[Weekly Compilation of Presidential Documents Volume 34, Number 30 (Monday, July 27, 1998)]
[Pages 1445-1448]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Remarks Announcing New Nursing Home Regulations and an Exchange With 
Reporters

July 21, 1998

    The President. Thank you, Secretary Shalala, and Nancy-Ann Min 
DeParle, and the advocates who are here. I wish your mother were here, 
Secretary Shalala. I have met her, and even a skeptical press corps 
would believe your account of her in full if they could see her.
    The duty we owe to our parents is one of the most sacred duties we, 
as Americans, owe to each other. Nowhere is that duty more important 
than when a family makes the choice to move a parent into a nursing 
home. When that time comes, all of us need to know that all our parents 
will be well cared for.
    Today, more than 1.6 million Americans live in more than 16,000 
nursing homes nationwide. When the baby boom generation moves into 
retirement, the number will rise even higher. By 2030, the number of 
Americans over the age of 85 will double, making compassionate quality 
nursing home care even more important.
    At their best, nursing homes can be a Godsend for older Americans 
and their families, providing a safe haven in times of need. But at 
their worst, they can actually endanger their residents, subjecting them 
to the worst kinds of abuse and neglect. For nearly 6 years, as 
Secretary Shalala said, we've worked hard to give our most vulnerable 
citizens the security and health services they need to live in peace and 
safety.

[[Page 1446]]

    I am committed to honoring the great social compact between the 
generations, first, let me say, by reserving every penny of the budget 
surplus until we save Social Security first. The historic balanced 
budget I signed last summer preserves the Medicare Trust Fund into the 
21st century. We've taken action to root out Medicare fraud and abuse, 
saving taxpayers over $20 billion.
    Finally, we're fighting to meet the challenge of our changing health 
system by enacting a Patients' Bill of Rights, to include access to 
specialists and the right to appeal health care decisions. I have 
extended those rights already to Medicare beneficiaries; they should be 
the rights of every American.
    One of the most important ways we can help our senior citizens is by 
improving the quality of care in our nursing homes. In 1995, when 
Congress tried to eliminate Federal assurances of nursing home quality, 
I said no. It was the right thing to do. That same year, we put into 
place tough regulations to crack down on abuse and neglect in our 
nursing homes. Since then we have made real progress, as Secretary 
Shalala said, stepping up onsite inspections and helping nursing homes 
to find and fix problems.
    As the HCFA report Secretary Shalala talked about shows all too 
clearly, however, the job is far from over. When people living in 
nursing homes have as much fear from dehydration and poor nutrition as 
they do from the diseases of old age, when families must 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.
    Today I'm acting within my power as President to crack down on 
unsafe nursing homes. Effective immediately, HCFA will require States to 
step up investigations of nursing homes, making onsite inspections more 
frequent and less predictable, so there is no time to hide neglect and 
abuse. Whenever we find evidence that a nursing home is failing to 
provide its residents with proper care, or even mistreating them, we 
will fine that facility on the spot. And if State enforcement agencies 
don't do enough to monitor nursing home quality, we will cut off their 
contracts and find someone else who will do the job right.
    I'll continue to do everything I can to fight nursing home abuse and 
neglect and to give more options to elderly, disabled, and chronically 
ill Americans who choose to stay at home. But Congress also must act. 
This week I am proposing comprehensive legislation to protect older 
Americans with a national registry to track nursing home employees down 
known to abuse nursing home residents, and criminal background checks to 
keep potentially abusive employees from being hired in the first place. 
I ask the Congress to put progress ahead of partisanship on this issue 
and pass this legislation to improve our Nation's nursing homes this 
year.
    Choosing to move a parent or a loved one into a nursing home is one 
of life's most difficult decisions. But with these steps we can at least 
give families a greater sense of security in knowing we are doing 
everything we possibly can to make our nursing homes safe and secure.
    Thank you very much.
    Q. Do you think the Congress would be against the registry, per se?
    The President. No, I have no reason to believe they would be, and I 
hope they would pass it.
    Q. What do you mean by putting partisanship aside?
    The President. Well, we haven't had a lot of bills coming out of 
Congress this year, but I hope very much that they will pass this. I 
don't believe--not since 1995, when there was an attempt to strip the 
Federal authority standards, has there been a serious move on this 
issue. And I believe there are a lot of Republicans, as well as 
Democrats, in Congress who will support this. So I'm quite hopeful that 
it will pass.

Patients' Bill of Rights

    Q. How about the Patients' Bill of Rights; do you think you're going 
to get that?
    The President. Well, I don't know. That's up to them. We have to 
have some significant amount of Republican support to get a strong bill. 
We have to have 60 votes to break a filibuster in the Senate and, 
obviously, a majority in the House, sufficient to actually make sure the 
bill could come to a vote. But we're still working on it, and it's 
terribly important.

[[Page 1447]]

    Everywhere I go in the country--you know, I was just home last 
weekend, and I was stunned at the number of people who came up to me and 
just started talking about it and talking about their own experiences 
and how important they thought it was. So I'm very hopeful we'll get it.
    Q. How can you parlay that, then, into a real public response?
    The President. Well, I'm working at it. We've had a lot of events on 
the Patients' Bill of Rights. I'm trying to get the public involved in 
this, trying to get them to express their opinions to their Members of 
Congress, and I will continue to do so.

Secret Service Agent Testimony

    Q. I wanted to ask you about another issue, sir. Now that the Secret 
Service agents have testified, are you concerned about what they might 
be saying, one; and, two, do you find yourself holding them more at 
arm's length, sir?
    The President. The Secret Service has made its own decisions about 
what to say and how to do it, based on their professional sense of 
responsibility, and I'm not going to get into this. I've refused to 
comment on it so far, and I'm going to continue to refuse to comment.

Libya and the Pan Am 103 Aircraft Tragedy

    Q. Mr. President, your administration is making a new push to end 
the standoff with Libya over the Lockerbie bombing, including possibly 
holding a trial in a neutral country, under U.S. or Scottish 
jurisdiction. Are you optimistic that this climate might help, and what 
has brought on this new push?
    The President. Well, we have always said that our first goal was to 
bring the perpetrators of Pan Am 103 murders to justice. That's our 
first purpose. And since I got here, we've been looking for ways to do 
that. We have had conversations with representatives of the British 
Government as well. We've always said we thought that there had to be a 
trial under American or Scottish law. There may be some possibility of 
standing up a Scottish court in another country, but there are lots of 
difficulties with it as well, apparently.
    All I can tell you is that it's one of the things that we have 
explored with a view toward accelerating the day--it's been a long time 
now; it's been a lot of years since that terrible day when Pan Am 103 
crashed over Lockerbie. And we're looking at it, but I don't know that 
it can be done. Our people have spent a lot of time on it. We've talked 
to the British at great length about it. We're trying to find some way 
that has real integrity, that will work. But there are all kinds of 
practical difficulties that I'm sure our folks can explain. I don't know 
if we can do it, but we're working on it.
    Q. What brought it up now? I mean, what--all of a sudden, after so 
many years?
    The President. I don't know why it is just now coming into the 
press. But it's not just being brought up now. We have literally been 
working for years; I have personally been engaged in this for years, 
trying to find a way to get the suspects out of Libya, into a court 
where we thought an honest and fair and adequate trial could occur.
    And in a case like this, like every other case, as the years go by 
you run more and more chances that something will happen to the evidence 
that is available, to any witnesses that might be available. So we've 
had a sense of urgency about this for some time. But my guess is that it 
has come to public light because a significant number of conversations 
have had to be held between the American and the British authorities and 
between others in potential third-party venues, like The Netherlands. 
And I know there's been some discussion of that. But it has not been 
resolved yet.
    Thank you.
    Q. Is there any indication that the Libyans might go along, sir?

Retracted CNN Report on Use of Nerve Gas in Vietnam

    Q. Sir, can you comment on CNN's nerve gas report, that the 
Pentagon--[inaudible]--today?
    The President. All I know is what Secretary Cohen has said to you, 
to the public, and to me, which is that their view is that it did not 
occur.
    Thank you all very much.

[[Page 1448]]

Note: The President spoke at 3:16 p.m. in the Oval Office at the White 
House. In his remarks, he referred to Nancy-Ann Min DeParle, 
Administrator, Health Care Financing Administration (HCFA); and Edna 
Shalala, mother of Health and Human Services Secretary Donna E. Shalala.