Now that the state legislature is back in session and facing the task of cutting more than $1.5 billion from the state budget, it makes sense that legislators would be focused on raising revenues and finding balanced solutions to the budget crisis.

Instead, some Olympia politicians are attacking I-1163, despite the overwhelming support from voters in November. More than 65 percent of Washingtonians voted for common sense protections for seniors and people with disabilities last November, the second time in three years we have sent this priority to the legislature.

I-1163 passed in all 39 counties.

Help protect I-1163, by writing a letter to the editor calling on our legislators to stop ignoring the will of the voters, allow these needed reforms to be implemented, and focus on real solutions to our budget crisis.

Our state needs revenue and a balanced approach to a filling this budget gap. But we cannot continue this all-cuts plan that puts the largest burden on our most vulnerable.

Write a letter to the editor and tell our legislators to listen to the voters and protect seniors.

Initiative 1163 Headed to Overwhelming Win

Voters Again Say that Increased Training, Background Checks for Long-Term Care Workers Are a Top Priority

Seattle (Nov. 8th) – Following the initial ballot count from the Secretary of State’s office showing I-1163 passing strongly statewide, the Yes on 1163 released the following statement: “In 2008, the voters of Washington State overwhelmingly voted to increased the training hours and require federal background checks for home care workers. Today, the voters have spoken again, making a strong statement that they expect quality care for our vulnerable seniors and people with disabilities to be a high priority.

“Throughout this campaign, voters have heard about the cost of this initiative, including a grossly inaccurate and inflated cost number from the opposition campaign, which was led by scandal-tarnished, for-profit long-term care providers, who placed their own profits ahead of needed reforms.

“But the voters have spoken out loud and clear, saying these reforms must be implemented now, before more vulnerable people fall through the cracks and suffer serious harm. And they voted yes on this measure while fully aware that this is a difficult time for this state’s budget. The voters knew the I-1163 costs and know the budget situation well, yet again clearly stated that better training is a priority and should be funded.

“Today, for the second time, voters in Washington have said that we cannot afford not to do this. Our state needs higher training standards for those who care for our most vulnerable and we need to ensure that those caregivers do not have violent or abusive histories. We now look to the legislature to fully implement the will of the voters regarding basic training and background checks for home care workers.”

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From Secretary Reed’s office:

– If you think you should have received a ballot but did not, go to your county elections office or voting center. If there is a question regarding your eligibility to vote, you are always eligible to vote a provisional ballot. Your voter registration status will be researched after the election, and the races and ballot measures on which you are eligible to vote will be counted.

– If you think that you received a ballot for the wrong address, go to your county elections office or voting center. Your voter registration status will be researched and the races and ballot measures on which you are eligible to vote will be counted.

Seattle (Nov. 7) – Drawing on their considerable experience in the long-term care field, working with caregivers and thousands of seniors and people with disabilities, three current and former Washington State Long-Term Care Ombudsmen have joined the broad coalition supporting I-1163. Led by the current ombudsman, Patricia Hunter, this group represents a strong voice calling for increased training for those responsible for the care of our most vulnerable.

Hunter’s support continues the work of two former state ombudsmen, who together have more than 30 years in the ombudsman’s office and decades of experience in long-term care programs, working to raise the quality of care for seniors and people with disabilities, while helping push through reforms that protect those in adult family and boarding homes.

After three years of seeing citations for abuse and neglect in adult family homes rise by 15 percent, they are speaking up in the fight to protect the thousands of people receiving long-term care in Washington State.

“Washington state is one of the nation’s leaders in using alternatives to nursing homes,” Hunter said. “More than 40,000 nursing-home-eligible seniors and people with disabilities choose to remain in their own homes or adult family and boarding homes, allowing them more independence and a better quality of life. It saves the state millions every year. But without adequately trained caregivers, many of these vulnerable citizens will be harmed or forced into nursing homes. That is bad for them and for taxpayers.”

The initiative restores a minimum of 75 hours of basic training and requires caregivers to pass a certification exam to provide care. While hair dressers receive 1,000 hours of training and nursing home workers receive 85, caregivers are required just 34 hours of training at most. Some workers receive less, despite being responsible for the care of vulnerable seniors and people with disabilities, many with serious and worsening conditions. The initiative also requires federal background checks for these workers, in addition to the state-level check that misses crimes committed outside of Washington.

In many ways, Washington’s program is a model, but there are serious reforms needed to ensure safe, quality care. But with a growing population in need of home care and many of our seniors choosing to stay in their own homes, the state will need more trained and screened home care workers. A recent Seattle Times article suggested that home care aides will be one of the fastest growing occupations in the state. Home care is more cost-effective than nursing home care, but the workers are under-trained compared to those in nursing homes, receive only state-level background checks and have high turnover due to low pay and poor benefits.

During their time serving as Washington State’s long-term care ombudsmen, Louise Ryan was an advocate for I-1029, while Kary Hyre worked to identify the need for expanded training in the program. Today that fight continues with I-1163.

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LAST year, The Seattle Times ran an investigative series detailing systemic problems in Washington state’s adult family homes, much of it caused by inadequately trained caregivers. The series, called “Seniors for Sale,” came two years after voters in this state overwhelmingly supported increased training and federal background checks for long-term caregivers, passing Initiative 1029 in 2008 with more yes votes that any initiative in state history.

Yet today, because I-1029′s reforms have not been implemented, the situation has grown only worse. Citations for abuse and neglect in adult family homes have risen by 15 percent since then. Since many caregivers work in isolated settings with our elderly and vulnerable, the need for adequate training is even more critical.

It is not easy to care for frail, disabled adults. Yet the current state training standard for caregivers — 34 hours — is less than half of what is required for the same work in a nursing home. I-1029 was meant to change that, requiring 75 training hours followed by a certification exam. The state twice punted on implementing I-1029, citing budget reasons that are penny-wise and pound-foolish.

That is why we support Initiative 1163. This initiative will restore common-sense protections for vulnerable seniors and people with disabilities. It sends a clear message that the state must heed the will of the voters, as well as medical professionals, public-safety officials and advocates. Our caregivers need the necessary skills to provide quality care and we need to ensure those caregivers don’t have a history of violent crimes that put our most vulnerable at risk.

The initiative requires long-term-care workers, who provide the same type of care as nursing-home aides but in a more isolated setting with little oversight, to pass a full federal background check. Our current state-level check misses crimes committed outside the state, leaving our seniors vulnerable to someone who may have moved here after committing a felony elsewhere.

I-1163 also restores a minimum of 75 hours of basic training and implements a certification exam, as is already required for nursing-home aides. Countless examples exist of quality of care improving when caregivers know what they are doing — know not to argue with a person who has dementia, for example, or how to safely bathe or dress a person who’s had a stroke.

Washington state is one of the nation’s leaders in using alternatives to nursing homes. More than 40,000 nursing-home-eligible, low-income seniors and people with disabilities choose to remain in their own homes or adult family and boarding homes, allowing them more independence and a better quality of life. It saves the state millions every year.

But unless the workers who care for them are properly equipped to provide needed care, many of these vulnerable citizens will be harmed or forced into nursing homes. That is bad for them and for taxpayers. We can do much better: I-1163 is simple common sense.

The voters have already said it is time to fix this. We all have parents, relatives or friends who need or may need long-term care. We want it to be in as homelike a setting as possible, and for the care to be decent and humane, and not done by criminals. When I-1029 passed, it looked like we would finally raise standards to meet those goals. Instead, we have slipped backward. I-1163 will fix that. We cannot afford to not pass this initiative.

Many respected organizations — like the Lifelong AIDS Alliance and Washington State Alliance of Retired Americans — as well as public-safety officials, local leaders and medical professionals support I-1163. It is time to send a message. We meant it when we made these reforms are a priority. The safety of our seniors and people with disabilities is at stake. Please vote yes on I-1163.

Dr. Eugene May is a trustee of the Greater Northwest Chapter of the National Multiple Sclerosis Society. Patricia Hunter is the Washington State Long-Term Care Ombudsman.

Link to Seattle Times story here.

Yet, despite the overwhelming support, that 2008 vote has only led to delays by the state legislature, pushing the implementation of these protections back to 2014. During that time, citations for abuse and neglect in adult family homes has increased by 15 percent, with more than 20,000 such citations handed out in 2010. Not only has the risk to our most vulnerable not been addressed, their situation has gotten worse.

That is why public safety officials like Pierce County Prosecutor Mark Lindquist and Snohomish County Sheriff John Lovick have endorsed I-1163, calling for these common sense protections to be implemented now. Writing in their local papers, these two leaders, who see the threats to our seniors everyday through law enforcement and prosecution, said it is time we took our responsibility to our seniors and people with disabilities seriously.

All of us will, at some point, likely rely on a caregiver, whether for a friend, a family member or ourselves. Let’s take this opportunity to protect the nearly 5,000 Pierce County residents who live in adult family and boarding homes and increase professionalism for the future.

In the Pierce County Prosecutor’s Office, we vigorously prosecute those who abuse the most vulnerable members of our community, but many of these crimes could be prevented with the common-sense reforms of Initiative 1163.

- Pierce County Prosecutor Mark Lindquist, Tacoma News Tribune, Oct. 19, 2011

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.

- Snohomish County Sheriff John Lovick, Everett Herald, Oct. 15, 2011

These two community leaders are standing with the millions of voters who have supported our most vulnerable — our parents, grandparents and thousands of people with disabilities. The voters have spoken. The Department of Social and Health Services has said these reforms are needed to improve our long-term care system. Only our state legislature has yet to join or hear the chorus of voices calling for these vital protections.

This November, our leaders must hear those voices again, when the voters of this state again vote on 1163. The safety and quality care of our seniors and people with disabilities depends on it.

Said Congressman Inslee: “Given the importance of protecting the least among us, I will be voting in support of this measure. Initiatives with budgetary impacts pose unique problems, and the Legislature will still have to balance funding this with other priorities.”

Rep. Inslee joins a bipartisan coalition of elected officials from Washington State who have supported common sense protections for our seniors and people with disabilities.

Last week, the Yes on 1163 campaign announced support from the following elected officials:

• Dow Constantine, King County Executive
• Aaron Reardon, Snohomish County Executive
• Mike McGinn, Mayor, Seattle
• Skip Priest, Mayor, Federal Way
• Mary Verner, Mayor, Spokane
• Bob Ferguson, King County Council
• Jane Hague, King County Council
• Larry Gossett, King County Council
• Julia Patterson, King County Council
• Tim Ferrell, Pierce County Council
• Jean Godden, Seattle City Council
• Nick Licata, Seattle City Council
• Richard Conlin, Seattle City Council
• Sally Clark, Seattle City Council
• Tim Burgess, Seattle City Council
• Mike O’Brien, Seattle City Council
• Tom Rasmussen, Seattle City Council
• Bruce Harrell, Seattle City Council
• Dave Somers, Snohomish County Council
• Stephanie Wright, Snohomish County Council
• John Snyder, Spokane City Council
• Richard Rush, Spokane City Council
• Ryan Mello, Tacoma City Council
• Jake Fey, Tacoma City Council

Seattle (Oct. 9) – A bipartisan group of local elected officials have stepped forward to protect seniors and people with disabilities by endorsing Initiative 1163.

Officials from across Washington are lending their names and voices to ensuring that our state’s most vulnerable receive safe, quality care, by restoring basic minimum training standards and requiring federal background checks for home care workers.

Endorsers include leaders such as King County Executive Dow Constantine, Snohomish County Executive Aaron Reardon, Spokane Mayor Mary Verner, and eight of the nine Seattle City Council members.

After nearly 73 percent of Washington State voters called for these protections in 2008, the state legislature delayed implementation twice, the second time to 2014. 1163 calls for these protections to begin immediately, something local officials from the state recognize as vital for the protection of our state’s most vulnerable.

The support of local officials extends from the executive level to city and county councils, as well as multiple mayors. These community leaders, who uniquely understand the challenges faced by their local law enforcement, recognize the need for federal background checks to ensure the safety of the most vulnerable Washingtonians. Since 2008, when voters across Washington overwhelmingly supported these needed protections, citations for abuse and neglect in adult family homes have increased by 15 percent, highlighting a growing problem in our communities.

“This is a very personal issue for me,” said Skip Priest, Mayor of Federal Way. “As we continue to see many of our seniors at high risk of abuse and neglect, as they voluntarily chose to receive care in their own homes rather than move into a nursing home, it is vital that we provide the type of protections that show we are committed to their safety and quality care.”

As Washington State continues to look for more cost-effective ways to provide quality care to those who need it most, home care has proven to be a preferred option for many seniors and people with disabilities. Remaining in their own homes allows their independence and connection to the community, which leads to healthier lives. It also comes at a significantly lower cost to the state, with home care costing about one-third the price of nursing home care.

But without proper training being available, the state is at risk of pushing thousands of these vulnerable people into nursing homes, which would cost the state millions more every year.

1163 also includes strict accountability measures which require 90 percent of the funding go to direct care, the hiring of additional fraud investigators and yearly audits.

I-1163 Elected Official Endorsements

• Dow Constantine, King County Executive
• Aaron Reardon, Snohomish County Executive
• Mike McGinn, Mayor, Seattle
• Skip Priest, Mayor, Federal Way
• Mary Verner, Mayor, Spokane
• Bob Ferguson, King County Council
• Jane Hague, King County Council
• Larry Gossett, King County Council
• Julia Patterson, King County Council
• Tim Ferrell, Pierce County Council
• Jean Godden, Seattle City Council
• Nick Licata, Seattle City Council
• Richard Conlin, Seattle City Council
• Sally Clark, Seattle City Council
• Tim Burgess, Seattle City Council
• Mike O’Brien, Seattle City Council
• Tom Rasmussen, Seattle City Council
• Bruce Harrell, Seattle City Council
• Dave Somers, Snohomish County Council
• Stephanie Wright, Snohomish County Council
• John Snyder, Spokane City Council
• Richard Rush, Spokane City Council
• Ryan Mello, Tacoma City Council
• Jake Fey, Tacoma City Council

 
Full Release.

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Seattle (Sept. 29) – Communities of color advocates and organizations have joined the broad coalition of supporters for I-1163, which empowers both home care recipients and their caregivers by providing increased training in cultural competency and foreign languages. A dozen prominent organizations that assist communities of color have now endorsed the initiative, which requires federal background checks and increases basic training requirements for long-term care workers.

Communities of color in Washington continue to grow faster than any other, further exacerbating the need for adequately trained caregivers who can provide care to the disproportionate number of people of color in need of assistance who voluntarily choose to stay in their own homes rather than move into a nursing home or other institutional care facility.

Significant majorities of several communities of color are represented in the home care part of Washington’s long-term care program. Both 61 percent of both Native Americans and African-Americans receive home care, as opposed to nursing home care or other types of long-term care. Sixty-eight percent of Hispanics and 76 percent of Asian/Pacific Islander receive in-home care. That is in addition to the low-wage home care workforce, which is disproportionately people of color and immigrants, with one-in-five workers being foreign born. The support of these community advocates underscores the importance of ensuring those who care for the state’s most vulnerable, thousands who are members of communities of color themselves, are equipped to provide safe, quality care.

“These improvements to basic training and background checks will help improve the quality of home care services most utilized by communities of color,” said Ada Williams Prince, OneAmerica Policy Director. “With significant majorities of these communities receiving their long-term care services in their own homes, we need to ensure that caregivers have adequate training to provide better care, as they would if they were in an expensive nursing home. OneAmerica believes a pathway to a living wage and professional recognition for low-wage home care workers will help build a stronger workforce, while ensuring the clients they serve receive safe, quality care.”

OneAmerica is joined by several other community advocates have also endorsed 1163, from low-income advocates to faith groups. With a growing population in need of home care and many of our seniors choosing to stay in their own homes, the state will need more trained and screened home care workers. Home care is more cost-effective than nursing home care, but the workers are under-trained compared to those in nursing homes, receive only state-level background checks and have high turnover due to low pay and poor benefits. I-1163 will help ensure quality care for vulnerable residents and is a first step towards a more stable and professional workforce with a living wage for these low-income, disproportionately people of color caregivers.

Full Release.

I-1163 Community Endorsements

• OneAmerica
• Asian/Pacific Islander Coalition of King County
• Seattle Asian Pacific Islander Americans for Civic Empowerment (APACE)
• Entre Hermanos
• Casa Latina
• Equal Rights Washington
• Faith Action Network
• Statewide Poverty Action Network
• Puget Sound Sage
• Washington Community Action Network
• SEA MAR Community Health Centers
• Lifelong Aids Alliance

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People of Color Utilize Home and Community-Based Services More Than Any Other Type of Long-Term Care (LTC).

1163 improvements to basic training and background checks for home and community-based LTC providers will help improve the quality of LTC services most utilized by communities of color. Thousands of minority and immigrant seniors and people with disabilities rely on home care services to live with dignity in their own homes and communities. Further, Washington’s 2010-14 Plan on Aging indicates minority populations in the State all show notably faster rates of increase than their white counterparts. The racial and Hispanic population projections show that in 2030, nearly 1 in 3 residents will be a minority. Minorities will comprise an increasing proportion of the older population as a more diverse cohort of Americans reach age 65. This trend is expected to continue in the foreseeable future and will result in the need for our State to strengthen its capacity to deliver culturally relevant and competent services.

Low Wage Home Care Workers are Disproportionately People of Color and Immigrants, and I-1163 is a Critical First Step Toward Creating a Stable, Professional Workforce that Earns a Living Wage.

Nearly one third of the home care workforce is comprised of people of color. More than 1 out of 5 Washington home care workers are foreign born indicating a high number of caregivers who belong to immigrant households. 1163 does not create any new hurdles to employment specifically for people of color and immigrants. All potential caregivers have to pass the same criminal background checks, take the same training, and pass the same certification exam. Training and certification will both be offered in multiple languages. As low-wage workers, long-term care workers who are also people of color and/or immigrants face additional socio-economic challenges. Some of the challenges caused by overall poverty among the workforce are exacerbated as racial inequity causes further disparities in health, economic status, and education. As such, improving training standards for long-term care workers is especially important because it helps create career pathways, opportunities for advancement, and increases in hourly wages for Washington’s caregivers.

New Training Curriculum Under I-1163 Devotes More Time to Cultural Competency Training.

Increased training under 1163 provides greater opportunity for training in diversity and cultural competence. For example, the 75 hour curriculum developed by the non-profit Training Partnership includes 3.5 hours devoted to this critical topic, while the current 28 hour curriculum allows only 2 minutes to discuss cultural competency issues.

Many of Washington’s Advocates for Communities of Color Support Initiative 1163.

Endorsers of 1163 include advocates for people of color and immigrants such as One America, Casa Latina, and Washington Community Action Network.

Full fact sheet.