SENIOR ASSEMBLY PROPOSAL NO. 27

INTRODUCED BY SENIOR ASSEMBLY MEMBER SORENSEN

LEGISLATIVE COUNSEL'S DIGEST

AP 27: NURSING HOME PATIENT SAFETY

EXISTING LAW PROVIDES FOR THE LICENSURE AND REGULATION OF HEALTH FACILITIES, INCLUDING SKILLED NURSING AND INTERMEDIATE CARE FACILITIES, BY THE STATE DEPARTMENT OF PUBLIC HEALTH.

EXISTING LAW ALSO PROVIDES FOR THE LICENSURE OF VARIOUS TYPES OF RESIDENTIAL CARE FACILITIES BY THE STATE DEPARTMENT OF SOCIAL SERVICES.

THIS MEASURE WOULD MEMORIALIZE THE LEGISLATURE AND THE GOVERNOR TO ENACT LEGISLATION THAT WOULD REQUIRE AN INSTITUTION THAT PROVIDES RESIDENTIAL CARE FOR SENIORS, INCLUDING, BUT NOT LIMITED TO, BOARD AND CARE HOMES, RESIDENTIAL CARE FACILITIES FOR THE ELDERLY, SKILLED NURSING AND INTERMEDIATE CARE FACILITIES, AND OTHER RESIDENTIAL FACILITIES TO SEPARATE YOUNGER PATIENTS WITH MENTAL ILLNESS FROM THE ELDERLY OR FRAIL PATIENTS AT THE FACILITY.

VOTE: MAJORITY.

AP 27: RELATING TO NURSING HOME PATIENT SAFETY

WHEREAS, CALIFORNIA NEEDS TO PROTECT ELDERLY OR FRAIL PATIENTS LIVING IN NURSING HOME SETTINGS FROM HARM OR ABUSE INFLICTED BY OTHER, YOUNGER NURSING HOME PATIENTS; AND

WHEREAS, MANY STATE MENTAL HOSPITALS CLOSED DURING THE 1960S BECAUSE OF DEPLORABLE CONDITIONS, IMPROVED MEDICATION TREATMENTS, AND CIVIL RIGHTS LAWSUITS; AND

WHEREAS, TODAY’S NURSING HOMES ARE A BUSINESS. SEVERAL NURSING HOMES ARE OFTEN OWNED BY A SINGLE OWNER. IN MANY INSTANCES, THE OWNER’S PRIORITY IS TO FILL THE BEDS THAT ARE OPEN; AND

WHEREAS, NURSING HOMES HAVE BECOME A DUMPING GROUND FOR YOUNG AND MIDDLE AGED PERSONS WITH MENTAL ILLNESSES, INCLUDING, BUT NOT LIMITED TO, BIPOLAR DISORDERS, SCHIZOPHRENIA, DEMENTIA, AND DEPRESSION. SOME OF THESE PATIENTS ALSO HAVE DIFFICULTIES WITH ANGER MANAGEMENT PROBLEMS; AND

WHEREAS, CALIFORNIA NEEDS TO PROTECT ELDERLY AND FRAIL PATIENTS FROM STRONGER PATIENTS; AND

WHEREAS, MANY NURSING HOMES ALLOW PATIENTS TO WANDER THROUGH THE FACILITIES; AND

WHEREAS, MANY NURSING HOMES REQUIRE ELDERLY OR FRAIL PATIENTS TO SHARE A ROOM WITH YOUNGER PATIENTS THAT HAVE MENTAL ILLNESSES. THE ELDERLY OR FRAIL PATIENTS OFTEN FEEL FRIGHTENED OR THREATENED BY THESE YOUNGER, MENTALLY ILL PATIENTS; AND

WHEREAS, CALIFORNIA NEEDS INCREASED ACCOUNTABILITY IN ORDER TO PROVIDE A SAFE HAVEN FOR ELDERLY OR FRAIL PATIENTS AT NURSING HOMES; AND

WHEREAS, NEGLECT OF BASIC CARE IN NURSING HOMES RESULTS IN MILLIONS OF DOLLARS IN ADDITIONAL COSTS FOR MEDICARE AND MEDICAID; AND

WHEREAS, CALIFORNIA HAS MORE LONG-TERM CARE FACILITIES THAN ANY OTHER STATE: 1,200 NURSING HOMES AND 14,000 RESIDENTIAL SETTINGS, WITH VARYING LEVELS OF CARE; AND

WHEREAS, THE OWNERS OF LONG-TERM CARE FACILITIES ARE INSULATED FROM ACCOUNTABILITY FOR BAD CARE. TOO MANY OF THE ELDERLY PATIENTS ARE LEFT UNSUPERVISED; AND

WHEREAS, UNDER FEDERAL LAW A NURSING HOME IS PROHIBITED FROM ADMITTING A MENTALLY ILL PATIENT UNLESS THE STATE MENTAL HEALTH AUTHORITY DETERMINES THAT THE PATIENT REQUIRES THE LEVEL OF CARE THAT A NURSING HOME CAN PROVIDE; THE STATE IS RESPONSIBLE FOR THIS PREADMISSION SCREENING PROCESS; AND

WHEREAS, IN ADDITION TO CONSIDERING THE NEED FOR THE NURSING CARE ITSELF, THE STATE’S SCREENING PROCESS SHOULD ALSO STRONGLY CONSIDER UNRULY AND AGGRESSIVE BEHAVIOR. THE STATE’S SCREENING PROCESS SHOULD ENSURE THAT YOUNGER, MENTALLY ILL PATIENTS DO NOT CREATE A DANGEROUS ENVIRONMENT FOR THE ELDERLY AND FRAIL PATIENTS; AND

WHEREAS, ONCE A PATIENT IS ADMITTED INTO A NURSING HOME, THE STAFF ARE OFTEN NOT EDUCATED OR TRAINED TO ADDRESS AGGRESSIVE BEHAVIOR, WHICH PLACES THE ELDERLY AND FRAIL PATIENTS IN GRAVE DANGER; AND

WHEREAS, ACCORDING TO A MARCH 22, 2009, ASSOCIATED PRESS REPORT, “YOUNGER MENTALLY ILL PEOPLE NOW MAKE UP 9% OF THE NATION’S NEARLY 1.4 MILLION NURSING HOME RESIDENTS, UP FROM 6% IN 2002”; AND

WHEREAS, THERE SHOULD BE PEACE FOR OUR ELDERLY POPULATION IN LATER PARTS OF THEIR LIFE AND THEY SHOULD BE SAFE FROM ABUSE; AND

WHEREAS, IN ORDER TO PREVENT DANGEROUS OR HARMFUL SITUATIONS FOR ELDERLY AND FRAIL PATIENTS, NURSING HOMES SHOULD SEPARATE THESE PATIENTS FROM YOUNGER, MENTALLY ILL PATIENTS. NURSING HOMES SHOULD PROVIDE ALERT SUPERVISION OF BOTH POPULATIONS; AND

WHEREAS, NURSING HOME STAFF SHOULD BE TRAINED TO BE ABLE TO CARE FOR THE DIVERSE NEEDS OF ALL OF THE NURSING HOME’S PATIENTS; NOW, THEREFORE, BE IT

RESOLVED, BY THE SENIOR ASSEMBLY AND THE SENIOR SENATE, JOINTLY, THAT THE SENIOR LEGISLATURE OF THE STATE OF CALIFORNIA AT ITS 2009 REGULAR SESSION, A MAJORITY OF THE MEMBERS VOTING THEREFOR, HEREBY PROPOSES THAT AN INSTITUTION THAT PROVIDES RESIDENTIAL CARE FOR SENIORS, INCLUDING, BUT NOT LIMITED TO, BOARD AND CARE HOMES, RESIDENTIAL CARE FACILITIES FOR THE ELDERLY, SKILLED NURSING AND INTERMEDIATE CARE FACILITIES, AND OTHER RESIDENTIAL FACILITIES, BE REQUIRED TO SEPARATE YOUNGER PATIENTS WITH MENTAL ILLNESS FROM THE ELDERLY OR FRAIL PATIENTS AT THE FACILITY; AND BE IT FURTHER

RESOLVED, THAT THE SENIOR LEGISLATURE OF THE STATE OF CALIFORNIA RESPECTFULLY MEMORIALIZES THE LEGISLATURE AND THE GOVERNOR OF THE STATE OF CALIFORNIA TO ENACT APPROPRIATE LEGISLATION THAT WOULD ADDRESS THE CONCERNS SET FORTH IN THIS MEASURE; AND BE IT FURTHER

RESOLVED, THAT A COPY OF THIS MEASURE BE TRANSMITTED TO THE SPEAKER OF THE ASSEMBLY, THE PRESIDENT PRO TEMPORE OF THE SENATE, AND THE GOVERNOR OF THE STATE OF CALIFORNIA.

RN 09 16478

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