PRIOR PRINTER'S NOS. 158, 485
PRINTER'S NO. 619
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
190
Session of
2021
INTRODUCED BY MENSCH, J. WARD, AUMENT, BAKER, BROOKS, MARTIN,
MASTRIANO, PHILLIPS-HILL, PITTMAN, STEFANO, YAW AND
HUTCHINSON, FEBRUARY 10, 2021
SENATOR BROWNE, APPROPRIATIONS, RE-REPORTED AS AMENDED,
APRIL 19, 2021
AN ACT
Providing for essential family caregivers in facilities during
disaster emergencies.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Essential
Family Caregiver Designation Act.
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Communicable disease." As defined in section 2(c) of the
act of April 23, 1956 (1955 P.L.1510, No.500), known as the
Disease Prevention and Control Law of 1955.
"Compassionate care situation." Any of the following:
(1) An end of life situation.
(2) A resident struggling with the change in environment
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and lack of physical family support who was living with
family before being recently admitted to a facility.
(3) A resident who is grieving after a friend or family
member recently passed away.
(4) A resident who is experiencing weight loss or
dehydration and needs cueing and encouragement with eating or
drinking which was previously provided by a family member or
caregiver.
(5) A resident who is experiencing emotional distress,
is seldom speaking or crying more frequently and who used to
talk and interact with others.
"Essential family caregiver." As follows:
(1) Any of the following individuals who are at least 18
years of age and who, prior to visitor restrictions, were
regularly engaged with a resident at least once per week:
(i) An immediate family member.
(ii) A caregiver of the resident who is not employed
by a facility.
(2) The term does not include an employee of a
regulatory agency unless the employee is an immediate family
member of the resident.
"Facility." Any of the following:
(1) A long-term care nursing facility as defined in
section 802.1 of the act of July 19, 1979 (P.L.130, No.48),
known as the Health Care Facilities Act.
(2) A hospice as defined in section 802.1 of the Health
Care Facilities Act, if the hospice renders care in an
inpatient setting.
(3) An assisted living residence as defined in section
1001 of the act of June 13, 1967 (P.L.31, No.21), known as
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the Human Services Code.
(4) A personal care home as defined in section 1001 of
the Human Services Code.
(5) An intermediate care facility for individuals with
an intellectual disability.
"Immediate family member." A spouse, child, stepchild,
parent, stepparent, grandparent, grandchild, brother,
stepbrother, sister, stepsister or like relative-in-law.
"Intermediate care facility for individuals with an
intellectual disability." The term shall have the same meaning
as the term "intermediate care facility for the mentally
retarded" in section 1905(d) of the Social Security Act (49
Stat. 620, 42 U.S.C. § 1396d(d)) on the effective date of this
definition.
"Secretary." The Secretary of Health or the Secretary of
Human Services of the Commonwealth.
"State of disaster emergency." A state of disaster emergency
declared under 35 Pa.C.S. § 7301(c) (relating to general
authority of Governor) that is due to a communicable disease.
Section 3. Essential family caregiver.
(a) Designation.--Notwithstanding any other provision of
law, during a state of disaster emergency declared as a result
of a communicable disease the secretary shall require a facility
to designate at least one essential family caregiver per
resident to provide companionship and assist with activities
requiring one-on-one direction, including compassionate care
situations. Only facilities that have the ability to follow
necessary precautions outlined by the Federal and State
Government may designate an essential family caregiver.
(b) Visitation.--Visitation by an essential family caregiver
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may be conducted through different means based on a facility's
structure and the needs of the residents, such as use of
resident rooms, dedicated visitation spaces and the outdoors and
visitation in circumstances beyond compassionate care
situations. The following shall apply:
(1) Except for on-going use of virtual visits,
facilities may still restrict visitation by an essential
family caregiver due to any of the following:
(i) A communicable disease county positivity rate
greater than the recommended threshold for visitation
according to the United States Department of Health and
Human Services Centers for Medicare and Medicaid Services
or other similar measure for reporting the spread of a
communicable disease.
(ii) The facility's communicable disease status.
(iii) A resident's communicable disease status.
(iv) Visitor symptoms.
(2) Except as provided under paragraph (1), a facility
may not restrict visitation by an essential family caregiver
without a reasonable clinical or safety cause.
(c) Essential family caregiver requirements.--The decision
to designate an essential family caregiver may be individualized
and integrated with resident-centered care planning. A visit
shall be held outdoors whenever practicable. For inside visits,
the following shall apply:
(1) Designation shall be by the facility executive
director or equivalent position or designee, in consultation
with the resident and the resident's representative, and only
upon agreement by the resident and their representative.
(2) A schedule and the amount of time allowed in a
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facility by an essential family caregiver shall be agreed to
prior to an essential family caregiver entering a facility
and may not exceed more than two hours per day.
(3) Notwithstanding any other provision of law,
visitation shall be contingent upon the facility having no
new communicable disease cases in the last 14 days. No
facility may conduct visitation during the time period the
facility is conducting outbreak testing.
(4) All who enter the facility must be screened for
signs and symptoms of the communicable disease and the denial
of entry of those with signs or symptoms must occur.
(5) Compliance with any necessary Federal or State
Government precautions designed to reduce the spread of a
communicable disease, including:
(i) Proper hand hygiene.
(ii) The wearing of a face covering or mask covering
both the mouth and nose.
(iii) Physical distancing.
(6) An essential family caregiver shall provide care and
support similar in nature as provided prior to the A
proclamation of disaster emergency issued by the Governor on
March 6, 2020, published at 50 Pa.B. 1644 (March 21, 2020),
and any renewal of the state of disaster emergency, AS A
RESULT OF A COMMUNICABLE DISEASE.
(7) An essential family caregiver shall adhere to any
conditions specified by the facility.
(8) Restriction or revocation of essential family
caregiver status shall be at the sole discretion of the
facility executive director or equivalent position or
designee.
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Section 4. Construction.
Nothing in this act shall be construed to supersede Federal
authority or guidance regarding long-term care facilities or to
prevent the secretary from taking necessary actions to render
the Commonwealth eligible for Federal funds or reimbursement
services provided in long-term care facilities.
Section 5. Effective date.
This act shall take effect immediately.
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