LOS ANGELES – Worried by the closure of dozens of board and care facilities for mentally ill and medically needy residents, the Los Angeles County Board of Supervisors voted Tuesday to find more funding to expand supply.
Supervisors Janice Hahn and Sheila Kuehl co-authored a motion calling for the county to identify funding sources. [View the motion here.]
“These board and care facilities are often the only thing standing between their residents and homelessness,” Hahn said. “The state needs to start reimbursing these facilities for the actual cost of the care they provide.
“But until that happens, the county is going to step up and give these facilities the support they need to keep their doors open so they can continue to be homes for our most vulnerable residents,” Hahn added.
California reimburses board and care facilities $35 per day for residents through their Supplemental Security Income benefits, which advocates say is not nearly enough to cover the actual cost of care.
The homes provide rooms, meals and care and in addition to staff wages, have to pay insurance, license fees and cover the cost of upkeep.
The motion estimates that 25,000 low-income Los Angeles County residents need such housing and services but only 10,400 are living in licensed facilities.
Since 2016, 39 such facilities serving Los Angeles County residents were forced to close their doors and many more are at risk of shutting down, according to Hahn and Kuehl.
“Given the roaring real estate market and low reimbursement rates, L.A. County board and care facilities have been closing at an alarming rate,” Kuehl said. “Without board and care beds, many of these men and women could face incarceration, institutionalization or homelessness.”
County employees have spent two years talking to board and care owners and residents to try and understand the problems, according to Hahn.
One advocate said it can cost as much as $3,500 a month to provide care or more than three times reimbursement rates.
“It’s beyond a crisis waiting to happen,” Caroline Kelly told the board. “It’s heartbreaking.”
Working with established board and care facilities to keep them in business may be easier than trying to create new ones, according to Department of Mental Health Director Dr. Jonathan Sherin.
“We’re losing to NIMBYs when we talk about board and care,” Sherin told the board, referencing residents taking a “not in my backyard” stance.
The state pays higher rates of reimbursement for a limited number of residents who have been homeless or have a mental health diagnosis versus those who are transitioning out of a nursing facility. The board asked staffers to develop a strategy to expand the number of residents for whom facilities can receive enhanced rates of reimbursement.
County officials will also look for opportunities to advocate for more state funding as well as private philanthropy to support board and care facilities.
A database that quickly identifies empty beds could also help expand capacity, according to the motion.
A report is expected back in 90 days.