Adaptive Housing for Quadriplegics: Impact of California’s Prop. 35

Struggling to Find Home

Luis Cervantes, a 29-year-old quadriplegic, faced a challenging decision after a car accident left him in need of constant care. Uncomfortable asking his family for help with his physical needs, he felt isolated and stopped participating in outings with them. This sense of helplessness led to suicidal thoughts and a hospitalization due to a urinary tract infection. After an unsatisfactory stay at a nursing facility, Cervantes discovered Laramie House, a congregate living health facility in Chatsworth. This facility, designed to provide medical care in a home-like setting, became a lifeline for Cervantes, who moved in this past fall.

Financial Struggles and Uncertain Future

While the concept of congregate living health facilities dates back decades, operators like Sian Welch of Laramie House are facing financial challenges. California’s plans to raise reimbursement rates for such facilities in January were derailed by the passage of Proposition 35 in November. This ballot measure aimed to secure funding for Medi-Cal, the state’s Medicaid program, but had unintended consequences for facilities like Laramie House. State Sen. Caroline Menjivar warned that without proper funding, these facilities, serving patients with complex needs, could be in jeopardy.

Unmet Financial Needs and Advocacy Efforts

Congregate living health facilities have not seen an increase in their reimbursement rates since the 1980s, leaving operators struggling to cover costs and provide necessary care. The lack of funding has forced many facilities to consider closure, displacing residents like Tyler Smith, who relies on Laramie House for medical care and support. Advocacy efforts, including lobbying for increased state funding and addressing regulatory challenges, are ongoing to ensure the sustainability of these vital facilities.

Personal Stories of Resilience

Individuals like Angel Bustos, who faced indignities at nursing homes before finding a home at Laramie House, highlight the importance of these facilities. Bustos, paralyzed after surviving gunshots, experienced a transformation at Laramie House, celebrating his wedding and regaining a sense of dignity and independence. His story, along with those of Cervantes and Smith, exemplifies the impact of adaptive housing for quadriplegics in providing not just medical care but also a sense of belonging and hope for the future.

As the future of congregate living health facilities hangs in the balance, the resilience and determination of residents and operators alike underscore the critical need for continued support and investment in these essential care settings.