New standards for the more than 500 adult foster care homes, homes for the elderly and halfway houses in the District of Columbia may force many of the homes to close at a time when there are already not enough facilities for the aged and mentally ill.
Most of the homes in the city that provide supervised room and board for the aged, mentally ill or handicapped would be affected by the new licensing standards, which go into effect Oct. 1.
The law, signed by Mayor Walter E. Washington last week, sets standards that include educational and experience requirements for the directors of the homes and their staffs, an extensive record-keeping procedure on all the residents, and fire safety, occupancy and dietary rules.
In addition, the law gives 60 mostly technical amendments to an earlier health care facilities law that pertained only to nursing homes, and establishes a central referral bureau to work with the department of human resources to monitor supervised residential facilities.
Owners and directors of adult supervision facilities said they agree with the spirit of the law in providing standards for such facilities for the first time. But many have said they cannot afford to make those changes, some of which would require hiring licensed medical personnel, without an increase in the monthly payments that the District gives these facilities to care for the aged.
Currently, more than half of the facilities providing supervised adult care get payments from the District amounting to about $180 per resident. A large number of those payments are for middle-aged mentally ill who receive out-patient services from St. Elizabeths Hospital.
A spokesman for the hospital said that if St. Elizabeths had to provide the same minimal care that adult supervision homes do, it would cost the hospital, at normal rates, $100 a day or about $3,000 a month.
"I'm in favor of the new bill because our operation was governed under the same regulations as a rooming and boarding house, and we are no more a rooming and boarding house than RFK Stadium is a roller rink," said Earl Lovell, owner of Fendall House, the largest adult supervision facility in the District.
"Under the new law (because of the size of his facility - about 150 residents) we will need a full-time social worker, activities director, dietician consultant and on-call residential physician," said Lovell, adding that his facility has lost more than $120,000 over the past three years. About 90 per cent of his residents are referrals from St. Elizabeths, Lovell said.
"The additional staff would cost us about $80,000 a year. We would also have to buy smoke detectors and that will cost us about $4,000," Lovell said. "We just cannot afford those changes with the payments we now get."
Mary P. Scott, spokesperson for the Adult Foster Care Home Association, said their facilities would need to get at least $300 a month to care for referrals from DHR or St. Elizabeths.
While the law provides a method for smaller facilities to receive a waiver of some requirements, such as homes in which from one to six people receive 24-hour supervision, the law will still create hardships for all facilities, Scott said.
"I run a home for seven people and I have already spent about $10,000 to upgrade it and I still have more to do," Scott said. "I'm going to have to install a dishwasher, I have to have a certain number of windows per room, my staff and I will have to take courses for food service and health care - it goes on and on," she said.
"There are so many things we will now have to do for $180, I think most of us will be forced out of business," Scott said.