Updated 10:55 a.m., 2/5/2015

State health officials want the Legislature to bail them out for not meeting a statutorily required deadline to start posting inspection reports for adult care homes online beginning Jan. 1.

And Gov. David Ige is looking to help accommodate them, despite saying on the campaign trail last year that he would ensure the deadline was met.

The Department of Health was given all of the resources it sought and 18 months to figure out how it would implement the new requirement from the time the law took effect in 2013.

Apparently that wasn’t enough. The department is asking lawmakers to pass a bill this session that would retroactively change the deadline to July 1, delaying implementation for at least another six months.

Home inspection magnifying glass

Inspection reports for care homes in Hawaii were supposed to be posted online starting Jan. 1, but the Department of Health is asking to push the deadline back six months.

Pallspera .com/Flickr

Senate Bill 1114 and its companion legislation, House Bill 945, were introduced last week as part of Ige’s package of bills sent to the Legislature.

It was somewhat surprising to see the bills included in the governor’s package because the legislation runs contrary to Ige’s position on the matter when he was asked about it last fall on the campaign trail.

In the days leading up to the Nov. 4 election, Ige told Civil Beat that if he won he would “ensure the law is executed immediately because seniors in adult care must be ensured a safe environment when they may be entering vulnerable years.”

A Culture in Need of Change?

Ige’s spokeswoman, Cindy McMillan, said Wednesday that it appears the request to pass a bill delaying implementation another six months was made due to a lack of staffing.

“The governor remains committed to the program,” she said.

The task of actually posting the inspection reports online falls on two agencies under the Health Department — the Office of Health Care Assurance and the Developmentally Disabled Division.

Inspection reports for care homes in over half the country have been available online for years. But in Hawaii, the public only has online access to the inspection reports for nursing homes, and that’s just because federal law requires it.

Update Keith Ridley, the head of OHCA, which has oversight over the vast majority of the state’s long-term care facilities, told Civil Beat Thursday that “administrative delays” have prevented his office from meeting the Jan. 1 deadline.

The law, which took effect July 1, 2013, provided the Department of Health with $148,000 to hire two people and buy computer equipment and whatever else might be necessary to start posting the inspections online. But as of Thursday, no one had been hired.

“We are still in the process of recruiting the position that will actually be doing the online posting,” Ridley said. “The state system is a bureaucratic system and it’s taken longer than we’ve liked.”

In the meantime, Ridley said the department has been making changes to its website so it will be easier to post the inspection reports to it and be more navigable for the public. His office has also started identifying and segregating the reports that will have to be posted.

The office has had issues with what forms will actually be posted. The law created a task force that worked for a year to recommend a form, but it turns out that form won’t work for technical reasons.

“The state system is a bureaucratic system and it’s taken longer than we’ve liked.” — Keith Ridley, DOH Office of Health Care Assurance

Ridley said his office will start by just posting the forms that are currently being used, then work to develop a unified form modeled after the federal form that the task force recommended.

“We are making progress,” he said. “We hope to have everything completed soon — knock on wood.”

McMillan said the governor’s office has asked the Department of Human Resources Development to expedite the hiring.

When she inquired why it’s taken so long, she said officials just told her that “things take longer in state government than anyone expects them to.” McMillan said this is a culture that Ige wants to change.

Inspection reports for care homes in over half the country have been available online for years. But in Hawaii, the public only has online access to the inspection reports for nursing homes, and that’s just because federal law requires it.

The inspection reports for several types of state-run facilities, ranging from community care foster family homes to adult day care centers, can only be obtained by formally requesting the records in writing from the Department of Health, waiting up to 15 days and paying for the copies and the time it takes officials to track the documents down and redact certain information.

That process is too long and costly for people who have to decide on short notice where to place a loved one who needs extra care. It also limits the public’s ability to compare the different facilities or view their violation histories, something that’s easy to do for nursing homes or and long-term care facilities in states like Missouri or Washington, where the inspection reports are posted online.

Giving Facilities Time to Respond

Including the two bills in the governor’s package doesn’t guarantee passage or even a hearing, but it is an implicit endorsement signaling it’s a priority of the administration.

Ige could have left the legislation out of his package and let the department try on its own to get the bills passed, but that would be a harder route to approval.

The justification sheets for the bills explain that the department could use the extension to try posting inspection reports for just one of the types of health care facilities that fall under the law, see how that goes and make changes as necessary.

Even that staggered approach would be optional the way the bills are currently written, which say the department “may” do that, instead of “shall.”

The legislation would also change the existing law by giving the department 30 days instead of five days after each inspection to post the report on its website. The department says that would give the facilities time to submit plans of corrective action that can be posted with the inspection reports.

The department is apparently still involved in discussions with a working group that the law initially created to help choose a new inspection form to be posted online. That group, comprised of 13 members, technically dissolved June 30.

The bills have yet to be scheduled for a hearing in the House or Senate.

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