Two important bills that are meant to improve the health of senior citizens won financial backing from a legislative budget committee Wednesday, one creating a public guardian program for vulnerable people and the other allowing people without Medicaid to hire a caregiver from the state home care registry.
Sen. Michael Dembrow, D-Portland, championed offering a public guardian through the office of the Long-Term Care Ombudsman with Senate Bill 1553. A public guardian will work as an advocate of people who cannot make decisions for themselves, often because they suffer from Alzheimer’s Disease or some other disability.
“Adults who are incapable of speaking for themselves have no one to speak for them,” Dembrow said. “These vulnerable persons are falling through Oregon’s safety net. They may be inadvertently placed in institutions at great cost to the state.”
Dembrow sponsored a similar bill, House Bill 2671, in the 2013 session with Rep. Margaret Doherty, D-Tigard, and it passed the House Human Services Committee by a unanimous vote, but it died in the budget committee for lack of funding. HB 2671 was a consensus forged among the Department of Human Services, Disability Rights Oregon, the ombudsman office and the Oregon State Hospital, among others.
But in the fall special session, the Legislature made adjustments to the senior medical tax deduction that limited tax write-offs for affluent seniors and raised $26 million in revenue to support senior services like Oregon Project Independence, which helps middle-class seniors stay in their homes.
The tax change will also enable the state to spend $950,000 to set up the public guardian office, which will employ two to five people. In the next, full biennium, it will require $2.2 million, but the office will help the state save money if a public guardian can help seniors avoid the state hospital, and assist patients in the state hospital find care in their communities.
Sen. Alan Bates, D-Medford, had the bill amended in his budget subcommittee, making it clear that the public guardian will be available for everyone who cannot speak for themselves, not just indigent seniors. This will help moneyed seniors with dementia from falling prey to unscrupulous caregivers or long-lost relatives. The public guardian can also assist younger adults with disabilities.
“The most difficult cases are where there are large resources available but they are unable to speak for themselves,” Bates said. “The amount of people around them who take advantage of them is astounding.”
Home Care Commission Expansion
Senate Bill 1542, which allows the state Home Care Commission to offer services outside the Medicaid system, requires $1.3 million in start-up costs for the next 18 months, but is then expected to be self-sufficient, with its administrative fees covered by consumers.
“This bill is a very critical one as we look at the growing demographic of seniors. We have an opportunity to provide quality, affordable healthcare to more Oregonians than ever before,” said Rep. Joe Gallegos, D-Hillsboro, the chief sponsor of SB 1542. “My wife is disabled, and this would be a great help to my family.”
Seniors and their loved ones will still have the option of hiring from a private homecare agency, but those are not available in many rural Oregon counties, and advocates for expanding the Home Care Commission say that the agencies charge more than what the state can offer.
State home care workers also must pass background checks and receive training, which cannot be said for caregivers hired privately off Craig’s List. The Home Care Commission will also take care of payroll, unemployment insurance and workers’ compensation insurance for the elderly person, much as a private agency would.
“As we age, there may not be as many people behind us to care for us,” said Rick Bennett of AARP, speaking of baby boomers. “This provides them with another option.”
Meghan Moyer, a political organizer for the Service Employees International Union, Local 503, said that the state can charge up to 107 percent of the cost of the caregiver to allow for administrative expenses. Home care workers are organized through SEIU and make about $13 an hour.
SB 1542 and SB 1553 now move to the full Joint Committee on Ways & Means before proceeding to the Senate floor early next week. The money for the home care registry expansion will likely be approved Friday while the end-of-session budget bill will address the $26 million package for seniors that comes out of the tax change.
Christopher David Gray can be reached at [email protected].