BOONE COUNTY, Mo. - State Sen. Caleb Rowden visited a Boone Supported Living LLC home to see what an independent supported living center should be like.
The ISL in Columbia is the same type of facility Carl DeBrodie was living in while in Fulton before his body was found encased in concrete. The owner of BSL, Julia Walden, said what happened in Fulton is rare and there are numerous safeguards in place to prevent something like that from happening. Among the safeguards are required monthly visits from the patients support coordinator and nurses as well as random checks from Medicaid officials that require months' worth of documentation to be provided.
Rowden, R - 19th District, said visiting the home is important to be able to put names and faces together with an issue that can sometimes get wrapped up into a much larger health care idea.
"I think a lot of us in Jefferson City, we just look at issues in a broad sense but to be able to put faces and names with that helps give us some new context and variables to consider," Rowden said.
BSL invited the senator to the home in response to the death investigation involving DeBrodie and the lack of oversight that home seemed to have.
"It got a lot of bad press," Rowden said. "I think the tendency could be the general public and/or the Legislature makes really broad assertions about what’s going on in that particular industry. So I think going out of our way and making sure others houses and other folks are getting the care they need to is important and is a good way to move forward."
Rowden said he recognized the need for more funding for the Department of Mental Health that would help provide better care for adults with severe disabilities. According to other care providers, it takes hours of training a new hire and doing background checks to make sure they meet all the state requirements.
But Rowden also emphasized the state budget outlook is not good, and likely won't be in a good place for a few years.
"There’s the fiscal reality to it," Rowden said. "But even more than that, there’s the care reality. You’re talking about care for individuals with really significant disabilities and folks that can’t do much on their own. So I think we have to make sure we are spending our money wisely, we’re getting the best bang for our buck and being proactive. You’re balancing between both of those but at the end of the day, the care trumps fiscal realities all day long. You want to make sure folks get the care they deserve."
After the tour of the home, Rowden went to a monthly meeting between BSL and other similar agencies in the area.
In that meeting, the attendees told Rowden about the copious amounts of paperwork they have to provide, oftentimes having to turn in multiple sets to different departments.
"We're spending so much time doing other things, where is the time for the care?" one of the attendees said.
Everyone in the group emphasized they do not do this work for the money, and many people in the industry make between $8 and $12 an hour. They said they feel called to do it, to help someone else have a better life that they wouldn't otherwise have.
They also talked about the various regulations and standards the state has been imposing. While the intentions are good, they said they often create more paperwork and more liability on the back end for the employees.
One example an attendee gave was a patient who wanted to eat all candy bars for lunch. Under the Home and Community Based Services (HCBS) guidelines, that patient has the right to eat what he wants for lunch. But the worker said that leaves staffers liable for neglect on the back end if the patient gets sick due to his diet.
At the end of the meeting, Rowden said he didn't think the next few years would be easy for lawmakers.
"Many legislators come in knowing very little but are asked to make important and difficult decisions," Rowden said.
Rowden said each lawmaker goes into legislative session with their own priorities and needs and biases. He told the group to approach lawmakers with as clear a message as possible for care as well as long-term fiscal repercussions.