Provides for the authorization and regulation of visitation of compassionate care-giving visitors at nursing homes and residential health care facilities.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A1052B
SPONSOR: Bronson TITLE OF BILL:
An act to amend the public health law and the social services law, in
relation to personal and compassionate caregiving visitors for residents
of nursing homes
PURPOSE:
This bill authorizes 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 resi-
dents of nursing homes and other residential health care facilities.
SUMMARY OF PROVISIONS:
Section 1: Adds a new section 2801-h to the public health law. This
section requires the department of health to develop rules, regulations,
and guidelines to allow personal caregiving and compassionate caregiving
visitors at nursing homes. Provides definitions for personal and compas-
sionate caregiving. These guidelines will include that facilities are
required to allow such visitation, procedures for designating a visitor
(as needed, with support from a medical or mental health professional),
set forth procedures on changing such designation, require waiving
liability, limits such designation to two caregivers per resident,
exempts such visitors from general prohibitions on visitation, set forth
the circumstances under which such visitation may be suspended or limit-
ed, establish safety protocols for such visitors, sets forth frequency
and duration of visitation, set forth the total number of such visitors
allowed in a facility at any one time, and make allowances for compas-
sionate caregiving.
Section 2: Adds a new section 461-u to the social services law. This
section requires the office of temporary and disability assistance to
develop rules, regulations, and guidelines to allow personal caregiving
and compassionate caregiving visitors at nursing homes. Provides defi-
nitions for personal and compassionate caregiving. These guidelines will
include that facilities are required to allow such visitation, proce-
dures for designating a visitor (as needed, with support from a medical
or mental health professional), set forth procedures on changing such
designation, require waiving liability, limits such designation to two
caregivers per resident, exempts such visitors from general prohibitions
on visitation, set forth the circumstances under which such visitation
may be suspended or limited, establish safety protocols for such visi-
tors, sets forth frequency and duration of visitation, set forth the
total number of such visitors allowed in a facility at any one time, and
make allowances for compassionate caregiving.
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.
FISCAL IMPACT:
To be determined.
LEGISLATIVE HISTORY:.
2020: A11075 referred to health
EFFECTIVE DATE:
45 days after becoming law.
STATE OF NEW YORK
________________________________________________________________________
1052--B
Cal. No. 85
2021-2022 Regular Sessions
IN ASSEMBLY
January 7, 2021
___________
Introduced by M. of A. BRONSON, GOTTFRIED, LUPARDO, SEAWRIGHT, STERN,
FAHY, CLARK, McMAHON, NOLAN, JACOBSON, SIMON, MEEKS, WOERNER, JONES,
ENGLEBRIGHT, GRIFFIN, LUNSFORD, SANTABARBARA, WALLACE, BARRETT, STECK,
BARRON, NORRIS -- read once and referred to the Committee on Health --
committee discharged, bill amended, ordered reprinted as amended and
recommitted to said committee -- reported from committee, advanced to
a third reading, amended and ordered reprinted, retaining its place on
the order of third reading
AN ACT to amend the public health law and the social services law, in
relation to personal and compassionate caregiving visitors for resi-
dents of nursing homes
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The public health law is amended by adding a new section
2 2801-h to read as follows:
3 § 2801-h. Personal caregiving and compassionate caregiving visitors to
4 nursing home residents during declared local or state health emergen-
5 cies. 1. As used in this section, the following terms have the follow-
6 ing meanings:
7 (a) "personal caregiving visitor" means a family member, close friend,
8 or legal guardian of a resident designated by such resident or such
9 resident's lawful representative to provide personal caregiving for such
10 resident, including a compassionate caregiving visitor;
11 (b) "personal caregiving" means care and support of a resident by a
12 personal caregiving visitor that is provided to benefit such resident's
13 mental, physical, or social well-being;
14 (c) "compassionate caregiving visitor" means a personal caregiving
15 visitor providing compassionate caregiving to a resident;
16 (d) "compassionate caregiving" means personal caregiving that is
17 provided in anticipation of the end of a resident's life or in the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD04858-10-1
A. 1052--B 2
1 instance of significant mental or social decline or crisis of a resi-
2 dent;
3 (e) "resident" means a resident of a nursing home; in relation to a
4 personal caregiving visitor, "resident" means the resident to whom the
5 personal caregiving visitor has been designated to provide personal
6 caregiving; and
7 (f) "visit" includes providing personal caregiving to a resident.
8 2. Personal caregiving visitors may visit residents of nursing homes,
9 subject to this section. The commissioner shall make regulations under
10 this section which shall:
11 (a) require nursing homes to allow personal caregiving visitors to
12 visit residents subject to this section;
13 (b) set forth procedures for the designation of personal caregiving
14 visitors by residents or resident's lawful representatives, which may
15 include in appropriate circumstances requiring a physical or mental
16 health professional to state that the personal caregiving will substan-
17 tially benefit the resident's mental, physical, or social well-being; an
18 nursing home shall not require that the health professional is affil-
19 iated with such nursing home;
20 (c) set forth procedures for changing a personal caregiving visitor
21 designation;
22 (d) provide that a resident shall not be entitled to designate more
23 than two personal caregiving visitors;
24 (e) provide that personal caregiving visitors shall be exempt from
25 prohibitions on visiting residents at nursing homes, subject to the
26 limitations and requirements set forth by this subdivision;
27 (f) set forth the circumstances under which visiting by personal care-
28 giving visitors may be temporarily limited or suspended at a nursing
29 home, including, but not limited to, local infection rates, temporary
30 inadequate staff capacity, or an acute emergency situation;
31 (g) require, at a minimum, that all personal caregiving visitors
32 follow safety protocols required for nursing home staff, including, but
33 not limited to:
34 (i) testing for communicable diseases;
35 (ii) checking body temperature;
36 (iii) health screenings;
37 (iv) appropriate use of personal protection equipment;
38 (v) social distancing (except as necessary for personal caregiving by
39 the personal caregiving visitor for the resident); and
40 (vi) any other requirement the department deems appropriate;
41 (h) set forth standards for frequency and duration of visits by
42 personal caregiving visitors at nursing homes;
43 (i) set forth standards for limiting the total number of personal
44 caregiving visitors allowed to visit a nursing home at any one time;
45 and
46 (j) make appropriate provisions for compassionate caregiving and
47 compassionate caregiving visitors.
48 § 2. The social services law is amended by adding a new section 461-u
49 to read as follows:
50 § 461-u. Personal caregiving and compassionate caregiving visitors for
51 residents of adult care facilities during declared local or state health
52 emergencies. 1. As used in this section, the following terms have the
53 following meanings:
54 (a) "personal caregiving visitor" means a family member, close friend,
55 or legal guardian of a resident designated by such resident or such
A. 1052--B 3
1 resident's lawful representative to provide personal caregiving for such
2 resident, including a compassionate caregiving visitor;
3 (b) "personal caregiving" means care and support of a resident by a
4 personal caregiving visitor that is provided to benefit such resident's
5 mental, physical, or social well-being.
6 (c) "compassionate caregiving visitor" means a personal caregiving
7 visitor providing compassionate caregiving to a resident;
8 (d) "compassionate caregiving" means personal caregiving that is
9 provided in anticipation of the end of a resident's life or in the
10 instance of significant mental or social decline or crisis of a resi-
11 dent;
12 (e) "resident" means a resident of an adult care facility; in relation
13 to a personal caregiving visitor, "resident" means the resident to whom
14 a personal caregiving visitor has been designated to provide personal
15 caregiving; and
16 (f) "visit" includes providing personal caregiving to a resident.
17 2. Personal caregiving visitors may visit residents of adult care
18 facilities, subject to this section. The commissioner of the department
19 responsible for the licensure or certification for each type of adult
20 care facility shall make regulations for such type under this section
21 which shall:
22 (a) require adult care facilities to allow personal caregiving visi-
23 tors to visit residents subject to this section;
24 (b) set forth procedures for the designation of personal caregiving
25 visitors by residents or resident's lawful representatives, which may
26 include in appropriate circumstances requiring a physical or mental
27 health professional to state that the personal caregiving will substan-
28 tially benefit the resident's mental, physical, or social well-being; an
29 adult care facility shall not require that a health professional is
30 affiliated with such adult care facility;
31 (c) set forth procedures for changing a personal caregiving visitor
32 designation;
33 (d) provide that a resident shall not be entitled to designate more
34 than two personal caregiving visitors;
35 (e) provide that personal caregiving visitors shall be exempt from
36 prohibitions on visiting residents at adult care facilities, subject to
37 the limitations and requirements in this subdivision;
38 (f) set forth the circumstances under which visiting by personal care-
39 giving visitors may be temporarily limited or suspended at an adult care
40 facility, including, but not limited to, local infection rates, tempo-
41 rary inadequate staff capacity, or an acute emergency situation;
42 (g) require, at a minimum, that all personal caregiving visitors
43 follow safety protocols required for adult care facility staff, includ-
44 ing, but not limited to:
45 (i) testing for communicable diseases;
46 (ii) checking body temperature;
47 (iii) health screenings;
48 (iv) appropriate use of personal protection equipment;
49 (v) social distancing (except as necessary for personal caregiving by
50 the personal caregiving visitor for a resident); and
51 (vi) any other requirement the office of temporary and disability
52 assistance deems appropriate;
53 (h) set forth standards for frequency and duration of visits by
54 personal caregiving visitors at adult care facilities;
A. 1052--B 4
1 (i) set forth standards for limiting the total number of personal
2 caregiving visitors allowed to visit an adult care facility at any one
3 time; and
4 (j) make appropriate provisions for compassionate caregiving and
5 compassionate caregiving visitors.
6 § 3. This act shall take effect on the forty-fifth day after it shall
7 have become a law. Effective immediately, the addition, amendment and/or
8 repeal of any rule or regulation necessary for the implementation of
9 this act on its effective date are authorized to be made and completed
10 on or before such date.
