Police and emergency workers at the Twin Spruce personal-care home near Sunbury in 2004 after a fire killed 3 residents. At that time, more stringent rules for fire safety had been beaten back by the personal-care industry.
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Part 3: Writing their own rules
Drive for change left Pa.'s personal-care industry at the wheel.
There is nothing unusual about business owners' lobbying policy-makers to curb regulations. But in this case the industry, through lawmakers, was able to virtually dictate a long list of changes to what regulators first proposed.
Richman and others said it was made clear that if they did not meet certain key demands, the rules would not win legislative approval.
"The mail was overwhelming, and [lawmakers] saw it as a constituent issue," she said, meaning they saw the operators - not the residents - as the key constituents.
As for the residents, she said, "I think the personal-care-home population . . . tends to become an invisible population."
Personal-care homes, also known as assisted-living facilities, have always been subject to less robust government oversight than nursing homes, both in Pennsylvania and nationally.
In Pennsylvania, the regulations were seen as particularly weak, and a series of tragedies in the 1990s underscored that. In 1997, Gov. Tom Ridge flew in a helicopter over the charred wreckage of a Harvey's Lake home where 10 residents died in a fire.
In 1999, the Ridge administration began a push to update the rules. After an aborted attempt to write one set of rules covering several types of adult facilities, the administration decided to move forward with tougher regulations of personal-care homes. A draft was released in March 2002.
Facility owners reacted with outrage, saying the regulations would require expensive changes without any state aid to pay for them.
Some owners of personal-care homes made exaggerated claims, with one contending the rules would cost more than $500,000 a year and drive 40 percent of homes into bankruptcy.
Those assertions were echoed in missives from state legislators.
In November 2002, Sen. Jane Orie (R., Allegheny), wrote to then-Welfare Secretary Feather O. Houstoun, forwarding her those cost estimates.
"I know your intent is not to force the closure of these homes for this vulnerable population," Orie ended her letter. "I am anxiously waiting your reply."
Orie said she was merely trying to make the Welfare Department aware of the industry concerns, and that she would never support anything that undermined resident safety.
"My intent was not to jeopardize the safety and welfare of any of these seniors," she said.
Another western Pennsylvania senator, Mary Jo White (R., Warren), wrote a similar letter in 2002 listing a host of objections, including her opposition to a three-day-per-year employee training requirement.
"Twenty-four hours of staff training each year is too high," wrote White, who did not respond to repeated requests for comment.
When it became clear that the Ridge administration would not be able to push through the regulations in its waning days, the industry began lobbying gubernatorial candidates.
One of them, then-Auditor General Bob Casey Jr., had already angered the industry with a 2001 audit that criticized the state for, among other failings, allowing personal-care homes to renew licenses without checking to see that serious violations were fixed.
Rendell, Casey's opponent for the Democratic nomination, called for a moratorium on the new regulations - and won the endorsement of a personal-care-home industry group.
"We salute Ed Rendell!" wrote the Northern Area Personal Care Owners Association in a 2002 newsletter.
