National Fire Prevention Week 2011 will be observed from October 9-15. This year’s theme is: Protect Your Family from Fire, and according to FEMA Regional Administrator Ken Murphy, the 2011 campaign is all about keeping ourselves, our families, and our communities safer from fire.
 “Annual observances like National Fire Prevention Week are excellent opportunities to focus on fire hazards-but we should all practice fire safety every day-at work, at play, and particularly at home,” said Murphy. “The most common causes of home fires include cooking, heating, electrical malfunction, smoking materials and candles.”
 Safety tips to reduce home fires include:
Stay in the kitchen when you are cooking. Many cooking fires start from “unattended” cooking.
Have heating equipment and chimneys inspected and cleaned annually.
If you smoke, smoke outside.
Keep flammable materials away from light bulbs, light fixtures and lamps.
Use flashlights during power outages, not candles. If you do burn candles indoors, blow them out before leaving the room, and keep them away from things that can burn.
Murphy also cautions against complacency. “It’s officially Fall, and as temperatures become cooler, the rate of fire and fire-related deaths increase. FEMA, and the U.S. Fire Administration (USFA) offer a wealth of safety information, fire prevention tips and resources online: www.fema.gov and www.usfa.dhs.gov” said Murphy. “I encourage everyone to contact their local fire department to learn more about making their homes safer from fire, or how to best participate in fire prevention activities.”
For more information on protecting your family and your home from fire, statistical tips and more, go to: www.firepreventionweek.org.
Editor’s note: In the hard copy version of the Senior Scene and the online version, we ran an article from Ingrid McDonald, Washington’s Advocacy Director for AARP. This is a follow up with additional information about the effect of the proposed cuts and AARP’s response and suggestions.
Urgent Advisory:The 2011 Special Session and Risk of Deep Cuts to Long Term Care Services
To address a $1.4 billion budget deficit, the Governor has asked state agencies to submit proposals for reducing spending by in the 2011-13 biennium. These proposals will form the framework for a budget proposal that state lawmakers will consider in a Special Session beginning November 28th 2011.
Current proposals would completely eliminate long term care services for more than 17,000 people, a 29% cut from current levels. This proposal turns the clock backwards on decades of progress towards providing client centered long term care services, consumer choice and cost containment through rebalancing. A recent AARP report rated Washington’s long term care system 2nd best in the nation. That status is now clearly at risk.
The mechanism for this proposed cut is a change in the functional ability eligibility requirement for Medicaid funded long term care services. According to the proposal, only people who require extensive assistance with most daily activities and are medically complex, including people with major cognitive issues, will retain services. Beneficiaries who need intermittent assistance, or who need supervision rather than hands-on assistance, will no longer be eligible.
Services would be eliminated for the following people:
11,700 people will lose homecare assistance
1,000 people who live in Adult Family Homes
2,700 people living in assisted living facilities
1,000 people living in boarding homes
 450 people living in nursing homes
In addition to these cuts, 1,000 people would be impacted by the elimination of Adult Day Health. By definition, with very few exceptions, the people who qualify for these Medicaid funded services have less than $2,000 in assets and less than $2,022 per month in income. They already contribute on a sliding scale to their own care. They cannot afford to cover the full cost of their care on their own. Where will they go and what will they do?
What will happen if Washington asks vulnerable adults to fend for themselves?
 Family caregivers will not be able to pick up the slack. Many long term care clients have no family or have only long distance support. A recent AARP report found that the average caregiver is a 49 year old woman who is still working and who also spends 20 hours per week providing unpaid care to her mother for nearly five years.
There will be more calls to law enforcement, 911 and Adult Protective Services. People who can sometimes get out of bed but not always or who can’t walk up and down the stairs in front of their house or who can’t cook – are not safe in their own homes and are at risk of injury and self neglect. Without supportive housing or home care help many will find themselves in crisis, and when friends or neighbors notice they will respond by calling 911 or APS.
People will decline faster and utilize more expensive health care services. Without appropriate support, the health status of this population will decline. Washington will see an increase in expensive emergency room visits and hospitalizations and more people qualifying more quickly for higher levels of care.
Thousands of caregivers will lose jobs. For every person who loses home care assistance, a home care worker loses income and in the event that was their only client, loses their job. With fewer paying residents, some long term care facilities will lay off their employees or shut their doors. In this recession, keeping people employed must be a top priority.
What is the alternative? Raise revenue.
AARP agrees with the many organizations urging the legislature to send a referendum to the people so the citizens of our state can decide whether they want to close tax loopholes or otherwise raise revenue to avoid painful cuts. In addition, we are urging the legislature to fully explore all possible options to offset long term care cuts by maximizing federal funds or raising fees – here are some examples:
 Community First Choice (CFC) – Washington State is eligible to receive a 6 percent increase in the federal matching percentage (FMAP) for home care services that is available through Section 2401 of the federal Patient Protection and Affordable Care Act. The Department of Social and Health Services included CFC in their budget proposal to the Governor but due to federal rules they will not be able to pursue this option if the functional ability cut is enacted. Washington should aggressively pursue this option which could generate tens of millions of dollars in new revenue.
 Adult Family Home License Fee – Adult Family Homes should pay for the full cost of their oversight as all other long term care providers do. Last year the legislature moved in this direction by increasing the license fee from $100 per home to $100 per bed in FY 2012 and $175 per bed in FY 2013 plus initial fee of $2,700. The legislature should accelerate this increase so that these providers are fully funding their own oversight and savings can be used to mitigate cuts.
 Maximize Safety Net Assessments – Last year the legislature passed a nursing home safety net assessment. To mitigate cuts, the legislature should consider upping this assessment to the federal maximum and look at what other providers, including home and community based long term care providers, could be similarly assessed.
What You Can Do
 1)     E-mail the Governor to express your concern
Researchers at VA Puget Sound Health Care System have recently received widespread national coverage about their current Alzheimer’s research. Dr. Suzanne Craft, a UW professor and Veteran’s Administration researcher with the study is cautiously optimistic about their findings. The study has concentrated on research of a direct delivery system that provides insulin to the brain of study participants through an intranasal administration. While the study results have been quite positive, Craft emphasizes that the study has so far been limited and needs larger scale testing over a longer period of time. The current pilot study involved a sample of only 104 participants over a four month period. Craft hopes to get funding for a larger study and begin additional research by next summer. She puts the timeframe for knowing whether the direct insulin approach is a viable therapy for Alzheimer’s at three to four years.
The study results were published this month by the journal Archives of Neurology.
When it comes to long-term care, Washington state ranks second in the nation according to a recently released report issued by AARP in conjunction with the Commonwealth Fund and the SCAN Foundation.
The report, “Raising Expectations: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers,†provides a detailed comparison of how Washington measures up compared to other states on numerous indicators related to long-term care affordability and access, choice of setting and provider, quality of life and quality of care and support for family caregivers.
Here in the Evergreen State, 63 percent of all Medicaid and state funded long-term care funding is going to home and community-based services—that’s compared to a median rate for all states of 30 percent.
That’s good for people and for the state budget. People can stay independent with the help of a home care worker, Meals on Wheels, adult day health and other supports—rather than feeling like nursing home care is their only option. And fewer people using Medicaid to pay for expensive nursing home care means big savings for the state—up to $1 billion over the past decade.
The news is in and it’s good—if you need long-term care, Washington is one the best states in the nation to live in. But that status is at risk. In recent years the state legislature has cut back on home care hours and other supports that people need in order to stay out of nursing homes. With fewer home care hours, less support and higher health care costs, more and more people will give up their struggle to remain in their own homes and settle for expensive nursing home care because they feel it is their only option.
To continue our popular and cost-effective approach, Olympia lawmakers need to make it a priority to preserve funding for home care, family caregiver supports and the array of supports funded through the Senior Citizens Service Act.
But while the new report scores Washington’s long-term care system second only to Minnesota, there are still many areas that need improvement—particularly in the areas of affordability and quality.
As many are acutely aware, people who pay privately for home care or nursing home care are at risk of quickly exhausting their resources. While these services are expensive in every state, the Scorecard report showed the average cost of nursing home care in the Washington is 221 percent of the average annual household income of Washingtonians age 65 and older—ranking us 23rd in the nation.
Though less extreme, the cost of home care services is also unaffordable for the typical user, averaging 93 percent of household income for older adults in the state, putting us at 30th in the nation. Moreover, fewer people in Washington than in other states have private, long-term care insurance to protect them from these costs. On this front, Washington ranks 18th in the nation.
Quality is another concern, but there is little national data to compare how well states are serving people in their own homes or in the community. In Washington, we know there has been a recent steep increase in consumer complaints against adult family homes, an issue that lawmakers addressed last legislative session. In nursing home settings, the Scorecard ranked Washington low compared to many states on the percent of high-risk nursing home residents with pressure sores (29th), the percent of long-stay nursing home residents who were physically restrained (16th) and the turnover rate for employees in nursing homes (44th). So when it comes to protecting our most vulnerable residents in nursing homes, clearly, there is more work to do.
The recently published Scorecard is cause for celebration—much good work has been done in Washington to promote high quality, person-centered long-term services and supports. Our struggle now is to improve our weak spots and maintain our investment in cost-effective home and community based services so we stay at the top of the chart. For more information, visit www.aarp.org/wa.
National Fire Prevention Week 2011 will be observed from October 9-15. This year’s theme is: Protect Your Family from Fire, and according to FEMA Regional Administrator Ken Murphy, the 2011 campaign is all about keeping ourselves, our families, and our communities safer from fire.
