Sen. English puts the bite on lax hospitals

Bill holds facilities responsibile for patient health aids

The Maui News
Sunday, March 24, 2002
A4

By MARK ADAMS
Staff Writer

HONOLULU - A bill authored by Maui state Sen. J. Kalani English now moving through the state Legislature has some teeth in it - literally. The legislation holds hospitals strictly responsible for keeping track of patients' health aids. Its genesis came last year when English's grandmother, Violet Soong English, was in the hospital on Oahu and her dentures were lost.

What should have been a minor inconvenience became a major problem as English said he first tried to work with the hospital to find the dentures, and then asked that they pay for replacement. The hospital refused, telling him they had no responsibility or liability for the missing items.

As the senator went through the process of replacing the dentures at a cost of $1,000, he ran into several other people in the same predicament, which started him thinking about other vital personal items patients take with them to the hospital.

A call to an optometrist and ear specialist confirmed his thought: Eyeglasses and hearing aids also are commonly lost when the user is in the hospital.

All of that led English to introduce the bill making it clear hospitals are responsible for keeping track of personal effects "necessary for the patient's health and well-being," and replacing them if they are lost through no fault of the patient.

"The bill is a direct outcome of my grandmother's horrendous experience in the last month of her life," English said.

SB2982 has been approved by the state Senate and was heard by the House Health Committee on Thursday, where it was approved with several amendments. It has been referred to the House Judiciary and Hawaiian Affairs Committee, but English said Thursday's amendments may take care of that committee's concerns and it could move straight to the full House for a vote.

The bill specifically names five items it covers: dentures, eyeglasses, hearing aids, walking devices and prostheses.

It states that when a patient checks in to the hospital, a written inventory should be made. At the time of discharge, the patient shall either sign a release acknowledging that all items are accounted for, or be given an opportunity to file a claim for any personal effects that are missing.

In its committee report on the bill, Senate Health and Human Services Committee Chairman David Matsuura said hospital facilities routinely take no responsibility for replacing missing personal items.

"Especially for the poorest elderly patients, the cost of replacement . . . is not within their means, and requires assistance through government programs that may not provide timely replacement," Matsuura stated. "Some elderly patients may never receive replacement of these assistive devices, and thus their already frail condition is further exacerbated by this loss."

In the Senate version of the bill, unless a hospital can establish that the items were lost due to an action of the patient or any of the patient's visitors, the hospital shall be liable for the cost of replacing the item and shall make payment within 30 days of a claim being filed.

If more than 30 days elapse without payment, the hospital is then liable for three times the replacement cost, and if 60 days have elapsed the penalty increases to six times the replacement cost.

The penalty provisions have been removed from the House version of the bill, and English said the penalties had also been a sticking point for House Judiciary & Hawaiian Affairs Committee members.

Because of the changes, the bill could wind up in conference committee after passage by the House unless the Senate agrees to the amended version. English said he might advise that the Senate accept the amended bill.

"I still think it protects the consumers and our elders," he said, by setting in place a formal process for logging items in and out. It also allows for a negotiated settlement of any losses.

"And it puts the burden of responsibility squarely on the hospitals," the senator said.

At Maui Memorial Medical Center, Risk Manager Carolyn Joyo called English's bill unnecessary, saying a procedure is already in place to log a patient's personal effects and make sure they are returned at discharge.

There are occasions when an item may be misplaced, she said. "We have, in fact, replaced these types of items," Joyo said, but each case is weighed individually after a complete investigation. Problems can arise when an item is brought in after a patient is admitted or when items are claimed that were not logged in initially, she said.

Joyo said the Senate bill places a potential burden on hospitals to prove that an item was not lost by its staff.

English said opposition to the bill has been voiced in committee by hospital representatives who contend they already have procedures in place to track items.

"But if they were taking care of it, we wouldn't have all of these people sitting in doctors' offices trying to cut deals because Medicaid wouldn't pay for a replacement," English said.

"People have to decide whether to pay the rent, buy food or buy dentures - it's not treating the elderly with respect."

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