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The Honolulu Advertiser
Posted on: Friday, March 14, 2003

Care-home bill allows for 'spot checks'

By Lynda Arakawa
Advertiser Capitol Bureau

State health inspectors would still give care-home operators advance notice of annual inspections for relicensing purposes but must also conduct surprise "health status checks" once a year, under legislation approved unanimously by the House Health and Human Services committees yesterday.

The approved House draft of Senate Bill 1061 also would require surprise annual relicensing inspections for care homes that have been the subject of complaints or charges. At the same time, it also allows the state Department of Health to waive annual relicensing inspections for up to two years for care homes with good records.

Under current administrative rules, care-home operators are told the month and day of the week they will be inspected.

"We're trying to get at the ones that are bad," said House Health Committee Chairman Dennis Arakaki, D-30th (Moanalua, Kalihi Valley, Alewa).

The issue of unannounced inspections has been a point of contention between care-home operators and advocates for the elderly for several years.

Care-home operators have said they welcome unannounced inspections but complain that inspections for relicensing purposes take several hours and often involve paperwork unrelated to residents' health and safety. They have suggested keeping annual inspections announced while allowing inspectors to conduct surprise 20- to 30-minute "spot checks."

Advocates say that while many care homes provide excellent care and are an essential resource for the state, unannounced inspections are a necessary tool to ensure the quality of care. They favored the Senate's draft of the bill, which required the Department of Health to conduct unannounced annual inspections.

Greg Marchildon, state executive director of AARP, which advocates on behalf of seniors, called the House draft "unworkable" because the Department of Health does not have sufficient staff to carry out those requirements. There are six inspector positions, with one of them vacant.

"This again is what we would consider a shell game," Marchildon said. "The solution should be unannounced annual inspections. That is a major step in the right direction. This is really simply not a step forward. In fact it provides an unworkable bureaucratic solution to a problem where there is really a simple answer to."

Arakaki said he didn't appropriate any money for additional inspector positions, saying the Department of Health is going to see if it would be able to handle the new requirements with existing resources.

"We figure if we give them the option to waive annual inspections that should free them up to focus on the health-status checks and the ones that are problematic," he said.

The bill now goes to the Judiciary Committee.