[Congressional Record Volume 142, Number 137 (Saturday, September 28, 1996)]
[House]
[Pages H11633-H11635]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         RESIDENT REVIEWS FOR NURSING FACILITIES UNDER MEDICAID

  Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent to move to 
suspend the rules and pass the bill (H.R. 3632) to

[[Page H11634]]

amend title XIX of the Social Security Act to repeal the requirement 
for annual resident review for nursing facilities under the Medicaid 
Program and to require resident reviews for mentally ill or mentally 
retarded residents when there is a significant change in physical or 
mental condition.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  Mr. DINGELL. Mr. Speaker, reserving the right to object, is this a 
unanimous-consent request?
  The SPEAKER pro tempore. Yes. Is there objection?
  Mr. DINGELL. Mr. Speaker, would the gentleman please restate the 
unanimous-consent request?
  Mr. BILIRAKIS. Mr. Speaker, if the gentleman will yield, the reason I 
asked for the unanimous-consent request was because the 1-hour notice 
was not given regarding the bill H.R. 3632.
  It was an inadvertent mistake on the part of the majority. The 1-hour 
notice was given for H.R. 3633, and it was the intent it also be given 
for H.R. 3632, so I thought I would go through the process but raise 
the red flag, and do it right and ask for unanimous consent.
  Mr. DINGELL. Mr. Speaker, I am trying to understand. What is the 
unanimous-consent request here?
  Mr. BILIRAKIS. To suspend the rules and to pass this bill.
  Mr. DINGELL. To suspend the rules and pass the bill.
  Mr. BILIRAKIS. With the understanding that the 1-hour's notice was 
not given.
  THe SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  Mr. DINGELL. Mr. Speaker, reserving the right to object, could the 
gentleman tell me why we are doing this under unanimous consent?
  Mr. BILIRAKIS. Mr. Speaker, will the gentleman yield?
  Mr. DINGELL. I yield to my good friend, the gentleman from Florida.
  Mr. BILIRAKIS. Mr. Speaker, as I said earlier, I indicated that the 
1-hour notice was required to be given. We gave the notice, as I 
understand it, at 1:15. That is less than the hour, and for that reason 
I asked for the unanimous consent. It is a technicality.
  Mr. DINGELL. I wondered. Now, continuing my reservation of objection, 
could my dear friend from Florida tell me a little about this bill we 
are bringing up before the hour's notice?
  Is this a bill we have seen before? Was this bill up in committee?
  Mr. BILIRAKIS. Mr. Speaker, if the gentleman will continue to yield, 
this is a bill we marked up a few days ago in the Committee on 
Commerce.
  Mr. DINGELL. We marked it up?
  Mr. BILIRAKIS. We did, sir. Questions were raised. It was a 
bipartisan thing. It was approved by the gentleman from California [Mr. 
Waxman].
  I know question was raised by either Mr. Waxman or someone in the 
minority about the quality standards, does this hurt the quality 
standards. Assurances were given there would not be any adverse 
consequences.
  Mr. DINGELL. Mr. Speaker, continuing my reservation of objection, it 
is normally considered appropriate to consult with the minority before 
unanimous-consent requests are made. Was there any consultation on 
this?
  Mr. BILIRAKIS. If the gentleman will continue to yield, consultation 
between the minority and majority staffs took place, I understand, 
regarding bringing up this piece of legislation at this time.
  Mr. DINGELL. By unanimous consent.
  Mr. BILIRAKIS. The only reason I added unanimous consent in there is 
because of the technicality. We are about 5 minutes short of that 1-
hour notice.
  Mr. DINGELL. But the gentleman said that there was consultation with 
the minority staff?
  Mr. BILIRAKIS. I saw them with my own eyes consulting.
  Mr. DINGELL. Mr. Speaker, it is strange that this is the first that I 
am hearing of it. I do have a little to do, as my good friend knows, 
with the business of the minority, and I am happy to hear that there 
was some consultation. Perhaps I should speak to the minority staff 
about this.
  Mr. BILIRAKIS. I wish the gentleman would talk to Mr. Waxman's staff 
about this.
  Mr. DINGELL. I am told Mr. Waxman is in California.
  Mr. BILIRAKIS. His staff is what I said.
  Mr. DINGELL. It would be very wonderful if the gentleman would speak 
to the staff of the minority side of the committee. I am sure Mr. 
Waxman is being informed of this out in California. We are seeing some 
rather extraordinary events.
  Just to help me a little more, and I will continue my reservation of 
objection----
  Mr. BILIRAKIS. If the gentleman would forgive me. I am not sure who 
has the time, but, Mr. Speaker, I would at this point to take back my 
unanimous-consent request.
  The SPEAKER pro tempore. The gentleman withdraws his unanimous-
consent request.
  Mr. BILIRAKIS. Mr. Speaker, I move the House suspend the rules and 
pass the bill H.R. 3632, a bill to amend title XIX of the Social 
Security Act regarding nursing home facility inspections.


                             Point of Order

  Mr. DINGELL. Mr. Speaker, parliamentary inquiry, and reserving a 
point of order.
  Is the hour that we are supposed to proceed in the way of this----
  The SPEAKER pro tempore. The gentleman will kindly suspend.
  The Chair is unable to entertain the gentleman's motion due to the 
fact that the 1 hour time limitation has not expired.
  Mr. DINGELL. Mr. Speaker, I do not want to lose my rights here. I 
reserve a point of order and make a parliamentary inquiry.
  The SPEAKER pro tempore. The Chair has already indicated that he 
cannot entertain the gentleman's motion and so there is nothing to 
respond to at this moment in time.
  Mr. DINGELL. Mr. Speaker, I have no objection to my good friend 
renewing his unanimous consent request.
  Mr. BILIRAKIS. Well, the gentleman certainly sounded, with all due 
respect, like he did have some objection a few minutes ago.
  So where are we now? All I want to do is get this bill passed that 
both sides wanted to get through the system today.
  Mr. DINGELL. I have no objection to proceeding. I am just trying to 
establish if we are dealing with the regular order here, Mr. Speaker.
  The SPEAKER pro tempore. The Chair would ask for regular order. Does 
the gentleman have a request of the Chair?
  Mr. BILIRAKIS. I did not hear the question, Mr. Speaker.
  The SPEAKER pro tempore. Does the gentleman from Florida seek 
recognition?
  Mr. BILIRAKIS. The gentleman from Florida, Mr. Speaker, moves that 
the House suspend the rules and pass the bill (H.R. 3632) a bill to 
amend title XIX of the Social Security Act regarding nursing home 
facility inspections.
  The SPEAKER pro tempore. Is there objection to the present 
consideration of the motion?
  Mr. DINGELL. Is this a unanimous-consent request, Mr. Speaker, or is 
this a motion?
  The SPEAKER pro tempore. The Chair is asking whether there is 
objection to the present consideration of the motion.
  Mr. DINGELL. It is a motion, then; am I correct?
  The SPEAKER pro tempore. It amounts to a unanimous-consent request to 
offer a motion.

  Mr. DINGELL. Has the hour passed, Mr. Speaker?
  The SPEAKER pro tempore. It amounts, sir, to a unanimous-consent 
request.
  Mr. DINGELL. I am not quite sure which one of my questions the Chair 
is answering. Are we answering my parliamentary inquiry as to whether 
the hour has passed, or whether this is appropriate, or is this a 
unanimous-consent request?
  Could the Chair help me, please?
  The SPEAKER pro tempore. Because the hour has not passed, only 
without objection may the gentleman's motion be considered. Therefore, 
the gentleman's request is in the nature of a unanimous-consent 
request.
  The Chair has inquired as to whether or not anyone has objection.
  Mr. DINGELL. Mr. Speaker, I do not want to object, but I do want to 
reserve the right to object simply to ask questions of my dear friend 
from Florida,

[[Page H11635]]

for whom I have the most enormous respect and affection.
  Mr. BILIRAKIS. Mr. Speaker, I renew my request for unanimous consent.
  Mr. DINGELL. Mr. Speaker, I reserve the right to object.
  The SPEAKER pro tempore. The gentleman from Michigan [Mr. Dingell] 
reserves the right to object.
  Mr. DINGELL. Simply to continue to have this very helpful colloquy 
with my good friend from Florida.
  Mr. BILIRAKIS. It might be helpful to the gentleman form Michigan, 
but it is not to me.
  Mr. DINGELL. Well, I apologize because it is my intent to be helpful 
in every particular to my good friend from Florida.
  I am trying to understand. This is a bill that was reported out of 
the committee?
  Mr. BILIRAKIS. The bill was marked up, I believe last week, out of 
committee.
  Mr. DINGELL. Mr. Speaker, if I could continue on my reservation of 
objection, is this the bill that was the amendment, that is exactly the 
same as the amendment? This is a different bill? Oh.
  Well, I will not object, and I gather, then, Mr. Speaker, that we are 
proceeding under the suspension rules and I will be immensely 
cooperative.
  The SPEAKER pro tempore. And the Chair thanks the gentleman. The 
gentleman from Michigan withdraws his reservation of objection.
  Without objection, the Clerk will report the title of the bill.
  There was no objection.
  The Clerk read the title of the bill.
  The text of H.R. 3632 is as follows:

                               H.R. 3632

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. REPEAL OF REQUIREMENT FOR ANNUAL RESIDENT REVIEW 
                   FOR MENTALLY ILL AND MENTALLY RETARDED NURSING 
                   FACILITY RESIDENTS.

       (a) In General.--Section 1919(e)(7) of the Social Security 
     Act (42 U.S.C. 1396r(e)(7)) is amended--
       (1) in subparagraph (B)--
       (A) by striking ``annual'' in the heading, and
       (B) by striking clause (iii); and
       (2) in subparagraph (D)(i), by striking ``annual'' in the 
     heading.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall take effect on the date of the enactment of this Act.

     SEC. 2. REQUIREMENT FOR REVIEW IN CASE OF SIGNIFICANT CHANGE 
                   IN PHYSICAL OR MENTAL CONDITION OF MENTALLY ILL 
                   OR MENTALLY RETARDED NURSING FACILITY 
                   RESIDENTS.

       (a) Requirement for Notification of State Authority.--
     Section 1919(b)(3)(E) of the Social Security Act (42 U.S.C. 
     1396r(b)(3)(E)) is amended by adding at the end the 
     following: ``In addition, a nursing facility shall notify the 
     State mental health authority or State mental retardation or 
     developmental disability authority, as applicable, promptly 
     after a significant change in the physical or mental 
     condition of a resident who is mentally ill or mentally 
     retarded.''.
       (b) Requirement for Review.--Section 1919(e)(7)(B) of such 
     Act (42 U.S.C. 1396r(e)(7)(B)), as amended by section 
     1(a)(1), is amended by inserting after clause (ii) the 
     following new clause:
       ``(iii) Review required upon change in resident's 
     condition.--A review and determination under clause (i) or 
     (ii) must be conducted promptly after a nursing facility has 
     notified the State mental health authority or State mental 
     retardation or developmental disability authority, as 
     applicable, under subsection (b)(3)(E) with respect to a 
     mentally ill or mentally retarded resident, that there has 
     been a significant change in the resident's physical or 
     mental condition.''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to changes in physical or mental condition 
     occurring on or after the date of the enactment of this Act.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida [Mr. Bilirakis] and the gentleman from Michigan [Mr. Dingell] 
each will control 20 minutes.
  The Chair recognizes the gentleman from Florida [Mr. Bilirakis].
  Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, H.R. 3632 has received strong bipartisan support and 
will correct a problem with the current implementation of the nursing 
home quality assurance standards. Let me say that Congressman Ehrlich, 
the sponsor of the bill, deserves special recognition for his efforts 
in moving this bill.
  One of the requirements of the act was annual resident assessment for 
all Medicaid nursing home residents. The underlying statute also has as 
a requirement that for each resident of a nursing facility who is 
mentally ill or mentally retarded, an additional evaluation be 
completed. These additional reviews have proved to be costly and 
unnecessary. The Commerce Committee, the States, and the administration 
have come to the conclusion that this additional annual review is 
unnecessary.
  This bill repeals this requirement for an additional assessment for 
the mentally ill and the mentally retarded. It would require, as an 
alternative, that additional assessments only occur when there is a 
significant change in the resident's physical or mental condition.
  I urge my colleagues to support this bill.
  Mr. Speaker, I reserve the balance of my time.
  Mr. DINGELL. Mr. Speaker, I yield myself 3 minutes.
  (Mr. DINGELL asked and was given permission to revise and extend his 
remarks.)
  Mr. DINGELL. Mr. Speaker, I strongly support this bill. I want to 
express my respect and affection for my good friend from Florida. We 
are not always able to keep track of the way these matters move around 
here, and so I always out of great affection, some respect of the very 
high character and desire to work with my Republican colleagues, I 
always ask questions to try to find out what it is we are doing here 
during these closing days.
  I would observe parenthetically that we just checked with the staff 
of the gentleman from California [Mr. Waxman], and they have not heard 
a word about this bill. So I hope the gentleman from Florida will 
excuse my inability to respond as speedily and as sharply and crisply 
as I might have liked to have done.
  In any event, the bill is a good bill and we support this excellent 
legislation.

                              {time}  1415

  Mr. BILIRAKIS. Mr. Speaker, I yield such time as he may consume to 
the gentleman from Maryland [Mr. Ehrlich], the sponsor of the bill.
  Mr. EHRLICH. Mr. Speaker, I thank the gentleman for yielding.
  Mr. Speaker, just briefly, I want to thank everyone involved with 
this bill, particularly the gentleman from California [Mr. Waxman], and 
I would also point out that this is a Corrections Day bill. As you 
know, the Speaker came up with the Corrections Day process in order to 
facilitate the elimination of regulations that simply do not make sense 
and that cost a lot of money. That is the very purpose of the 
corrections day process.
  I also congratulate the Speaker for implementing this process, and I 
believe this bill is probably the best example I can think of as to the 
way the Corrections Day process was supposed to work and actually does 
work. It has been a great honor for me to be a part of the process.
  Mr. DINGELL. Mr. Speaker, we do not have any further requests for 
time, and I yield back the balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I too have no further requests for time, 
and I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. LaTourette). The question is on the 
motion offered by the gentleman from Florida [Mr. Bilirakis] that the 
House suspend the rules and pass the bill, H.R. 3632.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

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