The Prince George's County Council passed legislation this week authorizing the county health department to begin the licensing and regulation of nursing homes by March.
Approving the legislation before a crowd of 100 senior citizens who have nurtured the bill since its inception, Council Chairman William B. Amonett said, "It appalls me that a state agency can't do its job. The patient care in nursing homes is not what it should be. We hope we can change that."
The legislation permits the county to inspect nursing homes and similar types of long-term care facilities before issuing a county operating license. Currently the Maryland Department of Mental Health and Hygiene issues a similar license, but council members said they did not feel state involvement was adequate.
"The state adamantly opposed this bill," said council member Frank P. Casula, "but we have to break down that bureaucracy. We need the performance that is in this bill."
County health department officials must visit each of the 16 homes in Prince George's County at least four times a year, according to the legislation, with three of the visits unannounced.
Council members and several senior citizens who testified at a public hearing on the bill said it is the increased frequency and surprise nature of the visits that should produce improvement in the quality of nursing home care.
"The one problem with enforcement on the state level is that the state isn't in the local community," said Pat Lusk, director of the project within the county health department. "Because we are already in several of the homes through our Medicare program, people know us, and we get a fair number of complaints about care in the homes.
"Our only limitation now about beginning the program is funding. Funds for most new programs start on July 1, so perhaps with an appropriation, we can start by the (March 1) effective date," Lusk said.
County Health Officer Donald Wallace stressed the potential funding problem in a letter to the council this week.
"The present staff cannot accept the additional burden of fulfilling the work," he wrote, adding. "The licensure cannot be carried through properly without additional funds."
Wallace estimated that $70,220 will be needed in July to start up and equip the program, which will require a dietitian and two nurses, in addition to clerical and supervisory staff. Council members said they were aware that approximately $15,000 will be needed to get the program operating from March to July.
The legislation sets a licensing fee of $1 per bed, requiring a minimum fee of $25 per home. The bill also calls for a fine of up to $1,000 or six months in jail or both as a penalty for operating a nursing home without a license.
The proposed law also enables the county council to appoint a nursing home advisory committee. This nine-member committee will include three government representatives, one nursing home representative and five at large appointments, three of which would be citizens over 55.
It was the senior citizens who pushed the hardest for passage of the bill. Several cam before the council public hearing with tales of neglect from experiences in nursing homes throughout the county.
"This is one area where everyone is going to have to squeeze a little bit," said Amonett, "and dig a bit deeper in their pockets so we can fund this on a local level."