On March 28, 2008 Governor Gregoire signed SB6807, Part 1 and 3. She vetoed Part 2.
Below is a synopsis of Parts 1 and 3:
Part 1: Under the terms of the legislation, a facility's voluntary withdrawal from the Medicaid program cannot be used as a basis for the transfer or discharge of residents from the facility. A facility cancelling its Medicaid contract will be required to retain any current residents (1) who were receiving Medicaid on the day before the effective date of the cancellation of the Medicaid contract; or (2) who have been paying the facility privately for at least two years and who become eligible for Medicaid within 180 days of the date of the cancellation. Notwithstanding withdrawal from the Medicaid program, the Medicaid contract will be deemed to continue in effect for the duration of these residents' tenancy.
Part 3: The legislation contains an "emergency clause". Under the terms of the "emergency clause" the provisions governing a facility's withdrawal from the Medicaid program will go into effect immediately upon signature by the Governor.
I have learned that Assisted Living Concepts (ALC) has notified the State of Washington that they are cancelling their Medicaid contracts at all of their facilities in the state effective 6/24/2008. This notice was dated 3/24/08. We think that the Medicaid residents in these facilities will be covered by the above law because it states that it applies to residents receiving Medicaid on the day before the EFFECTIVE DATE of the cancellation of the contract (not the date of notice).
Thanks again to all of you who worked toward the passage of this bill.
Tuesday, April 1, 2008
Tuesday, March 11, 2008
Great News!!
The LTC Ombudsman generated bill SB 6807 to provide protections for people on Medicaid who live in boarding homes has passed both the Senate and the House and is ready for signature for the Governor. This could not have been done without all of the work of many family members, residents and ombudsmen who have been affected by the ending of Medicaid contracting at West Woods & Victoria House and by the other family members who were promised the ability to convert to Medicaid and then when the time came were denied. The testimony, calls, letters and media attention provided by all of you had a meaningful impact on the legislators.
Thank you for all of your help!
The bill is a good start toward ending of Medicaid discrimination in our community based settings, in summary it does three things:
(1) Prohibits a boarding home from transferring or discharging a current resident on the basis that it is voluntarily withdrawing from the Medicaid program.
(2) Requires notice to persons beginning residence after the effective date of the act that the boarding home is not participating in the Medicaid program and the person may be transferred or discharged if they are unable to pay the facility charges.
(3) Requires full disclosure in writing to residents and potential residents or their legal representative the facility policy on accepting Medicaid as a payment source. The policy shall clearly and plainly state the circumstances under which the facility will care for persons who are eligible for Medicaid upon admission or who may later become eligible for Medicaid. Disclosure must be provided prior to admission, and the facility must retain a copy of the disclosure signed by the resident or their legal representative. The facility policy on Medicaid as a payment source as of the date of the resident's admission to the facility shall be considered a legally binding contract between the resident and the facility.
I'll keep you posted with regards to when the Governor will sign the bill; it would be great for supporters to come to the bill signing.
Thank you for all of your help!
The bill is a good start toward ending of Medicaid discrimination in our community based settings, in summary it does three things:
(1) Prohibits a boarding home from transferring or discharging a current resident on the basis that it is voluntarily withdrawing from the Medicaid program.
(2) Requires notice to persons beginning residence after the effective date of the act that the boarding home is not participating in the Medicaid program and the person may be transferred or discharged if they are unable to pay the facility charges.
(3) Requires full disclosure in writing to residents and potential residents or their legal representative the facility policy on accepting Medicaid as a payment source. The policy shall clearly and plainly state the circumstances under which the facility will care for persons who are eligible for Medicaid upon admission or who may later become eligible for Medicaid. Disclosure must be provided prior to admission, and the facility must retain a copy of the disclosure signed by the resident or their legal representative. The facility policy on Medicaid as a payment source as of the date of the resident's admission to the facility shall be considered a legally binding contract between the resident and the facility.
I'll keep you posted with regards to when the Governor will sign the bill; it would be great for supporters to come to the bill signing.
Thursday, February 21, 2008
Good News!
The wheels of State have been grinding away and I'm happy to report that
HB 3204 - "protecting residents in Boarding Homes who are on Medicaid" passed out of the House last week 95-0. It now needs to go to the Senate for a hearing and continue the legislative journey. I'll keep you posted as the bill travels. Thank you for all of your support to move the bill along!
HB 3204 - "protecting residents in Boarding Homes who are on Medicaid" passed out of the House last week 95-0. It now needs to go to the Senate for a hearing and continue the legislative journey. I'll keep you posted as the bill travels. Thank you for all of your support to move the bill along!
Saturday, February 2, 2008
Oops! Error in Senate Bill #
In the post titled "February 4th is a Critical Day" there was an error in the number of the Senate Bill. The correct number is 6807. The bills are correctly numbered in the posting titled "Big News".
Sorry for the error.
Sorry for the error.
Thursday, January 31, 2008
Plans for February 4th
If you would like to go to Olympia on Monday, February 4th for the Senate Hearing at 1:30 and you would like to carpool with others that are going, please call Sue Estes at 360.379.4418 or John Estes at 360.385.9577.
Wednesday, January 30, 2008
February 4th is a Critical Day!
The Senate Health and Long Term Care Committee is holding hearing about SB 6807 which will prevent "eviction" by cancelling Medicaid contracts.
The hearing is at 1:30 pm in the J A Cherberg Building (Senate office building) in Hearing Room 4.
It is important that we have a strong show of support. If you can't attend, send an email or make a hot line call.
Please help!
The hearing is at 1:30 pm in the J A Cherberg Building (Senate office building) in Hearing Room 4.
It is important that we have a strong show of support. If you can't attend, send an email or make a hot line call.
Please help!
Leader Article on Victoria House
MEDICAID EVICTION LAW EYED
By Allison Arthur, Leader Staff Writer
1-30-2008
Kay Harper will leave Victoria House on her own terms and not those of the corporation that owns the Port Townsend assisted-living facility.
Harper announced yesterday during a meeting of residents that she will leave Feb. 15, not Feb. 1. The latter was the deadline the Wisconsin-based multi-state company that owns the facility had given her and others to depart because it canceled its Medicaid contract with the state.
The plight of 11 residents in Port Townsend and 21 residents of another facility owned by Assisted Living Concepts in Tumwater has caught the attention of state legislators, three of whom introduced legislation last week that would prevent companies from doing what ALC did.
Assisted-living facilities that want to close their doors to people on Medicaid would not be able to evict existing residents such as Harper if House Bill 3204 is enacted.
Kevin Krueger, regional administrator for the state Department of Social and Health Services (DSHS), said the bill would ensure that people on Medicaid are "grandfathered" if any facility terminates its contract for people on state aid.
"If this bill were to be passed, if they terminate their Medicaid contract, they would have to grandfather those who are now on Medicaid. Why not let them attrition out?" Krueger said of allowing people to age in place as long as possible, moving only if their care needs changed.
Without such legislation, Krueger said there are "very real and valid fears" among those in boarding homes that what ALC did at Victoria House in Port Townsend and West Woods Assisted Living in Tumwater could be repeated throughout the state.
ALC owns 21 similar facilities in Washington and 208 assisted-living and independent-care facilities across the United States.
"This was a corporate decision, a business decision," Krueger said. He said he had met with a corporate representative and it was clear from that discussion that the company planned to terminate all Medicaid contracts for poor people at all facilities in Washington in order to accept private-pay residents who pay more for their care than the state does.
Laurie A. Bebo, the CEO and president of Assisted Livings Concepts, said yesterday that she would consider dropping the state contract should the bill move forward and before any legislation could take effect.
"We would have to seriously consider pulling out [of Medicaid contracts] before it goes into effect," she said. "To have a contract where there is no exit clause doesn't seem to be fair and reasonable to both parties."
Bebo accepted a call from The Leader while a reporter was at Victoria House to interview Harper and take photos of her making the announcement of her departure.
Victoria House Administrator Wayne Pattison initially said photos couldn't be taken inside the facility without written permission of the residents. Residents then verbally agreed to have their photos taken with Harper, which ombudsman John Estes noted in the minutes of the meeting.
Pattison got on the phone with Bebo, then offered The Leader a chance to talk to Bebo after he was advised she had not returned recent calls for comment.
Bebo had said in November that the reason the company wanted out of its contract with the state was because there were some Medicaid clients in Port Townsend who needed to move to a skilled-care nursing facility and were refusing to do so.
"They pose a challenge and a concern to us as far as our staff being able to take care of their needs," Bebo said in November.
Krueger noted that ALC could have discharged anyone whose needs it could not meet. He noted that only one of the people who moved from Victoria House went to a nursing home.All of those given notices to depart by Feb. 1 did so, except Harper.
Harper, whose son Nick Harper was lauded as Port Townsend Business Leader of the Year on Sunday, leased a house on McPherson Street that a friend, Patty Crutcher, found for her after reading about Kay's plight in The Leader.
Kay Harper, who had been at Victoria House for 10 years, said last week she was glad to be leaving and going where she is wanted. She will need support at her new home.
"It's mine. I'm going to be in charge. There won't be people running around telling me what to do. You always feel like you're in somebody's way. I do things. I make bread and pass it around," Harper said.She repeated that sentiment yesterday when she announced her departure.
"Doris, I'll miss talking to you across the hall," Harper said. "I'm going to be back to see you. Nobody really ever gets rid of me."
Several residents and those who have watched Harper over the years said her departure will be a loss for the residents. Harper also had led a protest in November against ALC's actions.
"She's been a voice for the residents," said Dee Pumplin, whose father has been at Victoria House for five years.
And John Boles said that while the corporation didn't like what Harper had to say, she was "always watching out for people."
Bebo said Harper's departure plans had been worked out between attorneys and she was comfortable with that decision even though it missed the Feb. 1 deadline.
"It was an unfortunate situation, but I think most people found alternatives nearby and I hope this doesn't happen again," Krueger said of what happened in Port Townsend and Tumwater and his hopes for the legislation, which he said likely would be controversial.
(Contact Allison Arthur at aarthur@ptleader.com.)
By Allison Arthur, Leader Staff Writer
1-30-2008
Kay Harper will leave Victoria House on her own terms and not those of the corporation that owns the Port Townsend assisted-living facility.
Harper announced yesterday during a meeting of residents that she will leave Feb. 15, not Feb. 1. The latter was the deadline the Wisconsin-based multi-state company that owns the facility had given her and others to depart because it canceled its Medicaid contract with the state.
The plight of 11 residents in Port Townsend and 21 residents of another facility owned by Assisted Living Concepts in Tumwater has caught the attention of state legislators, three of whom introduced legislation last week that would prevent companies from doing what ALC did.
Assisted-living facilities that want to close their doors to people on Medicaid would not be able to evict existing residents such as Harper if House Bill 3204 is enacted.
Kevin Krueger, regional administrator for the state Department of Social and Health Services (DSHS), said the bill would ensure that people on Medicaid are "grandfathered" if any facility terminates its contract for people on state aid.
"If this bill were to be passed, if they terminate their Medicaid contract, they would have to grandfather those who are now on Medicaid. Why not let them attrition out?" Krueger said of allowing people to age in place as long as possible, moving only if their care needs changed.
Without such legislation, Krueger said there are "very real and valid fears" among those in boarding homes that what ALC did at Victoria House in Port Townsend and West Woods Assisted Living in Tumwater could be repeated throughout the state.
ALC owns 21 similar facilities in Washington and 208 assisted-living and independent-care facilities across the United States.
"This was a corporate decision, a business decision," Krueger said. He said he had met with a corporate representative and it was clear from that discussion that the company planned to terminate all Medicaid contracts for poor people at all facilities in Washington in order to accept private-pay residents who pay more for their care than the state does.
Laurie A. Bebo, the CEO and president of Assisted Livings Concepts, said yesterday that she would consider dropping the state contract should the bill move forward and before any legislation could take effect.
"We would have to seriously consider pulling out [of Medicaid contracts] before it goes into effect," she said. "To have a contract where there is no exit clause doesn't seem to be fair and reasonable to both parties."
Bebo accepted a call from The Leader while a reporter was at Victoria House to interview Harper and take photos of her making the announcement of her departure.
Victoria House Administrator Wayne Pattison initially said photos couldn't be taken inside the facility without written permission of the residents. Residents then verbally agreed to have their photos taken with Harper, which ombudsman John Estes noted in the minutes of the meeting.
Pattison got on the phone with Bebo, then offered The Leader a chance to talk to Bebo after he was advised she had not returned recent calls for comment.
Bebo had said in November that the reason the company wanted out of its contract with the state was because there were some Medicaid clients in Port Townsend who needed to move to a skilled-care nursing facility and were refusing to do so.
"They pose a challenge and a concern to us as far as our staff being able to take care of their needs," Bebo said in November.
Krueger noted that ALC could have discharged anyone whose needs it could not meet. He noted that only one of the people who moved from Victoria House went to a nursing home.All of those given notices to depart by Feb. 1 did so, except Harper.
Harper, whose son Nick Harper was lauded as Port Townsend Business Leader of the Year on Sunday, leased a house on McPherson Street that a friend, Patty Crutcher, found for her after reading about Kay's plight in The Leader.
Kay Harper, who had been at Victoria House for 10 years, said last week she was glad to be leaving and going where she is wanted. She will need support at her new home.
"It's mine. I'm going to be in charge. There won't be people running around telling me what to do. You always feel like you're in somebody's way. I do things. I make bread and pass it around," Harper said.She repeated that sentiment yesterday when she announced her departure.
"Doris, I'll miss talking to you across the hall," Harper said. "I'm going to be back to see you. Nobody really ever gets rid of me."
Several residents and those who have watched Harper over the years said her departure will be a loss for the residents. Harper also had led a protest in November against ALC's actions.
"She's been a voice for the residents," said Dee Pumplin, whose father has been at Victoria House for five years.
And John Boles said that while the corporation didn't like what Harper had to say, she was "always watching out for people."
Bebo said Harper's departure plans had been worked out between attorneys and she was comfortable with that decision even though it missed the Feb. 1 deadline.
"It was an unfortunate situation, but I think most people found alternatives nearby and I hope this doesn't happen again," Krueger said of what happened in Port Townsend and Tumwater and his hopes for the legislation, which he said likely would be controversial.
(Contact Allison Arthur at aarthur@ptleader.com.)
Big News!!
We have bills before the State Legislature to end what happened to residents in Victoria House!
HB 3204 and SB 6807 will prevent discharge of residents from boarding homes due to their Medicaid Status.
Link to HB 3204: http://apps.leg.wa.gov/documents/billdocs/2007-08/Pdf/Bills/House%20Bills/3204.pdf
Link to SB 6807: http://apps.leg.wa.gov/documents/billdocs/2007-08/Pdf/Bills/Senate%20Bills/6807.pdf
There will be a hearing on Monday, February 4th at the Legislature in Olympia. The time and location will be posted as soon as I have the information.
Folks, we need to make some noise on this! Contact your state legislators--contact information is below on this blog. To send a brief message to legislators through an in-state toll-free hotline, call 1-800-562-6000. If you possibly can, be in Olympia for the hearing. If you wish to testify, please plan what you will say and it's perfectly okay to read your testimony. Legislators need to know how this effects residents and their families. Keep your comments succint and to the point and keep them to a maximum of two minutes.
We wanted this so now let's make it happen!!
HB 3204 and SB 6807 will prevent discharge of residents from boarding homes due to their Medicaid Status.
Link to HB 3204: http://apps.leg.wa.gov/documents/billdocs/2007-08/Pdf/Bills/House%20Bills/3204.pdf
Link to SB 6807: http://apps.leg.wa.gov/documents/billdocs/2007-08/Pdf/Bills/Senate%20Bills/6807.pdf
There will be a hearing on Monday, February 4th at the Legislature in Olympia. The time and location will be posted as soon as I have the information.
Folks, we need to make some noise on this! Contact your state legislators--contact information is below on this blog. To send a brief message to legislators through an in-state toll-free hotline, call 1-800-562-6000. If you possibly can, be in Olympia for the hearing. If you wish to testify, please plan what you will say and it's perfectly okay to read your testimony. Legislators need to know how this effects residents and their families. Keep your comments succint and to the point and keep them to a maximum of two minutes.
We wanted this so now let's make it happen!!
Friday, January 11, 2008
Ms. Bebo Meets with City Council Subcommittee
On Tuesday, January 8th the CDLU (Community Development and Land Use) Committee met and the only item on their agenda was the Victoria House/just cause matter. Laurie Bebo attended the meeting and presented information to the council members
and responded to questions from the council members. Council members also listened to comments from the public who were in attendance at the meeting. There was little new information provided by Ms. Bebo. She continues to assert that residents needed more care and the State was unresponsive to requests to move residents. Public comments were mostly to refute or correct statements by Ms. Bebo in her comments and in her letter to the City Council. The council members asked many insightful and pointed questions.
Many thanks to those of you who came to the meeting to show support for the residents of Victoria House and many thanks to the council members for giving their attention to this matter.
The next meeting is on Tuesday, January 22nd at 2:00 pm in the first floor conference room at City Hall.
and responded to questions from the council members. Council members also listened to comments from the public who were in attendance at the meeting. There was little new information provided by Ms. Bebo. She continues to assert that residents needed more care and the State was unresponsive to requests to move residents. Public comments were mostly to refute or correct statements by Ms. Bebo in her comments and in her letter to the City Council. The council members asked many insightful and pointed questions.
Many thanks to those of you who came to the meeting to show support for the residents of Victoria House and many thanks to the council members for giving their attention to this matter.
The next meeting is on Tuesday, January 22nd at 2:00 pm in the first floor conference room at City Hall.
Monday, January 7, 2008
Senior Lobby Day in Olympia
January 22nd is Senior Lobby Day for the State Legislature in Olympia. Sue is making appointments with the Legislators from our district. This is our chance to talk to our legislators about what we would like them to do! If you would like to take part in these visits, please contact Sue by adding comments to this blog or calling 379-4418.
Ms. Bebo's Letter to City Council
January 3, 2008
The Honorable Mark Welch
City of Port Townsend
250 Madison Street, Suite 2
Port Townsend, WA 98368
Re: Victoria House, Port Townsend, WA
Dear Mayor Welch:
We write in response to your letter of December 11, 2007, regarding events concerning certain residents of Victoria House Assisted Living. While we would have preferred to respond sooner, my travel schedule and the holidays have delayed my response.
While we appreciate the City Council's concern over the welfare of all the residents in the City, including those residing at Victoria House, some of the statements in your letter appear to be based upon either inaccurate information or state conclusions which simply are unsupported by any facts. In addition to responding to the concerns raised by the Council in your letter, we welcome the opportunity to appear before your council subcommittee and to meet with any council member interested in speaking with us.
Victoria House provides excellent care for its assisted living residents. Ours is one of the most regulated industries in the state. Each of our residents (or his or her legal representative) signs a contract and receives written disclosures regarding the level of care that they will receive at Victoria House. These disclosures are required by law and prevent any implied understandings or, more appropriately, misunderstandings, from taking place. Each and every one of the eight (not eleven) residents affected by the termination of the State Medicaid contract received these disclosures.
Your letter also suggested that the City has been told that none of the individuals impacted by the decision to terminate the Medicaid contract required transfer because their medical conditions required a higher level of care than that provided at Victoria House. Because your letter does not specify what you were told and by whom, it is difficult to respond to your concern. Medical privacy laws preclude us from discussing the circumstances of individual residents; however, we can say that there had been conversations with representatives of DSHS regarding the condition and the needs of each resident. The record of those conversations is either known or available to representatives of the State and authorized members of the individual resident's families.
The Honorable Mark Welch January 3, 2008 Page 2
In addition, you should be made aware that over the course of the last year, Victoria House recognized that several of these Medicaid residents were requiring higher levels of care than those provided at the residence. Because of these higher care needs we thought it appropriate for these residents to be transferred to other facilities that provided this higher level of care. Unfortunately, the residents refused to move and we were forced to initiate the Involuntary Transfer/Discharge process required by Washington law. The Involuntary Transfer/Discharge process was initiated because we believed that the increased care needs of a few residents, put other residents and the facility at risk. Because providing the highest level of care to our residents is our paramount concern, we knew we had no alternative but to transfer these residents.
During this transfer process, the local DSHS representative refused to support our position. Because of this lack of support, we eventually abandoned the process. Unfortunately, we believe that the local DSHS representative's position had more to do with the vocal nature of the residents involved and less to do with the care needs of these residents. Because of the local DSHS representative's lack of support, we felt that we could no longer maintain a Medicaid contract in the DSHS Region 5 which encompasses the Olympic Peninsula and the Olympia area. It should be noted that in similar instances we have not experienced the lack pf support from DSHS in its other Regions. Accordingly, we have not taken the extraordinary step of canceling our Medicaid contracts in these other regions. Again, while we cannot discuss the specifics of individuals in a public setting, we remain willing and able to discuss our concerns with appropriate personnel from the agency.
As we previously explained in our letter to the City Attorney, because we had not received meaningful responses from the agency regarding the care issues we had raised about some residents, we made the difficult decision to terminate the contract. We do appreciate the Council's recognition of the fact that the Medicaid reimbursement rates are inadequate and fail to address the changing needs of residents, making aging in place extremely difficult. Nevertheless, while the reimbursement rates played a part in our decision, it was not the primary basis for our action to terminate the contract.
While we cannot disclose the identity of our former residents or where they have transferred to, we can share that half of the residents impacted transferred to other assisted living facilities. However, the other residents identified by us as requiring a higher level of care have been unable to find placement in other assisted living facilities because those facilities are unable to care for their needs. Indeed, these residents have been informed by the other facilities that they are inappropriate for assisted living and in fact require skilled nursing care or specialized dementia from a nursing home or dementia care facility. Thus, Victoria House is not the only Assisted Living provider that believes that these residents required higher levels of care.
The Honorable Mark Welch January 3, 2008 Page 3
Finally, your letter implies that Victoria House promised that it would somehow become a "permanent home" for these Medicaid residents. We would like to clarify that only in very rare cases does an assisted living facility become a "permanent home" for an elder resident. In our opinion, assisted living facilities are part of the Long Term Care continuum. As a resident's conditions changes, his/her housing and care needs change. The suggestion that Victoria House promised to keep these residents indefinitely is unsubstantiated and at odds with the notion of the continuum of care.
We take the care of residents, and their rights, very seriously. Again, that was one of the reasons why we have written contracts, written disclosure statements, and frequent communication with the families of residents. As a result, the suggestion in your letter that the decision to terminate the Medicaid contract was in any way retaliatory is incorrect, unsubstantiated, and extremely unfair. There are mandatory reporting requirements for any unethical or unsafe conduct observed or suspected. There are anonymous hotlines to assist the residents in reporting any such accusations. The State Ombudsman's Office is available to advocate for residents. The fact is that we have received no complaints or communications alleging that the termination decision was retaliatory or has affected quality of resident care. The people who work at Victoria House, many of whom live in your city, work hard to provide quality care. They do not deserve to have their efforts disparaged.
As we previously reported in our letter to the City Attorney, the majority of the residents affected by termination of the Medicaid contract have successfully made arrangements to pursue care in other facilities. We remain committed to making the transfers as seamless as possible and we are working with the families of the residents to achieve that goal. We look forward to the opportunity of meeting you and answering any other questions that the Council may have.
Very truly yours,
Laurie A. Bebo
President and Chief Executive Officer
The Honorable Mark Welch
City of Port Townsend
250 Madison Street, Suite 2
Port Townsend, WA 98368
Re: Victoria House, Port Townsend, WA
Dear Mayor Welch:
We write in response to your letter of December 11, 2007, regarding events concerning certain residents of Victoria House Assisted Living. While we would have preferred to respond sooner, my travel schedule and the holidays have delayed my response.
While we appreciate the City Council's concern over the welfare of all the residents in the City, including those residing at Victoria House, some of the statements in your letter appear to be based upon either inaccurate information or state conclusions which simply are unsupported by any facts. In addition to responding to the concerns raised by the Council in your letter, we welcome the opportunity to appear before your council subcommittee and to meet with any council member interested in speaking with us.
Victoria House provides excellent care for its assisted living residents. Ours is one of the most regulated industries in the state. Each of our residents (or his or her legal representative) signs a contract and receives written disclosures regarding the level of care that they will receive at Victoria House. These disclosures are required by law and prevent any implied understandings or, more appropriately, misunderstandings, from taking place. Each and every one of the eight (not eleven) residents affected by the termination of the State Medicaid contract received these disclosures.
Your letter also suggested that the City has been told that none of the individuals impacted by the decision to terminate the Medicaid contract required transfer because their medical conditions required a higher level of care than that provided at Victoria House. Because your letter does not specify what you were told and by whom, it is difficult to respond to your concern. Medical privacy laws preclude us from discussing the circumstances of individual residents; however, we can say that there had been conversations with representatives of DSHS regarding the condition and the needs of each resident. The record of those conversations is either known or available to representatives of the State and authorized members of the individual resident's families.
The Honorable Mark Welch January 3, 2008 Page 2
In addition, you should be made aware that over the course of the last year, Victoria House recognized that several of these Medicaid residents were requiring higher levels of care than those provided at the residence. Because of these higher care needs we thought it appropriate for these residents to be transferred to other facilities that provided this higher level of care. Unfortunately, the residents refused to move and we were forced to initiate the Involuntary Transfer/Discharge process required by Washington law. The Involuntary Transfer/Discharge process was initiated because we believed that the increased care needs of a few residents, put other residents and the facility at risk. Because providing the highest level of care to our residents is our paramount concern, we knew we had no alternative but to transfer these residents.
During this transfer process, the local DSHS representative refused to support our position. Because of this lack of support, we eventually abandoned the process. Unfortunately, we believe that the local DSHS representative's position had more to do with the vocal nature of the residents involved and less to do with the care needs of these residents. Because of the local DSHS representative's lack of support, we felt that we could no longer maintain a Medicaid contract in the DSHS Region 5 which encompasses the Olympic Peninsula and the Olympia area. It should be noted that in similar instances we have not experienced the lack pf support from DSHS in its other Regions. Accordingly, we have not taken the extraordinary step of canceling our Medicaid contracts in these other regions. Again, while we cannot discuss the specifics of individuals in a public setting, we remain willing and able to discuss our concerns with appropriate personnel from the agency.
As we previously explained in our letter to the City Attorney, because we had not received meaningful responses from the agency regarding the care issues we had raised about some residents, we made the difficult decision to terminate the contract. We do appreciate the Council's recognition of the fact that the Medicaid reimbursement rates are inadequate and fail to address the changing needs of residents, making aging in place extremely difficult. Nevertheless, while the reimbursement rates played a part in our decision, it was not the primary basis for our action to terminate the contract.
While we cannot disclose the identity of our former residents or where they have transferred to, we can share that half of the residents impacted transferred to other assisted living facilities. However, the other residents identified by us as requiring a higher level of care have been unable to find placement in other assisted living facilities because those facilities are unable to care for their needs. Indeed, these residents have been informed by the other facilities that they are inappropriate for assisted living and in fact require skilled nursing care or specialized dementia from a nursing home or dementia care facility. Thus, Victoria House is not the only Assisted Living provider that believes that these residents required higher levels of care.
The Honorable Mark Welch January 3, 2008 Page 3
Finally, your letter implies that Victoria House promised that it would somehow become a "permanent home" for these Medicaid residents. We would like to clarify that only in very rare cases does an assisted living facility become a "permanent home" for an elder resident. In our opinion, assisted living facilities are part of the Long Term Care continuum. As a resident's conditions changes, his/her housing and care needs change. The suggestion that Victoria House promised to keep these residents indefinitely is unsubstantiated and at odds with the notion of the continuum of care.
We take the care of residents, and their rights, very seriously. Again, that was one of the reasons why we have written contracts, written disclosure statements, and frequent communication with the families of residents. As a result, the suggestion in your letter that the decision to terminate the Medicaid contract was in any way retaliatory is incorrect, unsubstantiated, and extremely unfair. There are mandatory reporting requirements for any unethical or unsafe conduct observed or suspected. There are anonymous hotlines to assist the residents in reporting any such accusations. The State Ombudsman's Office is available to advocate for residents. The fact is that we have received no complaints or communications alleging that the termination decision was retaliatory or has affected quality of resident care. The people who work at Victoria House, many of whom live in your city, work hard to provide quality care. They do not deserve to have their efforts disparaged.
As we previously reported in our letter to the City Attorney, the majority of the residents affected by termination of the Medicaid contract have successfully made arrangements to pursue care in other facilities. We remain committed to making the transfers as seamless as possible and we are working with the families of the residents to achieve that goal. We look forward to the opportunity of meeting you and answering any other questions that the Council may have.
Very truly yours,
Laurie A. Bebo
President and Chief Executive Officer
Friday, January 4, 2008
Ms. Bebo Writes to the City Council
Ms. Bebo has written a letter to the Mayor and City Council in response to their letter to her. We are having technical problems in copying the letter for posting on the blog. There is not much new in the letter. Ms. Bebo still maintains that residents in Victoria House needed a higher level of care than available there and the state would not make other plans for them. The letter contains several inaccuracies and misrepresentations. The letter will be posted as soon as we are able to do so.
Stay tuned.......
Stay tuned.......
Meeting with City Council Subcommittee
Below is an excerpt from an email from John Watts regarding the meeting:
Michele Sandoval, Chair of the Council CDLU committee, confirmed that the “Victoria House/just cause eviction” matter is on the CDLU agenda for Janaury 8, at 2PM at City Hall. Council on Dec. 3rd determined to send a letter to ALC and to refer the matter to CDLU to review options.
This also lets you know that Laurie Bebo, CEO of ALC, will be coming to Seattle and will attend the CDLU committee on Jan. 8.
Hey folks, please come to the meeting and show your support for Victoria House residents and others who might in the future be subjected to unfair eviction.
The meeting will be in the first floor conference room of “new” City Hall. Public comment is allowed.
Michele Sandoval, Chair of the Council CDLU committee, confirmed that the “Victoria House/just cause eviction” matter is on the CDLU agenda for Janaury 8, at 2PM at City Hall. Council on Dec. 3rd determined to send a letter to ALC and to refer the matter to CDLU to review options.
This also lets you know that Laurie Bebo, CEO of ALC, will be coming to Seattle and will attend the CDLU committee on Jan. 8.
Hey folks, please come to the meeting and show your support for Victoria House residents and others who might in the future be subjected to unfair eviction.
The meeting will be in the first floor conference room of “new” City Hall. Public comment is allowed.
Wednesday, January 2, 2008
Update on the Victoria House Eleven
I'm sure that you are wondering what has happened to residents who are facing eviction from Victoria House. As you know, one is deceased. Seven have moved to other accommodations. From what I have heard, most of them seem to be satisfied with their new living situations.
Kay Harper remains at Victoria House and is considering her options.
Two residents may be staying at Victoria House under the Low Income Housing Program. (I am pleased if these two individuals are able to stay at Victoria House. I'm just wondering--again--why these two particular people and how it is possible for them to stay and not other residents.)
I'll keep you posted on further changes as they occur.
Kay Harper remains at Victoria House and is considering her options.
Two residents may be staying at Victoria House under the Low Income Housing Program. (I am pleased if these two individuals are able to stay at Victoria House. I'm just wondering--again--why these two particular people and how it is possible for them to stay and not other residents.)
I'll keep you posted on further changes as they occur.
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