State government’s most fundamental duties revolve around the creation and enforcement of policy and law. So it’s been curious to watch the state Department of Health’s law-flouting reaction this year to a 2-year-old statute requiring the department to post inspection reports online for adult care home and multiple other kinds of long-term care facilities that it oversees — nearly 1,700 in all.
The reports were required to begin showing up online on Jan. 1. But neither of the two health department divisions that had been given nearly $150,000 over a two-year budget cycle to hire two staffers responsible for the posting actually hired anyone. The state’s hiring process was too hard and bureaucratic, they complained. And so they simply ignored the online posting law that required their compliance, despite having 18 months advance warning for when posting was to begin.
Criticism mounted, and by mid-February, the Developmentally Disabled Division, which oversees 295 adult foster care homes, fell in line. It began posting inspection reports in early February, and continues to do so. The DDD has now posted 166 reports — representing more than half of the facilities under its control and counting — on its website.
Sue Cornish, R.N., case manager from Elder Care Resource, Inc., speaks to residents at Hokulaki Senior Living care home in Kaneohe.
Cory Lum/Civil Beat
The Office of Health Care Assurance is a different story. Much larger than the DDD, it is responsible for several different kinds of facilities that in aggregate provide about 7,800 beds. OHCA finally began posting inspection reports in mid-March, but its minor run at compliance only include 79 reports and didn’t last long. Now OHCA Director Keith Ridley says, “Our office is unable to absorb this work on an ongoing basis with our current resources.”
It’s a novel defense. Perhaps you might try it yourself next filing season when the Hawaii Department of Taxation requires your income tax return. “I regret to inform you that I am unable to absorb this work, due to a lack of resources. Thank you for understanding.” (Tip: Be sure to hire an attorney first. Maybe two.)
Incredibly, Ridley attributes his failure to hire to the fact that the initial funding for a staff position to handle the postings was only temporary and not included in the next biennial budget. Maybe lawmakers might have been more supportive had they seen any movement on the health department’s part toward making the initial hires. We are not aware of any state agencies that succeed in turning up their noses at legislative appropriations because they weren’t delivered in the form or fashion that the agencies requested.
What’s even more appalling about this situation is that the inspection reports in question cover such facilities as adult residential care homes and assisted living facilities. Those two categories account for about 5,000 beds, and not a single inspection report has been posted on any of the facilities in question.
As with the other facilities, these places provide care for many of Hawaii’s most vulnerable people — those whose hopes for paradise in the Aloha State are often no more than a quiet bed and humane, competent care in a clean environment.
These places provide care for many of Hawaii’s most vulnerable people — those whose hopes for paradise in the Aloha State are often no more than a quiet bed and humane, competent care in a clean environment.
Prospective residents and their families often look to these inspection reports to determine what the best option is for them. Without online posting, those families are reliant on a plodding process reminiscent of 50 years ago, wherein they make written requests for the reports, wait for the department to find them and redact portions that can’t be released and finally pay for whatever paper copies they receive, as well as the staff time it took to produce them.
Has no one heard of electronic records, document scans, file downloads or smart forms at the health department? Apparently, such new-fangled ideas aren’t for them.
Fortunately, Gov. David Ige is as unsympathetic to the department’s excuses as we are — perhaps because the governor well remembers that he was one of the lawmakers who voted unanimously to approve the posting law. As a gubernatorial candidate, the governor promised last fall to execute the law “immediately because seniors in adult care must be ensured a safe environment.”
Through a spokeswoman, the governor told Civil Beat’s Nathan Eagle last week that he is aware of the posting situation and that it will be corrected soon.
That promise needs to be fulfilled. Thousand of families and current and prospective care home patients around the state are counting on it.
Likewise, health department director Dr. Ginny Pressler needs to explain why an agency under her direction doesn’t seem to be taking its obligations under the law very seriously. State agencies and their staff are not above the law, whether or not they believe they have the proper resources to comply.
Reorganizing personnel and redistributing duties to ensure legal requirements are met is always a smart management option, and where the stakes are this high, we’d argue it’s one that most reasonable people would prefer.
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