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                                                       PRINTER'S NO. 721

THE GENERAL ASSEMBLY OF PENNSYLVANIA


HOUSE BILL

No. 620 Session of 2003


        INTRODUCED BY PALLONE, BEBKO-JONES, BELFANTI, BISHOP, BROWNE,
           CAWLEY, CORRIGAN, CRUZ, DALEY, DeWEESE, EACHUS, FRANKEL,
           FREEMAN, GEORGE, GOODMAN, GRUCELA, HARHAI, HENNESSEY, HORSEY,
           JOSEPHS, MELIO, MYERS, PISTELLA, PRESTON, SHANER, SOLOBAY,
           TANGRETTI, TRAVAGLIO, WALKO, WASHINGTON, YOUNGBLOOD AND
           YUDICHAK, MARCH 3, 2003

        REFERRED TO COMMITTEE ON AGING AND OLDER ADULT SERVICES,
           MARCH 3, 2003

                                     AN ACT

     1  Providing for a long-term care death and abuse resource team;
     2     imposing duties on the Department of Aging and the Department
     3     of Health; imposing penalties; and establishing the Long-term
     4     Care Death and Abuse Resource Fund.

     5     The General Assembly finds and declares as follows:
     6         (1)  Every resident in a long-term care facility is
     7     entitled to live in a safe and healthy environment.
     8         (2)  Responding to abuse or abuse that results in the
     9     death of a resident in a long-term care facility is the
    10     responsibility of not only the Commonwealth but also the
    11     community.
    12         (3)  When a resident is abused or dies from suspected
    13     abuse in a long-term care facility, the response by the
    14     Commonwealth and the community shall include an accurate and
    15     complete determination of the cause of death and the
    16     development and implementation of measures to prevent future


     1     deaths from similar causes.
     2         (4)  When a resident is abused or dies from suspected
     3     abuse in a long-term care facility, the response from the
     4     Commonwealth and the community may include court action,
     5     including prosecution of persons who may be responsible for
     6     the abuse or death and the request for an injunction to close
     7     the long-term care facility and the transfer of the other
     8     residents for their protection.
     9     The General Assembly of the Commonwealth of Pennsylvania
    10  hereby enacts as follows:
    11  Section 1.  Short title.
    12     This act shall be known and may be cited as the Long-term
    13  Care Death and Abuse Resource Team Act.
    14  Section 2.  Definitions.
    15     The following words and phrases when used in this act shall
    16  have the meanings given to them in this section unless the
    17  context clearly indicates otherwise:
    18     "Abuse."  Any conduct as defined in the act of November 6,
    19  1987 (P.L.381, No.79), known as the Older Adults Protective
    20  Services Act, that results in the death of a resident in a
    21  facility.
    22     "Facility."  As defined in the act of November 6, 1987
    23  (P.L.381, No.79), known as the Older Adults Protective Services
    24  Act, the term includes any of the following:
    25         (1)  A home which provides "domiciliary care" as defined
    26     in section 2202-A of the act of April 9, 1929 (P.L.177,
    27     No.175), known as The Administrative Code of 1929.
    28         (2)  A "home health care agency" as defined in the Older
    29     Adults Protective Services Act.
    30         (3)  A "long-term care nursing facility" as defined in
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     1     section 802.1 of the act of July 19, 1979 (P.L.130, No.48),
     2     known as the Health Care Facilities Act.
     3         (4)  An "older adult daily living center" as defined in
     4     section 2 of the act of July 11, 1990 (P.L.499, No.118),
     5     known as the Older Adult Daily Living Centers Licensing Act.
     6         (5)  A "personal care home" as defined in section 1001 of
     7     the act of June 13, 1967 (P.L.31, No.21), known as the Public
     8     Welfare Code.
     9     "Resident."  A person receiving services in a facility. The
    10  term also includes that resident's attorney-in-fact, guardian or
    11  other legal representative acting within the scope of that
    12  person's authority.
    13     "Team."  The Pennsylvania Long-term Care Death and Abuse
    14  Resource Team.
    15  Section 3.  Initiation of request.
    16     (a)  Request for team.--Upon a reasonable finding that a
    17  resident was abused or that a resident's death was the result of
    18  abuse, a district attorney or a coroner may contact the
    19  chairperson of the local team and request the local team to
    20  assist in investigating the initial finding of the district
    21  attorney or coroner.
    22     (b)  Notification of local team assistance.--If a coroner
    23  requests the assistance of the local team, the district
    24  attorney's office in the county in which the abuse or death
    25  occurred must be notified of the coroner's request.
    26  Section 4.  Pennsylvania Long-term Care Death and Abuse Resource
    27                 Team; membership; duties.
    28     (a)  Establishment.--There is hereby established the
    29  Pennsylvania Long-term Care Death and Abuse Resource Team in the
    30  Department of Aging. The team shall be composed of the following
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     1  individuals or individuals' designees:
     2         (1)  The Secretary of Aging.
     3         (2)  The Secretary of Health.
     4         (3)  The Secretary of Public Welfare.
     5         (4)  The Attorney General.
     6         (5)  The Long-term Care Ombudsman.
     7     (b)  Composition.--The Governor shall appoint the following
     8  members to serve staggered three-year terms:
     9         (1)  A representative from the Statewide district
    10     attorney's association.
    11         (2)  A coroner.
    12         (3)  A forensic pathologist.
    13         (4)  A representative of a Statewide law enforcement
    14     association who has a background in homicide investigations.
    15         (5)  A gerontologist.
    16         (6)  A representative of an association representing
    17     individuals with disabilities.
    18         (7)  A representative from the domiciliary care home
    19     industry, home health care industry, nursing home industry,
    20     personal care home industry and adult daily living center
    21     association.
    22         (8)  A representative from a Statewide hospital
    23     association.
    24         (9)  A representative from a Statewide psychiatric
    25     association.
    26         (10)  A public member.
    27     (c)  Meetings.--Members shall meet at least twice a year or
    28  at the call of the chairperson.
    29     (d)  Duties.--Beginning no later than January 1, 2003, the
    30  State team shall:
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     1         (1)  Develop a Statewide long-term care death and abuse
     2     data collection system.
     3         (2)  Provide training to cooperating agencies,
     4     individuals and local teams on the use of the Statewide long-
     5     term care death and abuse resource data collection system.
     6         (3)  Conduct an annual statistical report on the
     7     incidences and causes of long-term care abuse and death in
     8     this Commonwealth during the past year and submit a copy of
     9     this report, including its recommendations for action, to the
    10     Governor and the General Assembly. The team shall submit this
    11     report on or before December 15 of each year.
    12         (4)  Develop standards and protocols for local teams and
    13     provide training and technical assistance to these teams.
    14         (5)  Develop protocols for local team investigations,
    15     including suggested protocols for law enforcement agencies,
    16     prosecutors, coroners, health care facilities and social
    17     service agencies.
    18         (6)  Study the adequacy of statutes, ordinances, rules,
    19     training and services to determine what changes are needed to
    20     decrease the incidences of preventable long-term care abuse
    21     and abuse that results in death and, as appropriate, take
    22     steps to implement these changes.
    23         (7)  Educate the public regarding the incidences and
    24     causes of long-term care abuse and abuse that results in
    25     death as well as the public's role in preventing these abuses
    26     and deaths.
    27         (8)  Designate a team chairperson.
    28         (9)  Develop and distribute an informational brochure
    29     which describes the purpose, function and authority of local
    30     teams. The brochure shall be available at the offices of the
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     1     Department of Aging, the Department of Health, the Department
     2     of Public Welfare and the local area agency on aging.
     3     (e)  No compensation.--State team members are not eligible to
     4  receive compensation.
     5     (f)  Department of Aging.--The Department of Aging shall
     6  provide professional and administrative support to the State
     7  team.
     8  Section 5.  Local long-term care death and abuse resource teams;
     9                 membership; duties.
    10     (a)  General rule.--Local teams shall abide by the standards
    11  and protocols developed by the State team. Local teams shall be
    12  composed of the following individuals or individuals' designees:
    13         (1)  A representative from the local area agency on
    14     aging.
    15         (2)  A representative from the county health department.
    16         (3)  A representative from the county public welfare
    17     office.
    18         (4)  A local long-term care ombudsman.
    19     (b)  Appointments by chairperson.--The chairperson of the
    20  local team shall appoint the following members of the local team
    21  to staggered three-year terms:
    22         (1)  A psychiatrist licensed in this Commonwealth.
    23         (2)  A representative from a local law enforcement
    24     agency.
    25         (3)  A gerontologist.
    26         (4)  A representative of a local hospital or trauma
    27     center.
    28         (5)  A public member.
    29     (c)  Chairperson.--The representative of the local area
    30  agency on aging shall serve as the chairperson of the local
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     1  team.
     2     (d)  Duties.--Local teams shall:
     3         (1)  Assist the State team in collecting local data on
     4     long-term care abuse and cases of abuse that result in death.
     5         (2)  Submit written reports to the State team as directed
     6     by that team. These reports shall include nonidentifying
     7     information on individual cases and steps taken by the local
     8     team to implement necessary changes and improve the
     9     coordination of services and investigations.
    10         (3)  Report findings to the district attorney's office in
    11     the county in which the abuse or abuse that resulted in death
    12     occurred so that the district attorney may take appropriate
    13     court action to protect the residents remaining in the
    14     facility.
    15         (4)  Report findings to the coroner's office in the
    16     county in which the abuse or abuse that resulted in death
    17     occurred, as well as the district attorney's office in the
    18     same county, if the coroner's office requested the assistance
    19     of the local team.
    20     (e)  Meetings.--Members shall meet at least twice a year or
    21  at the call of the chairperson.
    22     (f)  No compensation.--Local team members are not eligible to
    23  receive compensation.
    24     (g)  Local area agencies on aging.--A local team shall be
    25  established in each designated area agency on aging. The area
    26  agency on aging shall provide professional and administrative
    27  support to the local teams.
    28  Section 6.  Access to information; confidentiality; violation;
    29                 classification.
    30     (a)  Information.--Upon request of the chairperson of a local
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     1  team and as necessary to carry out the team's duties, the
     2  chairperson shall be provided within five days, excluding
     3  weekends and holidays, with access to information and records
     4  regarding a resident who was reported to the team as abused or
     5  whose death is being reviewed by the local team, or information
     6  and records regarding the resident's family:
     7         (1)  From a provider of medical, dental or mental health
     8     care.
     9         (2)  From the Commonwealth or a political subdivision of
    10     the Commonwealth that might assist a local team to review the
    11     abuse of a resident or the death of a resident.
    12     (b)  Investigative records.--A law enforcement agency with
    13  the approval of the district attorney may withhold investigative
    14  records that might interfere with a pending criminal
    15  investigation or prosecution.
    16     (c)  Subpoena.--The chairperson of the local team or his
    17  designee may apply to the court of common pleas located in the
    18  team's area for a subpoena as necessary to compel the production
    19  of books, records, documents and other evidence related to the
    20  investigation. Subpoenas so issued shall be served and, upon
    21  application to the court by the chairperson or a designee,
    22  enforced in the manner provided by law for the service and
    23  enforcement of subpoenas. A law enforcement agency shall not be
    24  required to produce the information requested under the subpoena
    25  if the subpoenaed evidence relates to a pending criminal
    26  investigation or prosecution. All records shall be returned to
    27  the agency or organization on completion of the review. No
    28  written reports or records containing identifying information
    29  shall be kept by the team.
    30     (d)  Confidentiality.--All information and records acquired
    20030H0620B0721                  - 8 -     

     1  by the State team or any local team are confidential and not
     2  subject to subpoena, discovery or introduction into evidence in
     3  any civil or criminal proceeding, except that information,
     4  documents and records otherwise available from other sources are
     5  not immune from subpoena, discovery or introduction into
     6  evidence through those sources solely because they were
     7  presented to or reviewed by a State or local team.
     8     (e)  Testimony.--Members of a State or local team, persons
     9  attending a State or local team meeting and persons who present
    10  information to a State or local team may not be questioned in
    11  any civil or criminal proceeding regarding information presented
    12  in or opinions formed as a result of a meeting. Nothing in this
    13  subsection shall be construed to prevent a person from
    14  testifying to information obtained independently of the team or
    15  which is public information.
    16     (f)  Limitation.--A member of the State or a local team shall
    17  not contact, interview or obtain information by request or
    18  subpoena from a member of a deceased resident's family, except
    19  that a member of the State or a local team who is otherwise a
    20  public officer or employee may contact, interview or obtain
    21  information from a family member, if necessary, as part of the
    22  public officer's or employee's other official duties.
    23     (g)  Public meeting.--State and local team meetings are
    24  closed to the public if the team is reviewing individual
    25  resident fatality cases. All other team meetings are open to the
    26  public.
    27     (h)  Penalty.--A person who violates the confidentiality
    28  provisions of this section commits a misdemeanor of the second
    29  degree.
    30  Section 7.  Long-term Care Death and Abuse Resource Fund.
    20030H0620B0721                  - 9 -     

     1     (a)  Establishment of fund.--The Long-term Care Death and
     2  Abuse Resource Fund is established in the State Treasury
     3  consisting of appropriations and moneys received from fees under
     4  subsection (c) and gifts, grants and donations made to the
     5  Department of Aging to implement subsection (b). The Department
     6  of Aging shall administer the fund. The Department of Aging
     7  shall transmit all moneys it receives to the State Treasurer for
     8  deposit in the fund.
     9     (b)  Staffing.--The Department of Aging shall use fund moneys
    10  for staffing and administrative costs of the State team and to
    11  train and support local teams.
    12     (c)  Fee.--The Department of Health shall impose an
    13  additional fee of $1 on each death certificate requested from
    14  the Commonwealth which shall be deposited with the State
    15  Treasurer in the Long-term Care Death and Abuse Resource Fund.
    16  Section 8.  Effective date.
    17     This act shall take effect July 1, 2003.









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