Bills address elderly abuse

By Mike Gordon
Advertiser Staff Writer

Nearly halfway into the legislative session, state lawmakers have endorsed a collection of bills aimed at protecting Hawai'i's seniors from abuse and creating ways to punish those who abuse or neglect them.

The Senate approved similar bills requiring unannounced inspections and civil penalties.

The bills address one or more weaknesses identified by Hawai'i advocates for the elderly who have said care homes need more scrutiny, laws need to be tougher, and potential abusers need to be identified.

But the measures have a long way to go before approval this session, which adjourns May 1.

"We are really thrilled that the Legislature is taking the problem of elder abuse so seriously, and appears very intent on protecting our vulnerable seniors," said John McDermott, the state's long-term-care ombudsman.

The most passionately debated issue in both the House and Senate is unannounced annual inspections of the state's 545 licensed adult residential care homes.

Several legislators introduced related bills at the start of the session because the state health department had not been able to enact a rule change despite repeated attempts since November 1999.

The department conducts surprise inspections to check out complaints or ensure that problems have been corrected. But care home owners are given a tentative schedule for the annual inspection.

Ironically, the bills are being approved just as health officials are ready to present their rule changes at an April 15 public hearing. Any additional changes, and final approval from the governor, will not happen before the Legislature adjourns, said Dianne Okumura, head of the licensing section for the state's Office of Health Care Assurance, which oversees care homes.

Okumura said passage of a bill and approval of a similar rule change would not pose a problem, because the administrative rules could be amended to reflect whatever was required under a new law.

"That will show that the whole state is committed to ensuring that anyone in any healthcare facility is protected," she said.

Alicia Maluafiti, associate state director for AARP Hawai'i, which claims 190,000 members locally, said she's excited by the inspection bills' progress, but she isn't claiming victory yet.

Only two people in the House voted against an inspection bill, but Maluafiti worried that 40 minutes of debate might lead to amendments later this session that weaken the law.

Statements made about what inspectors do and their level of training and sensitivity were largely uninformed, Maluafiti said. And she was frustrated by an apparent lack of concern among House members for care home residents.

"They don't seem to care that people are dying," she said. "All the talk on the floor was about how inconvenient it would be for care home operators to have an inspection."

Voting against the House bill were Rep. Alex Sonson, D-35th (Waipahu, Crestview), and Rep. Cindy Evans, D-7th (N. Kona, S. Kohala).

Sonson said he objected to the bill because annual inspections could be lengthy and require detailed preparation for care home owners. He said the annual inspections should continue to be tentatively announced, and the bill amended to allow also for unannounced "spot checks."

The two kinds of inspections are very different, he said. "We are looking at apples and oranges, and they are combining it into one bill and you have a mashed potatoes thing," he said. "The bill needs to be clearer."

Care home owners have resisted annual inspections on the grounds that they are a disruptive invasion of privacy. But Sonson said that is not what concerns him.

"What people want is to make sure nobody dies or is neglected," he said. "This bill will not do that. It is insufficient to address the concern. I am afraid people don't understand the difference between an annual inspection and a spot check."

The Senate overwhelmingly approved its version of the bill.

Sen. Sam Slom, R-8th (Kahala, Hawai'i Kai), voted against it. He said annual inspections cover a wide range of categories, including many not related to abuse or neglect. To require all that during an unannounced inspection infringes on the constitutional rights of the care home owner, he said.

"You want to protect people who are under care, but you also don't want to put people out of business or at any unnecessary risk, cost or regulation," Slom said. "With this bill, we are giving the state a hunting license."

But Slom said he supports the concept of a spot visit as a way to protect seniors. He thinks the Legislature will approve the idea before adjourning this year.

"A bill will come out of this session, no doubt about it. And it will be better than what we have now."

Reach Mike Gordon at mgordon@honoluluadvertiser.com or 525-8012.