CA: New website promotes psychoactive meds education

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CA: New website promotes psychoactive meds education
CA: New website promotes psychoactive meds education
CALIFORNIA – You've seen Jack Nicholson's portrayal of R.P. McMurphy in “One Flew Over The Cuckoo's Nest,” pretending to swallow pills given to him by Nurse Ratched in a small paper cup.

The frail elderly in the state's nursing homes aren't liable to be so wily when asked to ingest mood-altering and other psychoactive medications, according to Carole Herman, president of Foundation Aiding the Elderly, a local nonprofit that represents nursing home patients. Herman, in fact, claimed in a Sacramento Business Journal article “facilities are giving anti-psychotics without informed consent all the time.”

But nursing homes in the state are now on the offensive, launching a public awareness campaign to educate people about laws governing the use of such medications.

The California Association of Health Facilities designed the new website to explain, among other things, the strict laws that govern their use, as well as the requirement that every skilled nursing resident or representative provide informed consent in advance of any drug therapy.


‘I'm sorry' law proposed
PENNSYLVANIA – If a doctor or nurse shows personal concern to an ailing patient, it could make him or her vulnerable if that patient later sues for poor care. So the logic goes with risk management professionals.

But lawmakers in this state want to make such empathy inadmissible in malpractice lawsuits. The so-called “benevolent gesture” bill, HB 495, would protect caregivers who “convey a sense of apology, condolence, explanation, compassion or commiseration emanating from humane impulses.” The measure passed in the House on March 2 and was being reviewed by the Senate Judiciary Committee at press time.

“Providers and hospitals try to limit the possibility of litigation and its cost by telling doctors to stay stoic when talking with a patient facing an unfortunate outcome,” an editorial states in the Patriot News' online site, And such seemingly innocent gestures have a freezing effect across all sectors of the state's economy, according to Stanley Saylor (R-York), Pennsylvania House Majority Whip, sourcing a study by the National Federation of Independent Business that found six out of every 10 businesses feel they would be able to increase revenues if they were assured they would be protected from frivolous lawsuits.

It's no surprise that professional groups such as the Pennsylvania Medical Society strongly favor the bill, which “simply facilitates the ability of providers and patients to have an open discussion after a poor outcome. When a poor outcome occurs, patients want answers, and physicians want to provide the patient with those answers,” the organization notes on its website.

HB 495 would still allow injured patients to file personal injury lawsuits and would not impose award limits.
Meanwhile, more tort reform measures are underway. House Bill 1, the Fair Share Act, would among other things, reform the system of “joint-and-several” liability, under which a party minimally responsible for an injury can be forced to pay one hundred percent of damages.

Medicaid cuts fought
NEW JERSEY – The state is fighting more than $140 million in combined Medicaid cuts and possible reductions in federal matching funds.

The Garden State has seen $425 million in Medicaid cuts over the past five years; the latest round is especially painful. So legislators are moving to block the cuts, arguing, among other things, that a nursing home provider tax levy that funnels $136 million each year into the state treasury should account for the overall budget shortfall.

Moreover, the lawmakers argue the cuts could lower nursing home admission rates and force layoffs, leading to a boon in unemployment claims and facility closures.

SNF beds left empty
HAWAII – A nursing home operator says an unprecedented surplus in beds doesn't mean Hawaii's fresh air and clean living has allowed older folks to remain healthier longer.

Instead, Hale Makua, a 64-year-old skilled nursing community in Wailuku, a small town on the northern coast of the mainland, is facing what could be a similar challenge for many other U.S. facilities in this chaotic economy: Medicaid payment problems and businesses that encourage frail elderly individuals to remain in the care of loved ones by taking advantage Medicaid's home- and community-based programs.

CEO Tony Krieg told the Maui Weekly newspaper that the nonprofit nursing home has had as many as 35 to 40 beds empty in the past 10 months. He said that it is a situation he hasn't witnessed in over two decades. Vacancies recently were more than 10% at Hale Makua's Wailuku and Kahului locations.

Referral agencies targeted
WASHINGTON – The state has put the eldercare referral industry in its crosshairs, passing legislation to stop what it claims are practices that target the elderly.

Eldercare referral firms help people locate a suitable adult family home or assisted living facility. Up to now, such firms have proliferated rapidly and have been mostly unregulated, according to a report by the Seattle Times. While most firms provide such services for free, they receive large commissions from adult family homes and assisted living communities— a practice critics say sometimes steers elderly toward places that pay the highest commissions, not those that are the most suitable or affordable.

A lengthy investigation preceding the legislation revealed at least 143 cases since 2008 of seniors who had been victimized after being referred to state-licensed homes with documented histories of substandard care, including fatal neglect, according to the newspaper.

According to AARP, Washington is the first state to pass an eldercare referral law, which was awaiting Gov. Chris Gregoire's signature at press time.

By January 2012, eldercare firms will be required to disclose fees and commissions. They'll also have to report facility inspection dates, carry liability insurance coverage, perform felony background checks of employees and completely follow the state Consumer Protection Act, which gives the state Attorney General's Office the authority to investigate complaints.

Reforms favor arbitration
OKLAHOMA – Despite unanimous House approval of a bill that would allow nursing home residents to settle care and other complaint issues through binding arbitration, the bill's sponsor has pulled the bill to study possible changes. The measure is intended to stem costly lawsuits.

It was unclear at press time exactly which issues state Rep. Doug Cox wanted to revisit, but the state's long-term care ombudsman reportedly said that she wanted to ensure nursing home residents would be allowed to make the decision any time and not be forced to agree to arbitration when seeking admission to a nursing home.

Cox said Senate Bill 239 would make binding arbitration completely voluntary.

Earlier revisions changed a provision that would have commissioned a legislative study to determine the extent of overlapping facility regulation and whether the state Medicaid rate is sufficient to provide services to Medicaid-eligible nursing home residents.

Observers have noted that possible sticking points in the legislation concern the cost of arbitration and whether residents could hire attorneys on a contingency basis.

The bill joins other tort reform efforts. Another bill — SB 862 — would limit defendants' financial liability for damages when they are at fault, and potentially could protect healthcare providers from large jury awards in personal injury lawsuits.


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