On May 1, the California Department of Social Services (CDSS) announced its offer to pay residential care facilities with six beds or less $1,000 a day to house COVID-19 patients. And it requested that larger care facilities indicate their interest to do so.
By the first day of the month, however, these facilities were already hotbeds of the virus.
According to CDSS figures released May 3, nearly 10,000 patients and staff in long-term care facilities statewide had tested positive for the coronavirus, and 926 had died. As of this past weekend, Santa Clara County assisted living, skilled nursing, independent living and board and care facilities had confirmed 475 cases, 85 hospitalizations and 56 deaths.
Nearly half of all deaths related to COVID-19 in California are linked to elder care facilities. That figure is more than 40 percent in Santa Clara County.
Despite these harrowing statistics, the state is offering residential care facilities a $1,000-a-day bounty to bring COVID-19 positive patients into facilities that are staffed by workers who themselves are often at high risk for the disease and that already house vulnerable elderly patients. According to a May 4 Mercury News article, Mike Dark, a staff attorney for watchdog group California Advocates for Nursing Home Reform, wrote that that “these facilities are lacking in protective equipment for staff” and the staff are “just as vulnerable” as residents.
L.D.—a residential facility caregiver of 12 years who does not want to provide her name out of fear of retaliation—is one of those vulnerable workers.
“If my employer accepts COVID-19-positive patients, there is a high risk that I will get infected,” she said. “Like most caregivers, my employer does not offer us health insurance, and I am just earning minimum wage. I am scared not just for myself but for my family who depends on me for financial support if I get infected. With my asthma and elevated blood pressure, I could die of this virus.”
Ranela Placides, a caregiver for eight years at various residential care homes, currently works at a facility that lacks protective equipment for staff. She disclosed how, at the start of the stay-at-home order, her employer just gave her four masks. She said her co-workers were given the same number and that they were instructed to spray the masks with disinfectants and air dry them after each use. They are reusing the masks as well as the disposable gloves, she said.
“There is not enough PPE [personal protective equipment] in the care home I work for,” she said. “My co-workers and I are very worried that we will get infected if we have to take care of COVID-19 positive patients.”
The lack of PPE at residential care homes has been such a problem that the Pilipino Association of Workers and Immigrants (PAWIS) has been distributing equipment donated by Stanford University students and private individuals to care home workers throughout the South Bay. The California Department of Social Services may call care home workers essential, but it treats them as disposable.
Caregivers in residential facilities are not required to have medical training and their job is to assist residents with medication, feeding, dressing, grooming and bathing. In a May 4 interview with KPBS, Michael Wasserman, president of the California Association of Long-Term Care Medicine noted that these facilities are “not hospitals” and are not “medically structured.” He couldn’t think of a single assisted living facility in the state that “is prepared to handle COVID-19-infected people.” He called the current approach “naive” and “ignorant" and warned that this approach “will get more people killed.”
Although the state Department of Social Services has asked residential care facilities to segregate COVID-19 patients and the staff that cares for them, it has not ruled out mixing coronavirus positive and negative patients and utilizing the same staff if there is no other option, despite the fact that COVID-19 is highly contagious.
According to research published in the The Proceedings of the National Academy of Sciences, the simple act of talking can launch thousands of droplets so small that they can remain suspended in the air for eight to 14 minutes. The droplets may land on surfaces like doorknobs, where people can touch lingering virus particles and transfer them to their face, but some droplets can remain aloft and be inhaled by others. It is, therefore, highly likely that even if there is segregation residential care facility staff and patients who are not sick will become infected.
COVID-19-positive patients pose a mortal danger to the staff and to the medically fragile and elderly residents in these facilities. Residential care homes are not equipped to house coronavirus-positive patients. In a May 6 KPBS interview, UCSF nursing professor emeritus Charlene Harrington called the status quo“criminal.”
We urge the California Department of Social Services to abandon its ill-conceived and potentially criminal decision for the safety of the staff and the patients they care for.
Ruth Silver Taube coordinates the Santa Clara County Wage Theft Coalition. Felwina Opiso-Mondina is a member of PAWIS. Justher Gutierrez is a Filipina community organizer. Opinions are the authors’ own and do not necessarily reflect those of San Jose Inside. Send op-ed pitches to [email protected].