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Despite a state mandate, the Hawaii Department of Health has stopped posting online the inspection reports for nearly 1,700 adult care homes and several other types of long-term care facilities that it oversees.
Health officials say they don’t have the resources they need to do the job.
But Gov. David Ige apparently isn’t buying the excuse. Responding to an inquiry from Civil Beat, his office insists that the issue will be resolved soon.
A bill that cleared the Legislature with unanimous support in 2013 required the department to post the inspection reports on its website starting Jan. 1, 2015.
Advocates for the elderly and good-government groups who support greater transparency heralded the new law, which signaled an end to the practice of forcing the public to submit written requests to access the inspection reports, wait for the department to find the records and redact portions and then pay for the copies and the time it took to do so.
Lawmakers authorized $148,000 for fiscal years 2014 and 2015 to provide two positions that the department said it needed to implement the new requirement.
One position was for the department’s Developmentally Disabled Division, which oversees 295 developmentally disabled adult foster homes that each provide care for up to two people with intellectual or developmental disabilities.
The other position was for the department’s Office of Health Care Assurance, which oversees several types of health care facilities that collectively provide more than 7,800 beds.
Neither agency hired anyone to fill the positions. Both blamed the bureaucratic red tape that makes it hard to quickly create and then fill a new position.
Funding for the two positions, which were only authorized on a temporary basis, was not continued in the next biennium budget.
“Our office is unable to absorb this work on an ongoing basis with our current resources.” — Keith Ridley, OHCA
The department missed its January deadline to start posting the inspection reports online, even with the 18-month lead time. Some of the reports started going up a few months later after public pressure and political prodding.
In early February, the Developmentally Disabled Division started posting the inspections for the developmentally disabled adult foster homes and the agency has continued to do so. There are now 166 inspection reports on its website.
The Office of Health Care Assurance started posting its inspection reports online in early March, but only for some of the facilities it oversees and only briefly.
The office’s initial batch of 79 inspection reports were mainly for community care foster family homes except three for adult day care centers, five for skilled nursing facilities and one for an intermediate care facility for individuals with intellectual disabilities.
Not a single inspection report for any of the roughly 500 adult residential care homes, which provide more than 2,700 long-term care beds, was posted. Nor were any inspections for the 13 assisted living facilities in Hawaii, which account for some 2,250 beds.
“Whatever excuse they have, they’re breaking the law.” — John McDermott, longterm care ombudsman
Keith Ridley, who heads the Office of Health Care Assurance, blames a lack of resources.
“The staff position approved by the legislature to post the inspection reports was for a temporary position,” he said in a statement. “The position would allow our office to segregate, review, redact and post inspection reports online. Our request for a permanent position with funding was not approved by the legislature. As a result, online posting of inspection reports ceased as our office is unable to absorb this work on an ongoing basis with our current resources.”
For the current fiscal year, which started July 1, the Office of Health Care Assurance is set to receive $2.2 million in general funds, down from $2.3 last fiscal year.
Ridley said his office has continued to inspect facilities, including adult residential care homes.
The state’s longterm care ombudsman, John McDermott, said the law needs to be carried out as it was intended.
“Whatever excuse they have, they’re breaking the law,” he said.
“People’s taxes go to the cost of the inspection and the only reason we do the inspection is to protect the public,” McDermott said. “So why wouldn’t we make those inspections as open and accessible as possible?”
The adult care home industry came out in force to oppose the bill when lawmakers were considering it. Care home operators and nurses said that posting the inspection reports online violated their privacy and were too confusing for the public to understand.
Ige said on the campaign trail last fall 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.”
His administration moved the agency into compliance early this year. But his two-year budget did not include funding for the two positions the department sought to continue posting the records online, and the Legislature did not add money to do so last session, which ended in May.
Jodi Leong, Ige’s spokeswoman, said Thursday that the governor is aware of the issue and that it will be corrected soon.
“It should be up there,” she said. “We’re going to work on it.”
Civil Beat has been covering this issue since 2013. Read our previous coverage: