BOISE – Sweeping reforms of Idaho’s system for overseeing assisted-living centers won support from a House committee Thursday, after a year of negotiations.
The 35-page bill, plus two pages of amendments that an array of providers and advocacy groups had just agreed to Thursday morning, cleared the House Health and Welfare Committee late Thursday along with several additional amendments the committee members added.
“We’ve come a long way – I didn’t think we would be here today, to be honest with you,” said Bryan Elliott, president of the Idaho Assisted Living Association and operator of a Boise assisted-living center.
“It’s an extraordinary work, and long overdue,” said Rob Redford, CEO of Latah Health Services in Moscow, which operates assisted-living, skilled nursing and outpatient care programs.
Although the changes modernize the state’s oversight of the centers, which typically provide care for the elderly and others who don’t need nursing care but need help with everyday tasks, they also eliminate a longstanding requirement for annual state inspections of the centers.
“We had three facilities we had not been to in four years,” said Randy May, deputy administrator of Medicaid for the state Department of Health and Welfare.
The department doesn’t have the staff to inspect every center annually – especially since the number of the centers has exploded in recent years.
The department proposed instead to allow centers with excellent track records to be inspected less frequently and those with violations to be surveyed more often.
“We shift our focus to the 20 percent of the facilities that have 80 percent of the problems,” May told the House committee.
The bill, HB 265, also makes a series of other changes. It consolidates the laws regulating the centers, identifies the worst violations that can impact the safety of residents and distinguishes those from more minor questions, and increases the department’s role in training and providing technical assistance to the centers to help them meet standards.
“We would like there to be a perfect world, and inspections done annually,” said Marilyn Sword, director of the Idaho Council on Developmental Disabilities and one of the many who participated in the negotiations. “We recognize that that hasn’t been done in some time.”
Kathy Hart, Idaho state ombudsman for the elderly with the Idaho Commission on Aging, said Idaho now has twice as many beds in assisted living centers as it had in 1996, when the law last was revised. Hart said that like Sword, she’d advocate for more surveyors if Health and Welfare could add them.
Some debate focused on the bill’s requirement that all inspections of assisted-living centers be unannounced. Several operators said they thought some should be announced to allow operators to be there, prepare residents for the intrusion and have documents ready.
“I am concerned here that we’re setting up an adversarial situation with the inspections,” said Rep. Peter Nielsen, R-Mountain Home.
Scott Burpee, CEO of Valley Vista Care Services in North Idaho, said nursing homes have faced unannounced inspections for the past 30 years. He noted that state records show three people died in assisted-living centers in Idaho in the past two years in cases that were “totally avoidable, totally the fault of the providers.”
“I think the unannounced surveys is critical,” Burpee told the panel.
Jerry Mitchell, an operator from Idaho Falls, said he could be gone on a field trip with clients if the survey was unannounced. “Believe me, you can’t hide dead bodies in 48 hours – they will be discovered,” he said.
The committee’s last-minute amendments included a change to allow the department the discretion to announce some inspections, but not all.
Rep. Kathie Garrett, R-Boise, praised the department officials, operators and advocates who worked on the bill over the past year.
“I am just pleased and amazed and awestruck and a few other things about the process that we went through,” she said.
The bill now moves to the full House.
Local journalism is essential.
Give directly to The Spokesman-Review's Northwest Passages community forums series -- which helps to offset the costs of several reporter and editor positions at the newspaper -- by using the easy options below. Gifts processed in this system are not tax deductible, but are predominately used to help meet the local financial requirements needed to receive national matching-grant funds.
Subscribe now to get breaking news alerts in your email inbox
Get breaking news delivered to your inbox as it happens.