Monday, April 16, 2007

PA DPW's Plan for Personal Care Homes?

On April 12, 2007, the Pennsylvania Department of Public Welfare announced a plan for addressing the identified crisis in its supervision of certain personal care homes in the Commonwealth.

What is the impetus for such a new plan? Could it be the public scrutiny upon the situation described in a newspaper article?

Anna Mae Edwards' family thought well of Judith Reynolds after four years watching her competently care for the 90-year-old woman at Cedarwood Personal Care Inc., where Edwards was still healthy in relatives' eyes.

That faith was shattered the morning of Aug. 25, when, police say, Reynolds left Edwards and seven other residents unattended before a replacement staff person arrived.

Edwards collapsed to the floor of her room, bruised and with no one to provide immediate help. Three days later, she died in a hospital, with a heart attack from coronary artery disease listed as the cause. * * *

For the first time since 1991, major revisions in oversight of personal care homes are pending in Pennsylvania. The Department of Public Welfare plans to publish regulations by Nov. 4 that, if approved, would set new training and competency test requirements for administrators and staff, among a wide range of changes. * * *
Not directly. That excerpt was published on Sunday, September 5, 2004, in the Pittsburgh Post-Gazette, as written by Gary Rotstein in his article, entitled "New rules on the way for personal care home operators in Pa.", when he reported that the death of a woman "who lived at Cedarwood, Indiana Township, brings attention to wider issue". That article listed documented cases of abuse that had occurred in personal care homes in Pennsylvania.

The adopted updated
Personal Care Home Licensing regulations, effective October 24, 2005, can be found here (PA. Bulletin) and here (PA Code).

No, DPW is reacting to the further investigative journalism in 2006 & 2007 that resulted in publication by The Philadelphia Inquirer of its series "A Failure to Care", at the end of February, 2007.

I noted the series on March 1, 2007, in
Phila. Inquirer's "Shame of the State" Investigation (03/01/07) & its Updates. See also: Legislation on "Personal Care Homes" in PA (03/07/07), & its Update. (Unfortunately, the links I had posted to those articles now are broken, since the seven day "free" access period expired; but the articles can be obtained through the Inquirer's online subscription service.)

What is the announced plan? We cannot read about it yet on DPW's website, since it has not been the subject of a formal press release, among many issued, as listed here. So we must rely on news reports to learn about it.

Charles Thompson reported about DPW's plan in the Patriot News on April 11, 2007, in his article entitled
"DPW addresses home inspections backlog":
State Public Welfare Secretary Estelle Richman unveiled a plan Wednesday to attack an inspection backlog that has left, by her department's count, more than 70 percent of Pennsylvania's 1,589 personal care homes operating on expired licenses.

Richman said the Department of Public Welfare's plans to hire a short-term corps of retired workers who have worked in inspecting a variety of residential facilities for the state.

"Given that they've all had experience doing this kind of inspection before... we believe if we can hire 30 of them, we can have this done sometime around October," Richman told a House panel overseeing the state's regulation of the personal care industry.

Richman said the proposed inspection surge will allow the welfare department to focus its permanent personal care inspectors, including 15 new hires proposed this year, on more serious rule-breakers around the state. * * *
Associated Press reporter Martha Raffaele, who covers human service issues in Harrisburg, provided further details on April 12, 2007, in her AP article entitled "Welfare secretary: Retirees may help inspect personal-care homes".

The state is trying to hire 30 retired workers as temporary, part-time inspectors and may contract with a private company to help address a backlog of annual personal-care home inspections.

The retirees, who would have previous experience inspecting nursing homes and other facilities, will help the agency complete inspections of the nearly 75 percent of personal-care homes operating with expired licenses, Public Welfare Secretary Estelle Richman told a panel of state House members Wednesday. The inspections would be finished by the end of the year.

"With about 30 people, we can get through that," Richman said during a hearing on the state's oversight of personal-care homes.

Richman's testimony came three weeks after she disclosed the backlog during her Senate confirmation hearing. After that hearing, a spokeswoman for Richman said 1,190 of 1,589 personal-care homes were operating with expired licenses, and that the agency was moving to close 30 homes because of safety concerns.

But this plan is subject to debate, just as the regulations that were updated two years ago. Martha reported on this debate in her article published April 15, 2007, entitled "Advocates, operators still disagree over personal-care home rules":

Eighteen months after Pennsylvania began implementing tougher personal-care home regulations, neither the homes' operators nor advocates for the disabled are entirely happy with the results.

Their sharply contrasting views were laid out in testimony last week during a legislative hearing.

Administrators of the homes , where the elderly and disabled receive help with daily tasks such as dressing, bathing, and managing their finances , said the regulations were too costly and created time-consuming paperwork.

Advocates said while the new rules vastly improved the state's inspection and enforcement practices, some shortcomings still exist, such as a lack of adequate training for certain workers.

The Department of Public Welfare, which is responsible for 1,589 personal-care homes serving more than 50,000 residents, says it's too soon to reopen the regulatory debate just yet. * * *

The Philadelphia Inquirer continues to follow the issue that it drew to national attention. For its latest report, see: "Interim help will inspect care homes --Pa. will hire 30 retirees to clear an inspection backlog" by Martha Raffaele & Nancy Phillips, published April 12, 2007:

State Rep. Phyllis Mundy, chairwoman of the House Aging and Older Adult Services Committee, said yesterday that The Inquirer's report raised concerns that lawmakers needed to address.

"People should have peace of mind when they place a loved one in a personal-care home setting," Mundy (D., Luzerne) said.

Richman has acknowledged that her department has been slow to address health and safety issues, and she has pledged to correct that. * * *

Admittedly, DPW is addressing "interim help" with its proposed plan. Ultimately, the Legislature must envision & implement a long-term structure for personal care homes.