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Originally published Sunday, April 3, 2011 at 4:00 PM

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Guest columnist

Help make state's most vulnerable citizens safer

Guest columnist Doug Shadel argues for legislation that increase the safety of residents of adult family homes in Washington state.

Special to The Times

FOR many years, Washington state has enjoyed a reputation of having the most cost-effective, long-term-care systems in the nation, with ample choices to help people remain in their own homes or communities, where care is cheaper and more homelike than in nursing facilities.

Ironically, one of the central innovations of our "best in the nation" system has become a threat to that system — adult family homes. According to the state Department of Social and Health Services, the number of abuse and neglect complaints in these homes rose 53 percent between 2004 and 2010. An investigative series published by The Seattle Times last fall profiled several horrific examples of such abuse.

I recall reading The Seattle Times "Seniors For Sale" series with utter horror, not only because of the brutal abuse described but because it took me back to 2004 when my own parents, both in their 90s, were in need of such care.

My brother and I visited more than a dozen adult family homes and were shocked at the wild variation in conditions. Some homes were spotless and the operators were courteous and committed to providing high-quality care. In other cases, the homes had a decidedly dank and gloomy feel to them and it appeared to us that the clients were simply being warehoused until they died.

It was not clear who, if anyone, was monitoring these facilities, nor was it clear whom to call to get objective advice on the matter.

Clearly there is a need for additional oversight in an industry that cares for the most vulnerable among us. The state Legislature is currently considering two pieces of legislation that would do just that.

Step one is Senate Bill 5092 and its companion, House Bill 1277, which call for more frequent inspections of adult family homes, steeper sanctions for violations and higher safety standards.

Step 2 is House Bill 1494, which would require agencies that refer families to adult family homes and other supportive housing to clearly disclose their fees and terms of service upfront. Given the abuses that have occurred, both of these measures seem long overdue and the absolute minimum oversight we should expect.

But nothing in Olympia is ever simple or without opponents.

Adult family homes are screaming bloody murder that the license-fee increase needed to implement step 1 would put them out of business. This is nonsense.

Currently these homes are paying a meager $100 per home annual license fee, which covers only 6 percent of existing oversight costs. The governor and proponents of the legislation say that adult family homes should cover all of their oversight, just as boarding homes, nursing homes and other health-care providers do.

If lawmakers hold the line and do not submit to industry pressure, adult families homes would have to pay a $391-per-bed license fee. The average private patient in an adult family home pays as much as $72,000 per year for one bed. Subtract $391 for the new fee and you are left with $71,609 per year to cover your costs and profits.

So how about step 2? Elder care referral agencies are a booming business. Many support the minimal provisions in HB1494 because they are professional business practices they already abide by. But the largest referral business around — A Place for Moms — is working aggressively to water down or kill the bill.

Recently they turned out more than 50 of their employees and supporters for a Senate hearing but failed to explain to lawmakers why requiring their company to disclose their fee structure, collect basic information about clients' care needs and appropriately vet the adult homes they refer people to are bad ideas. The committee passed the bill, which is now awaiting a vote of the full Senate.

None of us likes to think about a time when we will need to be cared for by others. But one thing is certain. There is no getting out of it. We are all "temporarily able." When my time comes, I sure hope the adult family homes providing such care and the referral agencies that recommend them are subject to a bare minimum of oversight. We owe it to our elders and to ourselves.

Doug Shadel is state director of AARP Washington.

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