A lawsuit filed by the senior-citizen advocacy organization Kokua Council has drawn attention to a problem that the state must correct for the good of a rapidly aging population: its oversight of the adult care homes where many will live out their last years.
The complaint raises the issue of the state Department of Health (DOH), charged with the implementation of a 2013 law, Act 213, which requires the timely posting of inspection reports in an online database. This is intended to enable the public to review information about a facility before a family member is placed there.
Unfortunately, according to the complaint, filed July 25 in Circuit Court, the reports are not going online as quickly as the law intended. There is disagreement over what the law requires — whether the five-day deadline clock starts running when the inspection is performed or when the report is finalized.
But even setting that issue aside, the Health Department acknowledges that it’s been a struggle to manage the workload, given its data-gathering and staffing shortfalls.
Those might be challenges, but they can’t be allowed to languish unresolved, with progress made at the laggardly pace many have come to expect from government.
Act 213 took effect in January 2015, with the goal of making available the inspection reports on more than 1,700 facilities statewide. About 1,300 reports have been posted online, but the reports covering 2015 and 2016 — hundreds more — are still inaccessible.
Part of the problem, DOH officials have said, is the workload overwhelming available staff, which also is contending with restaurant inspections and other matters. The reports have to be redacted to excise some private information, said Janice Okubo, department spokeswoman, and all are paper records which then must be digitized to go online.
Further, she said, the department lacks the technology to make digital data collection and compilation easier and more efficient. That is a chronic failing across the entire state bureaucracy that frequently hobbles the delivery of services to the public.
However, it really is no excuse; this handicap can be overcome. Okubo acknowledged that the DOH faced a similar recordkeeping issue with the restaurant inspection regulatory system; technology helped the staff get that one in hand.
What is most distressing to learn about the launch of the care home inspection database is that it had been delayed by something as trivial as an internal dispute.
Okubo said in October that the dispute concerned whether the Legislature intended for the jobs to be temporary or long-term civil service positions. And that caused delay in posting the jobs. Funding lapsed, and then the department hired a temporary staffer in January, but that staffer left after two months.
No wonder the department is behind in its duty, given all the thumb-twiddling.
Providing public access to its care home inspections is a function the public needs urgently and should get priority attention. Testimony bolstering the enactment of Act 213, as well as anecdotal reports Kokua Council has gathered, show the dismal result. Families that need to know with some assurance that a care home is a good fit for their loved one end up getting little help from DOH.
That must change, and quickly. Hawaii residents, often juggling work and child-rearing with the care of frail elders, need help now as never before. This is too important a service, one that will be needed more critically with each passing year.