Legislature(1993 - 1994)
03/08/1993 03:00 PM House HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HB 3 - REGULATION OF HOME CARE PROVIDERS Number 445 REP. JERRY MACKIE testified as PRIME SPONSOR of HB 3. He noted that similar bills passed through the Senate in 1992, but died in the session's final days. He read a sponsor statement, which is on file in the committee room. In summary, the statement said that HB 3 would protect elderly people by restricting public home care providers (HCPs) from assuming sole power of attorney for their clients, and by requiring background checks on home care providers paid under certain state programs. He referred to a case in which a health care provider took control of a client's finances through a power of attorney and spent $500,000 of the client's money. He said he was not attacking the HCPs, but was trying to afford their clients' protection. He noted that 30 percent of state required background checks reveal criminal histories. Number 496 REP. BUNDE asked whether a criminal record automatically barred a person from working as an HCP. REP. MACKIE stated that this might be a question that would be addressed in regulations under the bill, not by the statutory language. He said the bill proposed in the previous legislative session required background checks to be completed within 10 days of hiring and upon request, and that certain actions had to take place within five days of receipt of such reports. He said such provisions were in effect in HB 3. Number 522 REP. BUNDE asked again whether a criminal record automatically barred a person from working as an HCP. REP. MACKIE said it would depend on individual circumstances, and the issue would be addressed in regulations. Number 522 REP. VEZEY observed that HB 3 would do little to deter a determined fraud. REP. MACKIE said all legislation can do is provide penalties for crimes, but cannot order 100 percent compliance with law. He said the bill is a substantial improvement over current law. He stated that courts, which usually give powers of attorney, would have to determine an acceptable second person, most likely not a partner of the HCP, but a relative of the elderly person. REP. VEZEY asked the need for two powers of attorney if an elderly person had a relative to whom such power could be given. Number 546 REP. MACKIE said that would be a decision of the court. The bill would prevent the HCP from being sole power of attorney, he said. REP. VEZEY asked whether HB 3 deprived elderly people of the right to bestow power of attorney of their own, and if it was directing the court to appoint people who would have power of attorney. Number 552 CHAIR TOOHEY said lonely old people frequently become dependent on HCPs as surrogate families. She related a case in which one client granted power of attorney to the HCP, who then proceeded to wipe out the client's money. Chair Toohey said under the bill, the courts could bar an HCP from assuming the sole power of attorney for a client. REP. VEZEY asked what was to bar an elderly person from signing over a second power of attorney to the HCP's partner in crime. CHAIR TOOHEY answered that nothing prevented that. REP. VEZEY said the bill therefore provided no protection. CHAIR TOOHEY said she disagreed. Number 565 REP. BUNDE said that, in his experience working with nonprofits, he had learned that it was best to share responsibility for financial expenditures between two people as a way to reduce the possibility of theft. Number 572 REP. VEZEY said HB 3 provided very little protection against a determined fraud. REP. MACKIE asked for suggestions on how to address that concern. REP. VEZEY said he had none. REP. MACKIE pointed out the limits of law to deter determined criminals. Number 580 REP. VEZEY suggested amending HB 3 to bar HCPs from holding power of attorney for their clients. REP. MACKIE said that in some cases it may be beneficial to grant an HCP the authority to act on a client's behalf, with oversight from a relative of the client's. REP. VEZEY stated it was not necessary to have power of attorney in such cases. Number 590 REP. MACKIE said it was beneficial not to give power of attorney to just one person. He referred to a situation in which an HCP in Haines had sole power of attorney and abused that power. He said some elderly people are being robbed of benefits through physical intimidation, with no legal protection. CHAIR TOOHEY said nurse practitioners are state licensed and may lose their licenses for unethical actions, while most HCPs do not have licenses. She expressed support for HB 3 as a bill that would address the needs she has seen as a nurse. Number 604 REP. G. DAVIS asked Rep. Mackie whether the section of the bill identified as Section 13.26.358 resulted from changes to the bill in the 1992 legislative session. TAPE 93-30, SIDE B Number 000 REP. MACKIE said the bill was modified through much work by the committees and had been thoroughly considered. Number 015 REP. BUNDE cautioned against barring an HCP from being granted power of attorney for a client. He said the bill might reduce the temptation to commit fraud on elderly people. REP. MACKIE said it might be necessary to consider whether elderly people who had become state wards or subject to governance by an estate might not need to have a second power of attorney appointed for them in addition to the state or estate. Number 066 REP. BRICE noted that HB 3 dealt with publicly funded HCPs who were not necessarily invited into the client's home. REP. MACKIE said section 2 of his bill bars the state from paying for an HCP without subjecting that person to a background check within 10 days of hire. Number 100 CHAIR TOOHEY asked if Rep. Mackie was referring to Medicaid funding for HCPs. REP. MACKIE answered that he meant any public funds, not just funds through the Medicaid program. Number 106 REP. VEZEY said he had not interpreted HCPs as indicating solely a public employees. REP. MACKIE said the bill referred to HCPs paid with state funds. He said the bill did not bar an elderly person from hiring and giving power of attorney to any private individual. He stated it was aimed at taking steps to prevent the state from paying for HCPs that might try to take advantage of their clients by obtaining powers of attorney. Number 123 CHAIR TOOHEY said that caring for elderly people with home care providers was an alternative to institutionalizing the elderly. REP. BUNDE asked what might happen if the state funded an HCP for a person with no living relatives, and therefore no one to whom a second power of attorney could be granted. Number 140 REP. MACKIE said it would be in the elderly person's best interest to have another person other than the state, such as a minister or public official, with power to sign off on actions concerning that elderly person. Number 143 REP. VEZEY said he believed that courts require bonds of those to whom they grant powers of attorney, usually members of the bar association. REP. BUNDE noted that such people get paid for that service. REP. VEZEY said they get paid fees from the elderly person's benefits. REP. MACKIE said it only related to HCPs. REP. VEZEY said a court would never grant power of attorney to a non-bonded person, to ensure accountability. Number 156 REP. MACKIE said he wanted to make sure the courts did not appoint just an HCP as a person with power of attorney and not a second person. REP. VEZEY said requiring bonds of HCPs would alleviate the problem. Number 164 CHAIR TOOHEY noted that HCP jobs pay only about $8 per hour, and few, if any, are bonded. REP. BUNDE said the second person would probably be an attorney. He asked whether the attorney would be paid from the elderly person's estate. Number 180 REP. MACKIE said that question dealt with a different area of state statutes than that addressed by HB 3. He repeated that the bill just dealt with what HCPs could and could not do; an HCP cannot have sole power of attorney for a client. He said it might cause problems if the client had no relatives, but he said that the abuses of powers of attorney by HCPs far outweighed any inconvenience the court may have in dealing with such possibilities. REP. BUNDE said he was trying to visualize some of the demands that might come up. Number 198 REP. BRICE moved passage of HB 3 with individual recommendations. CHAIR TOOHEY, hearing no objections, declared HB 3 passed with individual recommendations. She then brought HB 4 to the table. (Rep. Kott arrived at 4:08 p.m.)
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