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KOHL AND RYAN SEEK TO PROTECT SUCCESSFUL WISCONSIN NURSING HOME PROGRAM   Demonstration project would enable trained resident assistants to continue improving quality of life for nursing home patients

WASHINGTON – First District Congressman Paul Ryan and Senator Herb Kohl are introducing legislation that would enable Wisconsin nursing home residents to continue benefiting from the assistance of trained resident assistants (formerly known as "single-task" workers.)  Rep. Ryan today introduced this legislation (the Medicare and Medicaid Nursing Services Quality Improvement Act of 2001) in the House of Representatives. Senator Kohl expects to introduce an identical version of the bill in the Senate by the end of this week.

For more than seven years, Wisconsin nursing homes have relied on trained resident assistants to help with specific, non-medical tasks such as helping feed residents who need (non-medical) assistance during mealtimes. This assistance has supplemented the hard work of Registered Nurses, Certified Nursing Assistants (CNA's) and other nursing professionals, and it has been a key factor in permitting Wisconsin nursing homes to rank among the best in the nation in terms of caring for residents' nutrition and hydration.
 
Despite Wisconsin's success with using resident assistants as supplementary aides, last year the Health Care Financing Administration (HCFA) – which regulates the nation’s health care facilities – informed the state that its policy violated federal law. In an effort to find a common-sense solution that will address HCFA's concerns and protect Wisconsin nursing home residents at the same time, Ryan and Kohl have cooperated to draft legislation regarding resident assistants.

Ryan and Kohl's legislation establishes a demonstration project that would enable Wisconsin's resident assistants in Medicare and Medicaid nursing facilities to continue performing certain basic care-giving tasks as long as they have received specific training to perform these tasks and have met all competency requirements.

Ryan and Kohl's proposal contains safeguards that would prevent nursing homes from using resident assistants to meet minimum staffing requirements. It provides that a resident assistant may augment, but not replace, existing staff of a nursing facility. This ensures that resident assistants supplement, rather than take the place of, CNA's and other nursing professionals. It also requires supervision of resident assistants by a licensed health professional.

"This legislation aims to prevent a nursing home crisis in Wisconsin and to avoid the wholesale termination of valuable resident assistants, who have been a key part of our nursing homes' success," said Ryan. "We want to work with HCFA in order to ensure that our nursing home residents get as much one-on-one attention as possible and safeguard their quality of life. At the same time, we need to make sure that overworked nurses and CNA's get as much support as possible. Our resident assistant proposal will do this."

"Nursing home residents depend on quality care from committed nursing professionals who are already stretched to the limit.  Trained resident assistants have helped meet the nutrition and hydration needs of countless residents throughout Wisconsin.  Eliminating this important job would be a disservice to the residents and the nursing professionals who care for them.  Our demonstration project will allow Wisconsin nursing facilities to continue using trained resident  assistants and provide us with valuable information about additional ways to improve nursing home care," Kohl said.

As introduced today, Ryan's bipartisan legislation conditionally authorizes the use of resident assistants in Medicare and Medicaid nursing facilities. It directs U.S. Health and Human Services Secretary Tommy Thompson to conduct a demonstration project in up to eight states – including Wisconsin – that would permit nursing facilities in these states to employ trained resident assistants to perform certain specific non-medical tasks, generally dealing with feeding and hydration. Demonstration states would specify and review resident assistant training programs and competency evaluations in consultation with Secretary Thompson.

At the start of their participation in the project, facilities in demonstration states would be responsible for submitting data about their workforce and the performance of resident assistants to the appropriate state agency. The state agency shall forward the data it collects to Secretary Thompson, who will provide oversight. This legislation also requires Secretary Thompson to submit annual reports to Congress on the project, as well as a final report to be submitted no later than December 1, 2004. The final report would include recommendations from a citizen advisory panel which will include a state long-term care ombudsman or other resident advocate.

The Medicare and Medicaid Nursing Services Quality Improvement Act of 2001 is a bipartisan measure. Rep. Earl Pomeroy (D. – North Dakota) is an original cosponsor in the House of Representatives. To date, the Medicare and Medicaid Nursing Services Quality Improvement Act of 2001 has received the endorsement of the Wisconsin Health Care Association, the Wisconsin Association of Homes and Services for the Aging, the American Health Care Association, and the American Association of Homes and Services for the Aging.

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