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        PRIOR PRINTER'S NO. 142                        PRINTER'S NO. 516

THE GENERAL ASSEMBLY OF PENNSYLVANIA


HOUSE BILL

No. 133 Session of 1997


        INTRODUCED BY VANCE, E. Z. TAYLOR, GRUPPO, BLAUM, SAYLOR, TIGUE,
           BUXTON, NAILOR, KREBS, MASLAND, GEORGE, FLICK, ARMSTRONG,
           M. COHEN, NICKOL, COY, B. SMITH, MILLER, JAMES, BELARDI,
           TULLI, MAITLAND, WAUGH, CORNELL, FEESE, OLASZ, READSHAW,
           PESCI, DENT, BATTISTO, BOSCOLA, PETRARCA, DeLUCA, TRAVAGLIO,
           GLADECK, TRELLO, VAN HORNE, ROONEY, BEBKO-JONES,
           D. W. SNYDER, SHANER, MARSICO, ITKIN, MUNDY, MANDERINO,
           MICHLOVIC, CURRY, BUNT, COLAFELLA, C. WILLIAMS, TRICH,
           STEELMAN, L. I. COHEN, RAYMOND, LUCYK, EGOLF, ROBERTS, HABAY,
           ORIE AND EACHUS, JANUARY 29, 1997

        AS AMENDED ON THIRD CONSIDERATION, HOUSE OF REPRESENTATIVES,
           FEBRUARY 11, 1997

                                     AN ACT

     1  Providing for Statewide nurse aide training programs relating to
     2     nursing facilities.

     3     The General Assembly finds and declares that nurse aides in
     4  this Commonwealth are required to successfully complete a State-
     5  approved training and evaluation in order to be employed as a
     6  nurse aide in a skilled nursing facility or nursing facility in
     7  this Commonwealth. Further, it is recognized that the purpose of
     8  the training, as mandated by the Omnibus Budget Reconciliation
     9  Act of 1987 (Public Law 100-203, 101 Stat. 1330) is to ensure
    10  that nurse aides have the education, practical knowledge and
    11  skills needed to care for residents of facilities participating
    12  in the Medicare and Medicaid programs. The General Assembly
    13  declares, as a matter of public policy, that the training effort


     1  must give specific emphasis to identifying abusive situations,
     2  understanding what abuse is and learning methods and techniques
     3  to further prevent resident abuse from actually occurring.
     4     The General Assembly of the Commonwealth of Pennsylvania
     5  hereby enacts as follows:
     6  Section 1.  Short title.
     7     This act shall be known and may be cited as the Nurse Aide
     8  Resident Abuse Prevention Training Act.
     9  Section 2.  Definitions.
    10     The following words and phrases when used in this act shall
    11  have the meanings given to them in this section unless the
    12  context clearly indicates otherwise:
    13     "Abuse."  The occurrence of one or more of the following
    14  acts:
    15         (1)  The infliction of injury, unreasonable confinement,
    16     intimidation or punishment with resulting physical harm, pain
    17     or mental anguish.
    18         (2)  The willful deprivation by a caretaker of goods or
    19     services which are necessary to maintain physical or mental
    20     health.
    21         (3)  Abuse, as defined in 23 Pa.C.S. Ch. 61 (relating to
    22     protection from abuse).
    23  No older adult shall be found to be abused solely on the grounds
    24  of environmental factors which are beyond the control of the
    25  older adult or the caretaker, such as inadequate housing,
    26  furnishings, income, clothing or medical care.
    27     "Department."  The Department of Education of the
    28  Commonwealth.
    29     "Exploitation."  An act or course of conduct by a caretaker
    30  or other person against an older adult or an older adult's
    19970H0133B0516                  - 2 -

     1  resources, without the informed consent of the older adult or
     2  with consent obtained through misrepresentation, coercion or
     3  threats of force, that results in monetary, personal or other
     4  benefit, gain or profit for the perpetrator or monetary or
     5  personal loss to the older adult.
     6     "Neglect."  The failure to provide for oneself or the failure
     7  of a caretaker to provide goods or services essential to avoid a
     8  clear and serious threat to physical or mental health. An older
     9  adult who does not consent to the provision of protective
    10  services shall not be found to be neglected solely on the
    11  grounds of environmental factors which are beyond the control of
    12  the older adult or the caretaker, such as inadequate housing,
    13  furnishings, income, clothing or medical care.
    14     "Nurse aide."  Any individual providing nursing or nursing-
    15  related services to residents in a nursing facility or skilled
    16  nursing facility. The term does not include an individual who is
    17  a licensed health professional or an individual who volunteers
    18  to provide such services without monetary compensation.
    19     "Nursing facility."  A facility that provides either skilled
    20  or intermediate nursing care or both levels of care to two or
    21  more residents, who are unrelated to the nursing home
    22  administrator, for a period exceeding 24 hours.
    23     "Resident."  A person who is admitted to a nursing facility
    24  for observation, treatment or care for illness, disease, injury
    25  or other disability.
    26     "State Police."  The Pennsylvania State Police.
    27  Section 3.  Resident abuse prevention training.
    28     The State-approved nurse aide training programs shall in
    29  curriculum pertaining to residents' rights include, but not be
    30  limited to, specific training regarding the following:
    19970H0133B0516                  - 3 -

     1         (1)  Identification and prevention of abuse.
     2         (2)  Identification and prevention of exploitation.
     3         (3)  Identification and prevention of neglect.
     4         (4)  Identification and prevention of improper use of
     5     physical or chemical restraints.
     6         (5)  Procedures for reporting abuse, exploitation,
     7     neglect or improper use of physical or chemical restraints to
     8     appropriate supervisory, law enforcement or governmental
     9     authorities.
    10         (6)  Options and strategies for responsiveness to abusive
    11     behavior directed toward nurse aides by residents.
    12  Section 4.  Information relating to applicants for enrollment in
    13                 State-approved nurse aide training programs.
    14     (a)  Required information.--Individuals applying for
    15  enrollment in State-approved nurse aide training programs shall
    16  submit with their applications for enrollment the following
    17  information obtained within the preceding one-year period:
    18         (1)  Pursuant to 18 Pa.C.S. Ch. 91 (relating to criminal
    19     history record information), a report of criminal history
    20     record information from the State Police or a statement from
    21     the State Police that their central repository contains no
    22     such information relating to that person. The criminal
    23     history record information shall be limited to that which is
    24     disseminated pursuant to 18 Pa.C.S. § 9121(b)(2) (relating to
    25     general regulations).
    26         (2)  Where the applicant is not a resident of this
    27     Commonwealth, the applicant shall be required to submit with
    28     his application for enrollment a report of Federal criminal
    29     history record information pursuant to the Federal Bureau of
    30     Investigation's appropriation under the Departments of State,
    19970H0133B0516                  - 4 -

     1     Justice, and Commerce, the Judiciary, and Related Agencies
     2     Appropriation Act, 1973 (Public Law 92-544, 86 Stat. 1109).
     3     (b)  Original document.--For the purposes of this section, an
     4  applicant may submit a copy of the required information with the
     5  application for enrollment in the program. The applicant may,
     6  however, be required to produce the original document by the
     7  individual responsible for reviewing and approving the
     8  applications for enrollment in the program.
     9  Section 5.  Grounds for denying enrollment in State-approved      <--
    10                 nurse aide training program.
    11     (a)  Grounds enumerated.--In no case shall an applicant for
    12  enrollment in a State-approved nurse aide training program be
    13  approved for admission into such a program if the applicant's
    14  criminal history record information indicates the applicant has
    15  been convicted under one or more of the following provisions of
    16  18 Pa.C.S. (relating to crimes and offenses):
    17         Section 2502(a) or (b) (relating to murder).
    18         Section 3121 (relating to rape).
    19         Section 3122 (relating to statutory rape).
    20         Section 3122.1 (relating to statutory sexual assault).
    21         Section 3123 (relating to involuntary deviate sexual
    22     intercourse).
    23         Section 3124.1 (relating to sexual assault).
    24         Section 3125 (relating to aggravated indecent assault).
    25         Section 3126 (relating to indecent assault).
    26         Section 4302 (relating to incest).
    27         Section 6312 (relating to sexual abuse of children).
    28     (b)  Other offenses.--In no case may an applicant for
    29  enrollment in a State-approved nurse aide training program be
    30  enrolled into the program if the applicant's criminal history
    19970H0133B0516                  - 5 -

     1  record information indicates the applicant has been convicted,
     2  within ten years immediately preceding the date of the report,
     3  of one or more of the following offenses:
     4         (1)  An offense designated as a felony under the act of
     5     April 14, 1972 (P.L.233, No.64), known as The Controlled
     6     Substance, Drug, Device and Cosmetic Act.
     7         (2)  An offense under one or more of the following
     8     provisions of 18 Pa.C.S.:
     9             Chapter 25 (relating to criminal homicide) except for
    10         section 2502(a) and (b).
    11             Section 2702 (relating to aggravated assault).
    12             Section 2901 (relating to kidnapping).
    13             Section 2902 (relating to unlawful restraint).
    14             Section 3301 (relating to arson and related
    15         offenses).
    16             Section 3502 (relating to burglary).
    17             Section 3701 (relating to robbery).
    18             A felony offense under Chapter 39 (relating to theft
    19         and related offenses), or two or more misdemeanors under
    20         Chapter 39.
    21             Section 4101 (relating to forgery).
    22             Section 4304 (relating to endangering welfare of
    23         children).
    24             Section 4305 (relating to dealing in infant
    25         children).
    26             Section 4953 (relating to retaliation against witness
    27         or victim).
    28             A felony offense under section 5902(b) (relating to
    29         prostitution and related offenses).
    30             Section 5903(c) or (d) (relating to obscene and other
    19970H0133B0516                  - 6 -

     1         sexual materials and performances).
     2             Section 6301 (relating to corruption of minors).
     3         (3)  A Federal or out-of-State offense similar in nature
     4     to those crimes listed under paragraphs (1) and (2).
     5     (c)  Immunity.--No individual responsible for reviewing and
     6  approving applications for enrollment in a State-approved nurse
     7  aide training program shall be held civilly liable for any civil
     8  action directly related to good faith compliance with this
     9  section.
    10  SECTION 5.  GROUNDS FOR DENYING ENROLLMENT IN TRAINING PROGRAM.   <--
    11     (A)  GROUNDS ENUMERATED.--IN NO CASE SHALL AN APPLICANT FOR
    12  ENROLLMENT IN A STATE-APPROVED NURSE AIDE TRAINING PROGRAM BE
    13  APPROVED FOR ADMISSION INTO SUCH A PROGRAM IF THE APPLICANT'S
    14  CRIMINAL HISTORY RECORD INFORMATION INDICATES THE APPLICANT HAS
    15  BEEN CONVICTED OF ANY OF THE FOLLOWING OFFENSES:
    16         (1)  AN OFFENSE DESIGNATED AS A FELONY UNDER THE ACT OF
    17     APRIL 14, 1972 (P.L.233, NO.64), KNOWN AS THE CONTROLLED
    18     SUBSTANCE, DRUG, DEVICE AND COSMETIC ACT.
    19         (2)  AN OFFENSE UNDER ONE OR MORE OF THE FOLLOWING
    20     PROVISIONS OF 18 PA.C.S. (RELATING TO CRIMES AND OFFENSES):
    21             CHAPTER 25 (RELATING TO CRIMINAL HOMICIDE).
    22             SECTION 2702 (RELATING TO AGGRAVATED ASSAULT).
    23             SECTION 2901 (RELATING TO KIDNAPPING).
    24             SECTION 2902 (RELATING TO UNLAWFUL RESTRAINT).
    25             SECTION 3121 (RELATING TO RAPE).
    26             SECTION 3122.1 (RELATING TO STATUTORY SEXUAL
    27         ASSAULT).
    28             SECTION 3123 (RELATING TO INVOLUNTARY DEVIATE SEXUAL
    29         INTERCOURSE).
    30             SECTION 3125 (RELATING TO AGGRAVATED INDECENT
    19970H0133B0516                  - 7 -

     1         ASSAULT).
     2             SECTION 3126 (RELATING TO INDECENT ASSAULT).
     3             SECTION 3127 (RELATING TO INDECENT EXPOSURE).
     4             SECTION 3301 (RELATING TO ARSON AND RELATED
     5         OFFENSES).
     6             SECTION 3502 (RELATING TO BURGLARY).
     7             SECTION 3701 (RELATING TO ROBBERY).
     8             A FELONY OFFENSE UNDER CHAPTER 39 (RELATING TO THEFT
     9         AND RELATED OFFENSES) OR TWO OR MORE MISDEMEANORS UNDER
    10         CHAPTER 39.
    11             SECTION 4101 (RELATING TO FORGERY).
    12             SECTION 4114 (RELATING TO SECURING EXECUTION OF
    13         DOCUMENTS BY DECEPTION).
    14             SECTION 4303 (RELATING TO CONCEALING DEATH OF CHILD).
    15             SECTION 4304 (RELATING TO ENDANGERING WELFARE OF
    16         CHILDREN).
    17             SECTION 4305 (RELATING TO DEALING IN INFANT
    18         CHILDREN).
    19             SECTION 4952 (RELATING TO INTIMIDATION OF WITNESSES
    20         OR VICTIMS).
    21             SECTION 4953 (RELATING TO RETALIATION AGAINST WITNESS
    22         OR VICTIM).
    23             A FELONY OFFENSE UNDER SECTION 5902(B) (RELATING TO
    24         PROSTITUTION AND RELATED OFFENSES).
    25             SECTION 5903(C) OR (D) (RELATING TO OBSCENE AND OTHER
    26         SEXUAL MATERIALS AND PERFORMANCES).
    27             SECTION 6301 (RELATING TO CORRUPTION OF MINORS).
    28             SECTION 6312 (RELATING TO SEXUAL ABUSE OF CHILDREN).
    29         (3)  A FEDERAL OR OUT-OF-STATE OFFENSE SIMILAR IN NATURE
    30     TO THOSE CRIMES LISTED UNDER PARAGRAPHS (1) AND (2).
    19970H0133B0516                  - 8 -

     1     (B)  IMMUNITY.--NO INDIVIDUAL RESPONSIBLE FOR REVIEWING AND
     2  APPROVING APPLICATIONS FOR ENROLLMENT IN A STATE-APPROVED NURSE
     3  AIDE TRAINING PROGRAM SHALL BE HELD CIVILLY LIABLE FOR ANY CIVIL
     4  ACTION DIRECTLY RELATED TO GOOD FAITH COMPLIANCE WITH THIS
     5  SECTION.
     6  Section 6.  Regulations.
     7     The department shall promulgate regulations necessary to
     8  carry out the provisions of sections 4 and 5. These regulations
     9  shall:
    10         (1)  Set forth criteria for unsuitability for
    11     participation in a State-approved nurse aide training program
    12     in relation to criminal history record information which may
    13     include criminal history record information in addition to
    14     that set forth under section 5.
    15         (2)  Provide for the confidentiality of information
    16     obtained under section 4.
    17  Section 7.  Violations.
    18     An individual who is responsible for reviewing and approving
    19  applications for enrollment in a State-approved nurse aide
    20  training program and who willfully fails to comply with the
    21  provisions of section 4 or 5 shall be subject to a civil penalty
    22  as provided in this section. The department shall have
    23  jurisdiction to determine violators of section 4 or 5 and may,
    24  following a hearing, assess a civil penalty of not more than
    25  $2,500. Procedures for the assessment of civil penalties shall
    26  conform to 2 Pa.C.S. (relating to administrative law and
    27  procedure).
    28  Section 8.  Fees.
    29     The State Police may charge a fee of not more than $10 in
    30  order to conduct the certification as required by section 4.
    19970H0133B0516                  - 9 -

     1  Financial responsibility for the fee shall be assumed by the
     2  applicant for enrollment in the State-approved nurse aide
     3  training program.
     4  Section 9.  Implementation.
     5     The department shall incorporate the resident abuse
     6  prevention training under section 3 as part of the State-
     7  approved nurse aide training programs. In addition, the resident
     8  abuse prevention training shall be extended to be part of the
     9  regular in-service education of the nurse aide, as required by
    10  section 483.75(8) of the regulations of the Omnibus Budget
    11  Reconciliation Act of 1987 (Public Law 100-203, 101 Stat. 1330).
    12  Annually, after completion of the nurse aide training and
    13  competency evaluation program, the nurse aide shall attend an
    14  in-service program that incorporates section 3 as part of the
    15  presentation. The resident abuse prevention training component
    16  shall be included as part of the residents' rights curriculum in
    17  all nurse aide training classes and as part of the regular in-
    18  service education of the nurse aide, on or before March 1, 1998.
    19  Section 10.  Promulgation of regulations.
    20     The department shall promulgate regulations, as required
    21  under section 6, no later than May 1, 1998.
    22  Section 11.  Effective date.
    23     This act shall take effect as follows:
    24         (1)  Section 10 and this section shall take effect
    25     immediately.
    26         (2)  Sections 4, 5, 6, 7 and 8 shall take effect upon the
    27     date of publication in the Pennsylvania Bulletin of the final
    28     adoption of the regulations described under section 10.
    29         (3)  The remainder of this act shall take effect in 90
    30     days.
    L12L24DGS/19970H0133B0516       - 10 -