Tamela Carlson spends an average of 20 hours a week at a Avalon Care Center at Northpointe, talking to residents, staff, and administrators.

While she is present at the facility as much as a part-time employee would be, Carlson isn't there to draw a check. Rather, her aim is to check the facility regularly to ensure residents are being treated fairly and cared for properly.

Carlson is one of about 40 volunteers currently involved in the Eastern Washington Long-Term Care Ombudsman Program, which Spokane Neighborhood Action Programs (SNAP) has administered in Eastern Washington since 1990.

Linda Petrie, the program's director since its inception, says, "The very presence of an ombudsman makes a difference. They know we're the eyes and the ears of the community."

Most volunteers don't spent the amount of time that Carlson spends in the facilities they monitor, but last year, the program's volunteers made more than 2,700 facility visits and spent more than 5,600 hours in those facilities, which include assisted-living complexes, boarding homes, nursing homes, and adult-family homes.

Petrie says the program is working to maintain last year's volume and could see an uptick late this year. About 10 new volunteers currently are being trained and are expected to be in the field in coming weeks.

All volunteers go through a background check and a four-day certification training. They also attend ongoing monthly meetings and can participate in a support group.

Typically, SNAP assigns an ombudsman to a specific facility, usually near his or her home, and the volunteer visits that facility a couple of times a week, Petrie says. That way, she says, staff and residents get to know the ombudsman and become more receptive to sharing information if a problem arises.

Some residents fear that a home's staff might ask them to move out or retaliate in some way if they express concerns.

Such retaliation is rare, but Petrie says, "When you're a resident or a family member, it's a real fear. The ombudsman is important because we talk to them about the fear."

In addition to routine monitoring of some facilities, the program also investigates complaints about care, which can come from residents, family of residents, and facility staff. In 2012, about 230 people filed about 300 complaints.

"What we do is address those issues early so they don't turn into abuse," Petrie says. "If it gets too egregious, it gets turned over to licensures," which are administered through the Washington state Department of Social and Health Service and the Washington state Department of Health.

The number of complaints is down from previous years, she says, but one reason for the decline is that some interactions that used to be characterized as complaints are now listed as educational consults.

Complaints can involve residents' rights, quality of life, and a facility's policies and procedures.

The most frequent disputes involve discharges or evictions, when a facility is looking to discharge a resident who either doesn't want to leave or doesn't have another place to go, Petrie says. In some cases, she says, a facility might say it doesn't offer the level of care a resident needs. In other cases, a resident might be breaking a facility's rules, such as by repeatedly smoking inside a unit.

Carlson says that in one case she handled, a resident who suffered from dementia refused to sign rent checks. She encouraged the resident to sign the checks and in time was able to get him to do so.

"It's about trying to find that resolution," Carlson says. "It's being the mediator for both sides."

The long-term care ombudsman program here is one of 13 in Washington state. Multi-Service Center, a Federal Way, Wash.-based community action agency, administers the program and contracts with SNAP to provide services in Spokane, Pend Oreille, Ferry, Stevens, and Whitman counties. Multi-Service Center was developed after the federal Older Americans Act of 1978 called for all states to have ombudsman programs.

SNAP CEO Julie Honekamp says the program receives a mix of state and federal funds, as well as money from Aging and Long Term Care of Eastern Washington, Amerigroup, and others.

The ombudsman program also receives grants for mission-specific programs at times. For example, it recently received a grant from the Washington state Attorney General's Office to provide education on off-labeled usage of certain antipsychotics. It hopes to start work on that effort later this year.

In general, the program has had its funding levels reduced in recent years, and SNAP now has two paid staff%u2014Petrie and Barry Markle%u2014down from three full-time workers and one part-time staff member a few years ago.

Honekamp says, "We've held onto this program because of our values. It's a perfect alignment, and I hope we can keep it going for a long time."

SNAP, which is based at 3102 W. Fort George Wright Drive in northwest Spokane, provides a number of social services, mostly for home and low-income residents. In addition to the ombudsman program, the organization provides energy assistance, affordable housing, and other financial and human services. With a 2012 annual budget of about $23 million, the organization employed about 100 people and about 150 during peak energy-assistance season last year.