HCA Training in Washington

75 hour training  There are at least 40 places other than SEIU 775 to obtain DSHS approved 75 hour training to become an HCA in Washington State.  Below is a link to the page on the DSHS website.  There are various options from online modules to all in-class trainings.  You can choose which training program works for you.  Some are offered only in one county, others are throughout the state.

Training Sites  

The site is difficult to find on the DSHS website – one has to go through many pages and clicks to find it.  If you need help, contact me and I will help you.

Below is one example of one of these DSHS approved Training sites.  There are roughly 40 such agencies listed and these alternatives may help to ease our crisis.

Cornerstone Healthcare Training Company

Another issue with HCA is the situation that was written about in Crosscut October 25, 2018.   This article focuses on a different problem but also related to the fact that Washington State has some of the most restrictive requirements to becoming a Home Care Aide.

Would-be home health workers claim bias in state’s qualifying exam

“Washington state is also home to some of the toughest requirements for home care aides, thanks to a 2011 ballot initiative sponsored by the SEIU 775 Northwest. Within 200 days of being hired — or 260 days for those with limited English proficiency — home care aides must pass a background check and the certification exam.”

We need caregivers – we need to find a way to promote the training and passing of the requirements.  What we have is not working.

Thank you, Alpha Supported Living

This past year has seen great changes for my son and this past Thanksgiving, I realized how much growth my son has made since last Thanksgiving.

Last year, our son, age 21, had lived at the Intermediate Care Facility for people with Intellectual Disabilities (ICF/ID) for 5 years.  The ICF/ID was only 10 minutes from our family home and part of the community in which our son was born and raised.  We had frequent contact, outings and visits both at our home and his.  Unfortunately the team at the ICF/ID was unable to manage my son’s healthcare and daily support needs but we didn’t think we had another option.

I remember not only the great sense of relief I had when I took him back home after our Thanksgiving Dinner last year but also grief and sadness about his increased agitation and manic behavior which was so disruptive.  I questioned if we would be able to have him visit for future family holiday celebrations. He had been experiencing increasing mania and the physicians at the ICF/ID refused to follow the recommendations of our son’s psychiatrist regarding medications to control his mania.  I remember expressing my great concern regarding his increasing mania  to the psychiatrist during our meeting last December and feeling powerless in getting the needed medications prescribed and administered.

This Thanksgiving, our son was a totally different person.  He was at our family home for at least 4 hours and stayed focused and helpful.  His participation in meal prep and tasks was amazing.  He even sat at the table and ate a nice sized meal.  When it was time for me to take him back to his house, I realized that he had set a record for length of time at our house and that I was not totally exhausted and spent from trying to manage his mania, other disruptive behaviors and physical care.

I attribute these great changes to the move he made last spring from the ICF/ID to a supported living arrangement in a home with 2 housemates.  This was made possible by the Roads to Community Living Grant and Alpha Supported Living Agency in being able to provide these great services.  My son has greatly benefited in so many ways and in such a short time.

Within two months of moving and having his care provided by Alpha Supported Living, our son’s health issues were treated appropriately, medications and treatments administered as prescribed and other long standing health issues were addressed and managed.  It was great to see these changes and work with this team to create solutions that worked.   But the improvement and stabilization of my son’s health issues are just the beginning of the changes we have noticed.

Our son is learning new skills and is supported to increase his ability to make choices and take responsibility for various aspects of his daily life tasks.  He is now able to wash his hands, sit at the table and eat a whole meal, clean up his dishes, go grocery shopping for his own groceries, and is very compliant with taking his medications and other responsibilities such as ensuring his iPad is plugged in at night and putting his glasses on his dresser before going to bed. He is able to follow verbal prompts better and stay on task a few seconds longer.  He is becoming more self-directed in being able to communicate his needs and desires.

We are beyond proud of the accomplishments he has made this past year with the support from Alpha Supported Living.  Seeing first hand what a difference this care makes it is imperative for our states to support the wages of the caregivers.  We need continuity of care – both as the recipient of the care and as the caregiver – to continue to provide this care.

Some supported care agencies are experiencing staff turnover rates of 50-70%.  This is not only very disruptive to the clients but increases the overall cost of care when one looks at the cost of recruiting and training a revolving door of caregivers.  Once trained and placed in a job many direct care staff leave due to the intensity of the job and low pay. The state sets the pay rates and it is just not enough to cover costs of the direct care staff.

Supported living is in crisis.  Funding for direct care staff has been ignored for years while costs have continued to increase.  The level of intensity of staff support is increasing and we need to provide the appropriate staff.  This level of care is critical to many in our community to enable them to have a meaningful life experience.

A meaningful life is more than just having support staff in your home though.  It is being able to go out and be in the community.  Many agencies do not have funds to provide transportation or staff for outings, activities and medical appointments.  Many agencies are not able to hire a Registered Nurse to oversee healthcare or have a dedicated Healthcare Coordinator to manage the variety of healthcare needs. Again, the intensity of these needs are increasing.  We need to have providers trained in the particular needs of the population with intellectual and developmental disabilities. These aspects of care should not be “extras” but should be part of the service. But,  unless an agency is able to fund raise for these critical necessities  to a meaningful life, the clients will go without.

In my son’s situation, the transportation and healthcare are paramount to the success he is experiencing. .  My son has a job at Lowe’s working 2 hours each weekday morning  (supported employment provided by PROVAIL). and needs transportation to and from work .  He also has medical treatments at least 3 times a week for which he needs transportation and support at the treatment in addition to other medical appointments about once a week.  Without a dedicated vehicle for each home supported by Alpha Supported Living these necessary trips would be impossible.

It is only through fund raising that Alpha Supported Living is able to provide these life necessities to ensure not only the basics are provided but other opportunities to have a meaningful life – art classes, walking clubs, cooking groups, community outings are just a sampling of the other “extras” that help to provide quality experiences to one’s life.

Living in a home with supported living as opposed to in a state operated ICF/ID, is a collaborative effort.  We, as parents, guardians, residents, community members and staff, can make a real difference.  We can adapt to changes better and address issues directly when they arise.  There is more control over one’s life.  We can actually DO something to help make one’s live more meaningful – something that we generally cannot do for those who live in a state operated ICF/ID.

Below are some suggestions for what you can DO to help make someone’s life better:

  1.  Communicate this great need to our legislators – we need to meet minimum wage requirements and keep pace with the cost of living increases that we all experience.

2. Make a donation to a supported living agency to help provide for supports other than direct care staff wages.

Below is an example of how your donation helps to improve the quality of life of clients supported by Alpha Supported Living Services:

alpha-support-is-critical

(for clarification on the RN – this amount  has to do with the amount needed to bridge the gap between what Alpha is funded and what they provide. The professional services rates they receive from DDA provide for a part-time RN. The amount listed gets them to a full-time RN for 6 months)

If you would like to donate to Alpha Supported Living Services you can reach them at

Alpha Supported Living Services

MAIN OFFICE
16030 Juanita-Woodinville Way NE
Bothell, WA 98011

t 206 284 9130 | f 425 420 1133

 

Please join me in making a monthly donation to Alpha Supported Living Services – it WILL make a difference in someone’s life!

 

 

 

 

 

 

 

Whistleblowing

Someone needs to speak up and I’ll keep speaking up until some of these serious issues of healthcare inequity are actually looked at and corrected

A recent blog posting entitled “The Journey of a Whistleblower: The Challenges, the Pains and the Price ” identifies some of the issues when one is faced with some ethical decisions.

While my son was a resident at a state operated intermediate care facility, I brought issues of concern to the administration and the medical director.  When no action was taken, I approached the Human Rights Committee of the facility.  They did not think that the issues of healthcare neglect and injury were a concern of theirs.  I then went to the advocacy group for the residents of the facility.  The president told me that their goal was only to keep the facility open – they had no say in assessing or measuring standards of care.

Obviously the healthcare and quality of life for the residents was not on the radar of any of these groups.

So, I keep trying to get people, organizations, legislators and agencies to see the serious concerns with medical and nursing care at some of these facilities.

If your loved one was dependent on the care provided in a healthcare facility, would it be important to know that all the prescribed medications and treatments were administered?  Or would it be okay for the nurses to only administer sometimes but document that all prescribed administrations were completed?

Would medication compliance rates of 11-46% be acceptable to you?  These rates are certainly not acceptable to me.

But it’s not just the low compliance rates I’m concerned about – it’s the years of falsified records across the board on a variety of medications by many nurses that is a huge concern.  Who is to know if the medications are really administered with so little oversight?

Who monitors medication administration – apparently no one and this is a major problem that needs immediate attention.

There is immediate jeopardy to all residents of the facility until the medication administration problems are examined and corrected. It is shameful on the part of our state agencies that these practices have been and still are accepted practice.

As a nurse myself, I know this practice is unethical and illegal to falsify these documents.  I question the level of integrity of the nurses working at this facility who routinely engage in this illegal activity.

This time has come to go outside the state organizations and inform others.  It is not just about keeping a facility open, it is about providing safe, quality care.  Care that is not happening at this time.

 

Arc of Washington State – Question their data and resources

The Arc Washington State recently sent out an alert “Crisis Stabilization Needed in Local Communities.”  While this is indeed needed, the information provided by The Arc Washington is not only incorrect with facts but much is actually fiction.

As a respected advocacy agency which many legislators and community members look to for guidance publishing alerts such as this actually hurt the people The Arc is supposed to be supporting.  Where is the integrity and transparency in their reports?

The Arc states that “On average, only 1-3 beds a month are currently used for any respite.”  The Data obtained from the Department of Social and Health Services Executive Management Information System (EMIS)  dates June 2010 through June 2014 clearly show that the Arc is very incorrect.  Below is a graph of the data obtained from the EMIS.  The average has actually been 32 respite clients per month at Yakima Valley School.

Community Respite in RHCs

The Arc states “The cost for placement in Yakima Valley Nursing Facility is $587 A DAY, much more than a community setting.”  Again, data obtained from the EMIS and from the Office of Chief of Policy and Programs, DSHS Quality Programs and Stakeholders Office Chief, and the Crisis Services Program Manager,   the cost of community crisis respite is $1,166 dollars A DAY as opposed to the average $441 at Yakima Valley School of which only $216.00 is the cost to our state when the Federal Medical Assistance Program (FMAP) is taken into account. (EMIS 2012-2014)

Respite at YVSWhen provided with the actual data, one can see that we need to pass E2SSB 5243 rather than reject it.

This bill does not address anything having to do with respite that people receive in their homes and communities and will not take anything away from them.  It will only provide much needed services and help prevent crisis and family breakdown.

Yes, we all want respite in our communities but it is not happening for various reasons.  Respite can be used for a variety of community outings and opportunities but out-of-home respite is also needed.  I can tell you that if my son had been allowed to have any out-of-home respite at all while living at home on a waiver, it may have saved our family and may have prevented him from being moved into the RHC.  I believe that out-of-home respite is an essential component of the whole respite program and will add to the sustainability of community programs.

Resources:

Data received from the Department of Social and Health Services, Executive Management Information System  June 2010 – June 2014, with correspondence from Mark Eliason, DSHS Office Chief of Policy and Programs; Janet Adams, DSHS Quality Programs and Stakeholders Office Chief; Carol Kirk, DSHS RHC Program Manager; Monica Reeves, Monica Reeves, Crisis Services Program Manager.

DDA Policy regarding ICF/ID Admissions –http://www.dshs.wa.gov/pdf/adsa/ddd/policies/policy3.04.pdf

Report to the Legislature – December 5, 2011  http://www.dshs.wa.gov/pdf/adsa/ddd/Fiscal%20Status%20Report%20Consolidation%20of%20RHCs.pdf

“No Room?”

The list of words below is taken directly from the Developmental Disabilities Administration Vision, Mission and Values Statements:

Supporting Individuals – Continually improving supports – Individualizing supports – Building support plans based on needs – Engaging Individuals and families – transforming lives – Respect – Person Centered Planning – Partnerships – Community Participation – Innovation

I wonder why these concepts are violated by the very agency to which they belong and the agency which is there to build and sustain supports for our citizens with intellectual disabilities.

Currently, we have people in crisis in our local community who are eligible for and have requested emergent admission to the local Residential Habilitation Center, Fircrest (RHC).  The request was denied based on “no room” and the department is working hard, against the choices of the individual, her family and her guardians, to “divert” her to “community” homes which are not safe or appropriate for her needs or ship her away to the RHCs far from her family and community.  How do these actions fit in with the vision of the department?

Fircrest Institutional campus

These actions are not unique to the individual mentioned.  This is how the department chooses to manage the choices and requests of those with high support needs who request the supports and services available at the RHCs.  We hear that people do not want these supports and services, but this is not the real story of what is happening behind closed doors.

These photos below were taken August 1, 2014 showing a fully remodeled and empty unit which could house up to 16 people who need supports and services.  These are at the very RHC which the department states “no room”.  If we were allowed to utilize these units on campus we would not only be providing much-needed services to individual and their families but also being good stewards of our public resources.

open room 1 oepn roomopen kitcen

There is no reason people who need the level of supports in the RHC are denied due to “no room.” 

It is simply not true.

Please help us  utilize the resources we have.

 

By utilizing the resources we have we can help prevent crisis and trauma to people and their families.  We can support stability in people’s lives and have sustainable programs – if we were only allowed to do it.

The restrictions being forced upon people with intellectual disabilities are limiting their choices by making false assumptions about what people need and want.

Help us to hold the Developmental Disabilities Administration accountable to their own Vision, Mission and Values Statements!

DDA mission and vision

Mobility Park

We are on our way to major improvements for health, safety and community spirit building!

Please join the efforts in transforming the dangerous sidewalks in our community to a safe, welcoming, ADA accessible “pedestrian promenade.”

Our Campus Community is in great need of safe, ADA walkways.The campus is a beautiful setting and home to many of our loved ones with intellectual/developmental disabilities complicated by complex medical and/or behavioral concerns.

sidewalks 1

The sidewalks are left over from the 1940’s when this property was used for the Seattle Naval Hospital. The walkways are too narrow for 2 people to walk side by side and are dangerous for those who need assistance with mobility. There are many cracks, holes and uneven areas. Much has been spent on grinding surfaces over the years but this is only a band-aid “fix” to the problem of dangerous, non ADA compliant walkways.

sidewalks 6

http://www.gofundme.com/Fircrest-Mobility-Park

Given that this community is a community of people with disabilities, it is time that we supported the construction of ADA accommodations in the walkways on campus.

sidewalks 5

http://www.gofundme.com/Fircrest-Mobility-Park

Adding a pedestrian promenade will greatly enhance the life experience of our residents – we see it as a community connector and will be an invitation for them to get outside, walk, enjoy the sites and company of others and build community.

sidewalkes 3

http://www.gofundme.com/Fircrest-Mobility-Park

Please help us fund the survey and design for this much needed walkway.

sidewalks 4

http://www.gofundme.com/Fircrest-Mobility-Park

THANK YOU

 

Design Team:

We are building our design team.  Peggy Gaynor of GAYNOR, Inc. is providing landscape architectural design & consulting services on behalf of the project.  As soon as we have chosen our surveyor and/or civil engineer, we will publish their names as part of the professional design team also.

http://gaynorinc.com/design-philosophy/

 

“Deathmaking”

I wrote the letter below to the National Council on Disabilities for their meeting this past week. In doing research for this, I came across much information on “Deathmaking” and am horrified by what I have been reading. But on the brightside, it has also led me to the works of Dr. Wolf Wolfensberger, Syracuse University and Social Role Valorization.  There is a wealth of information here which is critical to our understanding of living with people who have developmental disabilities.

Letter addressed to the National Council on Disability (December 4, 2013):

In the recommendations to close and consolidate the Intermediate Care Facilities, please keep in mind that these are medical/healthcare facilities. These medical facilities provide not only nursing and medical care but dental, psychological, education, vocational and social/recreational in addition to habilitation for building skills for activities of daily living.

The North American Industry Classification System (NAICS) is the standard used by Federal statistical agencies in classifying business establishments for the purpose of collecting, analyzing, and publishing statistical data related to the U.S. business economy. In reviewing the NAICS, it is clear that they have a better understanding of the supports and services needed by our citizens with developmental and intellectual disabilities than many organizations which claim to advocate for those with DD/ID. As you can see from the excerpt taken below from the NAICS website published by the U.S. Department of Commerce. (http://www.census.gov/eos/www/naics/)

“Sector 62 — Health Care and Social Assistance

The Sector as a Whole

The Health Care and Social Assistance sector comprises establishments providing health care and social assistance for individuals. The sector includes both health care and social assistance because it is sometimes difficult to distinguish between the boundaries of these two activities. The industries in this sector are arranged on a continuum starting with those establishments providing medical care exclusively, continuing with those providing health care and social assistance, and finally finishing with those providing only social assistance. The services provided by establishments in this sector are delivered by trained professionals. All industries in the sector share this commonality of process, namely, labor inputs of health practitioners or social workers with the requisite expertise. Many of the industries in the sector are defined based on the educational degree held by the practitioners included in the industry.”

What has happened is that those who claim to advocate for people with ID/DD have only looked at the social assistance and have ignored the healthcare aspects. As you can see from Sector 62, those with ID/DD are on a continuum and we must provide supports and services for ALL people on that continuum – not just those who are “higher functioning”

This method of advocacy is tantamount to a new genocide -or “deathmaking” as described by Wolf Wolfensberger (2005) . This means that denying access to needed healthcare, separating people from their homes and communities leaving them without help and protection, imposing a dying role on people or destroying their will to live are all examples of a “new genocide” which many are imposing upon our most vulnerable citizens.

This is a crime – please reconsider your policies regarding “deathmaking.”