Hacienda HealthCare patient rape case prompts federal legislation
The rape of a patient at Hacienda HealthCare in Phoenix was the catalyst for a proposed federal law that is set to be introduced Thursday in Congress.
The bill aims to improve transparency by giving the public easily accessible information about quality problems and substantiated complaints at facilities such as Hacienda.
The bill will be introduced in the Democrat-controlled House by Rep. Ruben Gallego, an Arizona Democrat whose 7th Congressional District includes the 60-bed intermediate-care facility on East South Mountain Avenue in Phoenix where the patient was raped and on Dec. 29, 2018, gave birth to a boy.
A 911 call during the birth indicated that none of the staff had known the woman was pregnant. Phoenix police later arrested one of the patient's caregivers on sexual assault charges, citing DNA evidence.
"This is a problem that's in my backyard and it's our responsibility to fix it and to prevent it in the future," Gallego told The Arizona Republic on Wednesday.
Rep. Tom O'Halleran, a Democrat representing Arizona's 1st Congressional District, is a co-sponsor of the bill, which zeroes in on facilities that like Hacienda are designated as "intermediate-care facilities for people with intellectual disabilities."
Among the bill's measures is a mandate that information about intermediate-care facilities be publicly posted, including inspection reports and the number, type, severity and outcomes of substantiated complaints. The public needs to be able to easily find information about facilities' shortcomings, Gallego said.
Companion legislation is expected to be introduced in the Republican-controlled Senate by Sen. Martha McSally, R-Ariz., and Sen. Kyrsten Sinema, D-Ariz.
“Despicable abuse in residential care facilities, particularly those that care for vulnerable patients, should never take place again anywhere," McSally said in an emailed statement. "Following the appalling instances at Hacienda HealthCare in Phoenix, members of the Arizona delegation are partnering together to introduce bicameral, bipartisan legislation to increase transparency and accountability at these facilities and I am glad to lead the effort in the Senate.”
A 'horrific and unacceptable' crime
Until it came to Arizona lawmakers' attention during the last legislative session, intermediate-care facilities for people with intellectual disabilities had not required a state license since 1997.
Lawmakers fixed the problem by requiring the facilities to be licensed, and Hacienda HealthCare received its state license in April. The federal government also has oversight of the facility, but Gallego said more safeguards are needed.
Gallego and O'Halleran have been working on the federal bill together since the Hacienda rape became public and made international headlines in January 2019.
“The crime committed at Hacienda Healthcare last year was horrific and unacceptable,” O'Halleran said in an emailed statement.
“I am proud to help introduce this important bill that will work to eradicate this kind of neglect and abuse of our most vulnerable, and ensure care centers like Hacienda are held accountable to those they serve.”
An intermediate-care facility for individuals with intellectual disabilities is an optional Medicaid benefit for states, and Gallego's office found 5,919 such facilities in the U.S.
Intermediate-care facilities house some 68,000 patients nationwide, including about 134 in Arizona. While that's a small fraction of the number of people living with disabilities, individuals in intermediate-care facilities are among the most vulnerable, Gallego said in an interview on Wednesday.
National data bank for background checks
The patients at Hacienda and other intermediate-care facilities need highly specialized care because of severe and complex medical needs.
At Hacienda, most of the residents are incontinent and wear diapers. All need help with daily activities that most people take for granted, such as brushing their teeth, eating and bathing. Many residents are non-verbal.
The bill would allow intermediate-care facilities to run national background checks through the National Practitioner Data Bank — an online repository created by Congress designed to prevent health practitioners with records from harming patients by moving state-to-state to get jobs.
Another measure in the bill would establish an advisory council for intermediate-care facilities. The council would be responsible for making recommendations on improving quality care and reducing abuse and neglect.
The advisory council would consist of individuals with disabilities; family members of individuals with disabilities; representatives of the National Association of State Directors of Developmental Disabilities Services; and the American Network of Community Options and Resources, among others, the bill says.
The Arc of Arizona, which advocates for the rights of people with intellectual and developmental disabilities, has already endorsed the bill, as has the American Health Care Association, which represents long-term-care providers.
For too long, the systems meant to provide care and support for residents of intermediate-care facilities have been riddled with inconsistencies and loopholes and families have faced confusing and often contradictory processes to seek accountability when abuse and neglect occur, said Jon Meyers, the executive director of The Arc of Arizona.
“This legislation represents a significant step forward in the protection of vulnerable adults across the U.S.," he said in a written statement.
On a state level, two task forces and a state planning council have issued recommendations on how to improve protections for vulnerable adults in Arizona.
One of those recommendations — an independent audit of the state's Adult Protective Services division — is now in a bill that was introduced in the Arizona Legislature by state Rep. Tim Dunn, R-Yuma. The bill was scheduled for consideration on Thursday by the House Health and Human Services Committee.