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AARP Washington Tackles Gaps in Long-Term Care

Long-Term Care Ombudsman

A man slept outside an adult family home in a sleeping bag for three nights last year after staff locked him out.

He had been sent to the hospital after an altercation with a staff member over medication and returned to the home in Federal Way to find himself barred from entering, even though the argument was still under investigation.

“They knew he was on the porch,” says Patricia Hunter, the Washington State long-term care ombuds. “They would not let him in, and they refused to answer their phones.”

Cases such as this have prompted Hunter and other advocates to press lawmakers to ensure Washingtonians in long-term care facilities receive the same rights—including protection from wrongful discharges or evictions—whether they live in a nursing home, assisted living center, adult family home or other type of institution.

The issue is among AARP Washington’s priorities during the 2024 legislative session.

Three decades ago, state lawmakers extended the robust rights that nursing home residents receive under federal law to all Washington long-term care residents. But regulations to support those rights were never created. A bill currently making its way through the legislature would direct state agencies to adopt the formal rules required to ensure such protections are carried out for everyone.

Currently, residents in non-nursing home facilities aren’t equitably protected against unlawful discharge or eviction and need guaranteed access to basic rights, such as being able to choose their own attending physician, according to the Washington State Long-Term Care Ombudsman Program, which addresses complaints and advocates for improvements in the long-term care system.

Bolstering adult day services

AARP this year is also pushing for more funding for adult day services—another vital piece of the state’s long-term care system.

The state of Washington ranks second in the nation for its strong network of long-term care services, according to the latest AARP Long-Term Care Services and Supports State Scorecard.

But one area it falls short in is the supply of adult day services. Washington ranks 48th among states in that category, with only six slots available for every 10,000 people age 65 and over, the Scorecard shows. Nationally, the figure is 54 spots per 10,000 individuals.

The state Department of Social and Health Services has asked the governor for an additional $1.9 million annually for adult day care and health services. The extra funding would increase Medicaid reimbursement rates for such care by 30 percent. It’s a big need as the state’s population ages, says Bea Rector, the state’s assistant secretary of aging and long-term support administration.

“We really need new centers ... and they need a rate that makes that possible,” Rector says.

Adult day cares provide services such as meals, personal care help, medication management and recreational activities like crafts and gardening. They allow older adults to socialize with peers and give family caregivers a break, says Cathy MacCaul, AARP Washington’s advocacy director.

But the state’s adult day service providers are struggling to recover from shutdowns during the COVID-19 pandemic. That, plus workforce shortages and inflation, have forced some centers to shutter and discouraged others from opening, Rector says.

Since 2015, other forms of congregate care, such as assisted living facilities, have seen bigger Medicaid reimbursement rate increases than adult day services—some more than twice as much, according to the state’s social and health services agency.

Washington also pays less and has fewer providers than neighboring states, according to the agency. The state’s highest rate is in King County, with a daily reimbursement of $98.22 per client; Oregon’s rate in 2022 was $120.


Bill Would Promote Housing Development Near Transit

During the 2024 legislative session, AARP Washington is urging lawmakers to pass legislation promoting housing development closer to public transit options, such as light rail stops and bus stations.

bus photo

One measure would require the state Department of Transportation to offer grants to state agencies, local governments and housing developers to build housing near rapid transit. It would also bar cities from prohibiting multifamily residential housing near transit hubs.

Supporters say increasing housing near transit services would help address the state’s housing shortage.

There are many details to be worked out, says Cathy MacCaul, AARP Washington’s advocacy director, noting that AARP is focused on ensuring areas are walkable.

“If you are an older adult and let’s say you need to have a walker or you have mobility issues, a quarter of a mile might as well be 10 miles,” MacCaul says.

Lawmakers in 2022 approved nearly $17 billion for transportation projects around the state—including $3 billion for public transit—to be spent over 16 years.

Chris Thomas, a California-based writer and editor, covers business, health, food and consumer issues. She has written for the Bulletin for six years.

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