Legislature(1993 - 1994)
03/22/1993 01:00 PM House JUD
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* first hearing in first committee of referral
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+ teleconferenced
= bill was previously heard/scheduled
HB 3: REGULATION OF HOME CARE PROVIDERS Number 352 REPRESENTATIVE JERRY MACKIE, PRIME SPONSOR of HB 3, stated that his bill would restrict the ability of a home care provider to assume powers of attorney, and required criminal history background checks for home care providers being paid with public funds. He said that HB 3 would provide a measure of protection for elderly and disabled persons from those responsible for their care. He said that these people were particularly vulnerable to abuse, due to age, illness, disability, and the isolation of being alone in their home with a care giver. REPRESENTATIVE MACKIE commented that Alaska was on the brink of an explosion in home care services. He mentioned the rapid expansion of Alaska's senior citizen population, and said that the state had just received approval for Medicaid waivers for home- and community-based services, as an alternative to institutionalization. He said that once the Medicaid waiver program was in effect, the home care services industry would see rapid growth. REPRESENTATIVE MACKIE commented that HB 3 would also require criminal history records' checks for home care providers paid by Older Alaskans Commission (OAC) grants and respite care providers paid by the Division of Family and Youth Services (DFYS). He noted that HB 3 would require the Department of Health and Social Services (DHSS) to implement regulations identifying actions to be taken upon receiving reports of harm by home care providers. REPRESENTATIVE MACKIE mentioned an incident in his district which had given rise to the introduction of HB 3. He said that in that incident, a home care provider had walked off with approximately $500,000 of an elderly person's money. He noted that similar situations had occurred across the state. He said that elderly persons, due to their vulnerability, were being targeted for exploitation. He mentioned that the state Pioneers Homes were full, with long waiting lists to get in. REPRESENTATIVE MACKIE said that more and more elderly people would be cared for in their own homes, making it important for the state to regulate home care providers. He said that the Department of Public Safety (DPS) had informed him that 30% of criminal history background checks run on school teachers, day care providers, and others revealed criminal histories. He said that a bill similar to HB 3 had passed the House the year before. Number 428 REPRESENTATIVE GREEN stated that HB 3 seemed like a very good bill. However, he did not see representatives of the senior citizen community present, and asked Representative Mackie if he had spoken with members of that community. Number 433 REPRESENTATIVE MACKIE replied that the OAC was on record in support of the bill. He added that he was not aware of any opposition to either HB 3 or HB 4. Number 453 WALTER MAJOROS testified on behalf of the OAC in support of HB 3. He noted that the OAC would like to see section 1, relating to powers of attorney, strengthened. He recommended that powers of attorney for publicly-paid home care providers be prohibited, except in certain circumstances, or alternatively stipulating that the person with whom the power of attorney was shared could not be a person who had either a financial or a personal relationship with the home care worker. Number 479 REPRESENTATIVE DAVIDSON asked what incentive a third party might have to become a partner in a power of attorney situation. Number 485 MR. MAJOROS did not feel prepared to answer Representative Davidson's question. Number 492 REPRESENTATIVE DAVIDSON said that when a person took a job as a home care provider, that person took on a certain amount of risk and liability. He expressed concern that a person could unknowingly become involved in a messy situation. Number 507 CHAIRMAN PORTER asked Representative Davidson if he was referring to an additional signer, in addition to the home care provider, on the power of attorney. He thought of the third party as being a relative of the person receiving the home care, co-signing with the home care provider as a convenience. MR. MAJOROS expressed the OAC's position that those two people should share the power of attorney to ensure there was no abuse. Number 524 CHAIRMAN PORTER asked Mr. Majoros if he had any proposed language to offer. MR. MAJOROS had no language to offer at this time. Number 527 REPRESENTATIVE DAVIDSON commented that his question had been prompted by a situation in which an elderly person had no remaining relatives. Number 531 CHAIRMAN PORTER mentioned that surviving relatives sometimes lived far away from an elderly person receiving home care services. Number 539 REPRESENTATIVE MACKIE noted that home care providers were sometimes relatives of those for whom they cared. He commented that not every situation could be covered by statute. He said that the main purpose of HB 3 was to not allow a home care provider to also have sole power of attorney. He said that at least one other person should be involved in the relationship, to prevent a home care provider from abusing the position. He commented that HB 3 would only apply in cases where public funds were being used. Number 567 REPRESENTATIVE JEANNETTE JAMES mentioned that the legislature could not solve every problem that existed through statute. Sometimes, she said, the legislature passed laws to solve one problem, and created even more problems in the process. She commented that the job of a home care provider was not an easy one. She supported criminal history background checks for home care providers. She was of the opinion that powers of attorney could affect more than just financial transactions. She did not see why a home care provider would need to have a power of attorney for a person in his or her care. REPRESENTATIVE JAMES expressed concern that putting two people on a power of attorney would create an impediment to making quick decisions. She preferred that a power of attorney be held by one individual, someone other than the home care provider. Number 595 REPRESENTATIVE MACKIE said that in some instances, a home care provider was the only person caring for a particular individual. In that case, he said, the home care provider would do all of the shopping, banking, and bill paying transactions. In that situation, he said, it would be convenient for a home care provider to have a power of attorney. House Bill 3 would allow for that to happen, as long as a third party co-signed on the power of attorney. He noted that he had tried to focus HB 3 on those areas with the greatest potential for abuse. Number 615 REPRESENTATIVE JAMES said that HB 3 only affected home care providers whose services were paid for by the state. She commented that if a person had a great deal of money to steal, that same person probably would not be eligible for a publicly-funded home care provider. She expressed her opinion that HB 3 should be expanded to include all home- care providers, not just those who received public funds. Number 627 REPRESENTATIVE MACKIE said that Representative James had made a good point. However, he noted that there were constitutional problems involved in regulating privately- funded home care providers. Number 643 REPRESENTATIVE PHILLIPS asked Representative Mackie why he chose to apply the provisions of HB 3 only to publicly- funded home care providers. Number 647 REPRESENTATIVE MACKIE reiterated his point that people could spend their own money in any manner they saw fit. However, when public funds were involved, he did not feel that home care providers should be allowed to exercise a great deal of control over the affairs of elderly or disabled persons. Number 666 PAT O'BRIEN, on behalf of the DHSS, commented that the year before, the DHSS had suggested language to tighten up who could have a power of attorney. She said that the House Health, Education, and Social Services (HESS) Committee had raised the issue of the cumbersomeness of requiring two signatures on every transaction. Also, she said that the HESS committee had mentioned the difficulty of finding home care providers in the first place, due to the heavy responsibility associated with the job. If too many restrictions were placed on the profession, she noted, it would become even harder to find people willing to serve as home care providers. Number 680 MS. O'BRIEN said that although the HESS Committee had considered tightening up the requirements for powers of attorney, they had eventually agreed that that was not a good idea. The result was the language now contained in HB 3, she added. Number 687 REPRESENTATIVE JAMES asked Ms. O'Brien if she saw HB 3 as being a burden on home care providers. Number 702 MS. O'BRIEN replied in the negative. She said that a home care provider would not be required to accept a grant of power of attorney, and might choose not to accept such a designation. Number 709 REPRESENTATIVE MACKIE noted that HB 3's provisions might help to weed out those home care providers with bad intentions. He said that powers of attorney could take many different forms. He admitted that the provision in question could not be easily enforced. The intent behind the provision was simply to create a condition of employment and a vehicle for disciplinary action or termination. Number 726 REPRESENTATIVE GREEN made a MOTION to MOVE HB 3 out of committee with individual recommendations and an accompanying fiscal note. There being no objection, IT WAS SO ORDERED. CHAIRMAN PORTER announced that HB 112 was the next item of business before the committee.
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