Legislature(2001 - 2002)
03/04/2002 01:35 PM Senate HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 342-LONG TERM CARE OMBUDSMAN
MR. JERRY BURNETT, staff to Senator Green, sponsor of SB 342,
explained that SB 342 clarifies the duties of the long term care
ombudsman and increases some statutory authority. He gave the
following testimony.
Each state is required to have a long term care
ombudsman under the Older Americans Act (OAA). Alaska's
long term care ombudsman is located in the [Alaska]
Mental Health Trust Authority and recently the long
term care ombudsman resigned, citing as one of the
reasons for his resignation, frustration with Alaska's
statutes. Discussion with the executive director of
the Alaska Mental Health Trust led to the filing of SB
342, which brings Alaska statutes in line with the
federal law.
Specifically, SB 342 directs the long term care
ombudsman to visit long term care facilities and
identify problems, rather than assuming the more
passive role of only responding to complaints. It
provides that no long term care facility may deny
immediate access to an employee or volunteer from the
long term care ombudsman's office who is responding to
a complaint and it gives the long term care ombudsman
an active role in developing and providing technical
support to volunteer organizations which are interested
in the health, safety, welfare and rights of older
Alaskans.
CHAIRWOMAN GREEN asked Mr. Burnett to address the question of why
this issue is being revisited.
MR. BURNETT said, according to the executive director of AMHTA,
state statutes have not been brought up to date and are not in
compliance with federal law so there are tasks the long term care
ombudsman should be directed to do which he or she is not.
SENATOR LEMAN asked if the subsections in Section 3 will respond
to changes in federal law.
MR. BURNETT said he is not sure whether they respond to changes
in federal law or to the existing federal law. He noted the
development of the volunteer organizations and family councils,
etcetera, is specified.
CHAIRWOMAN GREEN said that sounds like an iteration of the
federal statute.
MR. BURNETT added that the long term care ombudsman is funded
with a combination of state and federal money. This bill should
not affect those funds.
SENATOR LEMAN referred to subsection (f) and asked what
"technical support" means in this context.
MR. JEFF JESSEE, Executive Director of the AMHTA, explained that
a little over a year ago, the AMHTA took over the job of
overseeing the office of the long term care ombudsman. During
that process he reviewed the framework under which the office
operated and identified discrepancies between the federal and
state laws. Section 3 of SB 295 contains a number of functions
the long term care ombudsman should be undertaking that are not
required in state law. The formation of resident and family
councils will assist folks who either live in or have family
members in long term care facilities to organize themselves so
they aren't dependent on the long term care ombudsman or other
individuals. Those councils will carry out a number of roles,
all of them of an oversight nature, but they are also very
valuable in providing activities or other support services to
residents and family members to enable them to work toward common
goals. Recently, the long term care ombudsman who was hired
after the office came under the purview of the AMHTA, left the
position. One reason he cited for his resignation was the
difficulty he encountered when looking at reinstituting the
volunteer program. When the original OAA was passed over a
decade ago, the volunteer ombudsman component was part and parcel
of what Congress had in mind. Congress wanted to avoid another
huge bureaucracy that relied only upon paid employees to provide
the critical functions of providing assistance to people who live
in long term care facilities. A volunteer program has been
instituted in every state and the OAA sets out clearly that
volunteers are a critical part of the program.
MR. JESSEE said that volunteers undergo training and testing, and
are certified and supervised. He informed members that he
provided copies of manuals used to train volunteers to committee
members. That manual is quite comprehensive and is being used as
a model around the nation. It includes education and training in
ethics, the role of the long term care ombudsman, the statutory
framework, the aging process, long term care facility
regulations, etcetera. The AMHTA believes volunteers are an
important part of the program, particularly in Alaska. If state
employees were hired to do this work, the office would have a
huge staff. He acknowledged there is an ongoing dispute among
some assisted living home providers as to whether the current
statutes allow volunteers to have access to their homes. One home
provider actually got a legal opinion that said the home owner is
not required to allow volunteers to enter her facility. The AMHTA
hopes this legislation will clarify that matter and prevent
litigation. He offered to answer questions.
SENATOR LEMAN asked Mr. Jessee if "technical support" is a term
of art that means other than financial support and asked if it
comes from the federal bill.
MR. JESSEE affirmed that term refers to information on how to
organize those groups, their structure, regulations and patient
rights.
CHAIRWOMAN GREEN said she has heard several concerns expressed,
the first being about confidentiality that is referenced on the
bottom of page 1 of the bill. She asked him to provide an example
of how that will work.
MR. JESSEE said he will describe what it does not mean. It does
not mean that the ombudsman or employees or volunteers in the
office are able to share confidential information without
complying with the confidentiality requirements that apply to the
office. It does mean there is a responsibility on the part of the
office to provide information to public agencies about
individuals who reside in long term care facilities. Without
giving individual information, the ombudsman is responsible for
bringing systemic issues to entities such as the legislature, the
Older Alaskans Commission and other public agencies that need to
be aware of the problems of older Alaskans who live in long term
care facilities.
CHAIRWOMAN GREEN asked if this information will be dispensed to
every agency in the state.
MR. JESSEE said it does not and, in fact, the long term care
ombudsman's office is prohibited from doing so by AS 47.62.030.
AS 47.62.025(b) specifically requires consent of the older
Alaskans or their legal guardians or, if unable to consent with
no legal guardian, a court order is required to get medical
records.
CHAIRWOMAN GREEN said the other area she has heard concerns about
is at the end of the bill that says a person may not deny
immediate access to a long term care facility or to an older
Alaskan by the ombudsman, an employee, volunteer, or other
representative of the office. She noted it is the "other
representative of the office" that is cause for concern. She
asked who would fall under that category.
MR. JESSEE said he cannot provide a specific example at this time
but he said that state and federal laws already require access to
any ombudsman, employee, volunteer or other representative to
investigate a complaint. They must have completed the training;
they must be certified; and they must be supervised. He suggested
that it might be an intern who has completed the training.
CHAIRWOMAN GREEN indicated that she thought it might be a higher
level investigator or inspector.
MR. JESSEE said it could conceivably be a contractor.
CHAIRWOMAN GREEN said the bigger issue is that these people must
be trained, certified, and supervised.
MR. JESSEE said that is correct. He commented that he is aware
of concerns about how the volunteer program operated in the past.
He assured her that the AMHTA will work with the provider
community to ensure that the volunteer program operates as it
should. If providers feel at any time that the program is not
operating in a proper manner, he encourages them to hold that
office and the AMHTA accountable for those shortcomings.
CHAIRWOMAN GREEN asked Mr. Jessee if the AMHTA will be doing some
training or transitioning with the providers when the volunteer
program is reinstituted.
MR. JESSEE said he has already opened dialog with the providers
and will continue to so that they are brought into the process of
developing the volunteer program.
CHAIRWOMAN GREEN announced that she would hold the bill until
Wednesday.
MS. LARRAINE DERR, Alaska State Hospital and Nursing Home
Association, informed members that SB 342 causes long term care
facilities great concern. Alaska has had three long term care
ombudsmen in the last three years. The changeover was due to the
fact that the ombudsmen were unable to handle the job duties they
had: SB 342 adds more responsibilities to the job. She said the
Association is comfortable with the ombudsman's ability to
investigate and resolve problems, but is concerned about what the
word "identify" means. Providers are also concerned about the
word "immediate" in relation to access and would like to know
that that means. She questioned whether anyone associated with
the ombudsman's office can come to the door and demand immediate
access. She said the bill has a "big brother" feel to it. She
asked for more time to poll her membership and review the bill.
CHAIRWOMAN GREEN said more time will be provided and announced
that the committee would take up SB 230.
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