Washington State

Office of the Attorney General

Attorney General

Bob Ferguson

Vulnerable Adult Initiative: Final Report 2008

Long-Term Care Work Group

VA Pic 17

The Long-Term Care Work Group took on the following issues identified at the summit:

  • Vulnerable adults in long-term care facilities are exposed to risk because there are too few resources dedicated to checking the backgrounds of caregivers.
  • The patchwork of rules regarding what disqualifies a caregiver from working with certain kinds of patients creates a barrier to creating a safe environment for vulnerable adults.
  • Government bureaucracy is a barrier to checking the backgrounds of caregivers.
  • Funding for Medicaid rates and other services is too low to provide adequate care for vulnerable adults.


1) Annual background checks should be required on people who provide direct care to vulnerable adults in a long-term setting. These checks are currently only required every two years. Special concern should be paid to individuals providing in-home care and who operate adult family homes or boarding homes.

2) Disqualifying crimes should be the same across settings. There are currently different disqualifying crimes for people who provide services to children, the disabled and for vulnerable adults. Disqualifying crimes should be the same across settings.

3) Electronic portal for background checks. DSHS is working on a pilot program to permit background checks to be conducted electronically. DSHS personnel will be able to perform background checks using an internal Web site at a field office. This program should be made accessible to outside facilities through the Internet as soon as possible.

4) Ability to “flag” individuals. Automatic alerts should be sent to vulnerable adult caregiver facilities when someone working for them has a change of status, i.e. they have a new disqualifying crime or a substantiated finding of abuse, neglect or exploitation.

5) Payment rates should be analyzed. Funding is too low to provide for adequate long-term care for those suffering from mental health issues. In addition, the flat Medicaid rate for all guardians is too low for increasingly complex cases.

[Back to top]
[Back to Vulnerable Adult Initiative Work Groups]