REGION: Cutbacks threaten voice for the elderly

By RENEE RAMSEY - For the North County Times | Sunday, November 30, 2008 5:46 PM PST

Pam Plimpton, with the County of San Diego Ombudsman Program, teaches an updated-skills class to ombudsman at the San Marcos Senior Center last month. (Photo by Bill Wechter - Staff Photographer)

A powerful voice for the elderly in San Diego County is facing the same budget threats already dismantling similar programs in other counties this fall.

"It really is going to be devastating," said Chris O'Connell, coordinator of San Diego County's long-term care ombudsman program for Aging and Independence Services, or AIS.

"Right now we're in limbo," O'Connell said about the future of the program that hears complaints ranging from quality of care to elder abuse in the county's hundreds of long-term care facilities.

Earlier this fall, Gov. Arnold Schwarzenegger, with a line item veto, eliminated the $3.8 million in state funding for the program that trains and oversees volunteer ombudsmen who advocate for the rights of seniors living in long-term care facilities.

The concern is that inspections by other agencies only happen once a year or once every five years, O'Connell said, making the ombudsman the only regular "outsider" to hear and relay concerns.

If the program is cut, "the bottom line is, the residents will suffer," she said. "The majority of residents don't have family or friends to regularly visit."

O'Connell said San Diego County's program, consisting of nine staff members who train and supervise 125 volunteers, remains intact because of continuing county funding to offset the difference.

"If we don't have some sort of restoration (of state funding) by the end of the next fiscal year, we could be cut in half," she said.

Pat McGinnis, executive director of the California Advocates for Nursing Home Reform, said San Diego County "is one of the few counties that didn't have to do immediate layoffs."

Because eliminating state funding for the program came in the form of a last-minute line item veto, McGinnis said, there wasn't the usual scrutiny that comes with the traditional debates over legislative budget cuts.

Plus, in this case, the elimination of funds  as of September was made retroactive to July 1---- the start of the state's fiscal year. Hence, the immediate layoffs in some counties suddenly finding themselves retroactively over their budgets, McGinnis explained.

"It's really horrible in some of the counties," McGinnis said.

The state funding accounted for half or more of the budgets of the programs, which also receive a mix of federal and local-level support.

McGinnis cited 17 layoffs in two programs covering Los Angeles County, the elimination of 14 positions in Orange County, and seven layoffs in Sacramento County in recent weeks.

McGinnis said it's difficult to get a total tally because each program is run by a different agency.

In San Diego County, the long-term care ombudsman program is under the umbrella of the AIS, a division of the county's Health and Human Services Agency.

The veto of state funding for the program followed a federal survey released earlier in September reporting that 99.1 percent of nursing homes in California had been cited for health and safety violations in 2007 ---- up from 98.2 percent in 2006.

Nationally, 91 percent of all nursing homes fit that category in 2007, with two in 10 incidents involving neglect or abuse, according to the report by the U.S. Department of Health and Human Services.

In California, McGinnis said the cutbacks are happening just months before a new California law becomes effective Jan. 1 requiring additional reporting responsibilities by the volunteer ombudsmen in cases of elder abuse.

This is on top of a California law requiring that long-term care ombudsmen be present for advanced directives involving health care and "end of life" decisions, she added.

"There are a lot of mandates, but where's the funding?" she asked.

McGinnis is urging the public to contact local legislators, the California Office on Aging and governor's office to demand emergency action to restore the state funds.

Even though the ombudsmen are volunteers, eliminating staff positions creates a domino effect, since the staff is responsible for training and supervising the volunteers. Staff members also act as ombudsmen when the volunteers are not available, and handle incoming calls from family members and facilities.

O'Connell, of San Diego County's program, said the county's 125 volunteers go through 40 hours of preliminary training, 10 hours of supervised training in the field and then another 12 hours of ongoing training each year. She said additional costs are incurred in doing mandatory background checks and fingerprinting.

Volunteers then are asked to visit a long-term care facility once a week, she said.

"We figure there are at least 25,000 licensed beds just in San Diego County," she added. "That's why we're always trying to grow the program."

In addition to being present for some 500 advanced directives each year, the advocates hear hundreds of complaints each month.

"We get several thousand complaints a year as small as not getting the right kind of food ---- although that's not small if you're on a prescribed diet ---- to major issues of abuse and neglect," O'Connell said.

 "Our eyes and ears are just that ---- our presence ---- asking, ‘Is everything okay?'" she said.

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Jim in Oceanside wrote on Dec 1, 2008 8:59 AM:It seems to me that the first thing State Government cuts are those programs that help the most needy in the state. Why not cut the excess fat out of all those Government Agencies? The multi-layers of upper management? Those making in excess of 90K/Year? There are millions of Californians who would love to be making 50K/Year and exist on far less. Seniors on fixed incomes, mentally ill, citizens with very low income need all the help we can give them and cutting these programs makes me want to vote for anyone running against those currently in office at ALL LEVELS! Want to balance the budget, trim the fat in upper management!

BarbsKid wrote on Dec 1, 2008 9:31 AM:I'm retired from working in social services. This is one of the most frustrating (and shameful) part of state "cutbacks"! Our state under the current governor has consistently cut back the fundings while increasing the mandates on the system. And, quite frankly, the elderly are the most vulnerable, to my mind. You have a crew of people watching out for child abuse, other parents, teachers, etc. But who watches out for the elderly? And now, thanks to this cut, even less people are watching out for them and speaking up for them.

Shame on you, Gov!

Carter wrote on Dec 1, 2008 10:12 AM:I served as an Ombudsman for about a year. My service was interrupted by a call to serve on Federal Grand Jury Duty.
During that year I felt I was making a difference. I worked with five homes. As with everything they varied in Quality. But none of the five were unacceptable. Of course, the presence of the Ombudsman program kept them at or above required standards.
I have felt for a long time the governor does not know what he is doing, and that he was only doing what he is told. This is a good example of that. He is being advised by people who are out to protect their own favorite projects and could care less about the elderly. I would like to find out who they are, and have the resource to see them standing before the public for retribution. Arnold should make their names known to the public.

Boat wrote on Dec 1, 2008 10:45 AM:Well, he did say "It is all about the children."

Classic Pandering wrote on Dec 1, 2008 1:48 PM:This is exactly how the government primes us for accepting further tax increases. In the past few weeks we have been saturated with articles about how the states financial crisis will force cuts in those most vulnerable populations that cause us all to sit up and take notice.

At the same time, government employees enjoy pension plans that far outpace private industry, and our elected officials have a complete reluctance to outsource jobs that can be more competitively handled by the private sector.

It is time that we remember that our government serves at our pleasure. We do not serve at the pleasure of our government. California now ranks 1-4 in the areas of state tax, local tax, property tax and sales tax...and we got there because it all costs only pennies a day.

Wake up people! Demand more from your elected officials.

Carter wrote on Dec 1, 2008 2:01 PM:To Boat: It's all about the elderly - those incapable of caring for themselves. The state is cutting a volunteer program - one that operates on cost only. The Ombudsman's time is volunteered. That will have to be replaced by Professional investigators which cost high wages, health care benefits,etc.
As ombudsman we went through a 40 hour training program, and an on the job training period with an experienced Ombudsman, before we were turned loose on our own.
We made unscheduled tours of the homes; however, most of our weekly visits were in response to calls to the office of AIS by the patients stating they were being abused. By law each home was to have a public phone and placed near the phone and in three other places in the halls, in great, bold print was the AIS Ombudsman number. We investigated the validity of the complaint and reported to the office of the AIS emediatly. If the report showed the complaint was of a nature the Ombudsman couldn't handle, a Professional was sent to the home for future investigation and the case, if called for, was prosecuted. The final decision was made by the professional. Seldom were the cases so severe that a professional had to investigate and the Ombudsman handled it on site, and finalized the report.
In addition, Ombudsman, were trained to hear last wishes by patients in Skilled Nursing Homes, and to sign as a witness. Plus many more valuable functions that were for the protection of the patient, I know for a fact that the ombudsman's presents was a comfort to the patients. I was not their care giver, nor was I their friend, I was their Ombudsman with a specific group of functions to perform.
Getting rid of that program is not responsible, but it out right is dumb and it will do nothing for children. It might even take money form their programs.

Carter wrote on Dec 1, 2008 2:28 PM:At the time I signed up to be an Ombudsman I was told that it would take about 5 hours a week. Not bad to help an old volunteer to feel good about himself.
A few months after I started as an Ombudsman Congress passed a law making all caregivers "Mandated reporters." that meant that if a Care-giver witnessed an abuse of a patient, the care-giver had about an hour to report it by phone, and 48 hours to fill out a formal report, form provided, and get it to the AIS office. Failure to do so could cost the care-givers thier jobs, their chosen profession, etc.
My time on the job as an Ombudsman went to 2 1/2 days a week.
There are many types of abuse. Physical, financial, sexual, to name a few. The patient can be abused by care-givers, fellow patients, relatives, so called friends, etc. sneaking a patents cell phone and using it is a finanicial abuse. One patient hitting another is abuse.
I have never seen a dumber, more pathetic move by CA.

Sad wrote on Dec 1, 2008 3:56 PM:Where are the children of these relatives? I am sure not all of these elderly have no children who can visit them and find out the status of their condition and environment.

To Carter wrote on Dec 1, 2008 3:58 PM:I thought Federal Grand Jury duty was something you volunteered for? It was that way up in LA (same Federal Government up there). Am I wrong?

Concerned wrote on Dec 1, 2008 7:02 PM:Ombudsman VOLUNTEERS shoulder the weight of the majority of service provided by the program.

It is probably one of the most cost effective programs in the entire state.

Why on earth would you cut funding to a volunteer based program?

Pandering - I think NOT.

Carter wrote on Dec 2, 2008 6:19 AM:Federal Grand Jury members are called by subpoena and selected in about the same manner as Superior Court jurors are selected from a large group.
There are County volunteer Grand Juries that evaluate county policies, procedures and services. A volunteer is competing with county judges preferences. Each judges can submit 6 people to the group of volunteers from which the grand jurors will be picked. There are 128 judges in the San Diego County System.

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