SEVEN YEARS in the making. A cast of hundreds. Several directors. Lots of rewrites. It sounds like a Cecil B. DeMille masterpiece, but these phrases actually describe the District government's efforts to publish -- not enact, just publish -- new regulations governing nursing homes and community residence facilities (CRFs) for the elderly, mentally ill and others.
It was back on Oct. 28, 1983, that the D.C. Council decided that licensing and regulation of these facilities should be strengthened. The council directed Mayor Marion Barry's administration to create task forces and have new rules and regulations ready for use by Feb. 24, 1986. The task forces forwarded recommendations to David Rivers, then head of the city's Department of Human Services. But the 1986 deadline came and went (this will be a recurring phrase) without reaching the stage of publishing proposed rules for public comment.
In May, 1987, DHS finally published proposed rules for community residence facilities, but the reaction was so negative they were never re-published as final rules. The years 1987 and 1988 came and went without any new rules for nursing homes. In 1988 the city's Long Term Care ombudsman, who is responsible for investigating and resolving complaints by residents of these facilities, and 10 such residents sued the city to force it to develop new rules. In 1989 the D.C. government agreed to strict new timetables. The new deadlines came and went -- no new rules.
In October of 1989, the ombudsman filed a motion for contempt against the city. In March of this year, a D.C. Superior Court judge gave the city 75 more days to get the new rules published. On May 25 of this year, the proposed new rules finally appeared in the D.C. Register. DHS officials blamed the delays on understaffing, leadership changes and the huge agency's many other responsibilities.
One might think that DHS must have come up with rules that would satisfy just about anyone. Wrong. Of the proposed new regulations for community residence facilities, ombudsman M. Anne Hart says, "Due to their complexity, lack of clarity, unworkability, inconsistency and illegality, we believe that these rules as published should be withdrawn." Mrs. Hart says the new nursing home regulations also need work. The bungle goes on.