Task force balks at resolution to make hospitals teach kin how to care for elders

After arguments pro and con, a task force on health care for seniors took no position Monday on a legislative resolution that would require hospitals to instruct family members in the proper care of relatives who are discharged.

The intent of House Concurrent Resolution 78 is to reduce the number of readmissions to hospitals. In 2013 there were more than 5,400 readmissions to an acute care hospital within 30 days of discharge. These potentially preventable readmissions tallied total hospital charges of almost $239 million, according to the Hawaii Health Information Corp.

More than two dozen advocates for the resolution attended the meeting, painting half of a room at the state Capitol bright with their red AARP shirts.

"There’s a common-sense solution to make sure that there is a healthy transition to the home and being cared for by somebody who has instructions so that they aren’t readmitted back," AARP State Director Barbara Stanton said in an interview.

But the resolution is opposed by hospital representatives, who say it is unnecessary.

Hospitals already provide instructions for caregivers upon a patient’s discharge, said Paula Yoshi­oka, a spokes­woman for the Queen’s Health Systems.

"We want to work with AARP, but we don’t think hospitals should be mandated by a bill," she said in an interview.

Yoshioka maintains that a mandate is unnecessary and would hold hospitals liable for actions made by the caregiver, which hospitals have no control over.

Likewise, Hawaii Pacific Health said in a statement that it already has systems in place to address the issue.

"Introducing legislation is not the most productive next step," the statement said.

The Caregiver Task Force Working Group, created by the Legislature in 2014, voted 16-8 to take no action on the resolution.

Nevertheless, Stanton, a member of the task force, said she hopes to see a bill introduced that focuses on three main provisions:

» Recording the family caregiver’s name when a relative is admitted to a health care facility.

» Notifying the family caregiver if the patient will be discharged to another facility or released home.

» Having hospitals or rehabilitation facilities provide an explanation and live instruction of medical tasks expected of the family caregiver.

"It’s good for the hospital, to make sure (the patient) has a safe discharge," Stanton said. "It’s good for the patient, who will have better care. It’s good for the caregiver, who will have the right instructions. It’s a triple win."

According to a 2014 study by the AARP and the Commonwealth Fund, Hawaii ranks sixth in the nation in long-term services and support for older adults, people with physical disabilities and family caregivers. AARP estimates there are 247,000 family caregivers in the state.

The task force includes 20 members representing hospitals and health care facilities, five representing state and county offices on aging, two representatives of the Department of Health, one representative each from the House and Senate, and six from community organizations supporting caregivers.