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POSTED: Monday, Oct. 20, 2008

Caregivers split over I-1029 training, costs

A state initiative that would require more training and expanded background checks for some caregivers of the disabled and the elderly would help protect a vulnerable population, its supporters say.

But opponents of Initiative 1029 warn that the legislation is unnecessary and would harm the very people it aims to help by shrinking the pool of what are known as long-term care workers and driving up costs for consumers.

"This bill would hurt families. It would be bad law," said Debbie Gann, director of Home Attendant Care Inc., which serves seniors who want to stay in their homes in Whatcom, Skagit, Island, Snohomish and San Juan counties.

The company has 100 employees.

If approved by Washington voters, I-1029 would:

-- Increase to 75 hours the amount of training required for most long-term care workers hired beginning Jan. 1, 2010.

Such workers go to the homes of elderly and disabled clients and to assisted living facilities. The current level of required training is 34 hours.

-- Require such workers to pass a written test.

-- Expand criminal background checks, including fingerprint checks against federal criminal databases.

The measure would apply to caregivers paid by the state or working for those organizations and businesses licensed by the state.

The additional training would not be required for parents who are paid by the state to care for their disabled child, or those who care for their elderly parents.

Because the initiative's primary sponsor is the Service Employees International Union, opponents like Gann wonder if the measure is an attempt by the union to control the sector and expand its membership.

The total cost to the state would be an estimated $30 million for 2009-11. Opponents fear the costs will be passed along to patients or that caregivers will have to pay for the extra training out of their pockets. The initiative does not say where that money will come from.

"I think we can afford it and we need it," said Nancy Dapper, director of the western and central Washington state chapter of the Alzheimer's Association.

Dapper has been in the forefront of initiative supporters, along with Louise Ryan, the Washington state long-term care ombudsman.

"People need to think that long-term care and the need for care eventually impacts everybody," Ryan said.

"What would they want for themselves and their loved ones? There is a cost, but I see it as an investment in our future, to keep us moving forward as long-term care continues to grow and continues to get more complex. It's not going to get any easier."

Members of Community Care Coalition of Washington disagree. The coalition is the main organization fighting the initiative and includes businesses like Gann's and nonprofits like Visiting Nurse Home Care, which serves Whatcom, Skagit and Island counties.

"It's too expensive and it's unwarranted," said Terri Briant Booth, executive director of Visiting Nurse Home Care.

Gann and Booth disliked what they described as a "cookie cutter" approach to training. For example, caregivers interested in working specifically with developmentally disabled children don't need training to care for those with dementia, they said.

"I am absolutely in support of quality training for caregivers," Gann said, "as long as it's appropriate and particular to the job that the caregiver is doing."

She also noted that a certification program already exists through Certified Nursing Assistants, which requires 85 hours of training.

Many caregivers do entry-level work such as cooking, cleaning and running errands and don't need the expanded training as a result, coalition members said.

But that training is necessary, Ryan said, pointing to incidences in the Seattle area that included the death of a woman whose neck was broken after a caregiver tried to "manhandle" her out of bed and into a wheelchair.

"It can be as serious as life and death," she said.

"It's not widespread," Dapper said of such incidents. "It doesn't happen every day, but it happens."

Mount Vernon resident Leland Mellott said he would vote yes on I-1029. The chronically ill and homebound man said he's gone through 14 care providers.

He expressed frustration with workers who were rude or who seemed "as if they had no training at all."

"We have a very serious problem," Mellott said, adding that he hoped the initiative would help increase the level of professionalism.