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Originally published Sunday, October 16, 2011 at 8:47 PM

Caregiver initiative's hurdle: state's budget hole

An initiative on the November ballot would require the state to increase spending by millions of dollars to boost training for long-term-care workers, at a time when the Legislature must slash nearly $2 billion from the state budget.

Seattle Times Olympia bureau

Initiative 1163

• Increases basic-training hours from 34 to 75 for most new long-term-care workers.

• Increases required annual continuing-education hours from 10 to 12 for most long-term-care workers. Requires caregivers to pass a test.

• Requires new caregivers to undergo FBI criminal-background checks. Current law requires federal background checks for workers new to Washington; the rest undergo state background checks.

• Creates a certification system, so that caregivers could be investigated and disciplined by the Department of Health.

• Covers those who work in private homes, boarding homes, adult family homes and assisted-living facilities.

Yes campaign: www.yes1163.com

No campaign: www.no1163.com

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An initiative on the November ballot would require the state to increase spending by millions of dollars to boost training for long-term-care workers, at a time when the Legislature must slash nearly $2 billion from the state budget.

Initiative 1163 supporters say the spending is appropriate, given the need for additional training. "What this initiative says is this is a top-tier priority," said Sandeep Kaushik, a spokesman for the campaign, financed almost entirely by the Service Employees International Union (SEIU), which represents long-term-care employees.

House Ways and Means Chairman Ross Hunter, D-Medina, said he will probably vote no on the measure because of the gaping budget hole. State agencies have prepared a long list of potential cuts, such as eliminating supervision of parolees convicted of violent crimes and ending state-subsidized health care for the working poor.

When voters look at I-1163, Hunter said, they should ask themselves, "Would I rather have this than anything on that list?"

Senate Ways and Means Chairman Ed Murray, D-Seattle, said he'll likely vote for the measure but noted the initiative doesn't provide a way to pay for the increased cost. "Initiatives without revenue sources are challenges," he said.

Ballots will be mailed out next week and must be returned with a postmark no later than Nov. 8.

The state already requires criminal-background checks, as well as 34 hours of training for most new long-term-care workers. I-1163 would boost the requirement to 75 hours and include more rigorous background checks. Training would include safety and the fundamentals of care.

It covers anyone paid to provide long-term care, with the exception of certain medical professionals such as registered nurses. Also, caregivers tending to the needs of a family member are subject to less stringent training requirements.

Long-term-care providers work in adult family and boarding homes, nursing homes, assisted-living facilities and patients' homes.

If I-1163 were fully implemented today, the state estimates there'd be roughly 50,000 long-term caregivers in the category required to have 75 hours of training.

However, only new workers would have to get the additional training. Existing workers would be grandfathered in.

In the 2011 fiscal year, Washington spent around $9.3 million in state dollars for the training of newly hired long-term-care workers who provide in-home assistance with personal daily activities such as eating, personal hygiene, dressing, bathing and mobility.

In-home providers represent about two-thirds of the overall long-term-care workforce. State officials said they could not break out costs for the remaining workers who provide care in out-of-home settings.

The Governor's Office projects that, if I-1163 is approved, state costs will increase an additional $32 million over the next two years for background checks, training and certification. That's expected to be partially offset by roughly $14 million in federal matching dollars and new state fees.

If all this sounds familiar, there's good reason. In 2008, voters overwhelmingly approved an almost identical initiative, also backed by the SEIU. However, the Legislature delayed implementing the initiative twice because of deep budget cuts.

If I-1163 passes next month, lawmakers could postpone it only with a two-thirds vote in both the House and Senate, a difficult task.

The SEIU disagreed with the latest delay earlier this year and decided to go back to voters. So far the campaign has raised nearly $1.4 million with almost all of that money coming from the union.

An Elway Research poll released in August found 77 percent of the voters surveyed supported I-1163, while 9 percent opposed it and 14 percent were undecided.

I-1163, except for a few tweaks, essentially reinstates the earlier initiative but requires the changes to begin kicking in next year, instead of 2014 under current law.

The state budget, however, is in worse shape now than it was when the first measure passed in 2008, during the recession.

The No 1163 campaign contends the initiative's costs could be even higher than projected by the Governor's Office, but in any case says the state can't afford it.

"Our state is in a deep enough hole. The voters need to take the shovel out of SEIU's hands," Cindi Laws, a spokeswoman for the no campaign, said in a statement. The no campaign is backed by a coalition of groups including the Washington State Residential Care Council and the Home Care Association of Washington.

Gov. Chris Gregoire says she'd like to see the training go forward but that now's not the time. "Candidly, that's why the Legislature and I have delayed it, not because we don't support the policy, we just don't have the financial wherewithal to pay for it right now. We've had to prioritize," she said.

Kaushik argues there's a proven need for the additional training, pointing to a 2010 investigative series by The Seattle Times, "Seniors for Sale," which detailed systemic problems in the adult-family-home industry, including harm to the elderly by untrained caregivers.

"It's clear there are some significant problems with the system that are in need of reform," he said. "The voters have already made it clear that they think fixing those problems is a priority."

As for I-1163 resulting in the state spending more when it needs to cut spending, Kaushik said, "Will DSHS (the Department of Social and Health Services) have to make some adjustments in their budget to fund this? I think that is likely. But we think this is an important enough priority that should happen."

Kaushik also argued that the state needs to look at increasing taxes to avoid making some of the cuts being discussed.

Some Democratic lawmakers are talking about putting a tax package on the ballot early next year. However, even if they decided to do so, the Legislature could not count on voter approval and would still have to craft a budget with steep cuts in spending.

Increasing taxes on their own would require a two-thirds vote in the Democrat-controlled House and Senate, considered a near impossibility.

Andrew Garber: 360-236-8266 or agarber@seattletimes.com

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