Nursing homes and other elderly caregivers will have to do national, fingerprint-based background checks on employees

Nursing homes and many other health care providers will be required to obtain national criminal background checks on new employees and others who provide direct one-on-one care to elderly residents or patients, under an emergency regulation outgoing Democratic Gov. Steve Beshear issued Friday.

Besides nursing homes, which have been the focus of concern about elder abuse, the regulation also applies to personal-care homes, intermediate care facilities, adult day health-care programs, assisted living communities, home health agencies, hospices, personal-services agencies, providers of home and community-based services, and staffing agencies, "including nursing pools that have contracts to provide staff to one or more of the listed employer types," a state news release said.

Only 7 percent of those providers are using a voluntary system to do national, fingerprint-supported background checks, Cabinet for Health and Family Services spokeswoman Beth Fisher told Kentucky Health News.

“Protecting the elderly and other individuals residing in these facilities is not only important – it is our duty as state leaders,” Beshear said in the release. “All too often, these vulnerable citizens become victims of the very individuals who are supposed to be caring for them. This regulation, based upon a federal law allowing these background checks, will ensure we are able to thoroughly track the history of anyone who has committed such an offense, whether it occurred in Kentucky or out of state, and ensure they will not be working at health care facilities in the commonwealth.”

State law requires only name-based, Kentucky-specific background checks, "creating a loophole that allowed applicants seeking employment in these long-term care and other settings to hide criminal actions committed in other states," the release said. "Meanwhile, the prevalence of alleged abuse or exploitation of seniors in these settings remained significant."

The release said that since May 2014, over 2,600 complaints have been filed against long-term care providers, almost 30 percent directly related to suspected abuse or exploitation of residents. Requiring fingerprint-supported background checks means that "applicants will not be able to hide criminal actions committed in other states," Cabinet for Health and Family Services Secretary Audrey Tayse Haynes said in the release. "National background checks are a critical initiative that dramatically improve the ability of long-term care and other providers to timely and accurately research the backgrounds of potential employees, ruling out individuals with histories of violence, abuse or exploitation that occurred in other states."

The state has operated a fingerprint-supported vetting program since 2011, using federal grants. “This program . . . has now been fully tested by voluntary participants over the last 18 months, and the feedback has been overwhelmingly positive regarding its ease of use, cost effectiveness and speed,” CHFS Inspector General Maryellen Mynear said in the release. “Our office will assist providers as they apply for initial licensure or renew their existing license to ensure a smooth and timely transition to a national criminal background check program that meets the requirements of this regulation.”

The program usually returns results in 24 to 72 hours, compared to three or more weeks using the traditional, paper-based process, the release said. However, only 85 of the 1,267 providers who will be covered by the new rule use the voluntary program, CHFS spokeswoman Beth Fisher said.

Because the rule is in an emergency regulation, Republican Matt Bevin could revoke it after he becomes governor Dec. 8, but Beshear's news release quoted Republican state Sen. Tom Buford of Nicholasville as saying,  “I commend Gov. Steve Beshear for this action to provide protections for our senior citizens.”

State Rep. Linda Belcher, D-Shepherdsville, said in the release, “I have been working on legislation to accomplish this for some time now and am very pleased Gov. Beshear has taken this step to further protect the elderly residents and patients.”

The release said the voluntary program "has performed more than 2,200 background checks and has screened out applicants who had been convicted of serious violent offenses in other states but had no criminal history in Kentucky." The program’s website, http://chfs.ky.gov/os/oig/kares, contains provider enrollment information, general information for both providers and the public, frequently asked questions and links to related programs and content. Additional information is available via email to KARES.Helpdesk@ky.gov or by calling 502-564-2159.

Mentally ill in personal-care homes, or at risk of going there, will have increased access to behavioral health care in Kentucky

The state Cabinet for Health and Family Services is extending an agreement that provides housing assistance and services to people with serious mental illness has been extended through Septemnber 2018, and is expanding it to provide increased access, according to a state news release

The agreement is with Kentucky Protection and Advocacy, an independent state agency that advocates for the rights of persons with disabilities. Its services are available to those with serious mental illness who reside, or are at risk of residing, in a personal-care home. Such facilities are long-term care facilities that provide care for persons who do not require hospital or nursing-home care, but who do require care beyond solely room and board.

The initial agreement only allowed the 14 regional community mental health centers to provide these services to individuals in their regions, but now they can serve individuals outside their service area. In addition, other behavioral health providers will now be able to provide services to these individuals.

The extended agreement also says that a regulation must be put into place that requires the use of these services to be a routine part of the Department for Behavioral Health, Development and Intellectual Disabilities protocols for those who reside in personal-care homes.

Services provided under the agreement include basic physical and behavioral health and health-related services, personal care services, residential care services, supported employment, case management, peer support services and social and recreational activities.

The extended agreement is expected to help avoid litigation under the Americans with Disabilities Act, which requires providing services to persons with disabilities in the most integrated setting.

It is estimated there are some 2,300 Kentuckians, most with serious mental illness, receiving the state supplement and residing in personal-care homes, according to the release.

Agreement will move at least 600 from personal-care homes to community mental health facilities

At least 600 people now in personal-care homes will be moved to community-based settings under "an agreement that advocates say will systematically change the way community mental health services are delivered in Kentucky, improving the lives of hundreds of people with mental illnesses and disabilities," Beth Musgrave reports for the Lexington Herald-Leader.

Stories by the Herald-Leader and investigations by Protection and Advocacy, a state agency for the disabled and mentally ill, "found that personal care homes often are an ill-equipped last resort for people with complex problems such as substance abuse, mental illness or a mental disability," Musgrave writes. "Past problems at personal care homes have included criminal arrests of operators for stealing money from residents, lack of food, poor medical care and deaths" when residents walked away from homes in Letcher and Pendleton counties.

The state Cabinet for Health and Family Services estimates that the changes will cost $19 million over the next three years, and it said the money would come from the budget for housing people in mental hospitals. "Under the agreement, people can use their state supplement of $520 a month for services that will keep them out of a personal care home. Under the current system, a person can receive the supplement only if they live in a personal care home," Musgrave writes. "That change will affect anyone who is eligible for personal care home services, not just the 600 people who will get additional services under the agreement." The cabinet will have until October 2014 to move the first 100 personal-care-home residents. (Read more)

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Read more here: http://www.kentucky.com/2013/08/16/2769986/kentucky-agrees-to-offer-more.html#storylink=cpy

Bills would require more assessment before a patient can be admitted to a personal-care home

Legislation dubbed "Larry's Law" is aimed at preventing what happened to Larry Lee from happening again.

House Bill 307, filed by Democratic Rep. Terry Mills, right, "would require an individual to be examined and assessed by a medical professional before admission to a personal care home, and it would require further assessment of the degree of disability for an individual with an acquired brain injury who was being considered for placement," report Valarie Honeycutt Spears and Beth Musgrave of the Lexington Herald-Leader.

Senate Bill 115, filed by Republican Sen. Jimmy Higdon, left, would require that a potential resident be evaluated by a mental health professional before someone is admitted to a personal care home, a cost that would be picked up by the state. Higdon and Mills are both from Lebanon, where Larry Lee lived until he went to Falmouth Nursing Home in Pendleton County.

In August, Lee, right, disappeared from the home, one of 82 free-standing personal care homes in Kentucky. Lee, who had a brain injury from childhood, had been diagnosed with schizophrenia, bipolar disorder and diabetes. He was found dead four week after his disappearance on the banks of the Licking River, which flows through Falmouth.

A pre-admission assessment "is the only thing that we found that could have saved Larry Lee," Higdon said. "His condition was too severe. He should have never been in a personal care home." (Read more)

Brain-injured man disappeared when home staff wasn't looking

On the day of his disappearance, a resident of a personal-care home who was found dead four weeks later had not been checked on by staff for nearly three hours, reports Valarie Honeycutt Spears of the Lexington Herald-Leader, citing documents from a state investigation.

Additionally, Falmouth Nursing Home did not have a policy to make sure residents were under constant supervision and "the facility failed to establish" one, investigators found.

Larry Joe Lee, right, was a ward of the state and had a brain injury stemming from a childhood accident. He was "schizophrenic, bipolar and diabetic," Spears writes. He disappeared from the nursing home Aug. 4. His body was found Sept. 3 near the Licking River by bow hunters. The cause of his death has not yet been determined.

Spears' calls to the  home were not returned. It has since submitted a plan of correction to the state, which includes professional development for staff and new policies to keep track of patients' whereabouts.

"Since Lee's death, advocates and state lawmakers have been questioning whether personal care homes are the appropriate plate for people with brain injuries," Spears reports. Republican Sen. Jimmy Higdon, who comes from Lee's hometown of Lebanon, said he is on a fact-finding mission to see what changes need to be made to prevent a similar occurrence from happening. (Read more)