Legislature(2001 - 2002)
03/16/2001 12:00 PM Senate HES
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 67-ASSISTED LIVING HOMES
CHAIRWOMAN GREEN announced SB 67 to be up for consideration. She
said she did not intend to pass it out today and wanted people to
have time to work on it.
MS. ALISON ELGEE, Deputy Commissioner, Department of
Administration, explained that SB 67 is the outgrowth of a
regulation project that they worked on with the Department of
Health and Social Services (DHSS) on assisted living licensing.
She said:
Our two departments have joint responsibility. The
Department of Administration licenses homes for senior
residents and the DHSS licenses homes under their
Division of Mental Health and Developmental
Disabilities for those two population groups.
When the licensing law was passed in about 1995, this
was a brand new venture for us and we decided that it
was important that we review the operations of the
assisted living industry against our regulations at the
time and our statutes to see whether everything was
working, whether there were areas that needed to be
strengthened and/or changed.
Public hearings were held throughout the state and they came up
with several items that were recommendations and couldn't be
dealt with in regulation. They required some statutory
modification. SB 67 addresses those areas. The regulation package
has been publicly noticed and is just beginning the adoption
process.
This particular bill requires that any assisted living home that
receives public funding be licensed. Current statute requires
homes with three or more residents to be licensed. The Division
of Senior Services has been licensing any home that receives
public funding just as a matter of policy. This would be a new
effort on the part of the Division of Mental Health and
Developmental Disabilities. It also sets some standards against
which background checks would be conducted. This is required for
employees of an assisted living home. This would expand the
number of people that would be subject to background checks so
that they could pick up other people who had unsupervised access
to residents of an assisted living home on a regular basis. It
would include family members who actually live in the home along
with the assisted living residents. It would include contractors
so that they don't have a loophole where somebody is not subject
to a background check because they are put on a contract instead
of being set up as an employee. Regular volunteers would also get
a background check where they have unsupervised access. It also
identified those people who would not be subject to background
checks, like occasional visitors or people who are only in the
home along with the professional staff.
Number 916
CHAIRWOMAN GREEN asked where that section was.
MS. ELGEE replied that Section 3 says who is not required. She
said:
The bill also provides provisions that the assisted
living industry has been very interested in obtaining.
The bill sets out the conditions under which an
assisted living provider could terminate a resident's
contract. Often times, the smaller assisted living
homes are not capable of managing every type of
behavior or medical condition and they need an
opportunity when an individual progresses beyond their
capability to handle, and subsequently, then, is at
risk, or has a behavioral issue that puts other
residents at risk. They need a process through which
they can terminate the contract of the resident and
find more suitable placement.
The primary mechanism through which this would be
addressed is contained in Section 4 and would allow for
a 30-day process for these determination proceedings.
It lays out specific activities that would generate the
assisted living providers right to terminate the
contract.
Section 5 essentially continues this process for
termination and it lays out the residents' rights to
have a conference with the assisted living provider
along with any advocates or family members to contest
that determination and show why that determination
should not occur.
There are occasions where an emergency termination of
contract may be necessary and Section 7 addresses the
emergency termination of contract and again lays out
what would constitute the emergency and sets out a much
shorter time frame than the normal involuntary
termination.
The bill also includes in Section 8 an immunity
provision for liability for acts or omissions in the
licensing, monitoring or supervision of a licensed
home.
Section 9 addresses the situation, which has occurred
and we determined we did not have the legal authority
to go in an assisted living environment and actually
take over the operation of the home. Where the home is
not being operated in a way that is safe for the
residents of the home, but where some time is needed in
order to place those individuals in another setting.
So, this addresses a real situation that occurred a few
years ago in the Anchorage area where we had two fairly
good-sized homes with approximately 16 residents each,
both operated by the same operator who ran into
financial difficulties. It was impossible to place the
30-some residents in other settings over night. So, we
need this window of opportunity and this is actually
modeled after a provision that's currently in statute
for nursing homes that allows the Department of Health
and Social Services the same kind of opportunity if
there is a similar situation with nursing homes.
CHAIRWOMAN GREEN asked if there was an appeal process, if
someone's license was being revoked for unfair reasons, for
instance.
Number 1178
MR. GARY WARD, Manager, Assisted Living Licensing Program,
answered:
The home does have an appeal process if the Division
takes action to revoke the license either on an
emergency basis or through routine procedures
revocation. The home is issued a notice of violation
with the intent to impose an administrative sanction.
That administrative sanction would be the revocation of
a license. The home, then, has 10 days in which to
request a hearing to appeal the revocation. Unless it's
an imminent situation, the home is allowed to continue
to operate. If they submit a request for an appeal or a
request for a hearing, then a hearing officer would be
assigned and it really depends on the schedule of the
hearing officer and then an administrative hearing is
held. That is usually down the road several months. The
home, unless it's an emergency situation where the
residents are at imminent risk of harm, would be
allowed to continue to operate pending the outcome of
the hearing.
CHAIRWOMAN GREEN referred to the immunity in Section 8 and asked
if that was typical language.
MR. WADE said he thought it was.
CHAIRWOMAN GREEN asked what that language was designed after.
MS. ELGEE answered that is was language very similar to that that
protects child protection workers.
SENATOR LEMAN wanted clarification on how an assisted living home
was taken over if it was in imminent danger.
MR. WADE replied:
In terms of the court order, administration of
receivership, you would have to petition the superior
court for temporary administration or receivership of
the home, in which case, the administration of the home
would be present at that hearing to defend their
situation. So, it's not something we can walk right in
and take over the home. We would have to petition the
court for receivership or temporary administration.
SENATOR LEMAN asked what the timeline was for when the department
decides that needs to be done and when it actually gets done.
MR. WADE replied that it is new language and they don't have
experience with this procedure. Previously, the options they had
were to do an emergency revocation of the license. He said:
In other words, go in, serve a notice to the home,
notify all the residents and/or their representatives
and inform that the license was being revoke under
emergency conditions. The reason, as Ms. Elgee stated,
was that in those situations, it's very difficult to
find especially if you have a large home with a fairly
large number of residents, it's very hard to find
alternative places for them on very short notice. It's
very difficult for senior citizens, elders, anyone, to
make a move like that even though it's required because
they are at imminent risk. So, the court ordered
administration would allow us to potentially go in and
take over temporary administration of the home or at
least allow enough time for the residents of the home
and/or the families and their representatives to look
for alternative placements.
SENATOR LEMAN said that much of this was patterned after things
in child welfare and he just wanted an understanding.
MS. ELGEE responded that if this language was in effect in the
instance she told them about, they would have tried to do some
court receivership. They worked for several months with the
administrator of the homes to try to correct the problems. It
became obvious that he could not overcome all the underlying
financial difficulties. "It's a last resort effort and we
wouldn't be attempting the other kinds of things that we can do
in terms of working with the homes first."
MR. SHELBY LARSON, Administrator, Health Facilities Licensing and
Certification, said they hadn't had circumstances like that in
the 12 years he had been with the agency. They didn't have
similar language either on nursing home licensure.
SENATOR LEMAN said it seemed like no one could answer that
question very well and he then asked Ms. Elgee if this also
applies to family members who take care of their related family.
MS. ELGEE answered:
In an assisted living home where the family resides
along with the assisted living residents, the family
members that may not provide direct care, but are in
the home and, therefore, have access on an unsupervised
basis to the residents, would also require a background
check unless they're younger than 16.
SENATOR LEMAN asked about language on page 2, line 10, referring
to a family member who is maybe off at school, but moves back
into the home. Would that family member, if they were not there
and then moves back into the home, be subject to a background
check?
MS. ELGEE replied that the background checks would apply to
visitors, and he could think of that family member as a visitor,
who are residing in the home for more than 14 days. A student who
is residing in a home for the summer would be subject to the
background check, as well.
SENATOR LEMAN said he thought to think about that area a little
bit more.
MR. ELMER LINDSTROM, Special Assistant to the Commissioner, DHSS,
said they had a memo to him from Mr. Larson relating to
background checks in nursing homes. They did not suggest that
background check information be added to the nursing home
statute, but it has been Mr. Larson's intention to adopt, in
regulation, the same background check standards that they have
now developed for assisted living and in order to do that, they
would need some statutory revisions for the nursing home statutes
that are parallel to those already included in the bill relative
to assisted living homes.
CHAIRWOMAN GREEN said they would continue to work on this bill.
MR. RON PARKS, Housing Administrator, Friendship Services
Assisted Living, said they were a nonprofit organization and used
volunteers. The fingerprint requirements would add $94 per
volunteer to their budget, which they can't afford. Every year
they have 50 - 60 volunteers come through their establishment. He
asked them to clarify the difference between a regular volunteer
and an occasional volunteer. In Section 2, line 10, he was
concerned specifically when volunteers are in direct contact with
staff and how that would work with church groups that do
fellowship with some of his residents. He was concerned that they
might be overprotecting the residents and violating their rights
if they want to invite one of those persons into their rooms to
have their services. He wanted to know when they would come into
violation as far as a criminal background check.
CHAIRWOMAN GREEN asked Ms. Elgee and Mr. Lindstrom to see if
there was a better definition and if regulations would cover that
more clearly that the language before them.
MR. PARKS said he had a hard time understanding some of the
terms. He asked if they could define 'contractor.'
MR. LINDSTROM replied that the exceptions in Section 3 say it
doesn't include a contractor who comes into the home who is
telephone repairman repairing utilities. A contractor is really
people who are providing services to the residents in the home,
not a contractor in the sense of a building repairperson.
CHAIRWOMAN GREEN asked if a contractor could be a therapist or
someone who provided food services.
MR. LINDSTROM replied yes. In his department, for instance, there
would be other Health and Human Services providers who would
likely be contractors providing services to people in the home
and that is what they are speaking to.
CHAIRWOMAN GREEN asked if those people weren't already under the
requirement of a background check.
MR. LINDSTROM replied that some of them might already be by
virtue of licensure requirements, but he couldn't say that all of
them would be.
CHAIRWOMAN GREEN asked if that helped Mr. Parks.
MR. PARKS replied that helped him somewhat and asked if they
could change "regular volunteers" to "care providers". He asked
since these people are coming into his facility, since he can't
use other agency's background checks for their purposes, does a
health care provider who comes into a room and closes the door to
take blood for blood work need to have a background check?
MS. ELGEE responded that Section 3 (2) specifically exempts from
the background check requirement an individual who is providing
services to the resident as an employee of a care providing
entity that is not affiliated with the assisted living home.
CHAIRWOMAN GREEN asked if this could be an RN or a doctor.
MS. ELGEE said the example of a physical therapist was a good
one. They contract with physical therapists in the Pioneers'
Homes, but the physical therapist is usually affiliated with a
hospital or another medical practice.
MR. PARKS asked if they are already health care providers, they
already have their own background checks.
MS. ELGEE responded that the assisted living home would not be
required to provide a background check as a part of their
licensure for those individuals.
MR. PARKS said the volunteer program is very important in their
facility and are important in their socialization programs and
getting people out. The wording in SB 67 in regards to volunteers
would be so restrictive that it would cripple their program and
he asked if language could be put in that would cover the
background checks for their volunteers.
MR. WARD responded that Mr. Parks had some good questions. He
said there was quite a bit of discussion about them. The key
piece in terms of volunteer, is if the volunteer was going to be
in direct contact with a resident in an unsupervised situation.
Groups from schools and groups to provide entertainment, etc.
would probably be in a public area in a situation where staff
would be in close proximity and those would not be subject to a
background check. They are most concerned about an individual who
is coming in on a one on one basis. He thought the larger
percentage of volunteers would not be required to have background
checks.
MR. PARKS said their senior companion program could be arranged
in a public area where staff is present, but if a resident
invites someone they have befriended into their room where they
have the right to close the door if they wish, this is the main
gray area of his concern.
CHAIRWOMAN GREEN said there was nothing in their fiscal note that
would cover the cost of background checks.
MS. ELGEE said that was right. The individuals, before
employment, are asked to get the name check and they cover those
costs. They cover the costs for people in the Pioneer Homes.
MR. PARKS agreed that they do cover the cost for employees, but
criminal background checks are very restrictive. Just fingerprint
checks are $94 and he doesn't have that in the budget.
CHAIRWOMAN GREEN said she hoped they could work through this
problem and not have it burdensome to the people who provide
services and set SB 67 aside.
| Document Name | Date/Time | Subjects |
|---|