A major provider of in-home care for developmentally disabled adults in Washington has announced it will cease operations in King County in the coming weeks because of a lack of affordable housing and challenges related to recruiting and retaining staff.
Aacres Washington announced its plan to exit King County, the state's most populous and highest cost-of-living county, in a November 15 letter to clients and their guardians. The move comes after the state of Washington put the company's King County operation on 90-day provisional status in October for failing to correct serious deficiencies that "jeopardized clients' health, safety and welfare."
In a separate letter to the advocacy group Disability Rights Washington (DRW), the company's CEO, Robert Efford, said Aacres was failing to meet its own standards of care in King County primarily because of the challenge of finding decent, affordable housing for clients and an inability to recruit and retain staff, including leadership.
"While this was a very difficult decision for us, we believe it is the right thing to do," Efford wrote to DRW. He added that during the transition, Aacres would continue to work to correct deficiencies in care and housing conditions identified by state inspectors.
In a statement to the media, Aacres said it has served clients in Washington since 1974, but in recent years has faced unprecedented challenges related to the rising cost of living in King County. Besides the difficulty of hiring and retaining staff, the company said it was struggling to find "affordable housing and landlords willing to maintain homes to acceptable standards."
"Despite our extensive efforts and investments over the last year, we find ourselves in a position where we are not able to build/sustain the infrastructure (...) to successfully operate the King County Suported Living Program at the level that consistently meets our own standards as well as those of our stakeholders," the statement said.
Washington's Department of Social and Health Services (DSHS) said the decision will affect approximately 65 developmentally disabled clients in King County. The state is working with four vendors to take over their care during a 90-day transition period.
"Our primary interest is always to ensure the safety and health of our clients," said Evelyn Perez, assistant secretary for the Developmental Disabilities Administration, in a statement. "To that end we are working closely with our clients and families to minimize the impact of this change."
In April, Aacres took over care of approximately 200 developmentally disabled adult clients in King and Spokane Counties after its sister company — SL Start — was shut down by the state because of repeated, serious violations of care standards. Both companies are owned by Spokane-based Embassy Management.
About a third of Aacres' 65 or so clients in King County were previously served by SL Start, according to the company.
At the time, disability advocates and some families questioned the decision to allow Aacres to step into the void left by SL Start. But the state insisted it was the best way to avoid a disruption of services.
Within months, however, it became clear the problems were persisting. By June, the state had taken enforcement action against Aacres' King County operation five times and imposed fines totaling at least $39,700. In one case a client died of aspiration pneumonia after Aacres staff allegedly failed to ensure that person didn't aspirate food. Then, in October, the state issued its notice of provisional certification to Aacres, the last step before termination.
In his letter to DRW, Efford offered to partner with disability advocates to address what he called a "staffing crisis" in the disability services sector, as well a lack of infrastructure statewide to serve the "increasingly complex" needs of clients.
DRW attorney Susan Kas said her organization was willing to meet with Aacres, but also wanted to learn more from DSHS about how it plans to ensure "choice and safety for all Aacres clients."
Aacres will continue to serve adult clients in several other Washington counties, including Snohomish, Pierce, Thurston, Clark and Spokane.