E228 CONGRESSIONAL RECORD — Extensions of Remarks February 25, 1998 up in their neighborhood anytime soon to pro- crime control and crime prevention measures. vey visitsÐsimply by hiring extra staff to make vide price competition to the incumbent cable I am also a steadfast proponent of smart gun operations look smoother than they really are. company. control laws and tough sentences for gun-re- In too many cases, the report finds that The effect of lifting consumer price controls lated violence. However, this misguided at- JCAHO's high test scores mask a darker re- 13 months from now in the absence of robust tempt imposes penalties for possessing a alityÐthat some accredited hospitals may be competition would be to permit cable monopo- weapon that are far more severe than are the endangering the health of patients because lies to charge what they want for everything sentences for many violent crimes, like man- they don't meet basic standards of care. but the broadcast-tier basic service without an slaughter. It is outrageous that the penalties The New York City report demonstrates effective marketplace check on their ability to imposed by this legislation for a first time of- widespread quality of care problems in 15 ac- raise rates excessively. This means that for fender for drug possession who has a gun at credited City hospitals. For example, it finds: the vast majority of cable consumers, the ex- the time of the crime is ten years while a rap- Inadequate supervision that can mean patients panded tier of service that typically includes ist receives only six years. We need to get are left in pain; substantial delays in treatment CNN, ESPN, TNT, DISCOVERY, MTV, and tough on crime, but we also must be smart in of emergency room patients; outdated and other popular cable programming services will our crime control strategies. Mandatory sen- broken equipment; overcrowded, understaffed be offered without any price limits in place. tencing does not allow judicial flexibility to ad- clinics; unsanitary conditions throughout the Without a legislative change to extend con- dress each crime individually, imposing tough hospital; incomplete and poorly documented sumer price protections for cable consumers sentences when necessary and second patient charts. past March 31, 1999, consumers will be hit chances when warranted. Clearly, when such conditions are present, with a cable rate El Nino. Congress must act The severity of sentences should reflect the JCAHO should respond with sanctions, not in time to adjust the law to take note of the seriousness of the crime committed. The sen- high praise. Yet only last year, JCAHO flunked fact that cable competition has not developed tencing policy included in this legislation which fewer than 1% of hospitals. The organization sufficiently to warrant lifting consumer price punishes criminals based not on their crime says that it fails so few because it prefers to controls. The recent cable competition report but on whether or not they possess a gun and work with hospitals to ``correct'' any violations from the FCC in January underscores this the type of gun they possess simply does not that are detected. But if its accreditation stand- fact. The new Chairman of the FCC, William make sense. ards are low to begin with, then can consum- Kennard, noted when releasing the report that f ers and plans really rely on JCAHO reports? policymakers ``should no longer have high This is a critical question for Medicare bene- hopes that a vigorous and widespread com- JAVITS-WAGNER-O’DAY BLIND ficiaries, since JCAHO-accredited hospitals petitive environment will magically emerge in WORKER OF THE YEAR are ``deemed'' to have met Medicare's ``Condi- the next several months.'' tions of Participation,'' a key proxy for quality Our legislation would simply repeal this sun- HON. JOHN E. PETERSON of care. set date from our communications statutes. OF PENNSYLVANIA The weaknesses of JCAHO's current sys- Cable operators would then be deregulated IN THE HOUSE OF REPRESENTATIVES tem are made plain in the New York report. through two underlying provisions that are al- Simply put, there are no surprise inspections, ready available under the law. Wednesday, February 25, 1998 and little apparent follow-up of pro-forma walk- The first test for deregulating an incumbent Mr. PETERSON. Mr. Speaker, I rise today throughs. ``Simply investigative steps, such as cable operator in a franchise area that is con- to recognize Joyce A. Gnoffo of Williamsport, unannounced visits, confidential employee tained in the Communications Act of 1934 Pennsylvania, who has been selected as Blind interviews, and document audits'' could make would be met if emerging competitors served Worker of the Year as a participant in the Jav- a vast difference in what JCAHO actually more than 15 percent of the households in a its-Wagner-O'Day program. found. particular franchise area (see Section Ms. Gnoffo was nominated for this honor by To make matters worse, under the Joint 623](l)(1)(B)). Second, if a local phone com- her co-workers at North Central Sight Serv- Commission's arbitrary scoring system, hos- pany offers a competing cable service directly ices, Inc., which provides a variety of com- pitals with serious quality of care problems are to subscribers in a franchise area then the in- puter media to the U.S. Department of De- often awarded high accreditation scores. In ef- cumbent operator is immediately deregulated, fense and pressure sensitive labels to General fect, JCAHO surveyors are encouraged to without waiting for the phone company to gar- Service Administration. Ms. Gnoffo was se- rank hospitals highly on each standard, even ner 15 percent of the market (see Section lected for this honor as a result of her on-the- if the hospital is unable to meet that standard! 623(l)(1)(D)). job performance at North Central Sight Serv- This practice makes a mockery of the review As I said during deliberations on the Act in ices, Inc. process. 1995, when Mr. SHAYS and I offered a cable I know I am joined by many in congratulat- In fact, almost all (98 percent) of the institu- consumer protection amendment, and which I ing Ms. Gnoffo in this wonderful achievement, tions surveyed in the New York City study re- continue to believe today, sound public policy and I wish her the very best of luck as she ceived scores of 80 or better on a 100 point should compel us to repeal consumer price competes nationally for the Peter J. Salmon scale, and none had a score below 70! Mr. protections only when effective competition Award. Speaker, I am astounded that, of the 18,000 provides an affordable alternative choice for Thank you, Mr. Speaker, for this opportunity institutions surveyed each year, none are consumers, making regulatory protections un- to recognize and to congratulate Joyce A. judged to fail outright. Nearly all of them met necessary. Gnoffo. JCAHO standards. Until that time, the question boils down to f These inflated grades are confusing and thisÐdo you want your monopolies regulated misleading. Although each facility is rated on or unregulated? JCAHO ACCREDITATION PROCESS individual standards, the highest score of 1 on In my view, such protections should not be A SHAM; MILLIONS OF LIVES AT a scale of 1 to 5 only indicates 91% compli- lifted on an arbitrary deadline set on the basis RISK AT ‘‘ACCREDITED’’ HOS- ance; a score of 2 indicates only 76% compli- of politics instead of economics. I urge my col- PITALS ance. leagues to support this effort on behalf of mil- The results of such a skewed system are lions of cable consumers across the country. HON. FORTNEY PETE STARK that public health authorities are left to do the f OF CALIFORNIA hard work of sanctioning and shutting down INCREASED MANDATORY MINIMUM IN THE HOUSE OF REPRESENTATIVES facilities that are appalling deficiencies. In 1994, New York City's Union Hospital SENTENCES FOR CRIMINALS Wednesday, February 25, 1998 POSSESSING FIREARMS was reviewed by JCAHO and given a score of Mr. STARK. Mr. Speaker, a recent inves- 92. Three years later, in March 1997, the hos- SPEECH OF tigation of New York City hospitals has uncov- pital's score rose to a near-perfect 97. But ered startling evidence of substandard care at later that year, the New York Department of HON. DIANA DeGETTE hospitals with high accreditation scores from Health concluded that hospital staff had failed OF COLORADO Joint Commission on Accreditation of Health to properly treat high-risk emergency room pa- IN THE HOUSE OF REPRESENTATIVES Care Organizations (JCAHO). In a scathing re- tients, including two rape survivors, and was Tuesday, February 24, 1998 port, the Public Advocate for the City of New using outdated and expired drugs. Nurses Ms. DEGETTE. Mr. Speaker, I rise today to York presents strong evidence that hospitals pointed to understaffing and a lack of experi- oppose H.R. 424. I strongly support effective circumvent JCAHO's annual announced sur- enced staff in the pediatric, post-partum, and February 25, 1998 CONGRESSIONAL RECORD — Extensions of Remarks E229 maternity departments and the emergency A SPECIAL TRIBUTE TO HARRY cated judge. His reputation for fairness earned room. By October, public health authorities THOMPSON ON THE OCCASION OF him the respect of his colleagues and peers. moved to partially shut the hospital, which has HIS RETIREMENT Mr. Speaker, during my career as a practic- since filed for bankruptcy. ing attorney, I tried cases in Judge Thomas' court. In my opinion, he is one of the finest In Brooklyn, New York, Interfaith Medical HON. PAUL E. GILLMOR trial judges in the nation. He is also a gen- Center received a JCAHO score of 89 in 1995 OF OHIO tleman whom I respect and greatly admire. that was raised to 94 a year later. Strange, IN THE HOUSE OF REPRESENTATIVES For this reason, I want to share the Plain because a 1997 Wall Street Journal article on Wednesday, February 25, 1998 Dealer article with my colleagues and others Interfaith painted a picture of a badly deterio- Mr. GILLMOR. Mr. Speaker, I rise today to around the nation. I extend my personal con- rated facility, with heating and plumbing sys- pay special tribute to a truly outstanding indi- gratulations to Judge Thomas and wish him tems in bad disrepair and non-functioning ele- vidual from Ohio's Fifth Congressional District, the very best in his retirement years. vators. Hospital staff, the story found, had to Mr. Harry Thompson. On Saturday, February A FAIR PIECE OF WORK stave off invasions of rats, mice, and flies. 28, 1998, Mr. Thompson will be retiring from (By Mark Rollenhagen) Even the hospital's president, Corbett Price, the Ottawa County Board of Elections. was quoted as saying, ``This hospital is being When William K. Thomas was sworn in as Mr. Speaker, Harry Thompson has dedi- a federal judge, one of the speakers at his held together by rubber bands and Band- cated much of his life to serving his country, swearing-in ceremony invoked the words of a Aids.'' his community, and his party. Mr. Thompson former law partner who had long ago said JCAHO's problems are not confined to New has served as a member of the Board of Elec- Thomas could never be a good lawyer. York. In Las Vegas, poor care at Columbia/ tions for ten years, the past eight as the Chair- ‘‘The trouble with Bill Thomas is he wants man. During his tenure on the board of elec- to be fair to both sides,’’ the partner had HCA's JCAHO-accredited Sunrise Hospital said. generated numerous newspaper articles and tions, Mr. Thompson was a strong public serv- ant, an impartial judge of electoral issues, and Thomas, who retires today after nearly 32 television pieces in October 1996, ultimately years on the federal court bench in Cleve- a valued colleague to those with whom he causing JCAHO to place the facility on proba- land, flashed a contented smile earlier this worked. tion a year later. week when he recalled those words. Like his unwavering service to the Board of At 86 years old, he leaves what he some- Just recently, JCAHO placed Columbia's Elections, Mr. Thompson dedicated a great times refers to as ‘‘the judging business’’ North Houston Medical Center on preliminary deal of time to the Ottawa County Republican with a reputation as a meticulous, hard- non-accreditation statusÐbut only because an Party. Mr. Thompson served as the county working jurist who treated lawyers, crimi- employee called a hotline number to report GOP Chairman for many years, retiring just nals and parties to civil lawsuits with re- that problems had been overlookedÐincluding this past year. Mr. Thompson diligently worked spect and fairness. ‘‘He’s one of the best I’ve ever tried a case a high level of incomplete patient records. to encourage and support increased participa- in front of,’’ said James R. Willis, a veteran After returning to North Houston in December, tion in our political process. His support of criminal defense lawyer who represented JCAHO downgraded the hospital's status. grassroots political exercises has certainly Cleveland Mafia boss James T. Licavoli when In other cases, where serious problems helped to strengthen the free form of govern- Licavoli was convicted in 1982 of racketeer- ing. ‘‘He was patient, he listened to what you have been brought to light by state inspection ment we enjoy. Mr. Thompson has placed an enormous em- were saying and the ruled decisively. That’s teams, JCAHO has proved reluctant to down- phasis on service to government, to politics, the whole package.’’ grade a hospital's accreditation status. and to the community. We have often heard The Licavoli case, in which the mob figure Given this spotty record, I am outraged by and others were convicted of conspiring to that America works because of the unselfish kill mobster Daniel J. Greene, was perhaps media reports that the Joint Commission is contributions of its citizens. I know that Ottawa the highest profile criminal case of Thomas’ considering softening its already loophole-rid- County is a better place because of the count- career. Greene, killed by a bomb in 1977, was den review process. According to a leading less hours given by Harry Thompson. His pub- in competition for control of organized crime trade publication, Modern Healthcare, JCAHO lic service and commitment to Ottawa County in the Cleveland area. may move to allow hospitals that self-report a will be sorely missed. But Thomas also presided over a trial in ``sentinel event'' within five days of its occur- Mr. Speaker, in addition to the flag being which porn king Reuben Sturman and sev- rence will be put on accreditation watch. The flown over the Capitol on Mr. Thompson's be- eral associates were found not guilty of ob- scenity charges, and he helped negotiate an definition of ``a sentinel event'' is one that half, I would urge my colleagues to rise and end to a police standoff in 1975 with bank could lead to the death or serious injury of a join me in paying special tribute to Mr. Harry robber Eddie Watkins, who was holding hos- patient. Thompson, a true American, a dedicated pub- tages at a bank in Cleveland. lic servant, and a good friend. We wish him The misguided scoring and lax oversight Watkins was sentenced to prison in 1967 by well in his retirement and in the years ahead. Thomas, but escaped. documented in the New York report suggests f Watkins had asked for Thomas. that another system of oversight is needed. I As for civil lawsuits, Thomas also shep- am cosponsoring two bills that would overhaul A SPECIAL SALUTE TO JUDGE herded a settlement of lawsuits brought by the current voluntary review process. The Ac- WILLIAM K. THOMAS students injured when Ohio National Guards- creditation Accountability Act of 1997 (H.R. men fired on a crowd of demonstrators at 800) would require all Medicare-accrediting or- HON. LOUIS STOKES Kent State University. With the jury delib- ganizations to hold public meetings. One-third erating, Thomas met with the lawyers in his OF OHIO chambers and pounded out a carefully word- of governing board members would be mem- IN THE HOUSE OF REPRESENTATIVES ed agreement in 1979 in which the state of bers of the public. Ohio agreed to pay the plaintiffs $675,000. Wednesday, February 25, 1998 Second, the Medicare and Medicaid Pro- Thomas said it would be difficult to pick vider Review Act of 1997 (H.R. 2543) would Mr. STOKES. Mr. Speaker, I am proud to out any of his cases as being bigger or more salute an outstanding member of the judicial difficult than any of the others. He said he levy user fees on hospitals and other health had never been one to look back. care providers to underwrite the costs of inde- system, United States District Judge William K. Thomas. Judge Thomas recently retired What he has enjoyed the most, the judge pendent federal compliance and audits. I am said, is the view of life he had from the happy to report that President Clinton included after nearly 32 years on the federal bench. I bench. take special pride in recognizing him at this the heart of this bill in the budget package he ‘‘I think the contact with individuals that time. recently sent to Congress. comes to a trial judge is a great reward,’’ President Lyndon Johnson in 1966 ap- Thomas said. ‘‘You have a chance to see the For too long, we've given JCAHO and the pointed Judge Thomas to the U.S. District ebb and flow of humanity.’’ Health care industry the benefit of the doubt. Court in Cleveland. In an article which ap- Thomas said his judicial temperament was Self-policing simply isn't working. The New peared on January 30, 1988, the Plain Dealer formed in part by the experience of being York City report is all the evidence we need to newspaper paid tribute to Judge Thomas, dressed down in front of a client by a federal judge when he was a lawyer. ‘‘I vowed that I show that patients sufferÐsometimes fatallyÐ highlighting his distinguished career. The arti- would never do that if I became a judge,’’ from substandard care provided by JCAHO- cle is entitled, ``A Fair Piece of Work,'' and Thomas said. accredited hospitals. Let's put patients' needs recognizes an individual who earned a reputa- Thomas became a judge in 1950 when his first, back where they belong. tion as a thorough, hard-working and dedi- friend, then-Gov. Frank Lausche, appointed