HCS Highlights - Winter 2021

HCS Highlights WINTER 2021

PLANNING FOR AFTER THE PANDEMIC HCS CLIENT SURVEYS

BEA’S MESSAGE February was National Heart Month. Every year, February serves as a reminder not only to protect and care for our clients, the majority of whom have cardiovascular disease, but also to check in on our own heart health. This year, when many other priorities have shifted our focus from our own health, it serves as a good reminder to check in on our healthy heart habits.

Bea Rector Director, Home and Community Services

Our clients are disproportionately affected by heart conditions. Over 70 percent of them have cardiovascular disease, including 63 percent who have hypertension, 15 percent who have congestive heart failure and 3 percent who have had heart transplants. The implications of these diseases are widespread, requiring everything from medication to special diets to regular inpatient medical treatments.

We as ALTSA employees are not immune to heart disease. Heart disease is the second leading cause of death in Washington state. One in five women and one in four men will die of the disease. One in four Washingtonians have high blood pressure.

Some of your risk factors for cardiovascular disease – things like older age, race/ ethnicity and family and medical history – are things you can’t change. Other risk factors, however, you can reduce or eliminate by making healthier lifestyle choices.

Here are some ways you can improve your cardiovascular health: Regularly monitor your blood pressure and cholesterol levels. If they are high, talk to you doctor about strategies to reduce them.

If you or someone in your household uses tobacco, take steps to quit or reduce your exposure to second-hand smoke.

Eat a healthy diet that includes lots of fruits, vegetables and whole grains and try to limit your sodium intake.

Get regular physical exercise. The Department of Health recommends 30 minutes of exercise at least 5 times a week. This can be broken down into short bouts of activity throughout the day.

This reminder is an opportunity not only to reflect on our own heart health and our clients’, but also on the compassion and dedication we all bring to this work every day.

Over the last year, we all have struggled to balance our home and work lives, to see to our own health and safety while also considering our clients and loved ones. So this month, I also want to thank you for the heart you bring to your work each and every day.

CONTENTS 4

REGIONAL UPDATES

7

BRIEF UPDATES

8

WELLNESS: THE IMPORTANCE OF WELLBEING

9

EQUITY, DIVERSITY AND INCLUSION

10 ACUTE CARE HOSPITAL SURGE 11 POST-PANDEMIC TRAINING 12 HCS CLIENT SURVEY 13 A CLIENT’S STORY 14 POST-COVID POLICY CHANGES 16 PARTNERSHIPS: ENHANCED SERVICES FACILITIES

REGION 1 UPDATES In early summer 2020, myself and Teri Bichler, Deputy Regional Administrator, began to plan Regional Listening Sessions. We scheduled 10 Listening Sessions, each 1.5 hours in duration, that included HCS staff from all 16 offices. Although we had hoped to meet these amazing team members in person, for our Listening Sessions, like everything else in 2020, we had to adapt. Zoom invites were sent to staff in specific HCS offices for the Listening Sessions. We encouraged folks to participate by video to enhance our connection with one another.

Tami Rucker Region 1 Administrator

There was no agenda going into the Listening Sessions. The intent of these Listening Sessions was to establish a safe place for staff to bring anything they wanted to share or discuss with Teri and me. We looked forward to receiving feedback on what is going well and what are the areas of needed improvement. It gave us an opportunity to meet staff we had not met in person and for them to see and meet us. These Listening Sessions were also an opportunity for Teri and me to enhance our relationships and trust with those staff in outlying offices that we don’t see much, if ever.

These Listening Sessions were better than we had hoped for! We completed all 10 Listening Sessions by mid-November 2020. We had great participation! Staff were engaged, open and honest with their feedback.

You might be thinking, now what?

Teri and I have combined the feedback from all 10 Listening Sessions and shared the feedback with our Executive Team Members. In February 2021, we will share the feedback with all managers and supervisors. One commitment that Teri and I made to staff involved in these Listening Sessions was that their thoughts, ideas and feedback would be heard, respected and considered. We plan to analyze the feedback with our Executive Team, managers and supervisors and develop strategies and a plan for improvement in the identified areas. A few themes related to areas of improvement included: additional monitors needed to enhance teleworking, improve technology to prevent connectivity issues on the virtual platforms (Skype/Zoom), frustration with DME process, better communication needed around the “why” in policy/procedure updates and changes. Things shared that are going well; staff LOVE teleworking and the flexible work schedule which supports a better work/life balance, staff appreciate the bi-monthly HCS statewide webinars, which have improved communication between HQ and the Regions, and staff working together efficiently and helping out where needed has built comradery.

In nearly every Listening Session the overall theme was “open

REGION 2 UPDATES communication,” which is one of our ALTSA values that is critical in the work we do here at Home and Community Services. THANK YOU to those staff that participated in these Regional Listening Sessions! Based on the feedback received, we look forward to this being an Annual Activity. We are hopeful that in the Fall of 2021 we can meet with these amazing team members in person!

A year in review from Region 2

Sonya Sanders Region 2 Administrator

On January 19, Region 2 had their first regional all staff of the year. Close to 280 staff attended. Program managers and supervisors did a “year in review.” They discussed the hard work of their employees and gave kudos and appreciation for the difficult work staff accomplished during 2020. For example, Wendy Wendell, PBS program manager, wrote a nice thank you to her PBS staff. In part, she stated, “I want to acknowledge some of the work we have completed in 2020. Throughout all of the chaos you’ve maintained excellent work habits, survived AVS and you did outstanding on your annual audits.”

SHDD received roughly 10 referrals a month and discharged an average of 6.6 clients per month. In 2020, that team discharged 79 clients from Western State Hospital. We participated in the acute care hospital surge twice with new hospital managers and new staff. This was not an easy feat. Nevertheless, we were able to make some headway with difficult discharges. According to Cindy Nomura, program manager, “our region discharged approximately 2,000 clients from acute hospitals.”

RCCM continue to case manage higher caseloads, dealing with COVID in facilities and the death of their clients because of it. In-home continues to be the front door for HCS and had higher than normal referrals.

Our nursing facility teams had an extraordinary year with several big nursing facility closures. In some instances, it was all hands on deck and assistance from other units made the discharges possible. This allowed us to be successful in all closures deadlines and allowed staff to transition some clients to adult family homes rather than other nursing facilities. I want to thank those employees who worked behind the scenes, such as customer services, clerical and office managers. They continued to keep the office functioning by ordering office supplies, PPE and equipment so staff can continue to telework or have the cleaning supplies necessary to be in the office.

2020 was a year of firsts and a year like we never seen before. I am proud of R2 staff who carried on in spite of the challenges, rules changes and uncertainties.

REGION 3 UPDATES We Are on The Home Stretch – But it is Still Hard While there is hope on the horizon as the vaccine rolls out, so many of us are feeling the cumulative effect of the past year and it is taking its toll. I hear about more and more people feeling burned out, as if they have hit the proverbially “brick wall.”

Debbie Willis Region 3 Administrator

Region 3 recently had a presentation by the Department of Health on the impacts of COVID and workplace resiliency. The speaker described what we are going through as something akin to what people go through in large natural disasters. Our lives have been turned upside down and everyone is impacted. In a disaster like an earthquake we can look around and see the devastation, it is very apparent. But in a pandemic, unless we are on the front lines at a hospital, it may feel somewhat invisible. We look around us and no buildings have fallen down, the world looks relatively the same but we are stressed, fearful, burned out, depressed, anxious, etc. Things look fine, so we think we should be fine.

Because of the invisibility we may be less forgiving of ourselves (and others) especially when this cumulative toll shows up as impatience, anger, anxiety, lethargy, lack of motivation, depression and so on.

Now is the time to be kind to yourself. Give yourself breaks and look for moments of happiness and gratitude and share those with others.

Don’t expect that you will have the same stamina as you did pre-COVID. Most of us don’t, whether we admit it or not. Be gentle, be kind and be understanding with yourself. You are not alone. Reach out to others, get support for yourself and set boundaries to keep things manageable.

Develop a self-care plan.

We can do hard things. We will get through this. We are on the home stretch.

BRIEF UPDATES KOMO News honors state’s unpaid caregivers A KOMO News story in December highlighted the work of Washington’s more than 350,000 unpaid family caregivers who are providing support to a loved one with dementia. Read the story on KOMO News.

ALTSA sends shipments of PPE to 46,000 IPs The ALTSA Incident Management Team completed another enormous shipment of PPE to our state’s more than 46,000 individual providers.

The shipment included surgical masks, face shields and a threemonth supply of cloth face coverings for both IPs and the clients they serve. Read the full story on Inside DSHS.

WELLNESS

The Importance of Wellbeing Amy Besel, ALTSA Org Development Administrator The concept of well-being is foreign to many, though as we evolve in our understanding of the connections between mind, body, and spirit, so too our knowledge continues to grow around our responsibility to understand and take an active role in our own wellbeing.

Your wellbeing is important. It makes a difference in the quality of your life and those around you. It affects your ability to do the hard work you do and, in turn, has an impact on each other and the people we serve. While your wellbeing starts with you, our Secretary, Assistant Secretary, your Director and leadership teams, support it. Within the framework

of DSHS Safe Start, there is even an Employee Wellbeing Subcommittee, which most recently shared this resource for supervisors addressing the importance of personal connection to employee wellbeing.

You are encouraged to watch for and participate in trainings and workshops related to your wellbeing coming in the months ahead. These are allowed on state time. In the meantime, here are some additional resources for you: • Links within January’s Wellness Note • Medical News Today Wellbeing Tool Kit

EQUITY, DIVERSITY & INCLUSION

NEW OPPORTUNITIES FOR STAFF

Over the next year, the Equity, Diversity and Inclusion (EDI) team will be offering two different opportunities for staff to engage in important discussions.

Listening Sessions are an opportunity for staff to talk, connect, check in and keep important conversations going. These sessions will be held every month.

EDI Round Table Sessions aim to provide an opportunity to take a deeper dive into EDI subjects with EDI team members and special guest speakers.

Staff will learn about a variety of EDI subjects and have the opportunity to ask questions to learn and engage with a panel of participants. These sessions will be held every other month.

Both the Round Table and Listening Sessions will be held via Zoom. See the charts below for meeting dates, times and information.

The popular ALTSA Listening Sessions, which last year provided many staff members with a muchneeded space to discuss issues that concern them, will also be returning in 2021. These

ALTSA LISTENING SESSIONS

https://dshs-telehealth.zoom.us/j/89790676040 ?pwd=dlU4ckdvSTFWZWJkOG41YTVDQnlVdz09 • Meeting ID: 897 9067 6040 • Passcode: 083398 April 6, 2021 May 4, 2021 June 1, 2021 July 6, 2021 August 3, 2021

September 7, 2021 October 5, 2021 November 2, 2021 December 7, 2021

All sessions take place from 2-4 p.m.

The HCS/APS EDI Specialists, Pakou Lee (Region 1), Michelle Joseph (Region 2), and Derrick Ross (Region 3) have been instrumental in our EDI work within HCS/APS regionally offices and in facilitating and supporting ALTSA Listening Sessions and Round Tables. We are fortunate to have these leaders working on behalf of our division to support staff and managers.

ALTSA EDI ROUND TABLE https://dshs-telehealth.zoom.us/j/8915712810 3?pwd=MlVEK3IvZ04rOHErY3F6bkMrQTZtQT09 • Meeting ID: 891 5712 8103 • Passcode: 380740 March 25, 2021 May 27, 2021 July 29, 2021 September 30, 2021

November 18, 2021 January 27, 2022 March 31, 2021

All sessions take place from 2-4 p.m.

ACUTE CARE HOSPITAL SURGE:

HOW HCS STAFF RESPONDED TO THE WINTER SURGE Home and Community Services staff collaboratively coordinate transitions of individuals from acute care hospitals as part of the Administration’s core business. The statewide caseload on individuals who remain hospitalized on any given day has averaged approximately 600. During the COVID-19 pandemic this team has responded to an anticipated hospital surge in COVID-19 cases needing to quickly transition individuals out of acute care hospitals. In doing so, they help free up space that may be needed for patients with COVID-19 while connecting transitioning individuals with long-term care options.

A second hospital surge began November 13 and ended on December 31 and was funded using money from the federal CARES Act. During that time, HCS helped facilitate a total of 1,019 transitions. Although the CARES Act expired at the end of the year, HCS has continued surge work into the new year, as the need for the work continued.

The goals of the surge are: To continue transitioning at least 75% of HCS-eligible clients out of acute care hospitals into appropriate community settings within less than 30 days of the hospital referral.

To reduce the time for creating assessments from 7 days to 4 days, and to reduce the average length of stay for individuals who remain in the hospital. So far, the surge effort has led to a reduction in length of stay from 47 days in mid-October to 39 days now.

To reduce the number of individuals who remain hospitalized for more than 100 days, and who tend to have complex medical and behavioral health needs. The number of individuals has gradually reduced to 54 currently, from 76 at the start of the surge.

More than 90 hospital assessors, in addition to supervisors, have been hard at work on this effort. By the end of December, these employees had claimed approximately 1,850 hours of overtime for their assistance with acute care hospital transitions.

No firm end date has been established. For now surge efforts continue based high levels of hospital admissions with COVID-19 patients as well as available resources.

PREPARING FOR POST-PANDEMIC TRAINING The TCDQ team is taking on the task of ensuring our long-term care providers become and remain fully trained One of the ways we supported our caregiving workforce during the pandemic was by suspending certain training requirements because in-person trainings were not available during parts of the pandemic. However as it has become safe to provide some in-person socially distanced training opportunities, the Training, Communication, Development and Quality Assurance (TCDQ) team has taken on the monumental task of ensuring that our providers can be safely trained and can complete training requirements.

Already, the team is hard at work preparing strategies to fully train our providers. Many trainers have or will resume providing in-person, classroom-based training. Before returning to in-person training, though, community instructors must submit their policies, procedures and methods for ensuring a safe and healthy classroom environment.

The TCDQ team is also working to expand virtual learning, which in some cases requires changes to WAC or policy. Core caregiver training is now fully available online, both synchronously and asynchronously.

Additionally, currently approved community instructors will be able to apply for delivering long-term care worker training using online webinar platforms. Colleges can now also offer virtual training for the Adult Family Administrator course, which is required to own and operate an adult family home.

The team has also created a new, standardized process for adult family homes and assisted living facilities to implement on-the-job training. DSHS collaborated with the Washington Healthcare Association, Adult Family Home Council and Leading Age to create the process,

which allows facilities to count on-the-job training toward the required caregiver training.

A virtual classroom training pilot has also been developed.

Like in-person classrooms, the virtual classroom training is instructor-led and taught in real time. Virtual training allows learners from across Washington State to access the curriculum and interact with each other and the instructor.

In addition to making training more accessible to providers, the TCDQ team has also been working with stakeholders and partners to develop emergency rules and legislative rule changes to provide more time to complete training, testing and background and fingerprinting requirements in order to address the training backlog.

The team has also recently completed two website projects, both of which began before the pandemic, but which will help us recruit and train our workforce going forward. The first, CareLearn Washington, is a learning management system connecting caregivers with learning opportunities that award continuing education credit.

Right now, the platform is limited to caregivers serving in residential facilities such as nursing homes and adult family homes, although it will expand to agency providers that are not trained through the Training Partnership in the future.

The second project is WA Care Careers, developed in partnership with the ALTSA communications team, which is aimed at people interested in becoming long-term care professionals. The site is an information hub with content focused on long-term care jobs, training and other support. Eventually, this website will be available in multiple languages.

HOME & COMMUNITY SERVICES

CLIENT SURVEYS Work began over the summer to conduct a client survey in early November. Launching of this survey involved coordinating with DSHS Research and Data Analysis, data pulls from CARE, creation of call sheets, scripts, and decision trees followed by a call for staff volunteers who were then trained and provided 1:1 support as needed. HCS Outcome Improvement Specialist Montana Salvoni played a key role in managing this with support from ALTSA Organizational Development Administrator Amy Besel.

“Thank you to everyone who volunteered,” Montana said. “We got really positive feedback from our clients, and I heard so many stories about how happy folks were to know that HCS cares this much. We collected really valuable information, and made people feel cared for at the same time – what an awesome accomplishment.”

Given the time commitment needed to get a statistically significant sample, which would have involved over a dozen staff working full time over the course of two weeks to complete the survey, HCS leadership decided to pursue a smaller sample through piloting the survey with a goal of completing 100 surveys. While this is not a statistically significant sample size, it was otherwise valid and random across all settings. Moving forward with the full survey would have been cost prohibitive and likely yielded similar responses. Therefore, HCS leadership decided not to proceed with the larger survey, but to share what we learned from the smaller sample and use it to inform future decision-making around what services we may offer remotely after the pandemic, while balancing the best practice, risk-reducing, value of in-person services.

Here is what we learned: 86.13% of respondents are happy with the services they have received remotely, 10.89% were neutral and only 2.97% were dissatisfied.

75% report ease in getting ahold of their DSHS/AAA case manager when needed, with 16% neutral and only 9% experiencing challenges.

63% want the option to receive some of their services remotely after the pandemic, 16.83% were neutral, and 19.8% do not want remote services.

We also gathered a handful of new clients to join the HCS Service Experience Team, a client advisory group that meets regularly to assist us in improving policy, services and information to those we serve.

Overall, this pilot survey was highly successful, reflecting our staff are doing great work meeting client needs through these unprecedented times.

A CLIENT’S STORY

FINDING HOME AFTER COVID-19 Helena is a client in Region 2 who was admitted to a nursing facility in November 2019 for rehabilitation following a knee replacement. In early 2020, just before she was set to be discharged, Helena fell and fractured her ankle. She had to get surgery and stay at the nursing facility for another few months.

Shortly after COVID-19 struck Washington at the end of February, Helena contracted the virus. Although her case was not severe enough to require hospitalization, she had to watch as friends at the nursing facility died or were hospitalized. Staff turnover was very high and visitation was restricted. Although her two daughters made a point of stopping by her window at least twice every day, Helena had a very difficult time not being able to see her family, friends and familiar staff like she was used to.

After a few months, Helena recovered from COVID-19 and was able to bear weight on her ankle again. She resumed physical therapy to continue improving, with a goal of returning home with one of her daughters.

Unfortunately, shortly before Helena, her case manager and her family set up a new discharge date, Helena suffered another fall. In the weeks that followed, she began to decline. Her cognition changed and she was increasingly confused and started to hallucinate. She lost the ability to safely walk up and down stairs, making a return to her daughter’s two-story home difficult.

After meeting with Helena’s case manager, her daughters reluctantly agreed it was not safe for their mom to go home. Instead, they began looking for a local adult family home, where Helena could be near family while receiving the support she needed.

She moved into her new adult family home in August. In the months since, Helena has thrived. She enjoys being outside and especially loves reading books on the deck.

“She loves the adult family home,” one of her daughters said. “The people, she said, treat her like a queen and every time I’m there, it shows.”

Because she is close by, her daughters can visit her often, wearing masks and social distancing on the deck outside the adult family home.

Helena’s daughter also thanked her mom’s case manager, who she called a godsend for the family.

“We were at our wits’ end and she really went out of her way to help not just mom, but to reassure my sister and I and truly, she changed all of our lives for the better.”

HCS EXPLORES MAKING SOME

COVID POLICY CHANGES PERMANENT AFTER PANDEMIC

The COVID-19 pandemic has forced ALTSA, and Home and Community Services in particular, to find new ways to serve our clients. In the early months of the public health crisis, HCS staff worked furiously with the federal government to determine which flexibilities we could implement in federal requirements so that we could continue serving our clients fully and safely.

These flexibilities range from performing some services, like assessments, remotely to pausing certain training requirements for our providers. All these flexibilities were necessary to avoid interruptions to services and reduce the risk that our providers and clients would get sick.

“It wasn’t easy to change the ways we do so much of our work,” said HCS Director Bea Rector. “At the beginning of this pandemic, HCS staff and AAA Directors came together and quickly identified how we could continue providing necessary services while keeping clients, providers and staff as safe as possible.”

Although these flexibilities have helped us continue providing safer services during the pandemic, we’ve also learned a lot about how we can better serve our clients. Many of these changes are working remarkably well, for both clients and providers. A lot of HCS staff began wondering whether some of these changes could be made permanent, even once the pandemic subsides.

This was feedback many HCS staff shared during the 2020 Roadshow events held by HCS Director Bea Rector and Deputy Director Kristin Byrne. Many field staff reported feeling successful in serving clients remotely. At the same time, they are anxious to get back to in-person client connection. They recommended a “hybrid” approach that streamlines the eligibility process for clients, ensures client safety, maximizes technology and continues to offer workplace flexibility.

“I think focusing on client safety and the safety of our providers has been really key,” said Cathy Kinnaman, deputy director of headquarters operations. “It’s given us a great opportunity to show that we can do these things effectively without impacting the work we do.”

ALTSA and HCS pride themselves in providing choice to our clients, and extending some of these flexibilities – if they can be done safely – would help expand client choice even further. That is why HCS enlisted the help of Montana Salvoni, ALTSA outcome improvement specialist, to help the division really examine all these flexibilities and determine which might be feasible for HCS to keep or adjust from the way things were done prior to the pandemic.

Montana pulled together about 15 workgroups made up of staff from HCS, Health Care Authority, the Developmental Disabilities Administration, the Area Agencies on Aging and the DSHS Community Services Division to examine specific flexibilities and determine whether they might serve clients and staff to make them permanent.

“I’m relying on the workgroup leads and the subject matter experts to tell me what questions we should be asking. I know that client impact is always first and foremost,” Montana said. “We always want to keep our values of choice and safety really well balanced. We want to make sure we’re balancing those two things in a way that’s really a win-win for everyone.”

The flexibilities being considered include everything from presumptive financial eligibility for Medicaid services and conducting parts of assessments telephonically, to allowing some Adult Day and home care services to be provided remotely. In a survey conducted last year, many clients indicated that they appreciated some of these changes and hoped HCS would continue offering them in the future.

To make these flexibilities permanent, HCS would in some cases need permission from the federal government. In other cases, the division has the authority to make changes permanent. In either case, HCS leadership is trying to get an early start to ensure a smooth transition and to take a lead nationally on changing the post-COVID long-term care landscape for the better.

“We’d like to be among the first states that say, ‘we’ve analyzed the impacts of these flexibilities and here are some we’d like to make permanent moving forward,’” Montana said. “It’s really important to Bea that Washington continue to lead, continue to be proactive and continue to prioritize vision around what’s possible in the future, not necessarily what’s been done in the past.”

I think focusing on client safety and the safety of our providers has been really key. It’s given us a great opportunity to show that we can do these things effectively without impacting the work we do.

– Cathy Kinnaman, deputy director of headquarters operations The workgroups will complete their analysis and HCS leadership and staff will have an opportunity to weigh in as appropriate. For those changes that require federal approval, amendments will need to be requested under the Medicaid State Plan and waiver authorities. Any changes to policy will be communicated through normal channels, including Management Bulletins and through supervisors. The federal government has committed to providing at least 60 days notice of the end of the Public Health Emergency and we will keep staff informed as we move forward.

“Everyone has been really open and eager to help and support this work,” Montana said. “That’s really rare in many work environments and I think that’s symbolic of the spirit of this place and the collaboration of the staff.”

PARTNERSHIPS: ESFs How ALTSA’s Enhanced Services Facility team is working with local communities

Washington’s Enhanced Service Facilities, or ESFs, are the newest long-term care residential setting.

ESFs benefit from strong partnerships between ALTSA (both RCS and HCS), developers and local jurisdictions, who work in conjunction to site, develop and monitor new facilities. These strong partnerships ultimately benefit the residents of these ESFs, who, due to their individual needs, may find more success in these facilities than in other types of residential settings.

“When ESFs were established, they really filled a gap in the continuum of care and the array of facilities we have,” said Sandy Spiegelberg, HCS residential support program manager, who oversees the statewide operations and programmatic work of ESFs. “We don’t have as many people going into nursing homes or bouncing back to a hospital setting because they can get their needs met and be part of the community. I think that’s a really necessary service option available for our residents.”

ESFs are community-based residential settings that

primarily serve clients with behavioral support needs and the need for long term services and supports.

The facilities can serve up to 16 residents in singleoccupancy rooms and have a staff-to-resident ratio of 1 to 4. They are not behavioral health facilities and do not provide behavioral health services. Residents are free to come and go, and many have jobs or volunteer in their communities.

“When you walk into an ESF, these clients aren’t sitting watching TV,” Sandy said. “They’re up, they’re out in the community, they’re taking a walk, they’re doing a craft.”

The first ESF opened in June of 2016. Currently, there are six in Washington: three in the Spokane area, one in Everett, one in Vancouver and one in Olympia. One more is scheduled to open soon in Vancouver. About eight others are in the process of being established around the state.

The developer of an ESF chooses the site for their new facility and works with the local planning office

to amend or write new zoning ordinances, if necessary.

Sometimes this requires outreach to the community, particularly if the matter goes before a planning commission or city council.

“We make ourselves available to answer any questions that might be on the table and participate in the conversation,” said Sondra Silverman, long-term care ESF policy program manager in Residential Care Services. “It’s a lot of educating. Often people don’t understand what an ESF is and there can be misconceptions.”

Once an ESF developer gets the go-ahead from the local jurisdiction to begin work, ALTSA works closely with the developer on the next steps.

“That relationship is huge for the actual development of the facility,” said Justin DeFour, HCS resource development program director. “It takes a long time and even longer now because of COVID, to get these up and running. There’s construction, there’s RCS licensing, there’s contracting. Having these partnerships with administrators makes that go a lot smoother and easier.”

These strong relationships ALTSA has with developers and local jurisdictions are crucial to providing a welcoming, supportive home to ESF residents.

We don’t have as many people going into nursing homes because they can get their needs met and be part of the community. I think that’s a really necessary service option available for our residents.

– Sandy Spiegelberg, HCS residential support program manager “It’s kind of like providing a team approach,” Sandy said.

“Our clients for the most part are coming from state hospitals, so if you think about our clients coming back into the community, we want to have strong services and supports for them at the ESFs. I think partnering closely with the ESF provider is so important because for the most part it’s new for them too. Helping them understand the importance of the transition really helps the clients.”

Snoqualmie Falls

Do you have a story tip? Want to submit a photo of Washington’s scenery?

SEND THEM TO MEGHAN.ERKKINEN@DSHS.WA.GOV!