A complaint filed with the state against the Southwest Washington Agency on Aging and Disabilities alleges that bad management practices, unwieldy bureaucracy and a hostile work environment have led to unsafe conditions, and at least one death, among the agency's elderly and disabled clients.
"It is a multilevel complaint with many allegations, and all of it is being looked at," said Bea Rector, the interim director of home and community services for the Aging and Disability Services Administration section of DSHS, which contracts for local services with the Southwest Washington Agency on Aging and Disabilities. She said the lead investigator will be Susan Engels, a DSHS unit manager.
The nonprofit Southwest Washington Agency on Aging and Disabilities operates numerous health and wellness programs for senior citizens and disabled people who want to remain independent and live at home. It has approximately 100 employees. It is governed by a five-member board of county commissioners from Clark, Cowlitz, Klickitat, Skamania and Wahkiakum counties.
David Benedicktus, a retired registered nurse and on-call case manager for the agency, filed a complaint Jan. 4 with the Washington State Auditor's office, and picketed the agency's Hazel Dell Avenue office.
With him were several former staff members -- case managers and social workers -- who shared his complaints. One, Quan Tran, was fired last year, has appealed his termination and is hoping to be reinstated.
"This is a call for a community dialog about best practices. This is a call for more help and consultation, in advance of the silver tsunami that's coming," said Benedicktus -- referring to the general aging of the population and the increasing workload for service providers that, like SWAAD, assist the elderly. "We are asking for an independent review," he said.
But his complaint wasn't taken up by the state auditor, nor by the Clark County Prosecutor's Office. It eventually found its way back to DSHS and Rector, who confirmed this week that an investigation is underway.
David Kelly, executive director of SWAAD, responded with a written statement, which said that an earlier review by the Aging and Disability Services Administration has already concluded that SWAAD and its case management had "no causal connection" to the death of client Dale Shoemaker last May.
Death of a client
Shoemaker, 59, died of smoke inhalation in a house fire east of Ridgefield on May 1, 2012. The fire was ruled accidental; Shoemaker's sister, Becky Wahl of Auburn, said that her brother had dementia and she'd been only days away from getting legal guardianship of him when he died.
Tran said Shoemaker had been his client, but after he'd been dismissed and the case was assigned to a substitute, "the plan wasn't followed." The "direct result," Tran said, was the accidental fire.
Wahl blamed both Legacy Salmon Creek Medical Center and the Clark County Jail, where Shoemaker had spent time, as well as SWAAD, for failing to find a safe, secure place for him to go. "There are lots of people responsible," she said. "I thought I'd set up safety nets for him. It didn't work. Everybody messed up."
Kelly's statement says that "a review regarding the circumstances of (Shoemaker's) passing was conducted by the Aging and Disability Services Administration, a division of DSHS. We have been informed by ADSA that the review conducted determined that there was no causal connection between the case management services Mr. Shoemaker was receiving from our agency and his tragic death.
"The ADSA review and our own internal review of the matter absolutely reinforces my belief that our agency appropriately and effectively provided case management services to Mr. Shoemaker and that we will continue to perform this valuable public service for all other clients that we serve in the surrounding community."
All questions should go to Bea Rector of ADSA, the statement concludes.
During telephone interviews, Kelly said that his top priority as executive director of SWAAD has been earning the community's trust. "We have built up trust over four years that I think is exemplary," he said. To fight off any damage to the agency's reputation, he said, "I will want and demand a full and complete review" of Benedicktus' allegations.
Just last fall, SWAAD won the Washington State Council on Aging 2012 Excellence in Action Award in part for its role in countywide planning for a boom in the senior citizen demographic in Clark County. Kelly accepted the award from Gov. Chris Gregoire on Oct. 26.
Benedicktus' complaint claims that SWAAD lacks critical incident-reporting procedures, leading to mistakes that don't get caught and reviewed, but requires a huge volume of redundant documentation that draw professional attention away from direct care for clients.
Benedicktus also claims that the SWAAD system for requesting safety and medical equipment and delivering it to frail Medicaid clients is dangerously slow, leading to waits of "several weeks, months and even up to a year without needed low-cost essential safety equipment such as bath chairs, grab bars, hand-held shower heads, raised toilet seats, canes and wheelchairs."
"These overly long delays, which are not explained or tracked with any efficient reporting system, have increased dramatically over the past three years," he wrote.
"People do not know what happens to their requests," he said. "The system is so logjammed, people just fall through the cracks." Benedicktus said he offered to design an effective, inexpensive software system to correct this when he started working for SWAAD three years ago, and got no response.
Benedicktus also alleges that hiring and firing at SWAAD is discriminatory, hostile and retaliatory against people who complain or question management decisions, and that inexperienced people have been promoted over others clearly better suited to the positions.
"When people speak up there is a pattern of micro-management and hostility. You have nonprofessional staff supervising professional staff," he said.
He also claims that training is inadequate for staffers handling clients with dementia, Alzheimer's, chronic pain or mental health issues who may present a danger to themselves or their visitors. That's despite numerous requests for such training, Benedicktus alleges.
"We have no tracking measures regarding how many clients have serious mental health issues," he said.
Benedicktus said he has years of experience in the field. He has worked as a psychiatric nurse in various clinical settings and as a care coordinator for United Behavioral Health, where he worked with people with complex mental and substance-abuse problems, writing best-practice guidelines and policies.