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Personal care industry braces for cuts

DAWSON -- State budget cuts will be hitting a local industry that provides hundreds of full- and part-time jobs, and offers services that directly affect the quality of life for thousands of people, young and old.

The owners of two independent businesses that provide personal care attendant services said they are concerned about the loss of jobs their industry may see, but most of all, worry what the cuts will mean to their clients.

"As a business, we can probably roll with the punches,'' said Shelly Elkington, owner of Avenues for Care in Montevideo, of the expected state budget cuts to personal care attendant services.

The independent businesses will manage the economic hit by reducing staffing, but how their clients will fare is very much an open question at this time, said Elkington and Janell Kemen, owner of Country Care Services LLC of rural Dawson.

The potential impact on her clients led Kemen to speak out recently at a legislative town hall meeting in Appleton. She is concerned that formulas for reductions will mean many clients will no longer be eligible for any type of services.

She started her business nearly 1½ years ago, after having previously served as a licensed social worker for public agencies since 1996. Her husband, Paul, farms west of Dawson, and Kemen works from their farm home to oversee personal care attendants serving clients in an area ranging from Willmar to the South Dakota border.

She is responsible for 52 full- and part-time personal care attendants serving 62 clients.

Avenues for Care is currently serving 100 clients with 110 personal care attendants, according to Elkington.

For many seniors, the weekly to daily visits by personal care attendants makes the difference between independent living in their own homes, or a forced move to institutional care, Kemen said.

The help of personal care attendants also means that family caregivers, the adult children of senior citizens or the parents of children, can continue to keep their own outside employment and the income they need.

The services can be include help with living chores, such as assisting with personal hygiene and other needs for elderly persons with physical or mental limitations. Many clients are afflicted with progressive diseases such as diabetes, dementia or osteoporosis, and need a helping hand to remain independent, Kemen said.

Even when the underlying causes are physical diseases, the arrival of a friendly face and helping hand can benefit their mental well-being. It also benefits overall care: She and her personal care attendants are part of a team that includes the client's health care providers and often county or other social service organizations, she said.

Elkington said that personal care attendants often make it possible to provide the best possible care and environment for those with needs.

She pointed to one client who adopted six children with special needs due to abuse they had suffered as infants. Their adopted mother said that she and her husband had not been able to take so much as one day off in three years due to the around-the-clock supervision and care required for the children.

Today, a personal care attendant assists the two parents. The mother said it allows them to create a far more organized and supervised environment for the children, ages 2 through 10, while also easing the burden on them.

She has written a letter to her state representative expressing her concerns about potential cuts. The assistance from a personal care attendant means that the children are able to continue to receive the nurturing care that is only available in a family setting, she said.

Asked what would happen if the personal care attendant help would no longer be possible, she paused and replied: "I haven't even been able to allow myself to think about that.''

Another client benefiting from the in-home care is a 76-year-old woman with dementia. Her son quit his full-time job to care for her. He is able to manage due to the wages he receives as a personal care attendant for her. The man told the Tribune that the care has helped slow the progression of the disease and improve his mother's quality of life, while also keeping her from needing far more costly care in a nursing home.

Providing in-home care is usually the most cost-effective way to deliver care, according to Kemen and Elkington. It can be provided at one-fourth to one-fifth the cost of residential care, Elkington said.

She and Kemen said they understand the necessity of cuts due to the state's budget situation. Elkington also said that there have been loopholes in the system, and she supports changes aimed at curtailing abuse.

But both are hoping that providers will have a voice in how the system is changed. There could be many unintended consequences depending on how reductions are achieved.

The mother of the six adopted children said she knows it would cost the state much more to care for the children in an institutional setting, but her bigger worry is what would happen to the children if they would lose the current in-home care and family environment they now enjoy. She asked: "What will their lives be like?''