Arizona may boost state oversight of long-term care facilities like the one in Phoenix where an incapacitated woman was raped and later gave birth, reversing a decision more than 20 years ago to drop state regulation.
Lawmakers are considering legislation that would require intermediate care facilities like Hacienda Healthcare to apply for a state license and conduct background checks of employees that care for clients.
Gov. Doug Ducey on Wednesday ordered state agencies to improve protections for people with disabilities. His executive order will require employees at state-funded care facilities to undergo annual training in recognizing and preventing abuse and neglect. He’ll also require that group homes and day programs prominently post signs about how to report abuse.
A Senate committee was scheduled to consider the licensure legislation on Wednesday but delayed the vote to clarify bill language amid concerns it might inadvertently apply too broadly.
Arizona in the 1990s created an exemption from state regulation for intermediate care facilities for individuals with developmental disabilities, leaving the oversight to the federal Centers for Medicare and Medicaid Services, which funds long-term care. State inspectors still visit the facilities about once a year under a contract with the federal government but can only enforce federal regulations in coordination with the agency’s regional office in San Francisco.
“We’re trying to close that loophole that was created decades ago,” said Sen. Heather Carter, a Phoenix Republican who is sponsoring the legislation.
Many of the people who work in care facilities have individual licenses from the state nursing or medical board, which requires a background check. Carter’s legislation would require care facilities to check child and adult abuse databases for anyone who cares for patients, even if they’re not doing work that requires them to be personally licensed.
Intermediate care facilities provide more services than assisted living centers and less than nursing homes, both of which must carry state licenses. Arizona has 11 intermediate care facilities.
Ducey, a Republican who is usually skeptical of state regulations and has touted his record of rolling them back, is open to expanding state oversight.
Ducey on Tuesday asked Attorney General Mark Brnovich to investigate Hacienda for potential violations of the Adult Protective Services Act or civil rights laws.
A spokesman for Hacienda did not respond to requests for comment.
The lack of state licensing was among the issues noted in a report last week by a state panel calling for policy changes to protect vulnerable adults from sexual abuse. The report by the Arizona Developmental Disabilities Planning Council was in the works before the rape at Hacienda.
The report also said people who are required to report abuse but fail to do so should face felony charges; currently, the maximum charge is a misdemeanor if the victim is an adult. It found job protections lacking for people who report violations and said high staff turnover can prevent caregivers from recognizing subtle behavior changes.
Authorities say Nathan Sutherland, a licensed practical nurse at Hacienda, raped the 29-year-old victim, who has been in long-term care since age 3. She gave birth to a boy at the facility on Dec. 29. Employees said they had no idea she was pregnant.
Investigators say Sutherland’s DNA matched a sample from the woman’s newborn son, who is being cared for by her family. Sutherland, 36, has pleaded not guilty to charges of sexual abuse.
The surprise birth triggered reviews by state agencies, highlighted safety concerns for patients who are severely disabled or incapacitated and prompted the resignations of Hacienda’s chief executive and one of the victim’s doctors.
The state has required Hacienda to hire a management company to handle operations.