Last-Minute Changes to Nursing Home Bill Mean More Reforms Will be Needed, Mercury News Says
The nursing home bill (AB 1075) approved by the state Legislature last week "started out as a mandatory staffing bill," but in the "chaotic closing hours" of the session, it was "chopped fine and ground up, with a few mystery ingredients added," a San Jose Mercury News editorial says (San Jose Mercury News, 9/21). Under the amended bill, California by Aug. 1, 2004, must "revamp its reimbursement system" by determining an individual rate for each of the state's 1,200 nursing homes. The bill also would put a yet-to-be-determined staff-patient ratio in place by Aug. 1, 2003 (California Healthline, 9/18). Staffing rations will be expressed in terms of caregivers per patients instead of the current standard of hours of care per patient. According to the editorial, the changes were written "primarily to suit" Gov. Gray Davis (D), making the bill's "approval appea[r] certain." But the measure was "so changed" that two advocacy groups -- the National Senior Citizen Law Center and the California Advocates for Nursing Home Reform -- have withdrawn their support of the bill and have urged Davis to veto it, the editorial states. Assembly Majority Leader Kevin Shelley (D-San Francisco), the original bill's sponsor, called the final compromise a "win-win situation," but the editorial says that with "all the opposition, we can't help but wonder: Who was the winner in Shelley's win-win bill? It sure wasn't the legislative process." The editorial states that the "meat-grinder procedure to which this bill was subjected isn't the way to create good law." The editorial adds that no legislation will "change" the poor quality of care in California nursing homes "unless it's matched by a commitment to set high standards, enforce them and provide enough money to maintain them." The editorial concludes, "The effort to provide good care for our frail elders is far from over" (San Jose Mercury News, 9/21).
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