The Clinton Administration indicated Wednesday that it would support some form of legislation to address restraint-related deaths. This is an issue that we have been aware of for some time. With more and more reports of inappropriate restraint use and the tragic results, the process is accelerating. But leaders of groups representing hospitals and private psychiatric facilities say the regulatory proposals are too broad. They strongly object to mandatory reporting requirements they say would jeopardize patient confidentiality and discourage the reporting of errors.
Hospital groups say the key is finding the best practices and spreading the word to each facility.
But in a change of heart Wednesday, the Joint Commission on the Accreditation of Healthcare Organizations came out in support of mandatory reporting and disclosure of restraint deaths. Lieberman's and Dodd's bills build on landmark nursing home reform legislation passed in 1987, which included tough rules on the use of restraint and seclusion. The use of restraints and seclusion in nursing homes has dropped by nearly a one-third nationwide since 1996, according to the federal Health Care Financing Administration. Lieberman said extending that successful legislation to mental health facilities would be effective and an easy bipartisan sell to senators who may be wary of new federal regulations. The DeGette bill goes furthest in putting forward a comprehensive solution to the problem, and is supported most strongly by advocacy groups and 22 original cosponsors in the House.