Yesterday's hearing was, I think, smaller in numbers, but more informed in general. There was the same ombudsman at the front table, Stew Grabel, as well as Karen Fields and this time Robin Gwozdz made an appearance. Only one of the Supervisors, Richard Elias, sent a representative. I understand according to legislation, the full five Supervisors cannot be in the same room at the same time outside of official meetings, but I think each of them should be sending someone in their stead. As important as this issue is to so many people, I think it's disrespectful to not bother to show up at all. Of course, I also find Chuck Hucklberry conspicuous in his absent. A sheet of proposal questions and answers was handed out the beginning of the hearing. It was noted at one point that this sheet mostly deals with issues concerning attendants as employees and how their jobs might be affected, rather than the issues of the clients. The inference made when these hearings were scheduled was they would center around the clients and their concerns about continuity of care.

It was also announced that the county has sent out questionnaires to be filled out be both attendants and clients. Once I receive mine, I shall write about it here.

Anyhow, several people stood to speak, clients, attendants, and family members alike. Now that some time has passed and people are being given the chance to truly participate in their own care planning, the concerns and questions being presented were clearer and more specific. Several statements made were in regard the county's ability to maintain quality of care when clients are moved away from the current system into 20 or more agencies. Who will monitor the care if and when interruptions of care occur? From the answer Robin G. gave, PHS plans to review all interruptions of service forms sent in once a month. I'm fairly sure I cannot and do not want to wait 30 days or more to find out if the county will act on any failures in my daily care. Several care givers, mostly those taking care of family members, told horror stories of agencies failing to provide care, clients becoming injured and ill, and ensuing nightmares of nursing home visits. But the basic comment being made was that the further from the county our care goes, the more likely there in fact will be interruptions of service with less policing of the contracts made with those agencies.

One very well spoken client pointed out something I've been discussing with several people: if this is a plan only in the discussion phase, why did the attendants receive a letter on December 1, 2007 stating the program was in fact being closed? My related concern has been the dismantling of the PCA pool, a vital part of the whole program. Yet, Robin G. stood up to say the Supervisors have the final say and that vote is planned for some time in March, after they review our input.The discrepancy was pointed a few times, yet she made no direct comment on it. I just cannot shake the feeling these hearings are a huge smoke screen to humor us, but they intend to get this over and done, no matter our concerns.

The above client also talked about the issues involved in the so called consumer directed care program, something she has dealt with here as well as in California, a program initiated by the county so that clients might hire, interview, back ground check, train and fire their own people. This program provides no backup system if schedules fail for any reason. I have in the past had to hire my own care givers. It is a long, exhausting process. She confirmed that for clients requiring several visits daily 7 days a week, such as myself, those type of programs do not work well.

She and one other speaker took on the topic of the care available from the agencies. Both have called the agencies themselves, and I know 2 others who have done so. The final count is the same; few of the agencies at this time can or will provide the services needed by many of the clients. Yet the county maintains that all 20 agencies are by contract required to offer all services currently received by all clients. And again, I am still being told by my own case manager that not one of those agencies will be a good match to me. Another reason I feel we are being lied to.

There were also several speakers, including a representative from the Tucson interfaith council, who touched on what the motives could possibly be behind dismantling the program in the first place. A program that works is being torn down and replaced by a system that hasn't been investigated nearly enough or proven to provide appropriate care to those who need dependable service. And once again, neither Robin nor Karen had good, direct answers.

In general this hearing was a good indictment of the flaws, inconsistencies, and hypocritical information we have up to this date received from the county. A great number of people are now aware of the county's plan and aren't going to just let this go by. I just hope Pima Health System is paying attention. If not, people are going to fall through the cracks.

More later.