[Congressional Record Volume 145, Number 108 (Wednesday, July 28, 1999)]
[Extensions of Remarks]
[Pages E1674-E1675]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


          INTRODUCTION OF PATIENT ABUSE PREVENTION ACT OF 1999

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                         Tuesday, July 27, 1999

  Mr. STARK. Mr. Speaker, I am pleased to introduce the ``Patient Abuse 
Prevention Act of 1999'', which is being simultaneously introduced in 
the Senate by Senator Herbert Kohl (D-Wis.). This bill is designed to 
ensure that all prospective employees in long-term care facilities 
undergo criminal background checks. The bill is similar to a proposal 
in the Administration's budget, also establishing a national registry 
of individuals with histories of patient abuse by utilizing data from 
existing state registries. The goal of the new national registry is to 
prevent workers with a history of abuse from being hired to provide 
care for the frail elderly.
  Previous legislation enacted in 1998 permits--but does not require--
nursing homes, skilled nursing facilities and home health agencies to 
conduct criminal background checks on applicants. This bill takes the 
next logical step by requiring that all long-term care facilities 
screen all applicants for employment. The bill is enthusiastically 
supported by the Secretary of Health and Human Services and the 
National Citizens' Coalition for Nursing Home Reform. Secretary Shalala 
believes that this is ``the toughest set of requirements ever proposed 
for long-term care workers.'' Both letters of endorsement are attached 
at the conclusion of this statement.
  In order to overcome industry resistance to this needed change, this 
bill allows long-term care facilities to include such costs on their 
reports submitted to the federal government for reimbursement purposes.
  It is clear from several General Accounting Office analyses and 
hundreds of media reports that in order to improve the quality of care 
provided in long-term care facilities and decrease fraud and abuse, the 
federal government must take a more active role in making certain that 
those who are hired to care for seniors are fully qualified to do so. 
Thus, in addition to the background check requirements, the bill 
imposes significant civil monetary penalties upon providers who hire 
workers who do not pass background checks.
  We have all heard the horror stories about convicted violent 
offenders obtaining jobs in long-term care facilities. Such occurrences 
are intolerable. This bill is an important step in guaranteeing the 
safety of our seniors who receive long-term care. I look forward to 
working with my colleagues in the House and Senate to pass this 
important quality improvement for Medicare and Medicaid patients.

                                       The Secretary of Health and


                                               Human Services,

                                    Washington, DC, July 21, 1999.
     Hon. Herbert H. Kohl,
     U.S. Senate,
     Washington, DC.
       Dear Senator Kohl: I want to commend you and Senator Reid 
     for your leadership on the vitally important matter of 
     assuring that our most vulnerable frail and sick elderly and 
     disabled Medicare and Medicaid beneficiaries are protected 
     from people with violent criminal backgrounds or a history of 
     abuse. We in HHS appreciate working with you and your staffs 
     to help ensure that seniors and persons with disabilities 
     receive the safe, high quality care they deserve.

[[Page E1675]]

       Your ``Patient Abuse Prevention Act'' will require nursing 
     homes and other long term care providers to initiate 
     background checks of prospective workers. We have a few 
     issues with the bill that we would like to continue to work 
     with you to address. We recognize, however, that this set of 
     requirements is the toughest ever proposed for long term care 
     workers. It builds on earlier proposals by the current bill's 
     sponsors and is similar in a number of respects to proposals 
     made by the President last year. For the many competent, 
     caring, professionals and facilities who provide safe, 
     quality long term care, it sends a message that we respect 
     and value their high standards and want to find new workers 
     who will live up to them as well. However, for criminals and 
     those with a history of abusing or neglecting those dependent 
     on their care, and for those who may have allowed such 
     individuals access to vulnerable beneficiaries, it says in a 
     clear and unmistakable way that you will not find a job in 
     long term care paid for by Medicare or Medicaid because we 
     will not tolerate it.
       As President Clinton said when he called for such an 
     approach, ``When families have to worry as much about a loved 
     one in a nursing home as one living alone, then we are 
     failing our parents and we must do more.'' This bill does do 
     more. We applaud your efforts and look forward to continuing 
     to work with you on this bill to improve the safety of sick 
     and frail elderly and disabled people.
           Sincerely,
     Donna E. Shalala.
                                  ____

                                  National Citizens' Coalition for


                                          Nursing Home Reform,

                                    Washington, DC, July 27, 1999.
     Hon. Fortney Stark,
     U.S. House of Representatives,
     Washington, DC.
       Dear Representative Stark: The National Citizens' Coalition 
     for Nursing Home Reform (NCCNHR) commends you and your staff 
     for your initiative in seeking to improve care and conditions 
     in long-term care facilities. NCCNHR is a non-profit consumer 
     organization whose mission is to improve the quality of care 
     and life for long term care residents. Our organization 
     represents residents and their advocates. We work closely 
     with the nation's long-term care ombudsmen and house the 
     National Long Term Care Omnibus Resource Center.
       We strongly support your proposed legislation cited as the 
     Patient Abuse Prevention Act, which would require criminal 
     background checks for nursing home workers. This legislation 
     would provide residents protection from individuals with a 
     history of committing crimes against residents. It would also 
     create a much needed National Registry for long-term care 
     employees with a history of abuse, to be used by nursing 
     homes hiring employees for their facilities.
       In particular, NCCNHR applauds your revisions to last 
     year's bill, the ``Long-Term Care Patient Protection Act of 
     1998'' to include (1) a requirement that criminal background 
     checks of employees will be conducted in all facilities 
     (including specifically, nursing homes, home health, and 
     hospices); (2) that applicants may not be charged for costs 
     of the checks; (3) that applicants who challenge the accuracy 
     of the background check will also be able to appeal the 
     decision and (4) that there is no longer a prohibition on 
     Medicare and Medicaid reimbursement for the costs of 
     conducting background checks.
       We strongly urge, however, that the legislation also expand 
     its language to provide criminal background checks on all 
     long-term care workers and not just employees who have direct 
     access to residents. Considering the vulnerability of long-
     term care residents, criminal background checks should be 
     conducted on all workers, including contract workers, in all 
     health care settings, including home care, and assisted 
     living.
       Again, NCCNHR congratulates you, Representative Stark, on 
     your persistence and foresight. If you need further 
     information, contact me or Ana Rivas-Beck, J.D., Law and 
     Policy Specialist.
           Sincerely,
                                              Sarah Greene Burger,
                                               Executive Director.

     

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