CVIndependent

Tue09222020

Last updateMon, 24 Aug 2020 12pm

If your anxiety and/or depression levels were high this weekend, you were not alone.

More than a handful of people have told me were out of sorts this weekend—something that I, too, experienced. I suspect the extreme heat and at-times apocalyptic-looking skies due to the fires had something to do with it.

Despite the bleakness … at least as far as the coronavirus goes, there are signs that we’re making progress at flattening that pesky, pain-in-the-ass curve once more.

Consider:

Eisenhower Medical Center posted on Friday: “We are seeing a sustained 14-day decline in our percent positivity rate, and a corresponding decline in hospitalizations.” Indeed, hospitalizations at all of the valley’s hospitals have been steadily decreasing.

• Other parts of Southern California are seeing improvements, too. Dr. Barbara Ferrer, the Los Angeles County public health director said today: “We’re cautiously optimistic that we’re getting back on track to slowing the spread of COVID-19. I want to emphasize the word ‘cautiously.’” 

The same goes for the state as a whole. “California Gov. Gavin Newsom said at his Monday press briefing more tests are being done, but the percentage of people testing positive is going down. The 14-day positivity rate is 7 percent compared to 7.5 percent a week ago,” according to SFGate.

We’re nowhere near the end of this thing … but it seems we’re heading in a better direction than we were a couple of weeks ago.

More news links:

Here’s the latest District 4 from the county. (District 4 includes the Coachella Valley, as well as points eastward.) Hospitalizations are down, as mentioned above, but the positivity rate remains too darned high. Worst of all: 20 of our neighbors died in the last week.

• There is an increasing amount of discussion about what will happen if a vaccine is ready to go. However, this positive comes with a big, honking negative: Nobody’s quite sure how a vaccine-distribution effort’s going to take place. The Washington Post today cited a number of people, from scientists to governors, who are concerned the federal government may not be up to the task. Key quote: “‘This is a slow-motion train wreck,’ said one state official who has been involved in planning efforts and spoke on the condition of anonymity to discuss a sensitive matter. The official pointed in particular to the administration’s botched rollout of remdesivir, an antiviral medication that is one of the only approved treatments for covid-19 patients. ‘There’s certainly a lot of concern, and not being able to plan creates a significant amount of confusion,’ the official said.”

• Related: The New York Times reported that more and more doctors are worried that the Trump administration may rush a vaccine—to make it available before Election Day—before it’s been proven to be safe and effective.

• And here’s another dose of cold, hard reality: The World Health Organization today reminded everyone that a great vaccine is no sure thing. Key quote, from WHO Director-General Tedros Adhanom Ghebreyesus: “A number of vaccines are now in phase three clinical trials, and we all hope to have a number of effective vaccines that can help prevent people from infection. However, there’s no silver bullet at the moment—and there might never be.”

• In other parts of the country, schools are beginning to reopen—and things aren’t necessarily going well. The Associated Press headline: “Parents struggle as schools reopen amid coronavirus surge.

Four former commissioners of the Food and Drug Administration today co-wrote a piece for The Washington Post saying that the use of blood plasma from recovered COVID-19 patients, according to the headline, “might be the treatment we need.” They wrote: “We need a concerted effort to collect blood plasma, along with clinical trials to determine when its benefits outweigh the risks so we can treat the right people at the right time. With that evidence in hand, we need to maintain a highly synchronized distribution system to get the plasma to the right health-care facilities in a timely and equitable way.”

• Sigh. The Center for Public Integrity reports that many businesses have been illegally denying paid sick leave to COVID-19-stricken workers: “Hundreds of U.S. businesses have been cited for illegally denying paid leave to workers during the pandemic, according to documents obtained through a Freedom of Information Act request. As of June 12, nearly 700 companies had violated the law’s paid-leave provisions and owed back wages to hundreds of employees, according to Labor Department records. Violators include six McDonald’s franchises and the franchise owners of a Comfort Suites, Courtyard by Marriott and Red Roof Inn.”

Eli Lilly announced today it’s starting a late-stage trial—among people who live in or work at nursing homes—on an experimental COVID-19 antibody treatment to see if it can prevent the spread of SARS-CoV-2.

It’s time to check your hand sanitizers: The FDA now has a list of more than 100 types that need to be avoided—either because they’re dangerous, or they don’t include enough alcohol to be effective.

NBC News published a sobering story today about how systemic racism remains pervasive in the housing market.

The San Francisco Chronicle looked at the mess that is California’s unemployment system—officially known as the Employment Development Department—and what lawmakers are talking about doing to fix it. “More than a million jobless Californians are in limbo, desperately seeking unemployment benefits. That includes 889,000 who may be eligible for benefits with additional information, and 239,000 whose cases are pending resolution, according to a letter EDD Director Sharon Hilliard sent to her boss, Labor Secretary Julie Su, (last) Wednesday.” The Chronicle also included a list of 12 tips that may help people get the benefits they need.

The Riverside Press-Enterprise looked at how the county’s small-business grant awarding process was going; the application period for the $10,000 grants remains open through Aug. 31. Businesses must have 50 or fewer employees; they must have been harmed by the pandemic financially; and they can’t have received Paycheck Protection Act funding. (Full disclosure: We learned over the weekend that the Independent was awarded one of these grants.)

• The Apple Fire, which continues to threaten homes and is only 5 percent contained, was started by the exhaust of a malfunctioning diesel-fueled vehicle, CAL FIRE announced today.

• Depressingly related: Two Purdue University environmental engineers, writing for The Conversation, offer tips on what communities can do to protect themselves from drinking-water systems that become polluted in the aftermath of a wildfire—as happened following the terrible Northern California fires in 2017 and 2018.

• Is it safe to play college football this fall? A number of Pac-12 players issued a letter via The Players Tribune over the weekend, demanding more COVID-19 safety regulations. That’s not all; the players also said athletic programs should protect other sports programs by “reduc(ing) excessive pay” of coaches and administrators, and demanded that the league take steps to end racial injustice in college sports. If these steps aren’t taken, players may opt out of playing.

• Members of the local LGBTQ community, take note: Our friends at Gay Desert Guide are hosting a ton of virtual events during these dog days of summer, including comedy shows, scavenger hunts and speed-dating events. The first one is tomorrow at 7 p.m., when Shann Carr hosts Big Gay Trivia! A small fee ($10 or so) applies for most events; get all the details here.

That’s plenty for today. Wash your hands. Wear a mask. If you appreciate honest local journalism, and have a few bucks to spare, please consider becoming a Supporter of the Independent. Stay safe, everyone.

Published in Daily Digest

Happy Monday, everyone. There’s a lot to cover, so let’s get right to it:

The coronavirus is spreading locally. According to the just-released Riverside County District 4 report, the local positivity rate—the percentage of tests that come back positive for the virus—is a too-high 14 percent. (The state wants that number kept below 8 percent.)

The numbers of cases keep going up. At first glance, the recent case numbers always look deceptively low on this report, and here’s why: The dates reflect positive cases based on when the tests are taken, not when the results come back—and since test results can take 3-5 days to receive, sometimes longer, we don’t have a lot of results back yet from last week. Just look at the numbers from May 25 on, and you’ll see the mess that the Coachella Valley is in.

• COVID-19-related hospitalizations, after being somewhat stable for the last week, have gone up substantially in recent days. County-wide, as of the weekend, 98.7 percent of our hospitals’ ICU beds were taken. However … according to the Los Angeles Times, that’s not the big problem, believe it or not; apparently, even in non-pandemic times, local hospitals frequently run out of ICU beds (!). Even now, there’s enough space, and plenty of ventilators. The problem is the number of medical professionals. Key quote:

Michael Ditoro, chief operating officer at Desert Regional Medical Center, said the facility hit ICU-bed capacity “well prior to COVID. Year after year.” The medical center’s surge beds are equally equipped to treat patients as regular ICU beds, he said.

Bed capacity might not be their biggest challenge, Ditoro said. Instead, it’s scant staffing.

“You don’t really have a centralized area with the beds all around it where it’s really quick to get to them. Instead, you may be in a longer hall unit where you need staff closer to each room,” he said of the surge units.

• Because of the increasing numbers, Gov. Gavin Newsom over the weekend cracked down on 15 counties, either ordering that they close bars—or strongly suggesting they do so. As a result, bars here in Riverside County—many of which had already voluntarily closed—will need to shut their doors tonight. Loophole alert: Bars can remain open if they serve food, and mandate that customers purchase food with their drinks. It’s also worth noting that Newsom said more closings could be ordered if things don’t improve.

The county Board of Supervisors meeting will take place online tomorrow, and parts of the County Administrative Center were closed, because several county employees tested positive for the virus

Los Angeles County is closing beaches over the July 4 weekend, since we, as Americans, are collectively proving that we’re incapable of wearing masks and social distancing and simply being intelligent in general.

• Cocktail break! Here’s Alton Brown’s refreshing mint julep recipe. If you don’t partake in spirits, here’s a non-alcoholic recipe.

• In Arizona, one of the COVID-19 hotbeds in the United States, Gov. Doug Ducey today ordered that bars, gyms, movie theaters and water parks close for at least 30 days, starting this evening. He also pushed back the planned opening of schools there by a couple of weeks. Weirdly enough, there’s still NOT a statewide mask order in the Grand Canyon State.

All Broadway shows have been cancelled through the rest of 2020 due to the pandemic—which has also led Cirque du Soleil to file for bankruptcy.

• However, in some places, the show is going on. CBS News looks at how some smaller theater companies are planning on presenting socially distanced plays.

• Oh, great. There’s more evidence this damn virus has mutated to make it more contagious. Just great!

According to this BBC News lede: “A new strain of flu that has the potential to become a pandemic has been identified in China by scientists.” OH COME ON YOU HAVE TO BE KIDDING ME.

• I don’t think we’ve ever taken two cocktail breaks in a Daily Digest before, but it seems necessary today. So, compliments of Independent cocktail scribe Kevin Carlow, here’s the lowdown on the history of the mai tai—with delicious recipes included.

Gilead has set the prices for remdesivir—the one drug sorta proven to help really sick COVID-19 patients—and it’s definitely not cheap.

• Maybe good news: According to The Conversation, SARS-Co-V-2 attacks cells kind of like some types of cancers do—but that means some cancer drugs may help battle the virus, too.

• We’ve often warned in this space that stories on scientific studies need to be taken with massive figurative grains of salt. CNN’s Sanjay Gupta isn’t wild about what he calls science by press release.

As a result of a screwed-up prison transfer, more than 1,000 inmates at San Quentin State Prison—that’s a third of the prison population there—have COVID-19.

• “Screwed up” can also describe the state inspectors’ response to COVID-19 outbreaks in nursing homes, which have killed thousands of people in California alone. Key quote from this Los Angeles Times piece: “Time and again, inspectors sent to assess nursing homes’ ability to contain the new virus found no deficiencies at facilities that were in the midst of deadly outbreaks or about to endure one.

• Finally, after all of that crappy-ass news, take 3 1/2 minutes, and let Randy Rainbow offer you a laugh or two—because he’s back with a new, mask-related ditty.

I think you’ll agree that this is more than enough news for the day. Please, everyone, wash your hands. Wear a mask. Social distance. Be kind. If you have the ability, please consider becoming a Supporter of the Independent, so we can keep paying Kevin Carlow to write about mai tais. (And so we can do other quality local journalism, too.) The digest will be back on Wednesday, barring something humongous happening tomorrow. 

Published in Daily Digest

Last Friday’s Riverside County Board of Supervisors meeting and its aftermath were simply remarkable—one of the most stupefying series of political events I’ve ever witnessed.

Here’s the short version: The supes voted unanimously to revoke three of county health officer Dr. Cameron Kaiser’s orders, as well as most of a fourth. Instead, the county will now defer to the state’s weaker (and, in some cases, less-clear) orders.

Frankly … the revocation of the orders involving golf courses and short-term lodging, and the partial revocation of the order involving schools, won’t change much. But that fourth one … in terms of sending a message, at least, it’s a doozy: The supervisors voted to revoke Cameron’s requirement that face masks be worn, and social distancing protocols be followed, in businesses and public places. Instead, face coverings and social distancing are now just “strongly recommended.” (They’re still required in Palm Springs, Desert Hot Springs and some cities, for the record.)

Here’s what is remarkable about the vote, and what followed:

• Local supervisor V. Manuel Perez voted with the rest of the supervisors to revoke the orders, and he hasn’t explained why. Before the vote, Perez signaled that he wanted to keep the face-mask requirement in place … but then he voted to revoke it. Since the vote, he’s been quiet on his social media. We asked his office for an explanation of his vote over the weekend, and have not yet received a response as of this writing. Therefore, all we have to go off of is a Facebook video posted on Sunday by Greg Rodriguez, Perez’s government affairs and public policy advisor … and it’s not very helpful. First: Although Rodriguez uses the term “we” throughout the video, he starts off by saying he is not speaking for Perez, so we should take him at his word. And second: Rodriguez never explains why Perez voted how he did anyway. Rodriguez says around the 4:35 mark: “You’ve got to have a majority of votes to pass something, and we did not have those votes to support what our stance was.”

So … Perez voted for something he was against?

My guess was that Perez was bowing to the wishes of the local business community, including the Greater Coachella Valley Chamber of Commerce (of which the Independent, I should disclose, is a member—and a less-than-happy one, FWIW), which has been clamoring for Perez to push for a faster reopening. But that’s just speculation.

Mr. Perez, you have some explaining to do.

• Perez was excoriated by his usual political allies after the vote. I don’t use the term “excoriate” lightly here. Perez is a progressive Democrat, and other progressive Democrats were not shy about openly criticizing him. On a Facebook post by Rodriguez, Palm Springs Mayor Geoff Kors commented about Perez: “He failed by voting to overturn all of the public health orders of the county’s public health officials which will delay our ability to reopen more businesses, hurt workers on the front lines and harm more residents’ health. How disappointing! To allow those who don’t want to wear face coverings to infect grocery workers is not something to be proud of. Glad Palm Springs City Council adopted our own rules to protect workers’ and residents’ public health.”

• The vote occurred after the county sheriff had already said he would not enforce the health orders anyway. Sheriff Chad Bianco—in a speech littered with falsehoods—had previously told the supes that the state had gone too far and had inappropriately taken away people’s constitutional rights with the shutdown order. He also at one point implied the virus really wasn’t a threat to healthy people (?!). So, therefore, he said, he wasn’t going to enforce the county’s orders. He then went on Fox and Friends and said similar things. So, yeah, holy shit.

• The supervisors, at this crazy meeting, did make some good points regarding the unfairness of Gov. Newsom’s reopening criteria. When Gov. Newsom announced what benchmarks counties would need to meet to further reopen, one of the requirements was that there be no COVID-19-related deaths for two weeks. If this requirement were truly followed, some of California’s larger counties might not be able to reopen until SARS-CoV-2 was more or less eradicated. Fortunately, Newsom has since signaled that the state would be a bit more flexible.

Expect more drama to unfold as soon as tomorrow, when Newsom is expected to offer more information about further business openings—including a possible timeline for in-restaurant dining.

Hang on, folks.

Today’s links:

• Remember the rule about studies these days—they need to be viewed veeeeeery skeptically—but, getting back to masks: A new study shows that consistent mask wearing may by itself be able to solve much of this COVID-19 mess we find ourselves in. From Vanity Fair: “Among the findings of their research paper, which the team plans to submit to a major journal: If 80 percent of a closed population were to don a mask, COVID-19 infection rates would statistically drop to approximately one twelfth the number of infections—compared to a live-virus population in which no one wore masks.” We say this with that figurative huge grain of salt, but wow.

• More encouraging health news: A clinical trial at Stanford is examining whether injections of a safe compound called peginterferon lambda-1a, when given early after a COVID-19 diagnosis, can reduce both deaths and patient recovery time.

• Also, some ER docs, writing in The New York Times, say checking at-risk people’s blood-oxygen levels early and often can help medical professionals get a jump on the virus.

• And according to this piece from The Wall Street Journal: Maybe ventilators aren’t the way to go with treatment?

• CBS’ 60 Minutes reports that the Trump administration is slashing the funding of some scientists working on a cure for COVID-19, because, again, nothing makes sense anymore.

Gov. Newsom and other Western governors are asking the feds for trillions in financial help. Yes, trillions with a “T.

• Meanwhile, in Shanghai, Disneyland is open again.

• The San Francisco Chronicle wonders: Are food trucks the future of dining in SF? (Follow-up question: Can we get some in the Coachella Valley? Please?)

• Also from the San Francisco Chronicle (which, in recent years, has improved to the point where it’s now one of the country’s most underrated newspapers): A data analysis shows that almost half of the coronavirus deaths in the state involve nursing homes.

• The Washington Post broke this story over the weekend, and it should really piss you off: A Texas company on Jan. 22 wrote the federal Department of Health and Human Services and asked if his company should ramp up production to make 1.7 million more N95 masks a week. He was ignored. Repeatedly. And that company’s still not making masks at capacity. Arrrrrrrrrrrrrgh.

United Airlines touted the fact that it would leave middle seats open because, you know, social distancing. Turns out that’s not always the case.

• The Wheels Are Coming Off, Chapters 157, 158 and 159: There was a packed rodeo in Shasta County. And two people were arrested after attacking a Van Nuys Target employee who insisted they wear masks. And Elon Musk continues to be a dick.

• Meanwhile, doctors are having problems getting remdesivir—and sometimes having to decide which patients get it, and which ones don’t.

Is it possible the Florida governor knew what he was doing when he was slow to close down the state, and quick to reopen it? The Washington Post takes a nuanced look at Ron DeSantis.

• Finally, John Krasinski and some friends from The Office are here with your weekly dose of Some Good News.

That’s enough for today. In fact, we think this is the longest Daily Digest we’ve ever done. So, yay, news! Anyway, buy our Coloring Book, because it’s awesome. Also, if you can afford to support 1,300-word-plus Daily Digests like these, plus all sorts of other awesome local journalism, please consider becoming a Supporter of the Independent. Wash your hands. Wear a mask. Be kind. Back tomorrow.

Published in Daily Digest

I have a slight bone to pick with Dr. Cameron Kaiser.

I say “slight,” because overall, the public health officer for Riverside County has done a fantastic job of handling what is, most certainly, an unprecedented health crisis. He was quick to declare a public health emergency. He’s been ahead of the figurative game on many moves—like a mandate to wear masks when leaving home. And the county health system has been good about updating the COVID-19 case numbers on a daily basis, and even including city-by-city breakdowns—something that’s not being done in many places.

So, to repeat: He’s doing a fantastic job overall—but when it comes to keeping the public informed, in some ways, he and his staff could be doing better.

On April 7, his office released some information that was well, scary as hell: a projection that the county, at current capacity, would fill up all 131 ICI beds by April 14; we’d run out of hospital beds by April 23; and we’d run out of ventilators by April 26.

The county also projected that by early May, the county would need 3,000 ICU beds. Again, the county’s current capacity, 131.

Excuse my language … but holy shit! The graphic made it clear that the projections would change based on reported cases, bed availability and resources, but still, there’s a huge difference between 131 and 3,000.

As April 14 has come closer—that’s four days from now, AKA TUESDAY—I’ve been watching for an update to the information. But … there has been no update. Yes, the main counts have been updated daily, but not the pants-wetting ICU-bed projections. Given that we are hearing better things on both a Coachella Valley-specific level and a statewide level, I’d really like an update.

A footnote: It’s also worth noting that one of our writers reached out about a week ago to Dr. Kaiser’s office for an interview. Our writer received a two-sentence response: “I'm sorry. Dr. Kaiser is not available.”

I have no doubt that Dr. Kaiser is bonkers-busy right now. I can’t imagine how busy he is right now. I understand.

But there aren’t that many functional news operations these days in Riverside County—sad, but true—and all we need is 15 minutes, tops. So on Monday, I am going to personally call Dr. Cameron’s office and ask for an interview. I’ll let you know how that goes.

And hey, if Dr. Cameron or someone on his staff is reading this: Can we get an update on those ICU beds, please?

Today’s links:

• I have mixed feelings about this: According to The Verge: “Apple and Google announced a system for tracking the spread of the new coronavirus, allowing users to share data through Bluetooth Low Energy (BLE) transmissions and approved apps from health organizations.” At least there are fewer privacy concerns with this method than the methods used in other countries’ tracking apps.

• The Riverside County mobile app has been updated to allow people to report people and businesses who are not complying with health orders.

• Important, if you didn’t file taxes for 2018 or 2019, and/or you don’t receive various federal benefits: The IRS has set up a website for you to sign up to get your stimulus payments.

• One of the biggest unknowns in this pandemic: How many people may have had COVID-19, but never knew it? A test in Los Angeles County of 1,000 people will help us start to figure out how much the coronavirus has really spread.

• Remember the jackass biotech exec who was sent to prison after jacking up the costs of HIV/AIDS medications? Martin Shkreli wants to be furloughed from prison to help with the fight against COVID-19.

• Even though nursing homes have been the sites of some of the worst coronavirus outbreaks, the federal government isn’t doing a great job of tracking them. So NBC News did their best to fill that gap.

• The Greater Coachella Valley Chamber Commerce is having a call-in legislative and COVID-19 update with Assemblymember Eduardo Garcia at 11 a.m., Wednesday, April 15. Details here.

• KESQ News Channel 3 talked to Coyote StageWorks founder Chuck Yates about the financial havoc the pandemic is causing for local arts organizations. You can read about the week when local theater came to a halt in this Independent piece.

Confused about face coverings, and good practices when it comes to using them? Eisenhower Health has some answers.

• I found this piece fascinating: You know which groups are doing a fine job at combating the spread of the coronavirus around the world? Some militant and criminal gangs!

• The pandemic has ripped a hole in the budgets of many LGBT pride organizations. They’ve banded together to create a Pride Operational Support Fund—and they need donations.

• It’s undeniable: Some people have been hit harder than others by the pandemic and the resulting health and financial crises. But, as this Wall Street Journal piece eloquently points out, this has been hard on almost all of us, in some way.

• The Camelot Theatres at the Palm Springs Cultural Center have joined other art-house theaters in offering a curated selection of indie films that you can purchase tickets for to watch at home! Not only can you watch great films; you can support the Palm Springs Cultural Center while doing so!

• Yesterday, we talked about the new Palm Springs Zoom backgrounds being offered by the local tourism bureau. Well, if those aren’t your cup of tea, Nickelodeon is offering some backgrounds that are a little more, well, cartoony.

• You know things are tough when the Hilton corporation, in a lovely gesture to help us feel better (if perhaps a bit fatter), releases what was heretofore a fiercely kept secret: The recipe for the famous DoubleTree chocolate-chip cookies.

• Wiping down food containers after going to the grocery store? Good idea. Washing your fruits and vegetables with soap? Not so much.

• Stressed? Well, calm down by getting together, for free, with the immortal Bob Ross, and paint some happy trees.

• By the way, if you wanted to submit art for our Coloring Book project, but haven’t gotten around to it yet, good news: A couple of artists asked us for more time, so we have extended the deadline to Tuesday, April 14. Get all the specs and details here.

That’s all for the traditional work week! Wash your hands. If you have a virtual event—a Facebook live concert, or a drag show, or a story time, or whatever—add it to our online virtual event calendar. Then go wash your hands again. Then if you value local, independent journalism, and are fortunate enough to have the means to do so, please consider becoming a Supporter of the Independent, so we can keep what we’re doing, and making it free to all—at a time when most of our advertisers have had to go on hiatus. Now make sure you’ve properly washed your mask, and make sure you wear it out in public. Tomorrow’s my sanity day off; we’ll return Sunday.

Published in Daily Digest

Rob Lyman of didn’t know what to do.

The Redwood City resident was helping his aunt, Sharron Evans, who had early-onset Alzheimer’s disease and needed constant supervision. A former teacher, she had run out of money and had no income. She qualified for government health-care assistance, but it appeared she’d need to go to the only setting that would be covered: a nursing home.

“Basically, that’s a hospital setting, and that was our only choice,” Lyman said.

To him, that didn’t make sense.

“My aunt just needed a safe place to be; there was nothing physically wrong with her,” Lyman said. “She didn’t need that level of care. It’s inappropriate. It costs the state a lot of money. But this is what people do. That’s the default choice.”

The baby boomers are aging. By the end of the next decade, 11.1 million Californians will be 60 or older, and the number of people 85 and older will jump 37 percent, to the 1 million mark, according to state officials. One in six Americans is expected to develop dementia, and care can be expensive enough to force even middle-class families into poverty and onto the public payroll.

For low-income seniors who can’t afford care at home and don’t need the full medical services of a nursing facility, the state’s few options aren’t enough to meet demand. A middle-ground choice—assisted living—requires special permission under government rules and is available to fewer than 4,000 Californians, although state health officials and lawmakers are both proposing increases. Taxpayers currently pick up the more-expensive nursing-home tab for more than 20,000 people who may not need it, by one advocate’s estimate.

Evans, now 69, was lucky enough to land a permitted spot in a Sacramento-area assisted-living home after nearly a year’s wait. The cost didn’t matter much to her or Lyman, because it was paid by Medi-Cal, the state’s version of the federal Medicaid program. The lower price tag for assisted living saves the state money, while also providing a more home-like setting and the right level of care for Evans.

For more than a decade, the state Department of Health Care Services has been trying to address the need for more-appropriate, less-costly care. But Medicaid pays only for what is “medically necessary,” such as nursing-home care, unless states ask for waivers. The state budget deal struck last week would provide administrative costs for a waiver to cover an additional 2,000 assisted-living slots.

That’s not enough, said Assemblyman Ash Kalra, a Democrat from San Jose. Kalra’s Assembly Bill 2233 proposes adding nearly 13,000 more, to cover a total of 18,500 people over the next five years. That would basically triple the number of Medi-Cal recipients with access to assisted-living care—assuming waivers, which last five years, can be secured.

“We’re hitting a crisis point with our senior care,” Kalra said. “It costs us twice as much for skilled nursing care.” His bill, which has no organized opposition, passed the Assembly and is now in the Senate.

The federal and state governments each pay roughly half of Medi-Cal expenses. A legislative staffer pegged savings for the state’s share at slightly more than $23 million over the five years, once all 18,500 patients are placed in assisted living. According to the Department of Health Care Services, which oversees Medi-Cal, the state’s share of the average cost for assisted living is about $22,000 a year per person—roughly half the $42,000 annual cost of a nursing-home.

“I have visited skilled-nursing facilities, and the nurses … told me that many of the patients don’t need that level of care. So we could be saving money for the state dramatically,” Kalra said.

According to the Department of Health Care Services, California has about 53,000 Medi-Cal patients in long-term institutional care, such as skilled-nursing facilities. A legislative analysis shows an estimated 11,000 of them have lower-care needs and could be fine in assisted living.

That figure could actually be twice as high, said Mark Cimino, who runs assisted-living homes in the Bay Area and around Sacramento, including the one where Evans lives. He said assisted-living facilities provide a wide range of care that could serve upward of 20,000 Medi-Cal patients who are now in nursing homes.

California’s first waivers, approved in 2004, covered about 1,000 people. That figure doubled in 2009 and nearly doubled again to about 3,700 in the most recent period, which runs out in March 2019.

“There’s a huge trajectory here,” Cimino said. “The question is: Is the expansion of the waivers enough?”

And there’s the human side of the equation, he added: “The assisted-living community is more home-like,” he said. “No one wants to spend much time in a (skilled-nursing) unit.”

The state “has specifically worked to expand access to assisted-living services,” said Department of Health Care Services spokeswoman Carol Sloan.

It’s hard to go any faster, she said by email, because the state has to check for “requirements, monitoring and oversight responsibilities, staffing, adequacy of available provider network and other resource limitations” before requesting more waivers.

As for the nursing-home industry: “If a resident can be shifted to a lower level of care, we think that’s a good thing,” said Deborah Pacyna, spokeswoman for the California Association of Health Facilities, a trade group. “We always support people getting the appropriate level of care for their needs.”

That won’t hurt business, she said: “The boomers are coming.”

For Rob Lyman, a move toward assisted living is a no-brainer.

“If the state, and we as a community, are going to provide assistance, we have to do it in a cost-effective way,” he said. “Putting people in skilled nursing when they don’t need it—that’s not good stewardship of public dollars.”

CALmatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics.

Published in Local Issues