California Department of Public Health (CDPH) Dr. Ronald Chapman announced this month he will be resigning on January 31, but he probably won’t be getting any cards from well-wishers at the California Advocates for Nursing Home Reform (CANHR).

“The Department’s effectiveness is at an all time low,” the group wrote on its website after Chapman made his announcement. They then proceeded to rattle off a laundry list of complaints about the department, which oversees nursing homes that house 300,000 Californians.

“Complaints involving abuse and neglect are often ignored; there is a huge backlog of complaints; the quality of nursing home inspections is very poor; required licensing inspections are not being carried out; enforcement of residents’ rights is abysmal; thousands of nursing home residents are subjected to chemical restraints; the Department allows unfit persons and companies to acquire and mismanage nursing homes; its Los Angeles County operations are in a state of crisis; other district offices are poorly led; it too often caters to the interests of the nursing home industry; morale of its employees is very low; and its employees are fleeing the Department faster than it can replace them.”

The list touched on items explained in more detail, and in a more subdued tone, by the California State Auditor in a scathing October report (pdf). The auditor found a backlog of more than 11,000 complaints related to long-term health care facilities, many of them with “relatively high priorities.” Around 370 situations involved patients in “immediate jeopardy―indicating a situation that poses a threat to an individual’s life or health.”

The department “has not effectively managed investigations of complaints related to long-term health care facilities,” the report said.

Chapman oversees a department in the Health and Human Services Agency with a $3 billion budget that employs 3,580. The department is the lead agency in California providing detection, treatment, prevention and surveillance of public health and environmental issues.

Some of these programs complement and support the activities of local health agencies; others are solely state-operated programs, such as those that license health care facilities.

The department was spun off from its predecessor (Department of Health Services) in 2007 as a direct response to the terrorist attacks of September 11, 2001. The state wanted a department focused on threats to the public from bioterrorism, as well as emerging antibiotic-resistant diseases and environmental threats.   

And that is what it got. A department with physician leadership guided by an expert advisory panel devoted to shoring up a public health system that was identified by the independent Little Hoover Commission in 2003 as the “weakest link in California’s homeland defense.”

Dr. Chapman was appointed director in June 2011. Before that, the family physician was chief medical officer at Partnership Healthplan of California, a managed care Medi-Cal plan serving Yolo, Solano, Napa and Sonoma counties.

–Ken Broder

To Learn More:

California Public Health Chief Ronald Chapman to Step Down (by Jon Ortiz, Sacramento Bee)

Head of California's Public Health Department to Step Down (by Melanie Mason, Los Angeles Times)

State Auditor Rips California Nursing Home Oversight (by Ken Broder, AllGov California)

Resignation of Department of Public Health Director Provides Opportunity for New Leadership at Troubled Agency (California Advocates for Nursing Home Reform)