Legislature(1993 - 1994)

03/08/1993 03:00 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
  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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