Header, the Administration of the Honorable Lincoln C. Almond
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July 7, 1997


In accordance with the provisions of § 43-1-4 of the General Laws, I am transmitting herewith, with my disapproval, 97-S 797, Substitute A, As Amended, "An Act Relating to Health and Safety."

This Act provides that, in the event Congress repeals certain federal statutory standards and requirements currently applicable to the licensing of nursing facilities and nursing facility resident rights, such repealed provisions would continue in effect in Rhode Island for 180 days as regulations of the Department of Health by operation of law. During this 180-day period, the Department would conduct a public hearing to determine whether the repealed federal standards should be adopted. While the Act appears to limit incorporation of the federal standards to 180 days, the legislation contemplates that these standards would extend beyond that period of time, except by affirmative action by the Health Department to the contrary. The Act appears to have been passed in response to the potential repeal of current federal standards and the desire to maintain certain federal requirements under Rhode Island law.

While many of the federal standards that would be extended and maintained under this Act are meritorious, and in fact essential to ensuring high quality nursing care with proper regard for the rights of nursing home residents, I must disagree with the wholesale adoption of comprehensive federal standards. I vetoed similar legislation last year.

The President and Congress have resolved to balance the federal budget over the next five years. A key component of the announced federal budget balancing plan provides for the reduction of federal Medicaid expenditures over a five-year period beginning in federal fiscal year 1998. Given the likelihood of reduced federal Medicaid funding, we should be pursing greater flexibility in our delivery of nursing care in order to more efficiently use scarce federal and state resources. This Act would have the opposite effect - to lock Rhode Island into the current "one-size-fits-all" federal regulatory scheme with rigid staffing and procedural requirements. Rhode Island should be free to establish both more accommodating and more rigorous standards and requirements depending upon Rhode Island's needs, including the needs presented by the particular nursing facility. This flexibility could prove crucial in developing greater home and alternative nursing care for our elderly.

Finally, since it is highly unlikely that Congress will act to repeal the federal statutes cited in this Act during its current session, this Act is premature.

For the foregoing reasons, I disapprove of this legislation and respectfully urge your support of this veto.


Lincoln Almond