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Nursing Care Per Resident Each Day

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Nursing Care Per Resident Each Day joint informational hearing of the SENATE COMMITTEE ON HEALTH and SENATE SUBCOMMITTEE ON AGING and LONG-TERM CARE Senator Deborah Ortiz and Senator Elaine Alquist, Chairs nursing home quality in the 21st century: staffng adequacy and complaint investigation Sunnyvale Senior Center July 20, 2005 staff: Nicole Vazquez, Consultant Robert MacLaughlin, Consultant Lynda Hancock, Committee Assistant Stephanie Yang, Intern Steven O’Mara, Intern 1329-S MEMBERS SAM AAN ESTAD California Legislature DAVE COX SHE ILA KUEHL Senate Subcommittee on Aging and Long-Term Care DEBORAH ORTI Z SENATOR ELAINE K. ALOUIST, CHAIR CONSULTANT ROBERT Mac LAUGHLI N COMMITTEE ASSISTANT LYNDA HANCOCK Nursing Home Quality in the 21st Century: Staffing Adequacy and Complaint Investigation A joint informational hearing of the Senate Committee on Health and the Senate Subcommittee on Aging and Long-Term Care Senator Elaine K. Alquist presiding Sunnyvale Senior Center 550 E. Remington Drive, Sunnyvale, CA July 20, 2005 9:30 a.m. - 12:30 p.m. Opening/Welcoming Remarks • Senator Elaine Alquist, Chairwoman, California State Senate Subcommittee on Aging and Long-Term Care (9:37-11:00) Panel I: Strengthening Accountability in Nursing Home Staffing Patterns Building upon recent gains in nursing home resources, what strategies can be deployed to increase compliance with state staff ratio laws? What incentives exist in current law, how do they work, and how are newly implemented laws anticipated to work? • Charlene Harrington, Associate Director of the UCSF John A. Hartford Center of Geriatric Nursing Excellence o A current assessment of the state's skilled nursing staffing patterns. o The affects of such staffing patterns on quality of care. o Ideal staffing levels, and current state mandates. 1020 N Street, Room 545 • Sacram ento, CA 95814 • Tel (916) 651-1541 • Fax (916) 323-5179 Printe d on~- Recycled Paper • Beth Capell, Representative, Service Employees International Union State Council o The history of improving wages, staffing and reforming the reimbursement system. • Willie Brennan, Chief, Rate Development Branch, Medical Care Services, Department of Health Services o Current responsibilities of the Department of Health Services related to staffing levels, and the new requirements under AB 1629 (Chapter 875, Statutes of 2004). o Strategies DHS will employ to assure compliance with mandates of AB 1629, in conjunction with existing law. • Dave Helmsin, Legislative Advocate, California Association of Health Facilities o An historical assessment of the nursing home industry's perspective on the realities of compliance efforts. • Alan Robison, Supervising Deputy Attorney General, Elder Abuse Prosecuting Unit, California Department of Justice o The need for verifiable staffing data in elder neglect prosecutions involving nursing home operators. o Data needs of California's chief enforcement entity. • Robert Goldsborough, resident of a local nursing facility o "Daily Life In an Understaffed Nursing Home" Consumer Sounding Board: Informal opportunity for consumers to provide input and insight to testimony provided. Cards will be distributed at the hearing for individuals to submit requests to present during this portion of the hearing. * * * * * (11:00-12:30) Panel II: Status of the Complaint Investigation and Enforcement System Actions needed to ensure that abuse and neglect complaints receive timely and thorough investigations. Current status enforcement practices, and efforts to ensure that California care standards and rights are fully enforced. • Willie Brennan, Chief, Rate Development Branch, Medical Care Services, Department of Health Services o The Licensing and Certification Branch of the Department of Health Services: an assessment of the L&C role in assuring compliance with current and emerging state policies. • Patricia L. McGinnis, Executive Director, California Advocates for Nursing Home Reform o Historical perspectives on the development of the existing complaint investigation system. Purpose and goals of California law and regulations, and the current state of California's complaint and abuse investigation systems. • Mark Reagan, Esq. California Association of Health Facilities o Industry view of current enforcement practices and the challenges it poses for compliance efforts. • Beth Capell, Representative, Service Employees International Union State Council o Contemporary enforcement challenges facing the state, the industry, and its effect on employees. • Linda Robinson, Long-term Care Ombudsman Coordinator, Santa Cruz County o A description of current concerns about the complaint investigation system from the perspective of a local ombudsman coordinator. o The effects the current system has on the way the Long-term Care Ombudsman carries out its mandates, and role. Consumer Sounding Board: Informal opportunity for consumers to provide input and insight to testimony provided. Cards will be distributed at the hearing for individuals to submit requests to present during this portion of the hearing. Public Comment Closing Remarks Senator Elaine K. Alquist 13th Senate District Representing the Heart of Silicon Valley A policy maker for over 20 years, Senator serving on the Elaine K. Alquist (D-Santa Clara) is in her Board of Educa­ first Senate term representing the Heart of tion of Jhe Cuper­ Silicon Valley in the 13th Senate District of tino Unio'n'• School Santa Clara County. ,The district covers District from 1983, 900,000 people living in the cities of San through 1991, in­ Jose, Sunnyvale, Santa Clara, Mountain cluding two years View, and Gilroy. as Biard Presi- dent. >5 ntin- As a nevy member of the Senat~·'elected in ued h ' ,~u:t- Novemp~f 2004, Senator Alquist is the first female Chair.of the Senate Committee on Public Safety, lf; i she is leading the fight to provide rous, safe, and secure environme California fami- A former small busi owner and finan- lies and business also chairs the cial lyst at Stanfi iversity, Senator Senate Subcomm· Aging & Long . became th reek-American Term Care and th Committee on ar4 electeclt . Ifornia State Leg- Emerging Tech and Econo ature when 'elected to repre- Con;ipetitivenes rlf the 22nd District in 1996. Committees on ecognized a by her peers, she Health, Human served as the ent of the incom- Taxation; the Sub ing freshman A y class .in her first Research Oversight; term . .~e 7.elected y ugemargin, in 1998 Committees on Deferis and 2~00: she continued to. re~tesent the dustry, Mobile & Man /~outh~:, Bay. through 2002. Jh addition, and School Safety. Senato qtlist served as t~e Assembly's repres tive on both the Seismic Safety Elaine Kontomina~ Alquist grew up in St. Commission and the Commission on the Louis, MO, earned h~r bachelor's degree Status of Women. ' in mathematics from MacMurray College in Illinois, and her master's degree in A recognized leader on K-12 and higher Guidance and Counseling from Washing.: eclucation issues, Senator Alquist has ton University in St. Louis. helped implement the nation's toughest educational standards, expand profes­ Her love of children and public service led sional development for teachers, increase her to teach math and be a counselor in per-pupil funding, and expand the Cal­ public schools. Senator Alquist moved to Grant student aid program. Santa Clara County in 1978. She immedi­ ately became involved in her sons' public Making government work better is another schools, first as PTA President and then passion of Senator Alquist's. As the Chair of the Assembly Committee on Information As a resident of the City of Santa Clara, Technology she blew the whistle on the Senator Alquist understands the transpor­ disastrous Statewide Automated Child tation and housing challenges that she Support System (SACSS) and saved tax­ and the other residents of the 13th Senate payers millions of dollars. District face. She was proud to have cre­ ated the First-Time Homebuyers Down A passionate advocate for seniors, she Payment Assistance Program and is work­ established the standing Committee on ing on solutions to ease traffic congestion Aging and Long-term Care and served as and help more Californians buy their own its first chair, authoring a la~grnark· law on fiome·s. Osteoporosis Prevention and HMO cover­ age of Hospice Care/costs. She also se­ Knowing that Silicon Valley is an eco­ cured permanent funding for Alzheimer's nomic engine for the eotire state, Senator disease by creating a tax checkoff ro"'. is also fighting create jobs and gram. A lifetime champion crime, s married to r ired State Senator Alquist is u Ition as the Her famil includes first woman to chai ate Committee Bryan W.hit . daugh­ on Public Safety t n he~ ground­ t(:lr-in-law Anju Chowdh~ White, \ .. grand­ breaking legislatio ade it easier for daughter Jasmine, and grandson ~ogan. law enforcement t down on child molesters. Capitol Office State Capitol, Roo ,• .,.. .. u.,,u Sacramento, CA 95 916-651-4013 -2- BACKGROUND Verifying Nursing Home Staff: A Key to Quality & The state of California's Complaint Investigation and Enforcement System July 20, 2005 I. Verifying Nursing Home Staff: A Kev to Oualitv The quality of a nursing home's care is directly related to the adequacy of its staff. Numerous studies have documented that insufficient or poorly trained staff endangers residents' health and safety. For example, a 2004 report by the Institute of Medicine found: The relationship between nurse staffing levels and patient outcomes in nursing homes has been shown in numerous studies ... inadequate nurse staffing has been shown to be associated with malnutrition, starvation and dehydration in nursing homes. In a 2004 report, the California Department of Justice reported a direct link between understaffing and elder abuse: There is no more accurate indication of failure or success in the delivery of care than that of staffing levels. This is best evidenced by the fact that every corporate neglect case prosecuted by the BMFEA has involved understaffing as one of the underlying problems. Effective January 1, 2000, skilled nursing facilities in California were required to provide at least 3.2 hours of nursing care per resident each day.
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