Long-term Care Vol. Ombudsman

Appropriates funds to DOH to establish a long term care volunteer
ombudsman program. (SD1)

HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 1
TWENTIETH LEGISLATURE, 1999                                S.D. 1
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  The legislature finds that the long term care
 2 ombudsman program is a federally mandated program which is funded
 3 through the Older Americans Act of 1965.  The program is charged
 4 with the responsibility of serving as an advocate for 6,780
 5 residents living in 46 licensed nursing facilities and 542 adult
 6 residential care homes; especially those who may be unable or
 7 afraid to speak for themselves.  Situated within the executive
 8 office on aging, this statewide program requires the ombudsman to
 9 visit all facilities.  The program is currently staffed by two
10 full-time program specialists.
11      The program's primary function is to respond, investigate
12 and assist in resolving complaints and requests for information
13 or assistance.  Outreach to residents in these facilities and
14 homes is an essential component of the program since the
15 residents served are usually frail and dependent with physical,
16 mental, or emotional needs.  Often, their dependency on others
17 for care presents the potential for reluctance in speaking out
18 when they are the recipients of inappropriate care.  Outreach to
19 these residents is particularly crucial in order to assure them

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 1 that they do have external supports should they need them.
 2      It was recently pointed out at the Governor's Conference on
 3 Adult Residential Care Homes that the long term care options in
 4 Hawaii are expanding.  There is an increase in assisted living
 5 and expanded care facilities.  While there is much supervision
 6 and family involvement in nursing homes, in a care home the only
 7 supervision is from the care home operator.  Current regulations
 8 require the department of health to notify the care home operator
 9 one month in advance before surveying the home for renewal of its
10 license.  Presently the long term care ombudsman is the only one
11 allowed to enter a care home without an appointment. 
12      Some of these homes are now receiving special waivers to
13 accept residents at a higher acuity level who are also less
14 likely to be able to speak for themselves.  In order to assure
15 proper services for these elderly residents, the long term care
16 ombudsman program's jurisdiction will increase.
17      As the State's elderly population continues to grow, the two
18 full-time staff members of the program will be unable to provide
19 the necessary outreach services.  Forty-six states have developed
20 a successful volunteer component to their long term care
21 ombudsman programs.  The American Association of Retired Persons
22 has developed a training manual specifically for the long term
23 care ombudsman program which many states have used as a starting

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                                     H.B. NO.           H.D. 1
                                                        S.D. 1

 1 point.  According to the Legal Counsel for the Elderly's 1995
 2 Report, "the presence and work of the volunteers make a major
 3 contribution towards the enhancement of the quality of life for
 4 residents of long term care facilities."
 5      The purpose of this Act is to appropriate funds to establish
 6 a long term care volunteer ombudsman program to ensure that
 7 quality outreach services are provided to the increasing number
 8 of elderly people residing in long term care facilities in the
 9 State.
10      SECTION 2.  There is appropriated out of the general
11 revenues of the State of Hawaii the sum of $90,721, or so much
12 thereof as may be necessary for fiscal year 1999-2000, to
13 establish a long term care volunteer ombudsman program, to
14 include but not be limited to a volunteer coordinator, clerk
15 steno, ground and air travel, training, and miscellaneous
16 volunteer reimbursements.
17      SECTION 3.  The sum appropriated shall be expended by the
18 department of health for the purposes of this Act.
19      SECTION 4.  This Act shall take effect on July 1, 1999.