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Nursing home oversight tops legislative agenda for AARP

Nursing home care tops the agenda for the Mississippi state office of AARP, a nonprofit membership organization formerly known as the American Association of Retired Persons, and dedicated to addressing the needs and interests of persons 50 and older. With more than 33 million members, the AARP is considered the most powerful lobbying force in America.

“One of the first things we’ll look at is the makeup of the state board of health,” said Walter Howell, AARP associate state director for advocacy. “Legislation was passed in 2003 that realigned the seats based on geographical districts. It was a revision of the basis for the old appointments. Nine of the 13 members in the new legislation are to have a medical background, with no more than four having the same graduate degree. That would imply to us that four of the seats are consumer seats.”

According to Mississippi Code 41-3-1 regarding board appointments, “nine members shall be persons engaged professionally in rendering health services, and of those nine members, no more than four may be engaged professionally in rendering the same general type of health services or possess the same type of professional license, and no two members may be associated or affiliated with, or employed by, the same entity or employer.”

“We want to get legislation amended so that none of those four seats are for people who have a nursing home association,” said Howell. “That includes owners, administrators or even family members. We don’t think that anyone with an association to nursing homes or adult care facilities should have a consumer seat on the state board of health. The reason is that we have people serving now on the board of health that own nursing homes and they consider themselves consumer representatives. In our view, they certainly don’t look after the needs of consumers.”

John Maxey, counsel for the Mississippi Health Care Association (MHCA), the state’s oldest and largest association of nursing homes, personal care homes and other long-term care facilities, said the board hasn’t taken an official position on the issue.

“If it is the same legislation as proposed last year, we would probably have no position on the legislation this year as well,” he said.

In 2001, state lawmakers passed the Vulnerable Adults Act, which required fingerprints and criminal background checks on people who work in nursing homes and child care facilities. Even though the state department of health had the responsibility for writing regulations associated with the legislation, nursing homes were not included in the mandatory checklist, said Howell.

“In 2002, the Legislature passed another bill requiring criminal background checks (on nursing homes) and they again refused,” he said. “Then in 2003, the board of health had a bill introduced in their legislative package that would have eliminated the requirement. We were able to defeat that and get wording back in, with the tremendous help of (state senator) Terry Burton, that if they did not write the regulations providing for that requirement by Aug. 1, then the responsibility would go to the Attorney General’s Office. Suddenly the board complied, and starting in August, they required fingerprint/criminal background checks. By Oct 15, they found 12 convicted felons working in nursing homes, including a rapist who was a fugitive from Georgia. This is why we say we need true consumer representation on the board of health.”

After a recent investigation following the devastating nursing home fire in Nashville this summer, AARP discovered that approximately half of all nursing homes in Mississippi lack sprinkler systems. In a related matter, the state board of health’s minimum standard regulations for nursing homes require at least two employees to be located inside the facility at all times in the event of an emergency.

“For the safety of the residents in nursing homes, both issues need to be addressed,” said Howell. “Having only two employees on duty at all times is terribly inadequate. We haven’t come up with a specific recommended number, but we do think that it should be tied to whether or not the nursing home has a sprinkler system, because if you have a fire in a 90- or 100-bed home, two people aren’t going to be able to get many people out. An absence of sprinklers makes it that much more acute.”

Maxey said nursing home staffing requirements in Mississippi are among the highest in the nation.

“It seems very unlikely there would be an occasion where a nursing home would have as few as two on duty,” he said. “All nursing homes in operation in Mississippi now must comply with strict fire codes of the Southern Fire Prevention Code. We honestly believe that the likelihood of a duplication of what happened in Nashville is virtually non-existent.”

AARP would like to see the state board of health regulate Mississippi’s adult daycare facilities, said Howell.

“An attorney general’s opinion has said the board should regulate them, but the board has refused,” he said. “It looks like we need legislative action to force them to do what they should be doing. We think Terry Burton of Newton will be introducing a bill on that in the upcoming session.”

Liz Sharlot, director of communications for the state department of health, said the Mississippi Adult Daycare Association is involved with a bill that will be proposed to the Legislature in 2004 for the third consecutive year mandating the state health department to develop rules and regulations regarding adult daycare centers.
Maxey said MHCA has taken no position on the regulation of the state’s daycare facilities.

The AARP is closely monitoring legislation promoting a tobacco tax increase, said Howell.

“Everyone knows there is a Medicaid funds shortage and we’re looking at resources to keep those services at current levels,” he said. “If the tobacco tax increase is introduced, then how those increases would be used will determine whether or not we could support the legislation. We’ll support it if it goes to Medicaid.”

Rep. Bobby Moody (D-Louisville), who will retain chairmanship of the public health and welfare committee if the new House Speaker does not make a change, said one of the primary concerns for seniors, particularly those on fixed and low incomes, is the continued funding of Medicaid.

“We also have seniors eligible for drug coverage up to 135% of the federal poverty level,” he said. “Those will be important and we’ll be addressing them. We’re not going to allow our seniors to go without medical care or proper nutrition. Those are programs we’ll continue working on. I’ve been asked to serve on the governor-elect’s transition task force and I reminded them you could always tell about a government by how well it treats its children and senior citizens. The public health committee is intricately involved with them and we’ll continue try to fund them to the greatest capacity we have.”

In the regular session and again in the third special session of 2002, bills were introduced to provide protection to people who violate banking laws, said Howell.

“This was done in the name of tort reform,” he said. “It would have limited jury awards to the amount of the loans in dispute. Since most of these loans are in the $1,500 to $5,000 range, it’s very difficult to get a lawyer to represent such a case. Those items were vetoed and in 2003, a similar bill was introduced, which died in committee. We are concerned about predatory lending, which tends to target seniors and low-income people. We’re going to watch any such legislation very carefully.”

Contact MBJ contributing writer Lynne W. Jeter at mbj@thewritingdesk.com.


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