Legislature(1993 - 1994)

03/22/1993 01:00 PM JUD

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