Why the Oklahoma sign law is far from 'OK'

Share this content:
Elizabeth Newman
Elizabeth Newman

Perhaps it's a sign of growing older when your response to a new government law is not, “That's horrible!” but rather, “Who is going to pay for that?!”

Such was the case when I read about Oklahoma's Humanity of the Unborn Child Act and Public Restrooms Act. Pushed by Oklahomans for Life, the state's language would say:

“There are many public and private agencies willing and able to help you carry your child to term and assist you and your child after your child is born, whether you choose to keep your child or to place him or her for adoption. The State of Oklahoma strongly urges you to contact them if you are pregnant.”

The signs would have to be posted in every facility in the state that has a public restroom licensed by the state's Department of Health. In other words, nursing homes, hospitals and restaurants are among those facing having to put up these signs next year. For nursing homes, while private resident bathrooms are expected to be exempt, the law would include public bathrooms in lobbies, dining areas or other places frequented by residents and staff, who are the intended target.

There are big complaints about the law coming from the long-term care industry, and I agree with all of them. To start, Oklahoma Association of Health Care Providers President and CEO Nico Gomez called the law another “unfunded mandate” that would hurt nursing homes.

“This creates an unnecessary hardship and greater proportional negative impact on our small businesses because our facilities have many restrooms and the primary individuals utilizing those restrooms are seniors beyond reasonable childbearing age,” he pointed out in a letter last month to the state counsel.

Installing the signs would cost an estimated $2.3 million, which the state didn't allocate. LeadingAge Oklahoma Executive Director Mary Brinkley says the estimated $80 per sign figure is conservative.

“A lot of these communities have spent money to have nice signage,” she told me.

There's some debate about whether the legislators intended for the states to provide the signs rather than the “language” meant to go on the sign. For its part, Oklahomans for Life said its intent was for the Health Department to create the signs, but only if the state provided funds, the Associated Press reported.

But the money is only one factor why LeadingAge Oklahoma doesn't support the bill, Brinkley says.

“We have worked so hard to advance culture change in long-term care and we work to make sure this is a home for individuals,” she says. Originally the signs were required to have a one-inch font and to be 2 feet by 3 feet, but the rules have since been revised, she says. She also finds it disturbing that there's no indication that anyone calling the Department of Health in a state of crisis will be connected with someone who will keep the information confidential, which should be a concern for those familiar with HIPAA.

But Brinkley ultimately goes back to the big concern of her members, who have worked hard to make “communities a real home,” she says.

This type of large sign “takes away from what we're trying to accomplish.”

Putting aside the question of whether one's taxpayer dollars are best spent on signs tackling a private issue best discussed with one's family, religious counsel and physician, one also has to wonder whether long-term care was inadvertently snared in a general healthcare net. As Gomez delicately wrote, “Our facilities have many restrooms and the primary individuals utilizing those restrooms are seniors beyond reasonable child-bearing age.”

“We're not going to get involved in the politics, but we're a misplaced target,” Gomez told me. “This is not a question of right or wrong. It's about the appropriate venue and funding.” He's optimistic that when the Legislature is in session, there will be a way to fix it.

Maybe it will — at least one lawmaker has said the signs are voluntary rather than mandatory. But the brouhaha provokes a memory of North Carolina's “bathroom bill,” which states that transgender people must use the bathroom that corresponds with their biological sex rather than their gender identity. Ultimately, it cost the state at least $400 million, and is believed to have been a factor in costing the Republican governor his job.

The long-term care industry may generally tilt pro-life, but it is, at heart, a group of small business owners. Nursing homes can't afford to be stuck with the price tag of government overreach that takes away from the homelike environment they're trying to create. You can agree with Oklahoma politicians' goal to create an “abortion-free society” and still think the bill is a ridiculous use of time, energy and money hurting the people who can least afford it.

Follow Elizabeth Newman @TigerELN.

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.