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Following is a reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, to a question by the Hon Kwong Chi-kin on the private residential care homes for the elderly in the Legislative Council today (April 30):
Question:
In the current financial year, the Government will provide additional one month's standard rate Comprehensive Social Security Assistance (¡§CSSA¡¨) payments for CSSA recipients and a one-off grant of $3,000 for each Old Age Allowance (¡§OAA¡¨) recipient. However, the media discovered that some private residential care homes for the elderly (¡§RCHEs¡¨) had free access to the bank deposits of some of their elderly residents because they paid the home fees with their CSSA payments. Some of these RCHEs had, without those elderly persons' authorization, deducted the additional month's CSSA payments, which were provided to them by the Government last year, for paying home fees. Such elderly persons were therefore unable to enjoy the Government's payouts. In this connection, will the Government inform this Council:
(a) regarding the above incidents of unauthorized deduction of elderly persons' CSSA payments by RCHEs, whether the Social Welfare Department has taken any action, such as penalizing the RCHEs concerned and demanding them to return the CSSA payments concerned to the elderly persons;
(b) focusing on the above problem, whether the Government will consider amending the Code of Practice for Residential Care Homes (Elderly Persons), such as stipulating that if the elderly persons pay the home fees with their CSSA payments, the RCHEs concerned can only collect one month's CSSA payments from them as home fees each month, in order to protect the elderly persons concerned; and
(c) of the measures and ways the authorities have in place to ensure that the additional CSSA payments and OAA provided in the current year to the elderly persons concerned will not be wrongfully deducted by RCHEs?
Reply:
Madam President,
(a) In 2007, the Social Welfare Department (SWD) received a total of 11 complaints and two enquiries relating to residential care homes for the elderly (RCHEs) using the additional one-month Comprehensive Social Security Assistance (CSSA) payments to subsidize home fees. Upon receipt of such enquiries and complaints, the Licensing Office of Residential Care Homes for the Elderly (LORCHE) of SWD had taken immediate follow-up actions, which included explaining the situation to the enquirers and investigating into the complaints. Of the 11 complaints received, four were found substantiated, one was settled through negotiation between the concerned RCHE and the complainant, and the remaining six were either due to misunderstanding or found unsubstantiated by LORCHE. For those substantiated cases, LORCHE had requested concerned RCHEs to return the over-charged home fees to the elders and immediately improve the fee collection procedure, etc. All enquiries and complaints were properly handled.
(b) SWD has provided clear guidelines on the fee charging arrangements of RCHEs in its Code of Practice for Residential Care Homes (Elderly Persons) (the Code). Chapter 8 of the Code stipulates that written consent and authorization should be sought from the resident and his/her guardian, guarantor, family members or relatives for possessions or property stored or held on behalf of every resident by the RCHE, including Hong Kong Identity Card, medical follow-up card and bank passbook, etc. Such consent and authorization should be sought either at the time of admission or as it becomes necessary, and should be properly documented. Moreover, RCHEs should not use the money in or withdraw money from the bank account of a resident for any purpose, including payment of home fees and other charges, unless a written consent and authorization of the resident and his/her guardian, guarantor, family members or relatives is obtained. Besides, by virtue of Section 16 of the Residential Care Homes (Elderly) Persons Regulation, RCHEs should establish and maintain a comprehensive system of updated records of possessions or property stored or held on behalf of every resident, and make them readily available for LORCHE¡¦s inspection.
To remind RCHE operators that they must strictly adhere to the requirements of the Code, LORCHE issued a Guideline on Handling of Elderly Residents¡¦ Possessions and Collection of Fees and Charges (the Guideline) to all private RCHEs in May 2006, setting out in detail the special arrangements required to be made by RCHEs in handling residents¡¦ personal financial matters such as payment of home fees. These arrangements include:
(1) If the resident is capable of handling his/her personal financial matters, he/she can make an informed decision to authorize the RCHE concerned to withdraw money from his/her bank account on his/her behalf for the purpose of payment of home fees and other charges. The RCHE should document a record of the written consent and authorization concerned, as well as set up and strictly enforce a well-developed monitoring system, whereby the RCHE operator should regularly examine the accounts, bills and receipts for such payments. Such accounts should be made readily available to the resident, his/her family members, LORCHE inspectors, the caseworker and relevant officers of SWD for inspection.
(2) If, for whatever reasons, the guardian, guarantor, family members or relatives of a mentally capable resident cannot personally handle the payment of home fees for him/her, they can sign an authorization letter to entrust someone or the RCHE with the matters relating to the payment of home fees and other charges.
(3) If a resident is certified by a registered medical practitioner as mentally incapable and is unable to handle personal financial matters, the RCHE should arrange for an independent third party such as his/her guardian, guarantor, family members or relatives, or entrust a social worker of the Integrated Family Service Centres or a medical social worker to handle the payment of home fees for the resident.
In the light of the Government¡¦s announcement of providing an additional one-month standard rate CSSA payments in the 2007-08 Budget, LORCHE issued letters to private RCHEs in May 2007, reminding them that the additional CSSA payments were not intended for subsidizing home fees.
LORCHE made further amendments to the Guideline in April 2008, clearly stipulating that RCHEs are strictly forbidden to adopt a pricing policy without specifying the actual amounts, such as ¡§charging the total CSSA payment as the home fee¡¨ or ¡§charging a fee equivalent to the CSSA amount granted by the Government¡¨. RCHEs admitting CSSA recipients must ensure that the monthly home fees for the CSSA recipients are within their means. RCHEs are also forbidden to draw on the long-term supplement or any of the additional standard rate payments granted to CSSA recipients for subsiding their home fees. The Guideline was issued to all private RCHEs on 8 April this year.
(c) Upon approval of the concerned funding by the Finance Committee of the Legislative Council, SWD will issue a letter to RCHE operators again, reminding them that the provision of additional CSSA payments is a one-off relief measure of the Government for CSSA recipients and that the additional payments cannot be used for subsidizing home fees. Also, LORCHE will step up its inspection efforts and issue advice or warning to the RCHE concerned if any non-compliance is found.
If the situation remains unchanged after the issuance of advice and warning, SWD may, by virtue of Section 19(1) of the Residential Care Homes (Elderly Persons) Ordinance (the Ordinance), require the RCHE to comply with the directions within a specified period and rectify the situation to ensure that ¡§it is operated and managed satisfactorily¡¨ or ¡§the welfare of its residents is promoted in a proper manner¡¨. If no improvement is made by the RCHE within the specified period, SWD may consider prosecution. Upon conviction, the person-in-charge of the RCHE is subject to a maximum fine of $100,000 and imprisonment for two years. He/she may also be liable to a fine of $10,000 for each day during which the offence continues. The Director of Social Welfare may direct that the premises concerned shall cease to be used as a residential care home if he is convinced that the RCHE has not complied with the directions specified in the notice issued under Section 19(1) of the Ordinance.
For suspected cases of financial abuse or fraudulent activities concerning elderly residents¡¦ possessions, which involve RCHE operators or staff members, SWD will refer them to the Police for criminal investigation and follow-up.
In addition, SWD has been in touch with The Elderly Services Association of Hong Kong (the Association) on this issue. The Association issued a letter to its members on 31 March 2008 reminding the sector to handle this matter carefully and pointing out that without a clear basis, RCHEs should not use the additional CSSA payments of residents to subsidize home fees.
Ends/Wednesday, April 30, 2008
Issued at HKT 15:36
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