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The proposed changes, which must still be approved by federal authorities, could also greatly reduce financial waste. Currently, hundreds of individual home care agencies handle their own payroll and taxes, even though many of the agencies employ just a few caregivers. In the future, people could bypass the agencies and these administrative tasks would be handled by several large state contractors. The resulting savings from consolidating overhead costs likely would free more money for patient care, some disability advocates say.
“This is about consumer empowerment,” said Steve Larson, senior policy director for Arc of Minnesota, which serves people with developmental disabilities. “We really feel that quality will improve and people’s lives will be better if they have more control over their own care.”
Still, some county officials and providers worry that the new program will end the requirement that patients receive home visits by a nurse or other qualified professional. In many cases, these visits are the only professional help that a caregiver receives — and one of the few ways for a provider to know if an elderly or disabled client is receiving adequate care, say county officials.
To Lassen, the balance already has shifted too far away from clear government oversight. During a recent trip to her father’s grave in Aberdeen, S.D., with her 4-year-old son, Joel, Lassen said she is still tortured by guilt over his death.
She regrets not asking more questions when she discovered her father alone and disheveled in the dark basement of the group home. She regrets not asking staff why no one had shaved or showered him for what seemed like days; and why he grimaced in pain as he walked to the dinner table to eat the banana cream pie she brought for him.
As family surrounded the open casket at his funeral, Lassen slipped a small, handwritten note into the breast pocket of her father’s suit. “I wanted him to know how sorry I was that he had to go through so much pain,” said Lassen, as she wiped away tears. “My fear is that, if nothing changes, it will happen again to someone else.”
Staff writer Glenn Howatt contributed to this report.
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