September, 2004
Nursing Home Residents’ Rights Week is
October 3-9! Do something special for residents in your area. For ideas and
information, visit the National Citizens Coalition for Nursing Home Reform
website at: www.nursinghomeaction.org
or www.nccnhr.org.
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1. State plans to use new
method to determine if applicants are medically eligible for Medicaid funded
nursing home care and the MiChoice Home and Community Based Waiver program
– Currently, consumers who need Medicaid funding to pay for their nursing home
care or for the MiChoice program need only a doctor’s signature to demonstrate
they are medically eligible. Beginning in the next few months, however,
consumers who need Medicaid funded nursing home care or who want to receive
services in the MiChoice program will be evaluated using a new screening tool
that looks at the consumer’s ability to handle activities of daily living,
cognitive impairments, medical status, behaviors and other factors. The state
hopes to save money by not funding long term care services for people who do not
meet the new medical eligibility criteria. Although the state wants to continue
providing services to people who are already receiving Medicaid funded long term
care, and although the new criteria are still fairly generous, some new
applicants who would previously have qualified for these services will likely be
denied services under this new procedure. The Campaign has submitted comments on
the proposed new procedures and been involved in discussions with the Department
regarding the new system.
2. Federal lawsuit challenges
the federal regulation that permits nursing homes to hire "feeding
assistants"– As we reported before, federal regulation now
permits states to allow nursing homes to hire "feeding assistants"–
staff with considerably
less training than nursing assistants – to feed residents. Previously, only
nursing assistants or nurses were allowed to help residents with meals.
In July, residents and advocates
filed a nationwide class action lawsuit in Washington to stop the use of feeding
assistants. The plaintiffs allege that the government violated the Nursing Home
Reform Law by authorizing feeding assistants to provide care to residents. If
the suit is successful, the federal government will have to bar states from
permitting feeding assistants. Any residents or their representatives who want
to join the suit should contact Eric Carlson at the National Senior Citizens Law
Center in Los Angeles (ecarlson@nsclc.org
or (213) 639-0930). Residents who wish to participate do not have to need
assistance with feeding themselves; they can simply oppose the regulation
because it allows less qualified staff to work in nursing homes.
In Michigan, a small workgroup has
drafted a proposal for a feeding assistant pilot project. The proposal includes
many more safeguards for residents than the federal regulation requires and will
likely be tested and evaluated in a few homes. Although the Campaign opposes
feeding assistants, when the state decided to try a pilot project, we
participated in the workgroup to create the best and safest model. In addition,
we pushed to ensure the pilot will be evaluated by experts to see if it benefits
or harms residents before any decision is made about whether more nursing homes
will be permitted to have feeding assistants.
3. Campaign fights
for bill to ensure safe temperatures in nursing homes –
H.B. 5537, a bill to ensure nursing homes maintain temperatures between 71 and
81 º F, is awaiting consideration in the state House of Representatives. A vote
on the bill is likely in mid-September. Campaign members (and a number of other
advocacy groups) have pushed hard to ensure the bill’s passage by testifying
in front of a House subcommittee, working on a legislative workgroup concerning
the bill, and paying visits to and calling their legislators to urge support for
the bill.
Contrary to popular belief, older people
are particularly susceptible to heat related illness and stress and some
Michigan residents have tragically died as a direct result of excessive heat in
nursing homes. In an informal telephone survey, law student volunteers found
that fewer than half of all Michigan nursing homes have air conditioning in
all resident rooms, making it difficult to assure the safety and comfort of
residents and staff in extreme temperatures.
In its current form, the bill, is a
compromise between what advocates and the nursing home industry wanted. The
Campaign sought to require all nursing homes to ensure comfortable temperatures
immediately while the industry pushed to exempt homes in northern Michigan and
allow a long implementation period. However, this bill has a chance of passing
this year and finally addressing this important issue – and it may even be
strengthened in the Senate. Please call your State Representative to urge
support for HB 5537 – it may be the most direct way he or she saves
lives during his or her entire tenure in the Legislature!
4. Federal Update:
A. U.S. Senate Finance
Committee Chairman Charles Grassley (R-IA) sent the federal Centers for Medicare
and Medicaid Services a five-page letter saying the nursing home inspection
process is "seriously corrupted" and "just plain broke."
Following a July 2003 hearing and federal report showing many problems including
violations not being properly identified as causing harm to residents, Grassley
authorized his staff to conduct anonymous interviews with about 20 surveyors and
former surveyors. In his letter, Grassley said, "The surveyors themselves
are demoralized when blatant quality of care deficiencies and findings are
watered down, substantively altered, and/or blatantly ignored or dismissed.
These surveyors have raised enormously disturbing issues for anyone who cares a
wit about the very health and safety of frail nursing home residents." The
letter is available at http://www.nccnhr.org/uploads/GrassleyLtr0704.pdf.
This issue has always been one of the Campaign’s priorities and we continue to
advocate for a better nursing home inspection process in Michigan.
B. The U.S. Government
Accountability Office released a scathing report about the government’s
failure to protect nursing home residents from fire. The GAO report includes
that there are some 2,300 structural fires a year in U.S. nursing homes and
that, on average, five residents each year die in fires. In 2003, deadly fires
in Connecticut and Tennessee killed more than 30 residents. Unfortunately,
sprinklers are not required in older buildings and, even in buildings without
sprinklers, residents’ rooms are not required to have smoke detectors. It
could be some time before the federal government requires the 20 to 30 percent
of nursing homes without sprinklers to install them. The GAO report is available
at http://www.gao.gov/new.items/d04660.pdf.
5. Campaign Has
Many Proud Accomplishments – As
we approach the Campaign’s sixth anniversary, let’s remember some of the
Campaign’s many victories in the battle for quality, dignity and choice in
long term care. In the early years, the Campaign convinced the Legislature to
allocate funding to hire many more nursing home inspectors; educated consumers,
the media, and policymakers on the dangers of bed side rails; pushed for
stronger, enforcement of federal laws; and ensured legislators understood
consumers cared about long term care. More recently,
’
The Campaign ensured that the state listened to consumers, not just nursing
home providers, about whether to permit dining assistants in nursing homes;
’
The Campaign persuaded the state to reverse its longstanding illegal policy
that barred some residents from returning to their room in the nursing home
after a hospital stay;
’
The Campaign participated in a successful effort to limit cuts in hours of
service to thousands of participants in the Home Help program.
’
The Campaign’s proposal for an easily accessible, standard complaint form
became one of the first pieces of legislation Governor Granholm signed after
taking office.
’ The Campaign
served as a plaintiff in the groundbreaking federal court
case that forced the state to reopen the MiChoice program.
The state is finally focusing on long
term care, so our advocacy is more important than ever. Thanks to all who
support our work and join our efforts!
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Thanks so much to our recent donors: Hy
Dooha, Harriette L. Woodards, and Mr. and Mrs. Harry Wayman. We make every
dollar count and we appreciate so much members’ continued support.
Contributions can be sent to the Michigan Campaign for Quality Care, c/o Nadene
Mitcham, Chairperson, 34216 Fountain Boulevard, Westland, MI 48185.
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