How is the Long Term Care Ombudsman Program Funded?
The short answer is not very well. Or, as an Institute of Medicine report stated, "the first priority is that the program be provided with resources commensurate with meeting all the current mandates, including those that have existed, but been neglected since 1981."The Federal government provides about $45 million to the States, with California's share being $3 million. Our State government matches this and distributes the funds to the local Aging and Adult Service Agencies (AAA) that must provide Long-Term Care Ombudsman services in their counties.
Alameda County's share is about $300,000.
Most California counties directly manage and staff their Long-Term Care Ombudsman programs. However, some contract the program out to non-profit organizations that can potentially provide much more bang for the taxpayers' buck. This is the case in Alameda County, and with our sisters in San Mateo and Contra Costa counties. Ombudsman, Inc. is the non-profit organization contracted to provide the Long-Term Care Ombudsman program for Alameda County. Part of providing more bang for the buck unfortunately comes from providing our hard working staff lower salaries and fewer benefits than county workers enjoy. Part comes from our volunteer Board. Much more comes from our many dedicated volunteer Ombudsmen who are the eyes, ears and voices for the 12,000 residents of long term care facilities in the county.
Simple math shows that $300,000 does not go far in watching out for the care of 12,000 elders in 70 Skilled Nursing Facilities (SNF) and 340 Residential Care Facilities (RCF). That's only $25 per year per person.
The State recommends that we monitor the quality of care with weekly visits to SNFs and monthly visits to RCFs in addition to investigating and resolving complaints and witnessing Advance Directives in SNFs. A volunteer can reasonably monitor quality of care and resolve complaints in two SNFs a week. That alone requires 35 volunteers before we start attending to RCFs.
Volunteers need support and training from staff. The Institute of Medicine recommends at least one full-time staff person to support every twenty volunteers. Our clients and their families need a number to call and a voice to listen. Staff must handle the more difficult and complex cases. Staff must meet and work with the Department of Health Services, Community Care Licensing and law enforcement on physical and financial abuse or neglect. Our staff works wonders but there are only so many hours in the day.
We need another $200,000 a year to have staff to support double our number of volunteers and run the program our elders need. We cannot expect our private donors, who have contributed so generously over the years, to make up this shortfall. We have had grants in the past from Foundations and local governments and spend considerable time applying for them. But there is much competition for limited funds, and grants are generally for only one or two years. The Board sees one of its priorities as understanding how to attract more government support for this wonderful program.
Long-Term Care Ombudsmen reduce health-care costs by improving quality of care in RCFs, which keeps people out of the more expensive SNFs, and by improving quality of care in SNFs, which keeps people out of even more expensive hospitals.
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