II

106TH CONGRESS

1ST SESSION S. 750

To protect the rights of residents of certain federally funded hospitals.

IN THE SENATE OF THE UNITED STATES

MARCH 25, 1999

Mr. DODD (for himself and Mr. LIEBERMAN) introduced the following bill;

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

A BILL

To protect the rights of residents of certain federally funded

hospitals.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Compassionate Care

5 Act of 1999’’.

6 SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE

7 ACT.

8 Title V of the Public Health Service Act (42 U.S.C.

9 290aa et seq.) is amended by adding at the end the fol10 lowing:
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1 ‘‘PART G—REQUIREMENT RELATING TO THE

2 RIGHTS OF RESIDENTS OF CERTAIN FACILITIES

3 ‘‘SEC. 581. REQUIREMENT RELATING TO THE RIGHTS OF

4 RESIDENTS OF CERTAIN FACILITIES.

5 ‘‘(a) IN GENERAL.—A public or private general hos6 pital, nursing facility, intermediate care facility, residen7 tial treatment center, or other health care facility, that

8 receives assistance in any form from any program sup9 ported in whole or in part with Federal funds shall protect

10 and promote the rights of each resident of the facility, in11 cluding the right to be free from physical or mental abuse,

12 corporal punishment, involuntary seclusion, and any phys13 ical or chemical restraints imposed for purposes of dis14 cipline or convenience.

15 ‘‘(b) REQUIREMENTS.—Physical or chemical re16 straints may only be imposed on a resident of a facility

17 described in subsection (a) if—

18 ‘‘(1) the imposition of the restraints are to en19 sure the physical safety of the resident or others;

20 and

21 ‘‘(2) the restraints and seclusion are imposed

22 only upon the written order of a physician that

23 specifies the duration and circumstances under

24 which the restraints are to be used (except in emer25 gency circumstances specified by the Secretary until

26 such an order could reasonably be obtained).
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1 ‘‘(c) DEFINITIONS.—In this section:

2 ‘‘(1) CHEMICAL RESTRAINT.—The term ‘chem3 ical restraint’ means the use of a

4 psychopharmacologic drug that is imposed for pur5 poses of discipline or convenience and is not required

6 to treat a medical symptom.

7 ‘‘(2) PHYSICAL RESTRAINT.—The term ‘phys8 ical restraint’ means any mechanical or personal re9 striction that immobilizes or reduces the ability of

10 an individual to move his or her arms, legs, or head

11 freely, that is imposed for purposes of discipline or

12 convenience, and that is not required to treat a med13 ical symptom. Such term does not include devices,

14 such as orthopedically prescribed devices, surgical

15 dressings or bandages, protective helmets, and other

16 methods involving the physical holding of a resident

17 for the purpose of conducting routine physical ex18 aminations or tests or to protect the patient from

19 falling out of bed or to permit a patient to partici20 pate in activities without the risk of physical harm

21 to the patient.

22 ‘‘(3) SECLUSION.—The term ‘seclusion’ means

23 any separation of the resident from the general pop24 ulation of the facility that prevents the resident from

25 returning to such population when he or she desires,
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1 that is imposed for purposes of discipline or conven2 ience, and that is not required to treat a medical

3 symptom.

4 ‘‘SEC. 582. REPORTING REQUIREMENT.

5 ‘‘(a) IN GENERAL.—Each facility to which the Pro6 tection and Advocacy for Mentally Ill Individuals Act of

7 1986 (42 U.S.C. 10801 et seq.) applies shall notify the

8 appropriate Protection and Advocacy system of each death

9 that occurs at each such facility. A notification under this

10 subsection shall include the name of the resident and a

11 general description of the circumstances of his or her

12 death, and shall be provided not later than 7 days after

13 the date of the death of the individual involved.

14 ‘‘(b) DEFINITIONS.—In subsection (a):

15 ‘‘(1) FACILITY.—The term ‘facility’ has the

16 meaning given the term ‘facilities’ in section 102(3)

17 of the Protection and Advocacy for Mentally Ill Indi18 viduals Act of 1986 (42 U.S.C. 10802(3)).

19 ‘‘(2) PROTECTION AND ADVOCACY SYSTEM.—

20 The term ‘Protection and Advocacy system’ means a

21 system established under part C of title I of the De22 velopmental Disabilities Assistance and Bill of

23 Rights Act (42 U.S.C. 6041 et seq.).’’.
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1 SEC. 3. INVESTIGATIONS OF CERTAIN DEATHS AND INJU2 RIES.

3 Section 105(a)(1) of the Protection and Advocacy for

4 Mentally Ill Individuals Act of 1986 (42 U.S.C.

5 10805(a)(1)) is amended—

6 (1) in subparagraph (B), by striking ‘‘and’’ at

7 the end;

8 (2) in subparagraph (C), by striking the semi9 colon at the end and inserting ‘‘; and’’; and

10 (3) by adding at the end the following:

11 ‘‘(D) investigate the death or serious in12 jury (any significant impairment of the physical

13 condition of the individual, including any burn,

14 laceration, internal injury, or any injury that

15 occurs as a result of repeated harm to any

16 organ) of an individual with a mental illness if

17 the death or serious injury occurred at a facility

18 to which this Act applies;’’.

19 SEC. 4. REGULATIONS AND ENFORCEMENT.

20 (a) TRAINING.—Not later than 1 year after the date

21 of enactment of this Act, the Secretary of Health and

22 Human Services, after consultation with appropriate State

23 and local protection and advocacy organizations, shall pro24 mulgate regulations that require facilities to which the

25 Protection and Advocacy for Mentally Ill Individuals Act
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1 of 1986 (42 U.S.C. 10801 et seq.) applies, to meet the

2 requirements of subsection (b).

3 (b) REQUIREMENTS.—The regulations promulgated

4 under subsection (a) shall require that—

5 (1) facilities described in subsection (a) ensure

6 that appropriate staff levels are maintained within

7 such facilities;

8 (2) appropriate training be provided for the

9 staff of such facilities in the use of restraints and

10 any alternatives to the use of restraints; and

11 (3) such facilities provide complete and accu12 rate notification of deaths, as required under section

13 582(a) of the Public Health Service Act (as added

14 by section 2).

15 (c) ENFORCEMENT.—A facility to which this Act (or

16 an amendment made by this Act) applies, that fails to

17 comply with any requirement of this Act (or such an

18 amendment), including a failure to provide appropriate

19 training, shall not be eligible for participation in any Fed20 erally funded program.

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