[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.J. Res. 107 Introduced in House (IH)]







106th CONGRESS
  2d Session
H. J. RES. 107

 Expressing the sense of Congress regarding the need for a White House 
 Conference to discuss and develop national recommendations concerning 
  quality of care in assisted living facilities in the United States.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 12, 2000

 Mr. Stark (for himself and Mr. Coyne) introduced the following joint 
      resolution; which was referred to the Committee on Commerce

_______________________________________________________________________

                            JOINT RESOLUTION


 
 Expressing the sense of Congress regarding the need for a White House 
 Conference to discuss and develop national recommendations concerning 
  quality of care in assisted living facilities in the United States.

Whereas assisted living is a growing and popular long-term care option for our 
        Nation's seniors;
Whereas the number of assisted living beds is estimated to range from 800,000 to 
        1.5 million;
Whereas although assisted living services are primarily privately funded, there 
        is a growing trend towards using public funding. Medicaid's Home and 
        Community-Based Services waiver grew 29 percent between 1988 and 1999;
Whereas the demand for assisted living facilities is expected to grow even more 
        rapidly as the projected number of elderly in need of long-term care 
        doubles over the next 20 years;
Whereas all States have regulations that encompass assisted living facilities, 
        the definition and philosophy of assisted living services varies across 
        the country, and 21 States do not have a licensing category or statute 
        that specifically uses the term assisted living;
Whereas assisted living facilities represent many arrangements, ranging from 
        housing residences to skilled medical service providers;
Whereas a 1999 General Accounting Office report found that 25 percent of 
        surveyed facilities were cited for five or more quality of care or 
        consumer protection violations during 1996 and 1997, and 11 percent were 
        cited for 10 or more problems;
Whereas one State prohibits assisted living facilities from serving people with 
        dementia, but as many as 25 percent of the State's assisted living 
        residents may have dementia, and in only five months in 2000, two of 
        those residents have died in assisted living facilities due to 
        inadequate care;
Whereas only 15 States require resident agreements to describe criteria for 
        admission, discharge, or transfer even though assisted living facilities 
        are promoted to consumers as places for ``aging in place'';
Whereas almost half of all States reported that problems with medications in 
        assisted living facilities occurred frequently or very often. The 
        Institute of Medicine found that medication-related errors in hospitals 
        account for a substantial number of deaths;
Whereas States reported that staff quality, sufficient staff, and inadequate 
        care received the next highest number of complaints after medication 
        issues, but there is little consistency in regulations of these areas;
Whereas some States have no requirement for the number of staff personnel who 
        should be on duty at all times while others make requirements ranging 
        from 1 staff person for the entire facility (no matter how large) to 1 
        staff person for every 6 people;
Whereas approximately 20 percent of States do not require background checks for 
        assisted living facilities and their employees;
Whereas each State has different regulations and oversight, leading to unequal 
        quality of care and consumer protections in various regions of the 
        country. For example, in regulating care in assisted living facilities 
        for Alzheimer's patients, some States have requirements in the areas of 
        training, staffing, activities, and environment while others have no 
        requirements in these areas;
Whereas the Joint Commission on the Accreditation of Healthcare Organizations 
        (JCAHO) and CARF, the Rehabilitation Accreditation Commission, recently 
        released assisted living standards, but accreditation is voluntary;
Whereas many lessons have been learned from the experience with nursing homes, 
        and we must ensure these types of abuses do not happen again in any 
        long-term care arrangement; and
Whereas a Senate Special Committee on Aging hearing discussed the crucial role 
        of assisted living in long-term health care, but also raised concerns 
        about the quality of care in certain assisted living facilities: Now, 
        therefore, be it
    Resolved by the Senate and House of Representatives of the United 
States of America in Congress assembled, That--
            (1) the While House, in conjunction with the Secretary of 
        Health and Human Services and the Secretary of Housing and 
        Urban Development, shall convene a conference to study quality 
        of care issues and develop national recommendations for 
        ensuring consumer protections in assisted living facilities in 
        America;
            (2) the Secretary of Health and Human Services shall issue 
        a report based on the findings of this conference, including 
        recommendations concerning quality of care in assisted living 
        facilities and any gaps in research that should be filled; and
            (3) this conference shall be convened within 1 year, and 
        the report based on the conference shall be issued in no more 
        than 6 months following the completion of the conference.
                                 <all>