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Date

The Honorable (Insert legislator's name)
Address
Tallahassee, FL (ZIP)

Dear Senator/Representative (NAME)

RE: Electronic Surveillance Equipment in Nursing Homes

In January 2002, the Agency for Health Care Administration and the Office of the Attorney General released a report mandated by the Legislature as part of SB 1202 on the use of electronic surveillance equipment in nursing homes. The report recommends statutory changes that would allow for the installation of such equipment if requested by or on behalf of a nursing home resident. It also recommends that safeguards should be in place to protect the privacy of residents and that the cost of the electronic surveillance equipment should be borne by the resident. Oddly enough, the report does not mention how electronic surveillance equipment would or could be used to improve resident care. In fact, no mention is made of how to protect the integrity of tapes. No mention is made of requirements of viewers to immediately report questionable activities to the nursing home administrator and AHCA. Other issues that I am concerned about include:

• Privacy/Dignity: Video surveillance cameras undermine the privacy and dignity of nursing home patients and their doctors, nurse practitioners, caregivers and visitors. The most personal type of care is often provided at a patient’s bedside. I view this as a breech of confidentiality as well as demeaning, demoralizing, and disruptive to the care of these frail, incapacitated human beings.
• Staffing: The use of video surveillance cameras will have a negative impact on the facility's ability to recruit and retain staff at the very time when there is a real shortage of nurses and certified nursing assistants. The surveillance cameras will also disrupt the positive, trusting relationship between a patient and caregiver that may have the potential to interfere with their therapeutic relationship as well. Another major impact will be the downward spiral of staff moral.
• Medical Directors: With medical directors already facing insurance liability coverage cancellation, non-renewal and huge premium increases, this recommendation comes at a time when we need to encourage more physician participation in long-term care. Video surveillance has the potential to create a serious shortage of physicians acting as medical directors or attending physicians.
• Proper Use: There are many unanswered issues about resident privacy, the appropriate use of video tapes, video equipment maintenance, and the integrity of the tapes.
• Interpretation: FMDA believes that the contents of tapes will be easily misinterpreted or misrepresented and used against staff, physicians and the nursing facility.
• Family Involvement: Close family involvement in the day-to-day care of their loved one in the nursing home is one of the fundamental principles of good care for patients. Having video cameras may reduce family involvement and decrease patient-family interactions that are so essential to the welfare of both.

In summary, we do not believe the report is a balanced or thorough analysis of the use of electronic surveillance equipment in nursing homes. Only one state (Texas) has a law which makes such equipment a right if it is requested by or on behalf of a resident. The Texas law was passed in 2001 and has not yet been implemented or tested. To pursue similar legislation in Florida at a time when nursing homes are struggling with grossly overpriced insurance premiums, few insurance options, and a serious nursing shortage would be a mistake that could adversely affect care.

Thank you for your time and consideration.