Friday, August 21, 2009
WALLA WALLA -- The state of Washington recently took a large step backward in the care of aging adults, the regional long-term care ombudsman believes.
Last week, a federal judge appeared to feel the same, issuing a temporary restraining order against the Department of Social and Health Services on behalf of two dozen state residents, including six from Southeastern Washington.
No one in Walla Walla was part of that ruling, but the impact of the state's budget decision could eventually be felt here, an area with a high population of senior citizens.
When the Legislature was looking for ways to reduce the state budget, the Adult Day Health program may have looked like a simple way to start the trimming process, said Kathy Stevenson, the Walla Walla-based Eastern Washington regional state ombudsman program for long-term care.
The day program provides certain health services for seniors with chronic medical conditions in their own home or in adult family homes. Help can include a hot meal, physical, speech and occupational therapy and wound care, as well as other nursing services.
Such measures often allow people to delay or prevent a need for nursing home placement, Stevenson said.
"Nursing home care costs $150 per day, while care in an adult family home can run as low as $48 a day," she added. The Walla Walla daily rate is $52.
The program costs the state about $20 million annually and is matched with federal money, making the budget decision a $40 million cut for seniors, Stevenson said.
While some community senior centers can provide sporadic health help, "there will always be a group of people that doesn't always fit in with a senior center."
Statewide, the program serves about 1,900 elderly and adults with developmental disabilities. Initially lawmakers proposed eliminating the services for everyone, but changed that to apply only to people in licensed residential care settings, beginning in early July.
In the meantime, no replacement care was set up, creating a gap for people needing help with getting dressed, walking and eating. Meaning at least one of her clients went from being "nearly self-sufficient to needing much more physical assistance," Stevenson explained. "One client, in the 17 days he wasn't getting outside services, went from walking (unassisted) to using a walker."
In addition to different therapies, Adult Day Health providers help people deal with the emotional components of aging and offer exercises designed to keep critical thinking skills sharp, she said.
On Aug. 13, Judge Richard Jones in Seattle's federal court ruled that services had been terminated without due process and with "incredibly unclear language" and must be restored immediately for 24 people, the ombudsman said. A Sept. 4 hearing scheduled will decide if the court will issue class-wide relief for 961 residents in adult family homes, according to the state office of the long-term care ombudsman program.
As well, DSHS must reissue nearly every "client action notice," so people have a fair hearing, Stevenson noted. "You can't give those (services) one day and take them away the next."
She appreciates legislators had huge budget decisions to make, but the state is required to meet certain medical needs, she said.
"I don't think they looked at long-term costs. When we start having to pay for every single person going to physical therapy or going into a nursing home...we're trying to keep people in the least restrictive care. It costs less and it has great benefit to social and emotional health."
For more information call Stevenson at 509-386-5176 or go to www.sewaombudsman.com.