Watchdog program to lose one-third of funds

Ombudsman for long-term care facilities takes hit

By Paris Achen, Columbian courts reporter

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A state program that sends volunteers into long-term care facilities to help prevent elder abuse and neglect will lose one-third of its funding because of a decision by the Centers for Medicare & Medicaid Services to stop reimbursing the program.

How to help:

The Southwest Washington Agency on Aging and Disabilities’ Long Term Care Ombudsman Program is seeking volunteers to serve as an advocate and liaison for residents of long-term care facilities.

Volunteers are expected to serve at least four hours per week and attend at least six out of 12 training sessions per year.

For more information or to print an application, visit www.helpingelders.org or call 360-694-9007.

“There is going to be a loss of staff,” said Patricia Hunger, state long-term care ombudsman. “We might not be able to respond to complaints as quickly.”

The Centers for Medicare & Medicaid claims that funding the state’s Long Term Care Ombudsman Program violates the law because the program is also funded (and mandated) by the U.S. Department of Health & Human Services’ Administration on Aging, according to a letter to the state’s Aging and Disability Services Administration. Providing Medicaid assistance to the program is duplicative except in cases that are directly related to Medicaid services.

The decision strips the state’s Long Term Care Ombudsman Program of $600,000 in Medicaid reimbursements from its $1.8 million budget, said Hunter. About $30,000 of that will be lost in the Southwest Washington region, which includes Clark, Cowlitz, Skamania, Klickitat and Wahkiakum counties, said Mike Reardon, community services program manager at the Southwest Washington Agency on Aging and Disabilities.

The state, which also contributes to the program’s funding, could choose to make up the difference from the Medicaid loss. However, that’s unlikely under the state’s current budget shortfall. In fact, the program could be vulnerable to state cuts on top of the Medicaid loss, Hunter said.

Five to eight staff positions in the state ombudsman program will be eliminated, including one part-time position in Southwest Washington, Hunter said. Hours also will be reduced at some of the program’s centers. The Cowlitz office will cut back its hours from 20 hours per week to 10 hours per month, Reardon said. Clark’s office hours will remain unchanged.

“The state office, therefore, will need to cover more calls through the 1-800 (complaint) hotline,” Hunter said.

Volunteers in Southwest Washington now receive mandatory training close to home in Vancouver. With the reduced budget, training may have to be consolidated in one place for the entire state, Hunter said. That will mean training sessions may be delayed, and volunteers may have to drive to Olympia or Tacoma for training.

Staci Levison, regional ombudsman at the Southwest Washington Agency on Aging, said she’s concerned that long waits for training, long drives to another city and cost of lodging could deter people from volunteering. The program is already short of volunteers, Levison said. There are only 28 volunteers working in Southwest Washington’s 490 nursing homes, assisted living centers and adult family homes, 89 percent of which are in Clark County.

“In many cases, the volunteer ombudsmen are the only outside contact these residents have and their only means to communicate concerns or complaints,” Levison said.

Filling a need

There are a total of 400 volunteers in 2,713 long-term care facilities around the state. The volunteers advocate for residents, educate facility staff on resident rights and resolve complaints by residents, Hunter said. They are required to undergo 36 hours of training prior to responding to complaints and an additional two hours of training each month, Levison said.

Complaints are sometimes lodged with volunteers themselves, but often volunteers are sent out to a facility because of a complaint called into staff at the complaint hotline, 1-800-562-6028. They also pay routine visits to facilities to check in. Statewide, the program responds to about 4,000 complaints per year, Hunter said.

Complaints can range from stolen laundry to reports of physical abuse and financial exploitation, said Carolyn Hutton, a Vancouver volunteer ombudsman.

“Volunteer-wise, we don’t have as many as we need, but if we can call the office when we have a question and get an immediate response, that allows us to move onto another case,” Hutton said.

Fewer to respond

With reduction in staff, there will be fewer people to respond to volunteer questions, she said.

Washington is the third state in the nation that the Centers for Medicare & Medicaid Services has determined claimed Medicaid expenses for ombudsman programs, said Terry Cumpton, special assistant in the agency’s Seattle office. The other two are New Jersey and Maine. New Jersey appealed the decision, but the agency’s decision was upheld, Cumpton said.

More states could turn out to be in violation during routine financial reviews, Cumpton said.

“As we find these areas (of violation) we will enforce the law and requirements consistently.”

She said it isn’t clear why states began the practice.

Paris Achen: 360-735-4551; http://www.twitter.com/Col_Trends; http://www.facebook.com/ColTrends; paris.achen@columbian.com.