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[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.J. Res. 13 Introduced in House (IH)]

107th CONGRESS
  1st Session
H. J. RES. 13

 Expressing the sense of Congress regarding the need for a White House 
 Conference to discuss and develop national recommendations concerning 
  quality of care in assisted living facilities in the United States.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            February 7, 2001

 Mr. Stark (for himself, Mr. Waxman, Mr. Coyne, Mr. Frost, Mr. Lantos, 
 Mr. George Miller of California, Ms. Schakowsky, and Mr. Strickland) 
 introduced the following joint resolution; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                            JOINT RESOLUTION

 
 Expressing the sense of Congress regarding the need for a White House 
 Conference to discuss and develop national recommendations concerning 
  quality of care in assisted living facilities in the United States.

Whereas assisted living is a growing and popular long-term care option for our 
        Nation's seniors;
Whereas assisted living may be defined as a special combination of housing, 
        supportive services, personalized assistance, and health care designed 
        to respond to the individual needs of a resident who requires help with 
        the activities of daily living in a way that promotes maximum dignity 
        and independence for the resident;
Whereas the resident capacity in assisted living facilities is estimated to 
        range from 800,000 to 1,500,000;
Whereas while over 85 percent of assisted living services are privately funded, 
        there is a growing trend towards using public funding, for example the 
        use of Medicaid's Home and Community-Based Services waiver increased 29 
        percent between 1988 and 1999;
Whereas the demand for assisted living facilities is expected to grow even more 
        rapidly as the projected number of elderly in need of long-term care 
        doubles over the next 20 years;
Whereas while all States have laws and regulations that encompass assisted 
        living facilities, the definition and philosophy of assisted living 
        services varies across the country;
Whereas 21 States do not have a licensing category, law or regulation that 
        specifically uses the term assisted living;
Whereas assisted living facilities represent many arrangements, ranging from 
        housing residences to facilities that provide skilled care through 
        contracts with outside licensed entities such as home health agencies, 
        rehabilitation agencies, hospice programs, or other skilled medical 
        service providers;
Whereas a 1999 General Accounting Office report found that 25 percent of 
        surveyed facilities were cited for five or more quality of care or 
        consumer protection violations during 1996 and 1997, and 11 percent were 
        cited for 10 or more problems;
Whereas although assisted living facilities are promoted to consumers as places 
        for ``aging in place,'' only 15 States require resident agreements to 
        describe criteria for admission, discharge, or transfer even though 
        assisted living facilities are promoted to consumers as places for 
        ``aging in place'';
Whereas almost half of all States reported that problems with medications in 
        assisted living facilities occurred frequently or very often;
Whereas in a separate study the Institute of Medicine found that medication-
        related errors account for a substantial number of deaths among 
        inpatients in hospitals;
Whereas States reported that staff quality, sufficient staff, and inadequate 
        care received the next highest number of complaints after medication 
        issues, but there is little consistency in regulations of these areas;
Whereas some State laws or regulations specify which and how many staff must be 
        on duty in assisted living communities at all times, while other States 
        have no such laws or regulations;
Whereas all States need to enforce sufficient staffing laws or regulations that 
        provide an adequate level of care to meet the actual and assessed needs 
        of each resident;
Whereas approximately 20 percent of States do not require background checks for 
        assisted living facilities and their employees;
Whereas each State has different regulations and oversight, leading to unequal 
        quality of care and consumer protections in various regions of the 
        country, for example, in regulating care in assisted living facilities 
        for Alzheimer's disease patients, some States have requirements in the 
        areas of training, staffing, activities, and environment while others 
        have no requirements in these areas;
Whereas not all States extend the long-term care ombudsman's role to include 
        assisted living residents;
Whereas the Joint Commission on the Accreditation of Healthcare Organizations 
        (JCAHO) and CARF, the Rehabilitation Accreditation Commission, recently 
        released assisted living standards, but accreditation is voluntary;
Whereas many lessons have been learned from the development of national nursing 
        home quality standards;
Whereas policymakers, industry stakeholders, and consumers must work together to 
        strengthen quality and safety standards in assisted living facilities 
        before abuses, like those that took place in nursing homes, become 
        commonplace in this newer long-term care setting; and
Whereas a Senate Special Committee on Aging hearing discussed the crucial role 
        of assisted living in long-term health care, raised concerns about, and 
        challenged the industry to improve, the quality of care and consumer 
        education, and enhance affordability in assisted living facilities: Now, 
        therefore, be it
    Resolved by the Senate and House of Representatives of the United 
States of America in Congress assembled, That--
            (1) the President, in conjunction with the Secretary of 
        Health and Human Services and the Secretary of Housing and 
        Urban Development, should convene a conference to study quality 
        of care issues and develop national recommendations for 
        ensuring consumer protections in assisted living facilities in 
        America;
            (2) the Secretary of Health and Human Services should issue 
        a report based on the findings of this conference, including 
        recommendations concerning quality of care in assisted living 
        facilities and any gaps in research that should be filled; and
            (3) this conference should be convened within 1 year, and 
        the report based on the conference should be issued in no more 
        than 6 months after the completion of the conference.
                                 <all>
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