Long-term care

Florida curtails effort to police ALFs

 

Under fire from some lawmakers and healthcare industry leaders, Florida’s struggling elder ombudsman program now has turned on itself.

cmarbin@MiamiHerald.com

When elder advocate Diane Carpenter entered Our Golden Home in 2008, she found an elderly woman languishing in a recliner, soaked in her own urine.

After ordering an aide to put clean clothes on the woman, Carpenter, a supervisor with the state’s volunteer ombudsman program, heard muffled cries from the rear of the Hialeah assisted-living facility. “Help me, help me,” a man pleaded.

Curled in a fetal position, the man was burning with fever.

Carpenter ordered caregivers to call an ambulance. They refused. She then threatened to call the state’s elder abuse hotline. When paramedics finally rushed the man to a nearby hospital, they had little time to spare: He had already lapsed into life-threatening renal failure.

Three years later, the program that Carpenter represents also is in grave condition.

Under attack by powerful industry groups, the once celebrated program launched during the Great Society legislation of the 1960s has been hit by a wave of resignations and firings that have left it reeling over the past year. Amid the turmoil, federal regulators blasted the state last month for allowing political meddling to cripple the advocacy group.

Just six months ago, key lawmakers wanted to do away with the group’s ability to perform yearly inspections of nursing homes and assisted-living facilities — the program’s key mission — even as its corps of trained volunteers was turning up a record number of abuse and neglect cases in ALFs across the state.

Created as an advocacy group for frail residents in long-term care homes, the program now finds many of its veterans at odds with their new leader, Jim Crochet — a longtime state administrator recommended by industry leaders. They say he is trying to diminish their roles as protectors of vulnerable adults to appease the industry.

“People just don’t understand how important these people are,” said David Gillespie, former manager of the Broward ombudsman office. “The volunteers are responsible for saving countless lives, and for improving the lives of countless others.”

Internally, nearly a dozen employees and volunteers have resigned or been fired as Crochet launched an overhaul of the agency after his appointment in April.

“We are going through a paradigm shift and it is difficult for some who have been ingrained in the old way,” Crochet said in an August email to a top administrator of the Agency for Health Care Administration, the state’s nursing home and ALF regulator. “Unfortunately, that shift may require that some folks will leave the program.”

The new approach, Crochet acknowledged, has infuriated both volunteers and paid administrators, many of whom are fleeing. When an AHCA administrator wished him “good luck’’ in a May 17 email following his appointment, he replied: “I’ll surely need it with the reception I received by the council,” a reference to the group that meets regularly to set policy and discuss issues.

Crochet’s shift in philosophy comes as ALF industry heads, several lawmakers and even AHCA leaders have mounted their own campaigns to weaken the program.

Earlier this year, state Rep. Matt Hudson, a Naples Republican, pushed legislation that would have eliminated the program’s ability to perform annual “assessments,” or inspections, of facilities — retaining authority only to evaluate complaints. Lawmakers and industry leaders had complained bitterly that ombudsmen were duplicating the role of AHCA, and AHCA inspectors had complained repeatedly of “interference” from the volunteers.

Read more Neglected to Death stories from the Miami Herald

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