[Congressional Record Volume 142, Number 138 (Monday, September 30, 1996)]
[Extensions of Remarks]
[Pages E1826-E1827]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  INTRODUCTION OF THE PATIENT AND HEALTH CARE PROVIDER PROTECTION ACT

                                 ______
                                 

                          HON. MAJOR R. OWENS

                              of new york

                    in the house of representatives

                      Saturday, September 28, 1996

  Mr. OWENS. Mr. Speaker, I rise to introduce a bill that would protect 
patients and health care providers in hospitals across the country. 
While Congress is debating the feasibility of universal service, and 
implementing incremental health-care reform bills to increase 
portability, the health-care industry is completely re-engineering 
itself. As a part of the transformation to remain competitive and save 
money, hospitals are replacing nurses with lesser-trained, lower-paid 
aides. Recent reports have noted that this de-skilling of America's 
hospitals has had an adverse and even fatal effect on unsuspecting 
patients. My proposal, the Patient and Health Care Provider Protection 
Act would ensure that patients, as well as nurses, aides, and doctors 
are armed with the adequate weaponry to fight the hazards associated 
with the restructuring of the health care industry.
  When any of my constituents enter a hospital, care may be 
administered by someone who looks like a licensed nurse, but is called 
a patient care aide, clinical care partner, patient care assistant, 
medical technician, patient care technician, or monitor technician. 
These aides may be charged with checking vital signs, inserting 
intravenous tubes, drawing blood, inserting catheters, and performing 
electrocardiograms--procedures usually reserved for licensed nurses. 
Unfortunately, in too many instances such responsibilities dealing with 
the direct care of the patient are being undertaken without proper 
training, and the results are astonishing.
  At Allegheny General Hospital, a patient care aide mistakenly hooked 
up a feeding tube to an opening in a patient's neck that helped him 
breathe. The liquid nourishment got into the lungs of the 81-year-old 
patient and he died a few days later. At Presbyterian University 
Hospital, a ``monitor technician'' failed to notice a patient's 
accelerated heart rate for 4 to 5 minutes. The patient later died of 
heart failure. At Rhode Island Hospital, an aide mistakenly filled a 
syringe with potassium chloride instead of saline to clean out an 
intravenous line. The potassium chloride killed the 11-month-old 
infant.
  This bill would avoid these catastrophes in three ways: first, the 
Patient and Health Care Provider Protection Act would ensure that 
patients are well-informed about who is treating them. Currently 
hospitals are not required to make pertinent information available to 
the public. As a result of this bill, hospitals would have to maintain 
and disclose daily staffing levels to the public. Second, this 
legislation would ensure that the Department of Health and Human 
Services issue staffing guidelines that hospitals could use as 
benchmarks to decide which levels of staffing do not jeopardize patient 
care. Third, all staff in hospitals would be mandated to wear 
identification tags with the name and licensed or certified position of 
the individual. Obscure and deceitful titles such as technical care 
partner would be unlawful.
  Moreover, the Patient and Health Care Provider Protection Act would 
ensure that the changes that are taking place in the health-care 
industry are studied on a national level. While massive hospital-
restructuring efforts are taking place in such states as California, 
Massachusetts, Pennsylvania, Texas, Rhode Island, Washington, and in my 
State of New York, we cannot point to a single comprehensive study that 
shows whether or not the industry has taken a turn for the better or 
worse. My bill would assure that national and systematic compilation of 
pertinent medical data is being undertaken to evaluate reform efforts 
on a periodic, on-going basis. The public would be privy to all 
information that is reported.
  The Patient and Health Care Provider Protection Act would further 
create a nongovernmental, independent, nonprofit body to advocate on 
behalf of health care consumers in each State--the Office of Consumer 
Advocacy for Health [OCAH]. OCAH would set up a step-by-step process 
that consumers could easily follow when they have any complaint about 
the health care services they are receiving. OCAH would assist people 
who had grievances with their health plans and needed information about 
available health care services. It would also serve as a screening 
center for

[[Page E1827]]

situations necessitating the emergency intervention of Federal 
officials. By calling a number such as 1-800-BAD-CARE, patients and 
health care workers could disclose any information about life-
threatening situations in a hospital. If the situation warrants, such 
as the case in Tampa, FL, when the Health Care Financing Agency sent 
our an emergency team to a hospital that amputated the wrong limb of a 
patent, then OCAH could call upon HHS to investigate.
  Moreover, each health plan would be required to form a consumer-
dominated Independent Consumer Advisory Committee [ICAC]. This 
committee would provide outreach to its members--patients--by holding 
hearings, and forums to facilitate discussion between a health plan and 
the community. ICAC would help establish safe staffing levels, and 
quality-care criteria to which the health plan must adhere. Members of 
ICAC would be selected by a classified lottery procedure. Health plan 
members interested in serving would be placed not four categories: 
senior citizens, parents of children under 18, individuals with 
disabilities, and all other health plan members.
  Finally, the Patient and Health Care Provider Protection Act would 
outlaw the gag order on nurses and doctors who must be free to 
communicate effectively with their patients. This bill contains strong 
whistle blower protections that prohibit the discharge, demotion, or 
harassment of any nurse, doctor, or other health care professionals who 
assist in an investigation of his or her employer.
  There are many bills floating around that accomplish some of the 
goals outlined here, but in piecemeal fashion. Patient safety cannot be 
achieved in this way. A comprehensive approach is necessary to make 
sure patients are aware of who is treating them, are knowledgeable 
about the effects of a hospital's restructuring plan, are armed with a 
potent voice to affect the policies of the health plan, and possess 
some recourse if their safety is endangered. At the same time, the 
value of nurses' work must not be undermined. As individuals on the 
front lines of the health care delivery system, nurses and aides must 
be well-trained and free to act in ways that foster, rather than 
compromise, the quality of patient care.
  Mr. Speaker, I strongly urge all of my colleagues to support this 
bill as a bold form of advocacy for the health care consumer--the 
patient. It is budget-neutral and would be financed by requiring health 
plans to contribute only 1 percent of their revenues to fund the Office 
of Consumer Advocacy for Health and the Independent Consumer Advisory 
Committees in each State. This is a small price to pay to protect 
patients, and to protect the integrity of such data on which the 
medical community should base its decisions. Congress has unequivocal 
role in assuring that cutting costs and increasing one's profit are not 
priorities of health care delivery at the expense of patient care 
quality and safety.

                          ____________________