A bill to establish a quality assurance system for homecare services provided under Medicare and Medicaid programs, the Social Services Block Grant Program, and the Older Americans Act of 1965.
Homecare Quality Assurance Act of 1987 - Adds a new title XXI to the Social Security Act entitled "Homecare Quality Assurance." Defines "homecare services" to include home help services (i.e., homemaker, personal care, and sitter services) and Medicare (title XVIII of the Act) home health services. Requires the Secretary of Health and Human Services to promulgate a homecare consumer's bill of rights which includes rights: (1) facilitating consumer participation in the planning and delivery of services; (2) requiring consumer notification regarding services, charges for services, and the termination or reduction of services; (3) protecting consumer dignity, privacy, and property; and (4) ensuring service from properly trained and competent individuals.
Requires homecare Contractors to: (1) satisfy Medicare home care agency requirements, unless they provide only home help services; (2) provide consumers with copies of the homecare bill of rights; (3) implement grievance review procedures and provide copies of such procedures to consumers; (4) provide consumers with schedules of the services to be provided; (5) have methods for identifying and reviewing a homecare consumer's needs and coordinating the provision of services with other homecare contractors; (6) ensure that each homecare provider whom they employ or have under contract receives training; and (7) evaluate annually and supervise each homecare provider whom they employ or have under contract. Requires the Secretary to encourage States to place at least as stringent conditions on State homecare service programs not covered by title XXI as those placed on covered services. Conditions coverage of durable medical equipment services on providers: (1) issuing written instructions to and training the homecare consumer and staff in the operation of such equipment; and (2) formulating an emergency plan for providing services to the consumer.
Directs the Secretary to establish procedures for: (1) conducting an equal number of announced and unannounced surveys of a homecare contractor's compliance with title XXI participation conditions, with more frequent surveys required for contractors with poor compliance records; and (2) validating surveys of contractors performed by accrediting organizations and States. Exempts certain homecare contractors from the Secretary's survey procedures provided they are subject to State quality assurance or licensing programs and certified by accrediting organizations whose standards and survey procedures are at least as stringent as those established under title XXI.
Directs the Secretary to promulgate regulations, within one year of this Act's enactment, pursuant to which peer review organizations (PROs) shall monitor the provision of home health services, devoting at least 75 percent of their efforts to quality assurance. Requires the inclusion of: (1) both documentary review and personal interviews of homecare consumers and providers in the PRO review process; and (2) representatives of homecare providers and consumers in PRO membership.
Requires each State to appoint a home help monitoring agent to monitor the provision of home help services. Requires each State to establish a Consumer Advisory Board, within one year of this Act's enactment, to oversee the quality assurance review activities of PROs and the home help monitoring agent. Directs the Board to report to the Secretary and the State's chief executive on October 1 of each year regarding such quality assurance review activities.
Requires the Secretary to encourage PROs and home help monitoring agents to develop coordinated mechanisms and outcome-orientated criteria for monitoring the quality of homecare, requiring that such monitoring include direct contact with homecare consumers. Requires that PROs and home help monitoring agents: (1) establish and operate statewide toll-free hotlines for receiving homecare questions and complaints, unless the State establishes such a hotline; and (2) assist consumers in resolving homecare quality problems. Directs Consumer Advisory Boards, PROs, and home help monitoring agents to cooperate with State and local officials in educating consumers regarding quality assurance programs and the assistance available for consumers with quality assurance problems. Directs the Secretary to encourage States to develop ombudsman programs for nonelderly homecare consumers.
Requires the Secretary to establish and the States to develop procedures for imposing sanctions against contractors and providers failing to comply with this Act. Requires the Secretary to report to the Congress on January 1 of each year regarding the availability, adequacy, and use of sanctions. Requires the Secretary to develop incentives to contractor compliance with title XXI participation conditions, including an annual directory of homecare contractors having a consistent record of compliance with such conditions. Directs the Secretary to: (1) encourage States to develop homecare provider licensing and certification policies; and (2) issue a biennial report on State implementation of such policies.
Establishes a Homecare Quality Assurance Council with which the Secretary must consult in implementing and administering title XXI of the Social Security Act.
Directs the Secretary to award grants for homecare contractor and provider training programs and furnish States, contractors, and providers with training materials.
Directs the Secretary to establish guidelines, fund, and issue a report regarding: (1) studies on homecare quality assurance measures; and (2) demonstration projects which include projects exploring the feasibility and desirability of developing certification requirements for individuals who provide homecare services, and projects considering alternatives to the use of PROs in monitoring homecare contractors. Requires the Secretary to report to the Congress on January 1 of each year and States to report to the Secretary on October 1 of each year regarding the nature and performance during the preceding fiscal year of the homecare quality assurance system. Authorizes appropriations for: (1) the home health monitoring activities of PROs and home help monitoring agents; (2) home health training program grants; and (3) the studies and demonstration projects established pursuant to this Act.
Amends the Older Americans Act of 1965 to extend the long-term care ombudsman program to homecare services. Requires each State to establish a toll-free telephone hotline to facilitate the communication of complaints regarding long-term and homecare services. Authorizes appropriations for the hotline and homecare ombudsman program.
Directs the Secretary to conduct demonstration projects to determine the most effective methods for an ombudsman to: (1) administer and perform homecare activities; and (2) coordinate such activities with other ombudsman activities. Requires the Secretary to report to the Congress regarding such projects by 1990. Directs the Secretary to conduct a study, within three years of this Act's enactment, into the feasibility of extending the ombudsman program to physician and hospital services received by older individuals.
Sets forth administrative and reporting requirements.
Referred to Subcommittee on Human Resources.
Introduced in Senate
Read twice and referred to the Committee on Finance.
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