Initiative 1163: Does state need stricter rules for home health workers?

No: I-1163 will require tax hikes or service cuts; only union benefits

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, the state of 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 and a projected $1.4 billion deficit, that means an additional 1.4 billion reasons to oppose I-1163.

As the Washington Research Council wrote in its new initiative analysis, “I-1163: Once, twice, still not a priority.”

Initiative 1163 concerns long-term care workers and services for elderly and disabled people.

This measure would reinstate background checks, training, and other requirements for long-term care workers and providers, if amended in 2011; and address financial accountability and administrative expenses of the long-term in-home care program.

Should this measure be enacted into law?

[ ] Yes

[ ] No

For more information, visit http://www.sos.wa.gov/elections then click on “2011 General Election Online Voters Guide.”

Voters, don’t be fooled. I-1163 represents the wrong priorities. Mandatory caregiver training and criminal background checks are already required by law. For caregivers moving from another state, FBI fingerprint 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.

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 eliminated entire programs, those elected officials were unwilling to fund a new government project. Only SEIU and their few allies supported the expensive new program.

Vulnerable hurt

Here’s the reality: 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 and hearing aids, dental care, and a reduction in prescription drug coverage. In-home care services, which allow low-income 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 DSHS already this year, affecting children, the mentally ill, and the working poor. Other areas of the state budget were slashed as well, including education and prisons staffing.

Less than four months after the legislative session ended, state agencies were ordered to prepare additional 10 percent cutbacks to address the latest shortfall. 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 dangerous mentally ill patients into the community, where there are no corrections officers or social workers to provide a safety net — because those positions have also been eliminated. Why? Because the state has no money.

SEIU doesn’t care. SEIU did not include a revenue source — a tax — in I-1163 because if they had, the initiative would fail. But SEIU is fixating on the elimination of the sales-tax exemption for out-of-state shoppers, which would have a devastating impact on border communities such as Vancouver and Clark County. SEIU does not care, as long as taxpayers are forced to pay for the training, and time-paid-for-training, for their 40,000 union members.

In addition to forcing a new program onto an unwilling state government, I-1163 will require significant new costs on long-term care, driving up the cost for all residents. Nursing homes, adult family homes, assisted living facilities and home care businesses will have to pay thousands of dollars more per year for this training program.

Clark County is home to hundreds of long-term-care providers. Collectively, these providers, most of which are small businesses, employ thousands of caregivers, most of whom would be forced into SEIU’s union program. The cost to taxpayers is staggering. And at a time when the state is forcing the most vulnerable among us onto the street and without any medical coverage or treatment, voting for a training program that enriches SEIU is simply wrong. Voters should soundly reject I-1163.

Cindi Laws is chairwoman of People Protecting Our Seniors — NO 1163 (www.no1163.com), a coalition that includes organizations advocating for senior protection, disability rights, residential housing, long-term care, business and consumer advocates.

Yes: Better training, screening needed to protect most vulnerable

By Dr. Eugene May

When the voters of Washington state supported federal background checks and increased training for home care workers by overwhelmingly passing Initiative 1029 in 2008, they were calling for needed protections for our seniors and people with disabilities.

Yet, despite receiving more votes than any measure in Washington state’s history, the will of the voters was ignored by the state Legislature and our most vulnerable residents are in a worse position than they were three years ago.

We have to stop letting them down. When the Seattle Times published “Seniors for Sale,” a stunning investigative series that unearthed horrific stories of abuse and neglect in adult family and boarding homes, many readers were devastated by the details of the death of a 78-year old woman as a result of neglect. After she’d lain on her back for nearly a month, a visiting nurse examined her and found what she called the worst pressure sore she’d seen in 20 years. These needless tragedies paint a grim picture of our Legislature’s failure to enact heavily supported reforms.

Now, three years later, I-1163 will restore common-sense protections for our most vulnerable. Our seniors and people with disabilities are at risk. Last year, Residential Care Services, which investigates allegations against employees of long-term care facilities, reported an increase in citations of more than 15 percent in adult family homes since 2008. According to Adult Protective Services, reports of abuse increased 31.5 percent from 2001-2009. These abuses include physical abuse, mental abuse, sexual abuse, neglect, self-neglect, financial exploitation, personal exploitation and abandonment.

Safety, instruction

Initiative 1163 will implement common-sense protections, heeding the will of the voters, while recognizing that the state has acknowledged the need for increased training hours, as have medical professionals and home care workers themselves.

They are in addition to the many public safety officials who see the danger of having workers in the homes of vulnerable seniors without knowing their full background.

In an area like Clark County, where nearly 3,700 people reside in adult family or boarding homes, a person who has committed a felony just across the border in Oregon can become a home care worker without the state knowing their full criminal history.

I-1163 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.

The initiative also restores a minimum of 75 hours of basic training and requires home care workers to pass a certification exam to provide care. While hairdressers receive 1,000 hours of training and nursing home workers receive 85, home care workers are required just 34 hours of training at the most. Some workers receive less, despite being responsible for the care of vulnerable seniors and people with disabilities, many with serious and worsening conditions.

Home care provides an independent lifestyle and often a better quality of life for thousands of our most vulnerable.

However, those who have chosen to remain in their own homes, saving the state millions, need adequately trained and screened caregivers. Initiative 1163 will restore these common-sense protections. Vote “Yes” on Initiative 1163.

Dr. Eugene May is a neuro-ophthalmologist and co-founder of the MS Eye Clinic in Seattle. He is a trustee for the Greater Washington Chapter of the National MS Society and wrote this op-ed on behalf of the National MS Society.