State can help meet the needs of frail elders

As an organization that helps frail elders stay healthy and out of nursing homes as long as possible, we at ElderHealth Northwest know how critical it is to maintain a safety net for society's most vulnerable citizens. The individuals who rely on us have Alzheimer's and a variety of other chronic and terminal illnesses. These are also people who served our country, raised families and ran businesses. Now they need our help.

The problem is that state funding for the service we provide -- adult day health care -- is not keeping pace with the needs of our growing elder population. The new governor and the Legislature are at an important crossroads where they need to decide if maintaining this non-institutional support system for elders is worth the investment.

ElderHealth operates five adult day health care centers in the Puget Sound region, and there are dozens more centers across the state run by other, mostly non-profit, providers. Altogether, we serve about 3,000 vulnerable individuals.

The purpose of adult day health care is to provide skilled long-term care services (nursing, meals, therapy, case management) in a "community day center" environment that helps keep frail individuals out of institutions as long as possible. We help frail individuals in the community to preserve their independence and their dignity, and we help them remain living with their families.

Reimbursement rates for adult day health care are very low and have not kept up with inflation. Our organization's financial situation has eroded over the past decade to the point that we are closing centers and freezing already-meager employee pay. This is happening to adult day health centers around the state.

The Aging and Disability Services Administration within the Department of Social and Health Services recently re-evaluated the reimbursement rates for adult day health care for the first time in many years and determined that the service is substantially underfunded. DSHS' own analysis resulted in a recommendation for a rate increase of up to 16 percent for adult day health care in order to come closer to meeting the real costs of this valuable long-term care option.

Their recommendations did not make it into former Gov. Gary Locke's budget because of a lack of revenue; Gov. Christine Gregoire has an opportunity to revise this in her own budget this month.

Washington is caught in a bind, with a state budget that is about 10 percent underfunded. Staunch pledges of "no new taxes" from elected officials fail to recognize the real human toll that this inflexible public-policy mind-set is having.

Aside from the responsibility we have to care for our elders, there is also a financial incentive to supporting people in the community in a way that prevents institutionalization at many times the cost to taxpayers. But funding prevention can be a tough sell in times of budget shortfall.

Although we are a non-profit organization, we need to operate like a business. When faced with a budget challenge, we look for places to cut that will do the least harm, and then we look for ways to increase our revenue to meet the most critical needs of our clients. The state should do the same.

There is a movement in Olympia to create greater tax fairness in the state, which has one of the most regressive tax codes in the country. Removing us from a dependence on consumption-based taxes to a more equitable and sustainable system would be a step in the right direction.

We have absorbed a decade of cuts in real dollars; now it is time to consider what it will take to meet our responsibilities as a society -- to take care of the generation that just a few decades ago was protecting our country, raising our children and building our great state.

Nora Gibson is executive director of ElderHealth Northwest.

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