HB 124-NURS.HOME/ASSISTED LIV. EMPLOYEES/VISITOR CHAIR DYSON announced that the committee would hear HOUSE BILL NO. 124, "An Act prohibiting nursing facilities and assisted living homes from employing or allowing access by persons with certain criminal backgrounds, with exceptions." Number 1092 KEVIN HAND, Staff to Representative Andrew Halcro, Alaska State Legislature, came forth on behalf of the sponsor. He described the changes made in the proposed committee substitute (CS) for HB 124 [Version O, 22-LS0087\O, Lauterbach, 3/21/01]. He stated that there is additional language for criminal background checks for nursing homes in Sections 1, 2, and 3 that mirrors the language already present in Sections 4 and 5 for assisted living facilities. The second major point of contention was that there were some class A misdemeanors that had no relevance to a person's ability to serve as an aide in nursing homes. He explained that [Version O] has removed the inclusion of all class A misdemeanors, in Section 1, paragraph (5), page 3, line 7, and in Section 4, [paragraph (5)] page 5, line 28. Two specific class A misdemeanors were included - the improper use of a corpse and failure to register as a sex offender. MR. HAND explained that the third change involves the emergency involuntary termination of a contract. He indicated that the new language is on page 9, line 20, and lengthens the minimum time before revocation of a contract to 72 hours. Specific language that the long-term ombudsman must receive notice of the termination contract has also been included. He added that if [a resident] requests a conference within 72 hours of receiving notice of the termination, he or she must be granted one. The language has been changed, on page 11, line 9, to strengthen this by stating, "appropriate care providers who shall discuss the justification for, and the appropriateness of, the proposed contract termination." Number 1537 MR. HAND noted that there is still one point of contention in the bill that is being worked on, which refers to any offense when the victim was a resident of a nursing home or receiving long-term care. He stated that this is hard to implement because of the difficulty in finding information regarding past cases, and because of the burden of investigating those cases. CHAIR DYSON asked if Mr. Hand is asking the committee to pass this bill out without that being fixed. MR. HAND responded that in the mind of the sponsor, that is an integral part of the bill. For example, there is a nursing home employee who was recently charged with heavy theft of a resident of a nursing home. He explained that there is nothing banning that person from working in a nursing facility. CHAIR DYSON remarked that it is current practice for people to have their state crime records checked, which is available immediately, and then go to work. He asked whether [an applicant] who "just got off the boat" and has an extensive criminal record, but not in Alaska, could be hired by a nursing home. MR. HAND answered that it was the consensus of everyone [who is involved in this legislation] that that was an acceptable circumstance because of the current labor pool problems in the state. Number 1706 CHAIR DYSON suggested that language be added whereby somebody new to the state could not be put to work or could not work alone, pending the background check. MR. HAND replied that it was irrelevant whether the person was new to the state or not. The time it would take to get the background check done would be the same. Number 1779 REPRESENTATIVE JOULE asked if it would legally be possible to refuse someone work who had just come to the state. CHAIR DYSON responded that it is his sense that a person can be refused hire pending a background check, or there can be special qualifications whereby the person must be supervised. REPRESENTATIVE WILSON asked how long the background check takes. MR. HAND answered that it generally takes about 90 days. REPRESENTATIVE WILSON remarked that when someone starts a new job, he or she is usually placed with someone else until he or she is familiar with the job. Number 1918 MELVIN RICHARDSON, Community Care Licensing Specialist, Mental Health & Developmental Disabilities, Department of Health & Social Services, testified via teleconference. He stated that he found some inconsistencies in the latest draft on page 10, lines 10-17 and lines 28-31, and page 11, lines 1-10. He clarified that he doesn't have a problem with what is being attempted; however, long-term care ombudsmen are not responsible for all the residents of the home. He suggested that the bill be modified to say, "the long-term care ombudsman will be notified if the resident is 60 years of age or older." He added that in [subsection] (c) specific people are identified who should be given written notice, who are different from those who attend the conference in [subsection] (d). He said he thinks there should be mirror language [in those two sections]. CHAIR DYSON asked Mr. Richardson if he thinks the language on page 10, lines 10-17, should be the same as the language on page 10, line 28 through page 11, line 10. MR. RICHARDSON responded yes, that the people at the conference who are notified should be the ones who are identified and receiving the written notice. He continued, stating that he believes the issue on page 5, lines 8-18, which addresses an individual who has committed a crime against a member of a nursing home or assisted-living home, can be addressed successfully in regulation if the language is adopted as-is by putting the burden of proof on the applicant. Number 2197 CHAIR DYSON asked Mr. Richardson whether or not a person who has just arrived in the state for whom there is no in-state records should be put to work pending the [background check]. MR. RICHARDSON responded that he understands the concern; however, there could be a resident who has been in Alaska for ten years or less who has a clean Alaska record but has committed many crimes prior to coming to Alaska. CHAIR DYSON asked how practical it is to have a person work under supervision pending the [background check]. MR. RICHARDSON answered that with large agencies it would probably be possible. However, in the smaller communities, where the labor pool is a great deal less, [the nursing facilities] probably would not be able to recruit a sufficient amount of employees to perform the mission. Number 2188 MONTA FAYE LANE, President, Alaska Caregivers Associations, testified via teleconference. Referring to Sections 6 through 9, regarding termination of a residential contract, she stated that it is necessary for homes to be safe in order to operate, not only for the staff but for the other residents. She stated: If this is taken away from the homes, they become liable for the safety of others and cannot make pertinent business decisions for themselves. No home is going to arbitrarily remove a resident from their home without seeking all remedies available. And those who think otherwise are people who do not know the home business and do not have the responsibility, both physically and fiscally, for other people. This amendment must not be changed. MS. LANE stated that she sees a burden with some of the barrier crimes because they are not clearly defined. She said she thinks [all the crimes] should be looked at individually. She remarked that if she were interviewing someone who "just got off of the plane" and there was not a name check or a [background check], she would [hire] the person on a temporary work basis under supervision. She stated that Section 14 [in the older version of the bill] is unacceptable since the majority of homes in Alaska are small and private, and it would be unthinkable that the state would come into a private home and take over while an owner and administrator lives there. The state needs to strengthen the statute and regulation, she said, rather than impose receiverships on private homes. She remarked that this bill addresses the possibility of administrators, staff, and volunteers who bring harm to vulnerable adults; however, this does not address the vulnerable adults who move into the home and bring danger and harm to others. TAPE 01-33, SIDE B MS. LANE continued, stating: Many of us have experienced residents who have had unknown histories of violence and have committed assault to a staff member and/or resident. This is totally unacceptable, and our association would like to see language included in this bill that would also protect those serving and living in the home. Number 2328 MS. LANE, in conclusion, stated: Please be gentle with the requirements for employment in assisted living [homes]. Excluding the Pioneers' Home, we have limited resources and a limited work pool (indisc.). Also consider that when we say "we," this is inclusive to the Bush. You must not lose sight of the fact that the work pool is even more limited outside of Anchorage, Fairbanks, and Juneau. These homes must also operate on their community resources, which are far more limited than ours. The felonies and misdemeanors must be very directly related to our industry and must give people opportunities to be gainfully employed, even when they have made a mistake. We're supposed to be Christian, forgiving people, and there are people who make mistakes. And if they have had treatment and they are trying to do the right thing, we should give them a chance. Number 2220 LARAINE DERR, President, Alaska State Hospital and Nursing Home Association, came forth and stated that there are some concerns on the part of their members. She said one [of the members of the long-term care committee] is concerned about the inclusion of contractors and volunteers in the language. She added that in the smaller places there is a lack of supervisory staff. If volunteers are going to have to be fingerprinted, the pool of volunteers will start to disappear. CHAIR DYSON asked where the balance is between what can be done in statute to protect [vulnerable adults] and making the law too cumbersome to employ people. MS. DERR responded that the balance is excluding contractors and volunteers and to not make it so cumbersome in the rural areas that [the homes] can't operate. Plus, she said, this continues to add cost. REPRESENTATIVE CISSNA stated that she has read stories on abuses and sometimes it has been volunteers. She said there might be a way to fix that. Number 2026 MR. HAND pointed out that [the bill] specifically prohibits a contractor, employee, or regular volunteer. In Section 2 it provides specific exemptions such as the following: (3) an individual who occasionally volunteers in a nursing facility and who is supervised by and performs these volunteer services in close physical proximity to the staff of the nursing facility; (4) a contractor who does not (A) provide services directly to one or more residents; and (B) have unsupervised access to a part of the facility where services are directly provided to residents. REPRESENTATIVE COGHILL remarked that it has been his experience that the paid staff usually has direct say over who does and does not volunteer. He said many times in [his] church, people working with children, as volunteers, have to get background checks because they work in unsupervised places. If someone was volunteering occasionally, he said, [background checks] were not done. He asked Ms. Derr if she finds her volunteers are under this kind of scrutiny. MS. DERR responded that [the volunteers] are under this kind of scrutiny at a nursing home where there are 90 beds; however, in a nursing home where there are ten people, with one or two people on staff, [duties] are turned over to volunteers. She noted that [the issue] comes down to what "occasional" means. CHAIR DYSON remarked that although there is a smaller labor pool in the smaller communities, everyone knows everybody. He said it seems to him that local references could be very valuable there; however, someone who "just gets off the boat" won't have [local references]. He suggested that there be no unsupervised contact with the residents until the long-term background checks are done. [HB 124 was held over.]