wait period between an operator opening one home, and with no history of violations, opening a subsequent one;

• Raising financial penalties on state violations to $3,000 per incident and fines for an unlicensed home to $10,000;

• Lengthening from five to 10 years the time an owner whose license was revoked must wait to apply for a new one.

DSHS Secretary Susan Dreyfus must direct her agency to work closer with law enforcement on suspicious cases. The Times' investigation showed that DSHS often ignored or excused reports of suspicious deaths and failed to contact the police. When the elderly die, the series concluded, few people paid attention. That must change.