PRINTER'S NO. 1984
No. 1627 Session of 2001
INTRODUCED BY PALLONE, PISTELLA, SCHULER, SAMUELSON, ARMSTRONG,
C. WILLIAMS, WATSON, BISHOP, B. SMITH, GRUCELA AND YUDICHAK,
MAY 21, 2001
REFERRED TO COMMITTEE ON AGING AND OLDER ADULT SERVICES,
MAY 21, 2001
AN ACT
1 Providing for long-term care resident fatality review; imposing
2 duties on the Department of Health; imposing penalties; and
3 making an appropriation.
4 The General Assembly finds and declares as follows:
5 (1) Every resident in a long-term care facility is
6 entitled to live in a safe and healthy environment.
7 (2) Responding to abuse that results in the death of a
8 resident in a long-term care facility is the responsibility
9 of not only the Commonwealth but also the community.
10 (3) When a resident dies from suspected abuse in a long-
11 term care facility, the response by the Commonwealth and the
12 community shall include an accurate and complete
13 determination of the cause of death and the development and
14 implementation of measures to prevent future deaths from
15 similar causes.
16 (4) When a resident dies from abuse in a long-term care
17 facility, the response from the Commonwealth and the
1 community may include court action, including prosecution of
2 persons who may be responsible for the death and the request
3 for an injunction to close the long-term care facility and
4 the transfer of the other residents for their protection.
5 The General Assembly of the Commonwealth of Pennsylvania
6 hereby enacts as follows:
7 Section 1. Short title.
8 This act shall be known and may be cited as the Long-term
9 Care Resident Fatality Review Team Act.
10 Section 2. Definitions.
11 The following words and phrases when used in this act shall
12 have the meanings given to them in this section unless the
13 context clearly indicates otherwise:
14 Abuse." Any conduct as defined in the act of November 6,
15 1987 (P.L.381, No.79), known as the Older Adults Protective
16 Services Act, that results in the death of resident in a
17 facility.
18 "Facility." A facility licensed by the Commonwealth to
19 provide long-term care. The term includes, but is not limited
20 to, a long-term nursing facility, a personal care home, a
21 boarding home and an adult daily living center. A boarding home
22 that merely provides room, board and laundry services to
23 residents who do not need scheduled or unscheduled adult daily
24 living services is exempt from this definition.
25 "Resident." A person receiving services in a facility. The
26 term also includes that resident's attorney-in-fact, guardian or
27 other legal representative acting within the scope of that
28 person's authority.
29 Section 3. General provisions.
30 (a) Notification of coroner.--When a resident of a facility
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1 dies and there are reasonable grounds to believe that the death
2 was the result of abuse, the police, sheriff, law enforcement
3 officer or official, health practitioner or hospital or any
4 person having knowledge of such a death shall immediately notify
5 the coroner of the known facts concerning the time, place,
6 manner and circumstances of the death.
7 (b) Notification of chairperson.--Upon examination and a
8 reasonable finding that the resident's death was the result of
9 abuse, the coroner shall immediately contact the chairperson of
10 the State Long-term Care Resident Fatality Review Team and the
11 chairperson of the local long-term care resident fatality review
12 team if one exists.
13 (c) Notification of review team.--Upon being notified by the
14 coroner, the chairperson of the State Long-term Care Resident
15 Fatality Review Team shall call a meeting of the team within 24
16 hours of such notice in order to begin a review of the initial
17 findings of the coroner. This initial team meeting may be
18 conducted by telephone or in person. If the State Long-term Care
19 Resident Fatality Review Team at this meeting determines that
20 there exist reasonable grounds to believe that the resident's
21 death was from the result of abuse, the chairperson shall
22 immediately notify the local review team chairperson by
23 telephone and in writing and authorize that a full investigation
24 into the matter be conducted.
25 (d) Authorization.--A local long-term care resident fatality
26 review team cannot begin any full investigation until it
27 receives authorization to do so from the chairperson of the
28 State Long-term Care Resident Fatality Review Team. Once the
29 local review team chairperson has received authorization, he
30 shall immediately take all necessary steps to begin a full
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1 investigation. The local team review chairperson shall then
2 contact the State review team chairperson in writing with
3 information that a full investigation has been initiated.
4 Section 4. Pennsylvania Long-term Care Resident Fatality Review
5 Team; membership; duties.
6 (a) Establishment.--There is hereby established the
7 Pennsylvania Long-term Care Resident Fatality Review Team in the
8 Department of Health. The team shall be composed of the head of
9 the following departments and offices or that person's designee:
10 (1) The Secretary of Health.
11 (2) The Secretary of Public Welfare.
12 (3) The Secretary of Aging.
13 (4) The Attorney General.
14 (5) The Long-term Care Ombudsman.
15 (b) Composition.--The governor shall appoint the following
16 members to serve staggered three-year terms:
17 (1) A representative from the Statewide district
18 attorney's association.
19 (2) A coroner who is a forensic pathologist.
20 (3) A representative of a Statewide law enforcement
21 association who has a background in homicide investigations.
22 (4) A representative of an association representing
23 individuals with disabilities.
24 (5) A representative from the nursing home industry,
25 personal care home industry and adult daily living center
26 association.
27 (6) A representative from a Statewide hospital
28 association.
29 (7) A representative from a Statewide psychiatrist
30 association.
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1 (8) A public member.
2 (c) Meetings.--Members shall meet at least twice a year or
3 at the call of the chairperson.
4 (d) Duties.--Beginning no later than January 1, 2002, the
5 State review team shall:
6 (1) Develop a long-term care resident fatalities data
7 collection system.
8 (2) Provide training to cooperating agencies,
9 individuals and local resident fatality review teams on the
10 use of the long-term care fatalities data system.
11 (3) Conduct an annual statistical report on the
12 incidence and causes of long-term care fatalities in this
13 Commonwealth during the past year and submit a copy of this
14 report, including its recommendations for action, to the
15 Governor and the General Assembly. The team shall submit this
16 report on or before December 15 of each year.
17 (4) Encourage and assist in the development of local
18 review teams.
19 (5) Develop standards and protocols for local review
20 teams and provide training and technical assistance to these
21 teams.
22 (6) Develop protocols for resident fatality
23 investigations, including protocols for law enforcement
24 agencies, prosecuters, coroners, health care facilities and
25 social service agencies.
26 (7) Study the adequacy of statutes, ordinances, rules,
27 training and services to determine what changes are needed to
28 decrease the incidence of preventable long-term care
29 fatalities and, as appropriate, take steps to implement these
30 changes.
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1 (8) Provide case consultation on individual cases to
2 local teams if requested.
3 (9) Educate the public regarding the incidence and
4 causes of long-term care fatalities as well as the public's
5 role in preventing these deaths.
6 (10) Designate a team chairperson.
7 (11) Develop and distribute an informational brochure
8 which describes the purpose, function and authority of a
9 team. The brochure shall be available at the offices of the
10 Department of Health, the Department of Public Welfare and
11 the local area agency on aging.
12 (e) No compensation.--State review team members are not
13 eligible to receive compensation.
14 (f) Department of Health.--The Department of Health shall
15 provide professional and administrative support to the State
16 review team.
17 Section 5. Local long-term care resident fatality review teams;
18 membership; duties.
19 (a) General rule.--If local long-term care resident fatality
20 review teams are organized, they shall abide by the standards
21 and protocol for local long-term care resident fatality review
22 teams developed by the State review team and must have prior
23 authorization from the State review team to conduct resident
24 fatality reviews. Local teams shall be composed of the following
25 persons or the person's designee:
26 (1) County district attorney.
27 (2) County coroner.
28 (3) A representative from the county health department.
29 (4) A representative from the county public welfare
30 office.
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1 (b) Appointments by chairperson.--The chairperson of the
2 local long-term care resident fatality review team shall appoint
3 the following members of the local team:
4 (1) A representative from the local area agency on
5 aging.
6 (2) A psychologist licensed in this Commonwealth.
7 (3) A representative from a local law enforcement
8 agency.
9 (4) A representative from the nursing home industry, the
10 personal care home industry and adult daily living center
11 association.
12 (5) A representative of a local hospital or trauma
13 center.
14 (6) A public member.
15 (c) Duties.--If local resident fatality review teams are
16 authorized, they shall:
17 (1) Designate a team chairperson who shall review the
18 death certificates of all long-term care residents who die
19 within the team's jurisdiction and call meetings of the team
20 when necessary.
21 (2) Assist the State review team in collecting data on
22 long-term care fatalities.
23 (3) Submit written reports to the State review team as
24 directed by that team. These reports shall include
25 nonidentifying information on individual cases and steps
26 taken by the local review team to implement necessary changes
27 and improve the coordination of services and investigations.
28 (4) Make recommendations to the district attorney's
29 office in the county in which the death occurred to take
30 appropriate court action to protect the residents remaining
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1 in the facility. Such recommendations may include the filing
2 of a petition for injunctive relief and making
3 recommendations for prosecutorial action.
4 (d) Meetings.--Members shall meet at least twice a year.
5 (e) Absence of local review team.--If an area of this
6 Commonwealth does not have an authorized local long-team care
7 resident fatality review team, the State review team shall act
8 as if it were the local review team and have all the powers
9 enumerated in this section except those enumerated in subsection
10 (d).
11 (f) No compensation.--Local review team members are not
12 eligible to receive compensation.
13 Section 6. Access to information; confidentiality; violation;
14 classification.
15 (a) Information.--Upon request of the chairperson of a State
16 or local review team and as necessary to carry out the team's
17 duties, the chairperson shall be provided within five days,
18 excluding weekends and holidays, with access to information and
19 records regarding a resident whose death is being reviewed by
20 the team, or information and records regarding the resident's
21 family.
22 (1) From a provider of medical, dental or mental health
23 care.
24 (2) From the Commonwealth or a political subdivision of
25 the Commonwealth that might assist a team to review a
26 resident fatality.
27 (b) Investigative records.--A law enforcement agency with
28 the approval of the district attorney may withhold investigative
29 records that might interfere with a pending criminal
30 investigation or prosecution.
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1 (c) Subpoena.--The chairperson of the local review team or
2 his designee may apply to the court of common pleas located in
3 the team's area for a subpoena as necessary to compel the
4 production of books, records, documents and other evidence
5 related to a resident fatality investigation. Subpoenas so
6 issued shall be served and, upon application to the court by the
7 chairperson or a designee, enforced in the manner provided by
8 law for the service and enforcement of subpoenas. A law
9 enforcement agency shall not be required to produce the
10 information requested under the subpoena if the subpoenaed
11 evidence relates to a pending criminal investigation or
12 prosecution. All records shall be returned to the agency or
13 organization on completion of the review. No written reports or
14 records containing identifying information shall be kept by the
15 team.
16 (d) Confidentiality.--All information and records acquired
17 by the State review team or any local review team are
18 confidential and not subject to subpoena, discovery or
19 introduction into evidence in any civil or criminal proceeding,
20 except that information, documents and records otherwise
21 available from other sources are not immune from subpoena,
22 discovery or introduction into evidence through those sources
23 solely because they were presented to or reviewed by a team.
24 (e) Testimony.--Members of a State or local review team,
25 persons attending a State or local team review meeting and
26 persons who present information to a State or local review team
27 may not be questioned in any civil or criminal proceeding
28 regarding information presented in or opinions formed as a
29 result of a meeting. Nothing in this subsection shall be
30 construed to prevent a person from testifying to information
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1 obtained independently of the team or which is public
2 information.
3 (f) Limitation.--A member of the State or a local review
4 team shall not contact, interview or obtain information by
5 request or subpoena from a member of a deceased resident's
6 family, except that a member of the State or a local review team
7 who is otherwise a public officer or employee may contact,
8 interview or obtain information from a family member, if
9 necessary, as part of the public officer's or employee's other
10 official duties.
11 (g) Public meeting.--State and local review team meetings
12 are closed to the public if the team is reviewing individual
13 resident fatality cases. All other team meetings are open to the
14 public.
15 (h) Penalty.--A person who violates the confidentiality
16 provisions of this section commits a misdemeanor of the second
17 degree.
18 Section 7. Long-term Care Resident Fatality Review Fund.
19 (a) Establishment of fund.--The Long-term Care Resident
20 Fatality Review Fund is established in the State Treasury
21 consisting of appropriations and moneys received from fees under
22 subsection (c) and gifts, grants and donations made to the
23 Department of Health to implement subsection (b). The Department
24 of Health shall administer the fund. The Department of Health
25 shall transmit all moneys it receives to the State Treasurer for
26 deposit in the fund.
27 (b) Staffing.--The Department of Health shall use fund
28 moneys to staff the State Long-term Care Fatality Review Team
29 and to train and support local long-term care resident fatality
30 review teams.
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1 (c) Fee.--The Department of Health shall impose an
2 additional fee of $1 on each death certificate requested from
3 the Commonwealth which shall be deposited with the State
4 Treasurer in the State Long-term Care Resident Fatality Review
5 Fund.
6 (d) Appropriation.--The sum of $100,000 is hereby
7 appropriated to the Department of Health to assist in staffing
8 the State Long-term Care Resident Fatality Review Team during
9 the first fiscal year in which it operates.
10 Section 8. Effective date.
11 This act shall take effect in 90 days.
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