You may be aware of recent commentary and media statements by AARP about its proposed Senate Bill 2264, also known as the "caregivers bill."

While we understand the intent of supporting patients needing care at home, we believe this bill will do more harm than good. A lot more harm.

AARP’s national office is not the appropriate agency to regulate hospital discharge procedures. The bill would apply to all patients, not just seniors. The proposed law does not take into account current regulation by the Centers for Medicare & Medicaid Services or The Joint Commission, and there are potential issues of conflict with federal requirements that have not been addressed.

SB 2264 is a cookie-cutter bill, developed nationally with absolutely no dialogue with local providers affected by the bill. That’s just not how we do things in Hawaii. We’re a collaborative state. No other state has passed this legislation. In other states, the step of assessing the problem has come first. AARP has not shown why this bill is needed in Hawaii, and has refused to meet with hospitals outside the Legislature to discuss collaborative ways to address the challenges of providing care to seniors after discharge.

There are also some glaring errors with the bill’s approach.

Hospitals routinely work with home health and other post-acute organizations for the best health and safety of patients being discharged. There is an entire industry of medically licensed home health professionals who are far better suited to assist family members with caring for loved ones at home. Health care provided in the home by certified medical professionals is often covered by Medicare. Yet the entire post-acute industry has been left out of this bill.

AARP wants hospitals to train non-clinical people to perform medical tasks. It makes no sense to force hospitals to do this, and it is not safe for patients. A single live demonstration by a hospital worker is not going to properly equip a caregiver to handle wound care and other complex medical tasks.

Who knows patients’ needs, when and how they should be discharged, better than their doctors? The bill as proposed would require live discharge training of a caregiver for every patient. Not just patients who need complex care at home. Every patient admitted to a Hawaii hospital.

The costs of increasing the level of discharge planning to find and coordinate with designated caregivers and to give each one a live demonstration are enormous. This will raise medical costs for everyone. Hospitals are already required by federal guidelines to do discharge planning, including training of caregivers when appropriate. Hawaii hospitals already spend more than $20 million a year on this.

The additional requirements of the caregivers bill are estimated to cost the state-run HHSC hospitals alone between $1.6 million and $5.36 million annually.

Further, the bill opens the door wide for hospitals to be held responsible for the actions, or inactions, of caregivers after the patient is discharged — again raising the cost of health care for everyone.

Medical professionals employed by hospitals have no means of ensuring that a caregiver will properly carry out tasks — or that the person designated as the caregiver won’t change. Yet if SB 2264 passes, the hospital could now be sued for inadequate care by family members and friends in the home.

Senate Bill 2264 just doesn’t make sense. Hawaii hospitals should not be regulated by the AARP national office. The life and safety of your loved ones is too important to entrust to this misguided legislation.