Taking Sides: Initiative 1163
The argument for and against new standards for long-term care workers
Vote Yes (Jump to the Vote No argument)I-1163 vital for safety of vulnerable adults
By John Lovick
In 2008, Washington voters overwhelmingly passed Initiative 1029, which required federal background checks and increased basic training for the people who care for seriously ill seniors and people with disabilities. Despite receiving more "yes" votes than any initiative in the state's history, the Legislature ignored the will of the voters, and those reforms were never implemented.
As a result of that inaction, in the three years since I-1029 passed we have seen the risk to our seniors and people with disabilities grow significantly. Last year, Residential Care Services, which investigates allegations against employees or volunteers of long term care facilities, reported a more than 15 percent increase in citations of neglect and abuse in adult family homes, to more than 20,000 in 2010. According to Adult Protective Services, reports of abuse increased 31.5 percent from 2001-2009. These include physical abuse, mental abuse, sexual abuse, neglect, self-neglect, financial exploitation, personal exploitation and abandonment.
Yet currently the state only requires a limited background check for home care workers, which misses serious felony crimes committed out-of-state. And long-term care workers still receive limited and clearly inadequate training.
Given the scope of the problem -- including many horrifying cases of abuse and neglect in Adult Family Homes detailed in a multi-part Seattle Times investigative series called "Seniors for Sale" -- you might think that for-profit long-term care providers would be working to clean up their act. Instead, the opposition to this year's I-1163 is being led by the same scandal-tarnished adult family home providers who put their own profits ahead of the well-being of their clients.
Snohomish County houses more than 6,000 people in nearly 500 adult family and boarding homes, and additional thousands receive care in their own homes. When seniors choose to stay in their own homes, or in small community homes for their long-term care, they lead more independent lives. The result is a much better quality of life and often a healthier life. But with the lack of training for home care workers, coupled with narrow state background checks, the risk for this vulnerable population remains too high.
This is a serious problem that needs to be addressed now. I-1163 will do that. It requires home care workers, who provide the same type of care as nursing home workers, but in a far more isolated setting and with little oversight, to pass a full federal background check. Our current, state-level check misses crimes committed outside the state of Washington, leaving our seniors vulnerable to someone simply because they may have moved here after committing a felony in another state. Closing that background check loophole is just common sense.
In addition, I-1163 will require home care workers to receive a minimum of 75 hours of basic training and to pass a certification exam in order to provide care. It makes no sense that a hairdresser must undergo 1,000 hours of training and a nursing home worker receives 85, while someone who cares for in-home patients with conditions such as dementia and developmental disabilities receives less than 40 hours.
Every day we hear stories of seniors being taken advantage of, abused or neglected. Each one of these reports can be partially attributed to our low standards -- both background checks that miss out-of-state crimes and substandard training. Our public safety officials have been vigilant, working diligently to protect the most vulnerable in our society. But they need help. They need adequate protections in place for the most vulnerable seniors in our state, who deserve quality care from trained professionals.
We often hear of 911 calls from homes of our local seniors who have suffered a seizure or have fallen ill from the effects of a condition they are battling. Yet, in so many of these cases, the emergency room visit could have been prevented if a trained home care worker had noticed the problem before it spiraled out of control. Not heeding our responsibility to adequately train and screen home care workers leads to substandard care for our parents and grandparents.
Thousands of Medicaid-eligible low-income seniors and people with disabilities who qualify for expensive nursing home care voluntarily choose to remain in their own homes. It allows them to stay connected to their families and communities, while saving taxpayers millions. But we need to make sure they are protected. These vulnerable people deserve safe, quality care that preserves their health, their sense of independence and their dignity. Vote yes on Initiative 1163.
About the author: John Lovick is the Snohomish County sheriff. Previously, he served as a state representative from the 44th District for 10 years, and spent 30 years in the Washington State Patrol.
Vote NoI-1163 too expensive, hits wrong priorities
By Cindi Laws
Initiative 1163 must be defeated because its $80 million cost cannot be paid for without tax increases or cuts to vital senior services.
Like the rest of the nation, Washington has grappled with crippling budget deficits for four legislative sessions. With Gov. Chris Gregoire calling a special 30-day legislative session to deal with the crisis, there's an additional 1.4 billion reasons to oppose I-1163.
As the Washington Research Council wrote in its new initiative analysis: "I-1163: One, twice, still not a priority."
Voters, don't be fooled. I-1163 represents the wrong priorities. Mandatory caregiver training and criminal background checks are already required by law. I-1163 costs $80 million in the next two years and benefits just one interest group -- Service Employees International Union (SEIU).
This SEIU-sponsored measure claims to protect vulnerable adults. What it really does is force taxpayers to pay for the watered-down training of union members, with inexperienced and uneducated trainers managed by SEIU, eliminating the current training conducted by medical professionals and credentialed educators -- who are licensed by the state. State officials agree. At a time when they couldn't agree on much, 82 percent of lawmakers voted to delay the previous training initiative, I-1029. At a time when the Legislature was eliminating entire programs, elected officials were unwilling to fund a new government project. Only SEIU and their few allies supported the expensive new program.
Here's the reality: Over four years, the Legislature took extraordinary measures to cut billions from state programs. In 2009, decisions were made that allowed convicted violent and sex offenders, in need of long term care, to be placed into "community residential care where such care could be found." Long term care in prisons and state hospitals is expensive. Recently, we learned the state was attempting to move a 94-year-old convicted first degree murderer into a local long term care home, even though the murders took place just three years ago.
Last spring, the Legislature cut more than $500 million in medical services and in-home care to seniors and adults with disabilities. Eliminated were vision, hearing aids and dental care, and prescription drug coverage was reduced. In-home care services, which allow seniors and the people with disabilities to safely stay in their homes with the help of visiting caregivers, were slashed. Overall, there were more than $2 billion in cuts at the Department of Social and Health Services, affecting children, the mentally ill and the working poor. Other areas of the state budget were slashed as well, including public education and prison staffing.
Less than four months later, state agencies have prepared additional 10 percent cutbacks to address the latest shortfall, including the elimination of another $873 million at DSHS. Care will end for 17,000 seniors and adults with disabilities; the Health Care Authority has sharply reduced emergency room visits for poor people receiving Medicaid; and our correctional facilities are releasing hundreds of inmates and mental patients into the community.
The state is desperate for money. There is simply no way to pay for I-1163.
Our industry is absolutely committed to the highest standards of training and professional business practices. That isn't what this initiative is about. It's about a powerful special interest writing self-serving policy for its own benefit. We won't have it. Our residents deserve caregivers with the best and most relevant training available, and the taxpayers can't afford I-1163.
How does SEIU propose to pay the $80 million price tag of I-1163? SEIU's selfish, cavalier approach to the current budget crisis is unconscionable. Whose medical services will be eliminated to pay for I-1163? Whose school lunches do they intend to cut? Whose taxes do they intend to raise?
In addition to forcing a new program onto an unwilling state government, 1163 will require significant new costs on long term care, which will drive up the cost for residents. Nursing homes, adult family homes, and home care businesses will have to pay thousands of dollars per year to fund SEIU's new program. How many long term care workers will lose their jobs? How many vulnerable adults will see the quality of their care diminished because long term care centers are forced to cut costs to pay for new training they neither want nor need?
To preserve services for seniors and people with disabilities, the only responsible thing to do is vote no on 1163.
About the author: Cindi Laws is chair of People Protecting Our Seniors -- NO 1163, a coalition that includes organizations advocating for senior protection, disability rights, residential housing and long-term care, as well as business and consumer advocates.
On the Web: Yes, www.yes1163.com; No, www.no1163.com
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