MENTAL HEALTH: HCFA Bans Misuse of Patient Restraints
In a move long awaited by mental health advocates, the Clinton administration -- Tipper Gore front and center -- announced Friday a new HCFA prohibition against use of physical or chemical restraints to coerce or discipline psychiatric patients, the Los Angeles Times reports. The regulation will take effect in 60 days and while it only applies to the 6,200 hospitals that receive Medicaid or Medicare funding, advocates said they hope private institutions will embrace the regulation as well. While the federal government has maintained such rules for several years, Clinton's announcement represents "the first financial penalties for documented abuses by cutting off federal funds to affected institutions." According to the National Mental Health Association, Harvard University's Center for Risk Analysis estimates that 50 to 150 deaths among hospital patients each year are attributable to restraints or seclusion. In a series of much-publicized articles last fall, the Hartford Courant reported 142 restraint-related deaths in 30 states during the past decade, 26% of which involved patients younger than 17. The regulation also stipulates the creation of a "national reporting system so federal officials can better monitor the problem" as well as providing patients and their families with a list of their rights. Additional provisions include "the right to privacy and confidentiality, and the right to make decisions about patient's care." HCFA has also mandated that health care workers learn the appropriate usage of seclusion and restraints (Cimons, 6/26). Michael Faenza, president and CEO of the NMHA, said, "HCFA is forcing hospitals out of the Dark Ages by hitting them where it hurts, the funding stream. Seclusion and restraints are not treatments, but reflect treatment failures" (NMHA release, 6/25). The patients' rights protections are part of Medicare's revised Condition of Participation requirement for hospitals (HCFA release, 6/25).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.