Kohl painkiller bill reappears in waning days of Senate term; AHCA voices objections

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Aging Committee chief hears complaints about nursing homes
Aging Committee chief hears complaints about nursing homes

 A bill meant to provide relief for nursing home residents who need painkillers would create the possibility of huge penalties for healthcare practitioners and long-term care facilities, a top lobbyist warned yesterday.

The Nursing Home Resident Pain Relief Act of 2011 (S. 1560) first appeared in Sept. 2011 from Sen. Herb Kohl (D-WI) but had been out of the limelight. Now, it is slated to appear for mark-up by the Senate Committee on the Judiciary on Thursday.

The measure would make it easier for physicians to give oral instructions on who can administer pain-relieving controlled substances when residents need immediate pain relief. But it also requires extensive written records and proposes strong criminal and civil penalties if the drugs are diverted, or recordkeeping requirements are violated.

That's the part the American Health Care Association objects to, saying it could result in thousands of dollars in penalties, or even prison, for operators and healthcare employees — including medical directors and physicians — in the event of paperwork errors. 

None of the alternate suggestions proposed by AHCA over the past year were adopted, association officials said. The bill “is still a hot mess,” said Jeff Myers, AHCA's senior vice president of policy and government relations.

“It's a giant overstep,” Myers explained. “We're concerned that there is no House companion and that there's an attempt to slide it in at the end of the term.”

A Judiciary Committee staff member said Tuesday "we are working with the Department of Justice and stakeholders to address industry concerns." 

Kohl is retiring at the end of this Senate term. But in 2011, the Senator said nursing home residents often have to wait too long for painkillers. “This legislation would help end these needless and avoidable delays,” he said.

The American Medical Directors Association did not return calls seeking comment Tuesday. But AMDA's interim executive director, Harvey Tillipman, wrote a letter of support for a revised version of the bill on Oct. 31, 2012, saying his members appreciated Kohl's efforts to “address the issue of ensuring nursing home residents access to proper pain medications.”

But the letter added that AMDA members remained concerned about the bill's requirements for multiple records “when one standard form would suffice.” He also expressed concern over the requirement of a logbook.

The American Geriatrics Society also wrote a letter of support for the bill on Nov. 12.