Montgomery County’s ombudsman program seeks independent contractor

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NORRISTOWN — A proposal to outsource positions advocating for some of the area’s most vulnerable residents was met with opposition during the April 1 Montgomery County Board of Commissioners meeting.

“These ombudsmen can navigate any critical issues that we are about to witness. For years they have built good relationships with long-term care facility staff and residents living in long-term care facilities. This is not the time to disrupt this important work,” said volunteer ombudsman Lydia Krezmininski.

“I agree it’s not the time, if any time, to make a change like this,” said Montgomery Township resident Carolyn Michener. “Our group of ombudsmen are so experienced and have ties through the community and I’d hate to see that change.”

Michener added that she was speaking during the commissioners’ public comment portion on behalf of her mother, who she said has dementia, and resides in a skilled nursing facility in Lansdale.

Both voiced their concerns during the meeting’s public comment portion to an upcoming agenda item concerning subcontracting positions to an independent agency.

According to Barbara O’Malley, Montgomery County’s deputy chief operating officer, officials were looking for a state certified company to conduct training, advocacy and “give voice to consumers of long-term care services.”

Ombudsmen serve as advocates for patients and residents staying in facilities, according to the Pennsylvania Department of Aging.

Volunteers are charged with helping to “improve the quality of life for residents,” according to the county’s “Volunteer to be an Ombudsman” webpage. They’re tasked with the following duties:

  • educating residents about their rights,
  • encouraging and assisting residents to ask questions and express concerns, and 
  • helping them reach solutions in collaboration with facility staff and family.

Gov. Tom Wolf imposed visitation restrictions to many long-term care facilities across Pennsylvania due to health and safety restrictions associated with the ongoing COVID-19 pandemic. 

“Ombudsmen are now allowed reentry into long-term care facilities, and I imagine what we are going to see will be extremely emotional after being blocked out for over a year from visiting and advocating for residents,” Krezmininski said.

Following Krezmininski’s comments, Montgomery County Commissioners’ Chairwoman Valerie Arkoosh thanked Krezmininski for her words and “work as an ombudsman.”

According to Doreen Hespell, administrator of the Montgomery County Office of Senior Services, there are currently five employees working as certified ombudsmen and up to seven volunteers supporting people in a number of local nursing, assisted living or other facilities.

With the independent contractor, Hespell said she’d like to secure six full-time people working in the county’s ombudsman program, and continue to work with volunteers.

Hespell added that a “capable,” cognitive patient or family member must contact an ombudsman in order to begin the advocacy process. Issues related to “residential rights advocacy,” such as food or a “discrepancy between resident and facility” are worked out.

“Everybody wants the same end result that the residents are satisfied,” she told MediaNews Group.

Still, O’Malley identified a “conflict of interest” surrounding the program as it exists today.

“The state has identified an inherent conflict of interest with counties operating the ombudsman program in relationship to the other services the county provides and in recent years they do not allow full supervision of ombudsman staff by county management,” she said during the April 1 meeting. “In fact, for example, county management does not have access to the database, and data system the ombudsman uses to manage their program.”

Hespell also said the conflict of interest with the ombudsman program has been an issue on previous occasions for departments related to assessments and protective services.

“So it comes down to difficulty managing a program that we can’t really truly own because of this conflict of interest,” Hespell said.

Hespell and O’Malley noted other counties across the commonwealth have transitioned to more independent avenues when it comes to hiring for respective programs, and representatives from Pennsylvania’s Long-Term Care Ombudsman Program have endorsed the revised action.

While Hespell said she didn’t directly hear the public comments during Thursday’s meeting, she suspected their concerns had to do with the “transition,” which she stressed has “nothing to do with our personnel and our ombudsmen; they’re very good, strong ombudsmen.”

“It’s just to resolve this conflict of interest, and make it a little easier to manage, and I think the program will grow and flourish with an entity that actually promotes and knows how to build a strong advocacy program,” she said.

O’Malley agreed.

“I will say it was a very difficult decision,” O’Malley said. “We have wonderful staff and wonderful volunteers. The RFP does require that all our staff are interviewed, and that also the volunteer program will be maintained.”

Arkoosh moved to approve several requests for proposals, including the ombudsman program item, which was seconded by Montgomery County Commissioners’ Vice Chairman Ken Lawrence Jr. The action was passed unanimously.

Hespell said the request for proposal will remain active until roughly the end of April. Following the bid closure, she said department heads would review and select prospective subcontractors with a program relauch expected later this summer.

“We are determined to make sure it runs smoothly, and it will happen, and we won’t choose an entity that we don’t feel confident can do so,” Hespell said.