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A06966 Summary:

BILL NOA06966
 
SAME ASSAME AS S06203
 
SPONSORBronson
 
COSPNSR
 
MLTSPNSR
 
Amd §2801-h, Pub Health L; amd §461-u, Soc Serv L; amd §3, Chap of 2021 (as proposed in S.614-B & A.1052-B)
 
Provides for the authorization and regulation of visitation at nursing homes and residential health care facilities.
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A06966 Actions:

BILL NOA06966
 
04/15/2021referred to health
04/19/2021reported
04/22/2021advanced to third reading cal.231
04/26/2021passed assembly
04/26/2021delivered to senate
04/26/2021REFERRED TO RULES
04/27/2021SUBSTITUTED FOR S6203
04/27/20213RD READING CAL.727
04/27/2021PASSED SENATE
04/27/2021RETURNED TO ASSEMBLY
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A06966 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A6966
 
SPONSOR: Bronson
  TITLE OF BILL: An act to amend the public health law and the social services law, in relation to personal caregiving visitors for residents of nursing homes; and to amend a chapter of the laws of 2021 amending the public health law and the social services law relating to personal and compassionate caregiving visitors for residents of nursing homes, as proposed in legislative bills numbers S.614-B and A.1052-B, in relation to the effectiveness thereof   PURPOSE: To authorize the Department of Health to develop regulations to allow personal caregiving visitation, for the provision of routine care and support, and for compassionate caregiving visitation, for the provision of short-term emergency care and support at end of life or other dire circumstances, by family members and legal guardians of residents of nursing homes and adult care facilities.   SUMMARY OF PROVISIONS: *Expands when compassionate caregiving can be provided for in end of life and crisis situations. *Clarifies that caregiving services provided do not ' replace the services that nursing homes and adult care facilities are required to provide *Clarifies that only caregivers complying with appropriate safety and screening procedures are allowed to be admitted to nursing homes and adult care facilities. *Allows each resident to have at least two designated caregivers. *Establishes a documentation requirement for nursing homes and adult care facilities related to designated caregivers to ensure compliance with the law.   JUSTIFICATION: In an effort to curb outbreaks of the coronavirus among nursing home residents, New York State issued-a ban on outside visitation by nones- sential visitors in March 2020. While the ban addressed a real need to limit spread of the virus, it has become apparent that isolation from loved ones presents significant risks of its own to the physical and mental wellbeing of nursing home residents. In many cases, family members prior to the ban regularly provided care for their loved one, assisting with feeding, bathing, dressing, communication and other essential activities of daily living. These family members-some of them on a daily basis for years-functioned as de facto "staff," augmenting the care and support provided by regular staff. We know that nursing home aides are too often stretched thin under the best of circumstances; during the pandemic, their numbers and capacity have been even lower, exacerbating the challenge of adequately meeting residents' needs. Personal care visitation would allow for such care to resume, with the designated caregiver following the same protocols as staff. In addition, this bill would expand on the definition, as conceived by CMS, of "compassionate care visitation," so that facilities allow for visitation not just at end-of-life situations but also in response to a marked decline in a resident's physical, mental or emotional wellbeing. This decline might be indicated by such conditions as depression, increased confusion or cognitive decline, weight loss or various other changes that signify a negative turn in physical or psychosocial health. Such changes are increasingly -showing up as side effects of policies that isolate residents from their loved ones for extended periods of time and, in the most serious cases, pose their own risk of morbidity. It is a sad fact that enforced isolation from loved ones has created a whole new set of risks to nursing home residents-in many cases acceler- ating mental and physical decline. Allowing exemptions for personal care visitors and enhanced compassionate care visitation would be a reason- able, pragmatic step toward re-establishing those critical informal channels of care that are so crucial to the wellbeing of nursing home residents.   LEGISLATIVE HISTORY: 2021: A.1052-B - Chapter 89 of 2021.   FISCAL IMPLICATIONS: None to the state   EFFECTIVE DATE: Immediate.
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A06966 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          6966
 
                               2021-2022 Regular Sessions
 
                   IN ASSEMBLY
 
                                     April 15, 2021
                                       ___________
 
        Introduced  by M. of A. BRONSON -- read once and referred to the Commit-
          tee on Health
 
        AN ACT to amend the public health law and the social  services  law,  in
          relation  to  personal  caregiving  visitors  for residents of nursing
          homes; and to amend a chapter of the laws of 2021 amending the  public
          health  law  and  the  social  services  law  relating to personal and
          compassionate caregiving visitors for residents of nursing  homes,  as
          proposed  in  legislative  bills  numbers  S.614-B  and  A.1052-B,  in
          relation to the effectiveness thereof
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Section  2801-h  of  the public health law, as added by a
     2  chapter of the laws of 2021 amending  the  public  health  law  and  the
     3  social  services  law  relating to personal and compassionate caregiving
     4  visitors for residents of nursing  homes,  as  proposed  in  legislative
     5  bills numbers S.614-B and A.1052-B, is amended to read as follows:
     6    §  2801-h. Personal caregiving [and compassionate caregiving] visitors
     7  [to] for nursing home residents during [declared local or state]  public
     8  health  emergencies.  1.    As used in this section, the following terms
     9  have the following meanings:
    10    (a) "personal caregiving visitor" means a family member, close friend,
    11  or legal guardian of a resident designated by  [such]  the  resident  or
    12  [such]  the  resident's  lawful  representative to [provide] assist with
    13  personal caregiving or compassionate caregiving  for  [such]  the  resi-
    14  dent[, including a compassionate caregiving visitor];
    15    (b)  "personal  caregiving"  means care and support of a resident by a
    16  personal caregiving visitor that is provided to benefit such  resident's
    17  mental, physical, or social well-being;
    18    (c)  ["compassionate  caregiving  visitor" means a personal caregiving
    19  visitor providing compassionate caregiving to a resident;

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04858-11-1

        A. 6966                             2

     1    (d)] "compassionate caregiving"  means  personal  caregiving  that  is
     2  provided  in  anticipation  of  the  end  of a resident's life or in the
     3  instance of significant mental, physical, or social decline or crisis of
     4  a resident;
     5    [(e)]  (d)  "resident" means a resident of a nursing home; in relation
     6  to a personal caregiving visitor, "resident" means the resident to  whom
     7  the  personal caregiving visitor has been designated to [provide] assist
     8  with personal caregiving or compassionate caregiving; and
     9    [(f)] (e) "visit" includes [providing] assisting with  personal  care-
    10  giving [to] or compassionate caregiving for a resident.
    11    2.  [Personal] During a public health emergency declared under section
    12  twenty-four or section twenty-eight of the executive law personal  care-
    13  giving  visitors  may  visit residents of nursing homes, [subject to] in
    14  compliance with federal law and regulations and state  regulations  made
    15  under  this  section.  Nursing homes shall admit any personal caregiving
    16  visitor who is in compliance with  applicable  requirements  under  this
    17  section.
    18    3.  The  commissioner  shall make regulations under this section which
    19  shall:
    20    (a)  require nursing homes to allow personal  caregiving  visitors  to
    21  visit residents subject to this section;
    22    (b)  set  forth  procedures for the designation of personal caregiving
    23  visitors by residents or resident's lawful representatives,  which:  (i)
    24  shall include documentation of each designated personal caregiving visi-
    25  tor  in  the  facility  records; (ii) shall include procedures to ensure
    26  that the preferences of the resident  regarding  the  designation  of  a
    27  personal  caregiving  visitor  are  respected; and (iii) may include, in
    28  appropriate circumstances,  requiring  a  [physical]  health  or  mental
    29  health  professional  licensed  or  certified under the education law to
    30  state that the personal caregiving will substantially benefit the  resi-
    31  dent's  mental,  physical,  or  social  well-being[; an]. A nursing home
    32  shall not require that the health professional [is] be  affiliated  with
    33  such nursing home;
    34    (c)  set  forth  procedures for changing a personal caregiving visitor
    35  designation;
    36    (d) provide that a resident shall [not] be entitled to designate [more
    37  than] at least two personal caregiving visitors;
    38    (e)  provide that personal caregiving visitors shall  be  exempt  from
    39  prohibitions  on  visiting  residents  at  nursing homes, subject to the
    40  limitations and  requirements  [set  forth  by]  of  this  [subdivision]
    41  section;
    42    (f) set forth the circumstances under which visiting by personal care-
    43  giving  visitors  may  be  temporarily limited or suspended at a nursing
    44  home to protect the health, safety and welfare of residents,  including,
    45  but  not  limited  to, local infection rates, temporary inadequate staff
    46  capacity, or an acute emergency situation;
    47    (g)  require, at a   minimum, that all  personal  caregiving  visitors
    48  follow  safety  protocols  [required  for nursing home staff, including]
    49  which may include, but need not be limited to:
    50    (i) testing for communicable diseases;
    51    (ii) checking body temperature upon entry into the nursing home;
    52    (iii) health screenings upon entry into the nursing home;
    53    (iv) appropriate use of personal [protection] protective equipment;
    54    (v) social distancing (except as necessary for personal caregiving  by
    55  the personal caregiving visitor for the resident); and
    56    (vi) any other requirement the department deems appropriate;

        A. 6966                             3
 
     1    (h)    set   forth standards for  frequency and duration  of visits by
     2  personal caregiving visitors at  nursing homes;
     3    (i)  set  forth  standards  for  limiting the total number of personal
     4  caregiving visitors for a resident and/or limiting the total  number  of
     5  personal  caregiving visitors allowed to visit a nursing home at any one
     6  time based on the circumstances of the residents and the  nursing  home;
     7  [and]
     8    (j)  require  personal  caregiving  and compassionate caregiving to be
     9  documented in the resident's individualized comprehensive plan of  care;
    10  and
    11    (k)  make  appropriate  provisions  for  compassionate caregiving [and
    12  compassionate caregiving visitors].
    13    4. The department shall post the requirements  consistent  with  regu-
    14  lations,  on  its website, including any requirements as to time periods
    15  and region.
    16    5. This section does not require the  medical  assistance  program  to
    17  cover  personal caregiving or compassionate caregiving and such caregiv-
    18  ing shall not be reimbursed under the medical assistance program.
    19    6. This section does not relieve any nursing  home,  or  nursing  home
    20  operator  or  administrator, of any obligation or responsibility imposed
    21  by any other applicable law or regulation.
    22    7. Nothing in this section shall be construed to limit access  by  any
    23  visitor to a facility that would otherwise be permitted under federal or
    24  state law or regulation.
    25    §  2.  Section 461-u of the social services law, as added by a chapter
    26  of the laws of 2021 amending  the  public  health  law  and  the  social
    27  services  law relating to personal and compassionate caregiving visitors
    28  for residents of nursing homes, as proposed in legislative bills numbers
    29  S.614-B and A.1052-B, is amended to read as follows:
    30    § 461-u. Personal caregiving [and compassionate  caregiving]  visitors
    31  for  residents of adult care facilities during [declared local or state]
    32  public health emergencies. 1. As used in  this  section,  the  following
    33  terms have the following meanings:
    34    (a) "personal caregiving visitor" means a family member, close friend,
    35  or  legal  guardian  of  a resident designated by [such] the resident or
    36  [such] the resident's lawful representative  to  [provide]  assist  with
    37  personal  caregiving  or  compassionate  caregiving for [such] the resi-
    38  dent[, including a compassionate caregiving visitor];
    39    (b) "personal caregiving" means care and support of a  resident  by  a
    40  personal  caregiving visitor that is provided to benefit such resident's
    41  mental, physical, or social well-being.
    42    (c) ["compassionate caregiving visitor" means  a  personal  caregiving
    43  visitor providing compassionate caregiving to a resident;
    44    (d)]  "compassionate  caregiving"  means  personal  caregiving that is
    45  provided in anticipation of the end of  a  resident's  life  or  in  the
    46  instance of significant mental, physical, or social decline or crisis of
    47  a resident;
    48    [(e)]  (d)  "resident"  means a resident of an adult care facility; in
    49  relation to a personal caregiving visitor, "resident" means the resident
    50  to whom a personal caregiving visitor has been designated  to  [provide]
    51  assist with personal caregiving or compassionate caregiving; and
    52    [(f)]  (e)  "visit" includes [providing] assisting with personal care-
    53  giving [to] or compassionate caregiving for a resident.
    54    2. [Personal] During a public health emergency declared under  section
    55  twenty-four  or section twenty-eight of the executive law personal care-
    56  giving visitors may visit residents of adult care  facilities,  [subject

        A. 6966                             4

     1  to] in compliance with federal law and regulations and state regulations
     2  made under this section.  Adult care facilities shall admit any personal
     3  caregiving  visitor  who  is  in compliance with applicable requirements
     4  under this section.
     5    3. The commissioner of the department responsible for the licensure or
     6  certification  for  each  type  of  adult care facility shall make regu-
     7  lations for such type under this section which shall:
     8    (a)  require adult care facilities to allow personal caregiving  visi-
     9  tors to visit residents subject to this section;
    10    (b)  set  forth  procedures for the designation of personal caregiving
    11  visitors by residents or resident's lawful representatives,  which:  (i)
    12  shall include documentation of each designated personal caregiving visi-
    13  tor  in  the  facility  records; (ii) shall include procedures to ensure
    14  that the preferences of the resident  regarding  the  designation  of  a
    15  personal  caregiving  visitor  are  respected; and (iii) may include, in
    16  appropriate circumstances,  requiring  a  [physical]  health  or  mental
    17  health  professional  licensed  or  certified under the education law to
    18  state that the personal caregiving will substantially benefit the  resi-
    19  dent's  mental,  physical,  or  social  well-being[;  an]. An adult care
    20  facility shall not require that a health or mental  health  professional
    21  [is] be affiliated with such adult care facility;
    22    (c)  set  forth  procedures for changing a personal caregiving visitor
    23  designation;
    24    (d) provide that a resident shall [not] be entitled to designate [more
    25  than] at least two personal caregiving visitors;
    26    (e) provide that personal caregiving visitors  shall  be  exempt  from
    27  prohibitions  on visiting residents at adult care facilities, subject to
    28  the limitations and requirements [in] of this [subdivision] section;
    29    (f) set forth the circumstances under which visiting by personal care-
    30  giving visitors may be temporarily limited or suspended at an adult care
    31  facility to protect the health, safety and welfare of residents, includ-
    32  ing, but not limited to, local  infection  rates,  temporary  inadequate
    33  staff capacity, or an acute emergency situation;
    34    (g)  require,  at  a  minimum,  that  all personal caregiving visitors
    35  follow safety protocols [required for adult care facility staff, includ-
    36  ing] which may include, but need not be limited to:
    37    (i) testing for communicable diseases;
    38    (ii)  checking  body  temperature  upon  entry  into  the  adult  care
    39  facility;
    40    (iii) health screenings upon entry into the adult care facility;
    41    (iv) appropriate use of personal [protection] protective equipment;
    42    (v)  social distancing (except as necessary for personal caregiving by
    43  the personal caregiving visitor for a resident); and
    44    (vi) any other requirement the [office  of  temporary  and  disability
    45  assistance] respective commissioner deems appropriate;
    46    (h)  set  forth  standards  for  frequency  and  duration of visits by
    47  personal caregiving visitors at adult care facilities;
    48    (i) set forth standards for limiting  the  total  number  of  personal
    49  caregiving  visitors  for a resident and/or limiting the total number of
    50  personal caregiving visitors allowed to visit an adult care facility  at
    51  any  one  time based on the circumstances of the residents and the adult
    52  care facility; [and]
    53    (j) require personal caregiving and  compassionate  caregiving  to  be
    54  documented in the resident's case management notes; and
    55    (k)  make  appropriate  provisions  for  compassionate caregiving [and
    56  compassionate caregiving visitors].

        A. 6966                             5
 
     1    4. The respective commissioners shall post the requirements consistent
     2  with regulations, on their website, including  any  requirements  as  to
     3  time periods and region.
     4    5.  This  section  does  not require the medical assistance program to
     5  cover personal caregiving or compassionate caregiving and such  caregiv-
     6  ing shall not be reimbursed under the medical assistance program.
     7    6.  This  section  does  not  relieve any facility licensed under this
     8  article, or any facility operator, of any obligation  or  responsibility
     9  imposed by any other applicable law or regulation.
    10    7.  Nothing  in this section shall be construed to limit access by any
    11  visitor to a facility that would otherwise be permitted under federal or
    12  state law or regulation.
    13    § 3. Section 3 of a chapter of the laws of 2021  amending  the  public
    14  health  law and the social services law relating to personal and compas-
    15  sionate caregiving visitors for residents of nursing homes, as  proposed
    16  in legislative bills numbers S.614-B and A.1052-B, is amended to read as
    17  follows:
    18    § 3. This act shall take effect [on the forty-fifth day after it shall
    19  have become a law. Effective immediately, the addition, amendment and/or
    20  repeal  of  any  rule  or regulation necessary for the implementation of
    21  this act on its effective date are authorized to be made  and  completed
    22  on or before such date] immediately and regulations shall be made, which
    23  may  include  emergency  regulations,  within forty-five days after such
    24  date; provided however, nothing herein shall impact the effectiveness of
    25  current department of health guidance pertaining  to  nursing  home  and
    26  adult care facility visitation.
    27    §  4.  This  act shall take effect immediately; provided however, that
    28  sections one and two of this act shall take effect on the same date  and
    29  in  the same manner as a chapter of the laws of 2021 amending the public
    30  health law and the social services law relating to personal and  compas-
    31  sionate  caregiving visitors for residents of nursing homes, as proposed
    32  in legislative bills numbers S.614-B and A.1052-B, takes effect.
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