EXTENSIONS of REMARKS 32671 EXTENSIONS of REMARKS MEDICARE SKILLED NURSING System
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October 1 G, 1986 EXTENSIONS OF REMARKS 32671 EXTENSIONS OF REMARKS MEDICARE SKILLED NURSING system. These recommendations have been after a long House session. For this reason, HOME QUALITY CARE AMEND endorsed by a wide coalition of senior citizens too, I am grateful to him. MENTS OF 1986 and nursing home reform organizations. I wish BILL the very best in the years to At the heart of the institute's recommenda come. He has been an outstanding Member HON. FORTNEY H. (PETE) ST ARK tions is the recognition that the regulatory of Congress and will be an outstanding pro OF CALIFORNIA system has been overconcerned with paper fessor as well. IN THE HOUSE OF REPRESENTATIVES compliance. and far too little concerned with what kind of care the elderly actually receive. Wednesday, October 15, 1986 This legislation seeks to implement many of CORPORATE AVERAGE FUEL Mr. STARK. Mr. Speaker, today I am the institute's legislative proposals and assure ECONOMY-CAFE STANDARDS pleased to· introduce along with Mr. WAXMAN, our Nation's elderly and disabled that they will the chairman of the Subcommittee on Health live in an environment that maintains or en HON. DAN COATS and the Environment of the Committee on hances the quality of their lives. In all, more OF INDIANA Energy and Commerce, the Medicare Skilled than a dozen requirements for medicare par IN THE HOUSE OF REPRESENTATIVES Nursing Home Quality Care Amendments of ticipation are outlined in the bill. To promote 1986. This bill is a companion to H.R. 5450, quality of care, nursing facilities wou!d have to Wednesday, October 15, 1986 the Medicaid Nursing Home Quality Care develop a plan of care for each resident, con Mr. COATS. Mr. Speaker, recently, the Na Amendment of 1986. like H.R. 5450, it is de duct resident assessments, protect and en tional Highway Traffic Safety Administration signed to improve the quality of care and qual hance residents' rights, provide appropriate [NHTSA] issued its final rule regarding reduc ity of life for our Nation's elderly and disabled access and visitation rights and provide equi tion of the corporate average fuel economy in skilled nursing facilities. table admission, transfer, and discharge poli [CAFE] standards for the 1987 and 1988 With the aging of the population, an in cies. The bill would also restructure the cur model years. The Agency wisely lowered the crease in chronic illnesses, and the move to rent survey and certification and inspection of standards to 26.0 miles per gallon for these shorter lengths of stay in hospitals, more and care processes. Equally important, this legisla years, noting in its press release accompany more Americans will spend some time in a tion would expand the range of enforcement ing the decision that "a higher standard would skilled nursing facility. It projected that the el options available to both the Federal and have resulted in the loss of jobs for tens of derly nursing home population will increase by State governments. thousands of workers in the domestic auto in more than 50 percent from 1978 to 2003. We have decided to introduce the bill at this dustry." Clearly this is a victory for American Presently, Medicare and Medicaid account for time in order to allow those interested in nurs consumers and auto workers alike. over haH of the payments for nursing home ing home reform to consider the specific pro NHTSA concluded in the rule that GM and care on behaH of about 1.5 million residents. posals and make their recommendations Ford, which constitute a substantia~ part of the To protect these elderly and disabled Ameri known. As chairman .of the Subcommittee on industry, took or planned appropriate steps to cans, a Federal-State regulatory system was Health, with jurisdiction over Medicare, I plan meet the 27.5 miles per gallon standard for developed. Unfortunately, according to studies on holding hearings early in the 1 OOth Con the 1987 and 1988 model years, but they in California and other States this system is gress on ways to strengthen and improve were prevented from fully implementing those not working. these provisions in order to assure quality of steps by unforeseen events. NHTSA's analy When the Reagan administration attempted care in nursing homes. sis found that the only actions now available to add insult to injury by deregulating this al Mr. Speaker, we must not turn our backs on to those manufacturers to raise their CAFE ready inadequate regulatory system, the Insti our Nation's elderly and disabled nursing levels to 27.5 miles per gallon would involve a tute of Medicine, at the urging of Congress, home residents. I look forward to working with combination of production restrictions, includ was commissioned to study the nursing home my colleagues in the next session on making ing substantial job losses, and transferral of industry. After 2 years of study, in March sure that Medicare and Medicaid nursing production of large cars outside of the United 1986, the Institute of Medicine released its home residents receive the kind of care they States. Obviously these steps would not have report entitled "Improving the Quality of Care deserve and are entitled to receive. been in the best interest of the companies, in Nursing Homes." This prestigious institute their employees and suppliers, and American concluded that the present regulatory system TRIBUTE TO THE HONORABLE consumers. is apparently unable either to force substand G. WILLIAM WHITEHURST NHTSA stated in the rule that the maximum ard facilities to improve their performance or hypothetical difference in gasoline consump to eliminate them. tion by lowering the standard is less than one A nursing home regulatory system should HON. DON FUQUA half of 1 percent of the projected national ensure that any person requiring nursing passenger car gasoline consumption over the home care be able to receive appropriate OF FLORIDA IN THE HOUSE OF REPRESENTATIVES life of those cars. The Agency also noted that care, be treated with courtesy, and enjoy con the average fuel economy of the total fleet of tinued civil and legal rights. The Institute of Tuesday, October 14, 1986 new cars sold in the United States is expect Medicine found that: Mr. FUQUA. Mr. Speaker, I am delighted to ed to exceed 27.5 miles per gallon during This happens in many nursing homes in have the opportunity to say a few words in 1987 and 1988, despite GM and Ford falling all parts of the country. But in many other tribute to BILL WHITEHURST. As a member of below this level. government-certified nursing homes, indi viduals who are admitted receive very inad the Armed Services Committee, he has Many arguments were presented in favor of equate-sometimes shockingly deficient served his Nation well and been a strong ad reducing the CAFE standards temporarily, but care that is likely to hasten the deteriora vocate for America's military needs. As a one which has been less frequently and fully tion of their physical, mental, and emotion member of the Committee on Standards of articulated is the consideration of vehicle al health. They also are likely to have their Official Conduct he has not only served his sizes and their relationships to fuel economy rights ignored or violated, and may even be Nation but his colleagues in this body with his and safety. A March 24, 1986 letter from Brian subject to physical abuse. fair and honest decisions on difficult issues. O'Neill, president of the Insurance Institute for Mr. Speaker, this deplorable situation must BILL is not only my colleague in this House Highway Safety [llHS], to NHTSA clearly pre not be allowed to continue. In its report, the but we are also neighbors in nearby houses in sents this point. The letter observes that Institute of Medicine made several recommen northern Virginia. Many is the time he has gra weight has more of an effect on fuel economy dations for reforming the current regulatory ciously given me a ride home late at night than does vehicle size, so cars can be made e This "bullet" symbol identifies stat~ments or insertions which are not spoken by the Member on the floor. 32672 EXTENSIONS OF REMARKS October 16, 1986 more fuel efficient without compromising 1978-80, there were more than twice the ers and their children from exposure to haz safety to a degree by reducing weight without number of deaths per 100,000 registered ve ardous asbestos in schools and other build reducing vehicle size. However, there is a hicles in small subcompacts (96-inch wheel ings. point beyond which weight cannot be effec base or less) as in full size cars <Wheelbase Hart voted to maintain Davis-Bacon and over 120 inches). During this period, the dis Service Contract Act protections as written tively reduced without making vehicles smaller parity in deaths per car registered for small and thereby compromising safety. Mr. O'Neill for U.S. contracts. and large cars held for all crash configura Hart co-sponsored legislation restricting points out in this regard that "occupants of tions. In addition, insurance injury claims "double-breasting"-a ploy used by union smaller cars are at much greater risk of death data show that small cars produce many contractors to pay non-union wages. and injury than occupants of larger cars." more occupant injury claims than do large Hart sponsored legislation to restore While the llHS letter ·does not specifically cars <Attachment C). America's crumbling roads and bridges, endorse a reduction in the CAFE standards, it These results cannot be explained by the enable states to pay for the work and revive does point out NHTSA should review this differences in the mass of small and large related construction trades <the National In cars because small car occupants in single frastructure Act).