Best at Home: Assuring Quality Long-Term Care in Home and Community-Based Settings (1996)

OLDER AMERICANS ACT AMENDMENTS OF 1992

[Public Law 102–375, September 30, 1992 (106 Stat. 1195)]

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SEC. 212. STUDY ON BOARD AND CARE FACILITY QUALITY.

1. ARRANGEMENT FOR STUDY COMMITTEE.—The Secretary of Health and Human Services shall enter into an arrangement, in accordance with subsection (d), to establish a study committee described in subsection (c) to conduct a study through the Institute of Medicine of the National Academy of Sciences on the quality of board and care facilities for older individuals (as defined in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.)) and the disabled.

2. SCOPE OF STUDY.—The study shall include—

   1. an examination of existing quality, health, and safety requirements for board and care facilities and the enforcement of such requirements for their adequacy and effectiveness, with special attention to their effectiveness in promoting good personal care;

   2. an examination of, and recommendations with respect to, the appropriate role of Federal, State, and local governments in assuring the health and safety of residents of board and care facilities; and

   3. specific recommendations to the Congress and the Secretary, by not later than 20 months after the date of the enactment of this Act, concerning the establishment of minimum national standards for the quality, health, and safety of residents of such facilities and the enforcement of such standards.

3. COMPOSITION OF STUDY COMMITTEE.—The study committee shall be composed of members as appointed from among the following:

   1. NATIONAL ACADEMY OF SCIENCES.—The members of the National Academy of Sciences with experience in long-term care. The members so appointed shall include—

      1. physicians;

      2. experts on the administration of drugs to older individuals, and disabled individuals receiving long-term care services; and

      3. experts on the enforcement of life-safety codes in long-term care facilities.

   2. RESIDENTS.—Residents of board and care facilities (including privately owned board and care facilities), and rep-

resentatives of such residents or of organisations that advocate on behalf of such residents. Members so appointed shall include—

1. residents of a nonprofit board and care facility; or

2. individuals who represent—

   1. residents of nonprofit board and care facilities; or

   2. organizations that advocate on behalf of residents of nonprofit board and care facilities.

3. OPERATORS.—Operators of board and care facilities (including privately owned board and care facilities), and individuals who represent such operators or organisations that represent the interests of such operators. Members so appointed shall include—

   1. operators of a nonprofit board and care facility; or

   2. individuals who represent—

      1. operators of nonprofit board and care facilities; or

      2. organisations that represent the interests of operators of nonprofit board and care facilities.

4. OFFICERS.—

   1. STATE OFFICERS.—Elected and appointed State officers who have responsibility relating to the health and safety of residents of board and care facilities.

   2. REPRESENTATIVES.—Representatives of such officers or of organisations representing such officers.

   3. OTHER INDIVIDUALS.—Other individuals with relevant expertise.

   4. USE OF INSTITUTE OF MEDICINE.—The Secretary shall request the National Academy of Sciences, through the Institute of Medicine, to establish, appoint, and provide administrative support for the study committee under an arrangement under which the actual expenses incurred by the Academy in carrying out such functions will be paid by the Secretary. If the National Academy of Sciences is willing to do so, the Secretary shall enter into such arrangement with the Academy.

   5. INVOLVEMENT OF OTHERS.—

      1. GOVERNMENT OFFICIALS.—The study committee shall conduct its work in a manner that provides for the consultation with Members of Congress or their representatives, officials of the Department of Health and Human Services, and officials of State and local governments who are not members of the study committee.

      2. EXPERTS.—The study committee may consult with any individual or organization with expertise relating to the issues involved in the activities of the study committee.

   6. REPORT.—Not later than 20 months after an arrangement is entered into under subsection (d), the study committee shall submit, to the Secretary, the Speaker of the House of Representatives, and the President pro tempore of the Senate, a report containing the results of the study referred to in subsection (a) and the recommendations made under subsection (b).

7. BOARD AND CARE FACILITY DEFINED.—In this section, the term “board and care facility” means a facility described in section 1616(e) of the Social Security Act (42 U.S.C. 1372e(e)).

8. AUTHORIZATION.—There are authorized to be appropriated to carry out this section $1,500,000 for fiscal year 1992 and such sums as may be necessary for subsequent fiscal years.

SEC. 213. STUDY ON HOME CARE QUALITY.

1. ESTABLISHMENT STUDY OF¹ COMMITTEE.—The Secretary of Health and Human Services shall enter into an arrangement, in accordance with subsection (d), to establish a study committee described in subsection (c) to conduct a study through the Institute of Medicine of the National Academy of Sciences on the quality of home care services for older individuals and disabled individuals.

2. SCOPE OF STUDY.—The study shall include—

   1. an examination of existing quality, health and safety requirements for home care services and the enforcement of such requirements for their adequacy, effectiveness, and appropriateness;

   2. an examination of, and recommendations with respect to, the appropriate role of Federal, State, and local governments in ensuring the health and safety of patients and clients of home care services; and

   3. specific recommendations to the Congress and the Secretary, not later than 20 months after the date of the enactment of this Act, concerning the establishment of minimum national standards for the quality, health, and safety of patients and clients of such services and the enforcement of such standards.

3. COMPOSITION OF STUDY COMMITTEE.—The study committee shall be composed of members appointed from among —

   1. individuals with experience in long-term care, including nonmedical home care services;

   2. patients and clients of home care services (including privately provided home care services and services funded under the Older Americans Act of 1965) or individuals who represent such patients and clients or organizations that advocate on behalf of such patients and clients;

   3. providers of home care services (including privately provided home care services and services funded under the Older Americans Act of 1965) or individuals who represent such providers or organizations that advocate on behalf of such providers;

   4. elected and appointed State officers who have responsibility relating to the health and safety of patients and clients of home care services, or representatives of such officers or of organizations representing such officers; and

   5. other individuals with relevant expertise.

4. USE OF INSTITUTE OF MEDICINE.—The Secretary shall request the National Academy of Sciences, through the Institute of Medicine, to establish, appoint, and provide administrative support for the committee under an arrangement under which the actual expenses incurred by the Academy in carrying out such functions

will be paid by the Secretary. If the National Academy of Sciences is willing to do so, the Secretary shall enter into such arrangement with the Academy.

5. INVOLVEMENT OF OTHERS.—

   1. MEMBERS AND OFFICIALS.—The committee shall conduct its work in a manner that provides for consultation with Members of Congress or their representatives, officials of the Department of Health and Human Services, and officials of State and local governments who are not members of the committee.

   2. INDIVIDUAL OR ORGANIZATION WITH EXPERTISE.—The committee may consult with any individual or organization with expertise relating to the issues involved in the activities of the committee.

6. REPORT.—Not later than 20 months after an arrangement is entered into under subsection (d), the committee shall submit, to the Secretary, the Speaker of the House of Representatives, and the President pro tempore of the Senate, a report containing the results of the study referred to in subsection (a).

7. AUTHORIZATION.—There are authorized to be appropriated to carry out this section $1,000,000 for fiscal year 1992 and such sums as may be necessary for subsequent fiscal years.