Urge Your Members of Congress to Support Passage This Year!
The Senate Finance Committee last week unanimously approved the Elder Justice Act, paving the way for it to be voted on by the full Senate in September and to be taken up in the House of Representatives before the end of the year. The legislation has undergone substantial revisions since it was first introduced in 2002, but it is still one of the strongest nursing home-related bills in years.
Former Sen. John Breaux (D-LA), who was the original sponsor of the bill, was in the Finance Committee audience August 3 when the committee met to mark it up. Sen. Orrin Hatch (R-UT) and Sen. Blanche Lincoln (D-AR) are the current sponsors.
Provisions particularly significant to nursing home residents and advocates are described below.
Elder Justice Panels. Establishes a governmental Elder Justice Coordinating Council and a public Advisory Board on Elder Abuse, Neglect and Exploitation. The advisory board would include multidisciplinary panels on improving the quality of long-term care, including addressing resident-on-resident abuse.
Workforce Grants. Establishes incentive grants to attract individuals (such as welfare recipients) to become direct care workers; grants to develop programs to encourage staff retention, such as career ladders and wage and benefit programs; grants to providers for training to improve management practices; and grants to facilities to create standardized clinical health informatics systems to reduce adverse events and health care complications from medication errors. NCCNHR has had concerns throughout the debate over this legislation about whether such funds would be spent effectively and were adequate to make a real difference in workforce quality and stability; the bill calls for CMS to establish accountability measures related to the grants.
Consumer Rights Section. Establish a consumer rights section on Nursing Home Compare with “documentation on available nursing facilities; consumer rights; the survey process; and services available through the state long-term care ombudsman.” It is not clear how much of this information would be new or expanded from data currently on the website, but it would add one significant piece of new data – all adjudications of criminal violations by nursing facilities or employees. The provision was added by Sen. Charles Grassley (R-IA), chairman of the Finance Committee.
Grants to Improve Ombudsman Capacity to Resolve Abuse Complaints. Provides for grants to improve the capacity of the ombudsman program to respond to complaints about abuse and neglect; pilot programs; training; and the National Long-Term Care Ombudsman Resource Center. (The authorization levels for these grants are $5 million in 2007, $7.5 million in 2008, and $10 million in 2009 and 2010.) In addition, the bill establishes programs for state ombudsman programs and national organizations to provide ombudsman training on elder abuse, neglect and exploitation. These programs are authorized at $10 million a year through 2010. (Note that these are authorization levels. The actual funding amounts would be subject to the federal appropriations process every year.)
Uniform Data Collection. Provides for development of a uniform system to collect data nationally on elder abuse, neglect and exploitation.
Long-Term Care Consumer Information Clearinghouse. Establishes a long-term care consumer information clearinghouse, including information about long-term care options; Medicare and Medicaid benefits; and long-term care providers.
Study of Consumer Concerns about Residential Long-Term Care Facilities. Requires the Secretary of HHS, in consultation with the Attorney General, to conduct a study of consumer concerns relating to residential long-term care facilities other than nursing homes, including prices, level of services, oversight and enforcement, and admission and discharge criteria.
Mandatory Reporting of Crimes against Long-term Care Residents. Requires mandatory reporting to regulators and law enforcement officials of crimes that occur in any long-term care facility that receives at least $10,000 a year in federal funds. The bill also provides penalties for owners, operators and employees who fail to report a “reasonable suspicion” of a crime and additional penalties for retaliation against employees who report crimes. Crimes that cause bodily injury must be reported immediately and others within 24 hours.
Notification of Facility Closure. Requires long-term care facilities that receive at least $10,000 in federal funds to give at least 60 days notice to HHS and the state regulatory agency when they plan to close and to provide a plan for adequate relocation of residents. It also establishes civil monetary penalties up to $1 million for failure to comply.
National Nurse Aide Registry Study. Provides for a national study on establishing a national nurse aide registry.
Other provisions of the bill would establish grants to improve forensic investigations of elder abuse and provide a dedicated funding stream for Adult Protective Services programs.