The adult care home industry supported a bill Wednesday that would increase the number and types of facilities subject to having their state inspection reports posted on the Department of Health’s website.
A House panel ended up scrapping the plan, but the industry’s willingness to support an expansion of the online posting of inspection reports represented a remarkable turnaround from two years ago when care home operators strongly opposed the idea.
Lawmakers did keep the part of the bill care home operators were most interested in — a section that would create a forum on the department’s website for the public to view available vacancies at their facilities.
Lilia Fajotina, president of the Alliance of Residential Care Administrators, a group that represents many care home operators, said she believes in transparency and sees a serious need to have a place for consumers to go on the Department of Health’s website to find an appropriate care home.
“There were issues or problems with inappropriate placements in the past where the resident or client does not have a clue where he or she was going to live and was not given the choice or (had) not even seen the home,” she said. “Discharge planners in the hospitals or long-term care facilities mostly just talk the patient who is being discharged or family into living in an area the resident or resident’s family do not prefer or desire for their love one to live or stay.”
She suggested the online vacancy list include the name of the facility, name of the primary caregiver; demographics; location; a short description of the facility; if it is an ADA-approved facility or if it can accommodate wheelchair bound clients; if the facility is recommended and any other information that the DOH deemed important to include.
In 2013, the Legislature passed a bill requiring the inspection reports for certain types of care homes to be posted online starting Jan. 1, 2015. Only the Department of Health’s Developmentally Disabled Division has started doing so, and just for developmentally disabled adult foster homes.
Inspection reports for the other types, which fall under the jurisdiction of the department’s Office of Health Care Assurance, are only available from the agency if the public requests them in writing, waits up to two weeks and then pays for the copies and time it took for health officials to track them down and redact portions.
The OHCA, headed by Keith Ridley, is seeking a six-month delay to start posting those reports online. Gov. David Ige had said he would immediately work to get the inspections posted when he took office Dec. 1, but has accepted the need for the delay and included legislation to effectuate it in his package of bills.
In response to concerns over the delay from members of the House Health Committee, chaired by Rep. Della Au Belatti, Ridley said his office has yet to hire someone to help with the posting. Now that it’s been almost two years and the temporary positions the Legislature authorized are going to expire soon, he’s asking for continued funding for the positions so he can proceed with hiring people.
“There were issues or problems with inappropriate placements in the past where the resident or client does not have a clue where he or she was going to live.” — Lilia Fajotina, ARCA president
Ige’s budget does not include money for the requested positions, so the Legislature would have to add it in.
The department said in its testimony that if funding is not approved, the agency will be unable to obey the law with its current staff.
Still, Ridley said he hopes postings will begin within the next couple of months.
The Health Committee voted to pass House Bill 859 but stripped the part that would have added therapeutic living programs and independent group residences to the list of facilities that would have their inspection reports posted online.
The committee preserved the seven other types that were included in the 2013 law. Those are adult day health centers; adult day care centers; community care foster family homes; developmental disabilities domiciliary homes; developmentally disabled adult foster homes; long-term care facilities and special treatment facilities.
The committee also changed the bill to make it clear that the DOH could post vacancies on its website and that the facility operators would be permitted to post on the website too. The amendments also create a working group to discuss the posting of the vacancies.
Ridley said the department is OK with hosting the forum on its site as long as there are certain disclaimers.
The bill, introduced by House Vice Speaker John Mizuno, is set to head to the House Finance Committee for its consideration.
House lawmakers moved two other care home bills forward Wednesday after making a few key changes.
The state currently lets community care family foster homes have up to three clients. Two must be on Medicaid and one can pay out of his or her own pocket. The care-home industry wants to flip this.
Care home operators are pushing for the passage of House Bill 600, which would allow two private-pay clients and one Medicaid recipient, which critics fear could leave the poor with fewer places to go for long-term care.
Some care home operators have acknowledged the change in the law will help them make more money, but others maintain it’s just to help couples stay together.
Jonathan Hanks, who runs a care home in Kaneohe with his wife, is in the latter group. He brought one of their clients, Noboru Kawamoto, to the Capitol again Wednesday.
Kawamoto, an honored World War II veteran, is a private-pay client. His wife of 67 years is unable to join them at Hanks’ home because she would be a private-pay client too.
As introduced, the bill would let two private-pay clients if they were “a married couple, reciprocal beneficiaries, siblings, a parent and a child, or best friends.” Health officials have said the “best friends” part in particular is overly broad and presented a potential for abuse.
Before passing the bill Wednesday, the House Health and Human Services committees amended it to only allow two private-pay clients who are married — an exception the Kawamotos could benefit from.
House Bill 1195 would let adult residential care homes have three nursing-facility level of clients instead of two.
The care home industry fought for this change in 2010 and succeeded in getting the bill passed over the concerns of health officials. The law was supposed to sunset in 2013, but the Department of Health has allowed the practice to continue.
The House committees voted to pass the bill. Belatti said she prefers it be in statute rather than leave it up to the department’s discretion.
The bills head to the House Finance Committee next.