Saturday, January 28, 2006

Demanding An Alternative: The Plight of Assisted Living in Idaho

Idaho Code assures that "the state will foster the development of, and provide incentives for, residential care or assisted living facilities serving specific mentally ill and developmentally or physically disabled populations which are small in size to provide for family and homelike arrangements" (39-3304). Based on this statute, one could contend that the recent attempt to redefine state regulations pertaining to assisted living facilities by the Idaho Department of Health and Welfare places Health and Welfare in direct violation of Idaho Code.

In the January 26, 2006 edition of The Idaho State Journal, the plight of local assisted living facilities became front page news, but the history of their plight is as lengthy as their existence. Every proposed assisted living facility has faced a battle few actually win.

A few years ago in Cassia County, a targeted service coordinator for developmentally disabled adults sought to build and manage an assisted living facility in a rural area. Citing close proximity to a major highway, her proposal was refuted. In all reality the reasoning behind the battle rested with neighbors who were untrusting of the developmentally disabled population.

In the assisted living business if it is not one battle it is always another. In the coming weeks as the Idaho State Legislature considers changes to the rules and regulations governing the operation of assisted living facilities, many wage a battle that cannot be won.

The proposed rule changes directly impacting assisted living facilities, especially those rules that are detrimental to the future of smaller facilities not included in the nursing home or elderly care industry, do not seem to offer an alternative. Facilities are either forced to abide by, in some cases, ridiculous regulations or face stiff penalties and fines. This black and white proposal offered by the Department of Health and Welfare has been loudly criticized. Administrators of smaller facilities understand the long term ramifications of these new regulations and seek to fight the new regulations with the assistance of statewide organizations like the Idaho Assisted Living Association (IDALA).

Though in agreement that the vast majority of these new rules and regulations are absurd and cater to the big-money nursing home industry or facilities strictly for the elderly rather than the rights and needs of disabled residents in assisted living facilities, those who choose to fight Health and Welfare on this and request the support of their legislators should offer an alternative, not simply a complaint.

Hearing upon hearing resulted only in disgruntled assisted living administrators and infuriated policymakers. The last resort for these facilities and organizations such as IDALA is a plea in the eleventh hour to their state representatives to vote against the rule changes. Granted, this is the process; this is how the public should interact with their representatives, but the public should at least be courteous enough to offer their state legislators a solution to the problem, not merely a definition of the problem.

As individual facilities struggle to find time, funds, and methods of meeting the daily needs of their residents, they do not have the luxury of actively lobbying the state legislature. For that reason organizations such as IDALA operate. The mission of IDALA should be to represent and support the various assisted living facilities in the state of Idaho, but how can an organization successfully represent and support both the industry providing care for the elderly and the smaller assisted living facility for the disabled?

Those critical of the rule changes should not only be requesting the support of their legislators, they should be demanding a reform in the organization that represents them, if not a complete break down and reconstruction of it.

The IDALA website specifically acknowledges that "Idaho Assisted Living residents can be young or old, affluent or impoverished, mentally ill or brain injured, developmentally or physically disabled," yet never has the question been raised as to whether one association should represent the needs of such a wide array of people.

IDALA should not represent facilities for the developmentally disabled and facilities for the elderly. There is not a fine line between the two, but a gaping hole. The level of care is significantly different and a comparison between the two impossible. Operating an assisted living facility for the developmentally disabled or mentally ill is in no way similar to operating a home for the elderly. Representation by one organization of these two truly diverse businesses is not logical.

If, to quote Adlai Stevenson, "understanding human needs is half the job of meeting them," there must be a separation of these two populations, the elderly and the developmentally disabled, in order to sufficiently meet their needs. The needs of the two populations cannot be understood collectively.