Revised bill allows
care home spot checks

---

By Helen Altonn
haltonn@starbulletin.com

Unannounced inspections to evaluate the health status of residents of adult residential care homes would be permitted during business hours under a revised version of Senate Bill 1061 SD1.

Legislature Directory Legislature Bills & Hawaii Revised Statutes

The House Health and Human Services committees approved the controversial measure Thursday with changes proposed by Health Chairman Dennis Arakaki (D, Kamehameha Heights-Kalihi Valley).

Arakaki suggested different levels of announced and unannounced inspections to resolve hardened positions for and against the bill.

The bill initially proposed unannounced annual inspections for licensing, which care home operators adamantly oppose as disruptive, unnecessary and unreasonable. Health professionals and medical organizations argue surprise inspections are necessary to uncover bad facilities.

Arakaki recommended deleting much of the language in the bill which, he said, will be reflected in new administrative rules by the state Health Department governing adult residential care homes. Public hearings are scheduled April 15 across the state.

He said the changes he's proposing are aimed at finding the bad operations.

Unannounced investigations in or outside business hours to follow up on complaints and announced annual licensing inspections during regular business hours already are permitted.

Arakaki proposes adding unannounced annual inspections for no more than three consecutive years to determine if violations of licensing requirements are being corrected.

He also proposes allowing the Health Department or insurance commissioner to establish an insurance risk pool for adult residential care homes so they can obtain reduced rates.

Deputy Health Director Jane Kadohiro said the agency would like flexibility to make unannounced visits for compliance problems, as well as checking on the residents' health status.

Committee members raised some questions about the changes and asked if the state Health Department has the staff to conduct required inspections.

Dianne Okumura, acting chief of the Office of Health Care Assurance, told legislators at an earlier hearing that she has six inspectors statewide and one position is vacant. They are able to visit every facility once a year, she said.

Arakaki said more adjustments may be made in the bill in consultation with health officials as the measure progresses to Judiciary and Finance committees.