AG 2003 05 16 - Laserfiche WebLink

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II. STATEMENT OF NEED The Cabarrus County Department of Social Services (DSS) is a public service organization dedicated to meeting the needs of its aged and disabled citizens. We also serve as the lead agency for the Community Alternatives Program for Disabled Adults (CAP/DA) in Cabarrus County. CAP/DA has been highly instrumental in helping older adults to receive the care needed to forestall entry into institutional care. While CAP/DA is beneficial in meeting the needs of the county's frail population, expansion of services is needed to alleviate caregiver stress and improve the quality of life to our residents. In the administration of CAP/DA, the agency is restricted in its options for providing care to the most fragile population. Frequently choices are limited due to the regulatory certifications mandated in the hiring of home care workers. Three specific cases come to mind. In one instance, a client is ventilator dependent and requires frequent suctioning. This client has a spouse who is very loving and supportive. However, due to current rules and regulations, the spouse cannot leave the client alone, even with a CNA I on duty, because the CNA I is prohibited from suctioning the client. The spouse has expressed increased stress to the cask., manager regarding the inability to have even a few hours of freedom. In this particular situation, the family is paying privately for a neighbor, which the spouse trained, to come in to perform the tasks needed to give the spouse a few hours of respite after the CNA I leaves for the day. The family expressed this is a financial burden, but the relief is needed. There is no home care in the area that would provide a CNA II to perform this task. In another instance, a family was paying a family friend privately to allow the husband to maintain employment until the onset of CAP/DA. With CAP/DA, the privately paid individual was allowed to work for four months, with the stipulation a CNA I certification would be obtained during this time period. This particular individual was previously certified in another state as a CNA I. Unfortunately, the paid caregiver did not obtain the required certification in the specified time frame and employment was terminated. The family at fir, st indicated that they were planning to withdraw from the program and continue to pay this individual privately. However, upon further consideration, the financial burden was found to be too great and the family decided to remain with the CAP/DA Program. A CNA I was placed in the home, with the family continuing to pay the family friend for additional hours of care. Finally, there is a young man suffering with cerebral palsy who was recently discharged from Private Duty Nursing (PDN). He is total care with frequent respiratory exacerbations, requires bolus feedings, and suctioning. While he received PDN, his mother was able to work outside the home. Now she is in the home almost 24 hours per day providing continuous care for her son. In our community, we have been unable to identify any licensed home care agency willing to accept the liability involved in staffing such a case. This family is left without any type of direct care support. With CDS, clients and their families could hire and train individuals to perform the specific tasks needed. This would lead to the almost immediate stress relief of family members doing their level best to keep their loved ones at home. Of the three cases referenced above, two of the 2