Amended IN Assembly May 19, 2022 Amended IN Assembly April 28, 2022 Amended IN Assembly April 20, 2022 Amended IN Assembly March 23, 2022 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Assembly Bill No. 2546Introduced by Assembly Member NazarianFebruary 17, 2022An act to add Section 1569.3185 to, and to add Chapter 2.47 (commencing with Section 1439.70) to Division 2 of, the Health and Safety Code, relating to long-term care facilities, and declaring the urgency thereof, to take effect immediately. Chapter 2.47 (commencing with Section 1439.70) to Division 2 of the Health and Safety Code, relating to long-term care facilities.LEGISLATIVE COUNSEL'S DIGESTAB 2546, as amended, Nazarian. Resident-Designated Support Persons Act. Long-term care facilities during public health emergencies.Existing law provides for the licensure and regulation of health facilities, including skilled nursing facilities and intermediate care facilities, by the State Department of Public Health. Existing law provides for the licensure and regulation of residential care facilities for the elderly by the State Department of Social Services. A violation of those provisions is generally a crime. Existing law establishes the Office of the State Long-Term Care Ombudsman, under the direction of the State Long-Term Care Ombudsman, in the California Department of Aging. Under existing law, the office has the responsibility of protecting and advocating for the rights and health and safety of long-term care facility residents, and in providing leadership, direction, and support to local long-term care ombudsman programs.Existing law sets forth the conditions for declaring a state of emergency by the Governor, a local emergency by the governing body of a local government, a health emergency by the State Public Health Officer, or a local health emergency by a local health officer, and the powers resulting from those declarations.This bill would require the State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, to convene a working group, with a specified composition, no later than May 1, 2023. The bill would require the working group to develop recommendations regarding best practices for public health officials and long-term care facilities, as defined, when developing policies, including certain visitation policies involving designated support persons, related to long-term care facilities during public health emergencies, as defined. The bill would require the working group to provide the recommendations to the Assembly Committee on Aging and Long-Term Care no later than November 30, 2023.This bill would enact the Resident-Designated Support Persons Act for purposes of residents of long-term care facilities, defined to include skilled nursing facilities and intermediate care facilities, among other specified health facilities, and to include residential care facilities for the elderly. Under the bill, each long-term care resident would have the right to in-person, onsite access to a minimum of 2 designated support persons during any public health emergency, as defined, in which residents visitation rights are curtailed by a state or local order. The bill would grant the designated support person certain rights to access the facility to visit the resident, as specified. Under the bill, a residents right to visitation by designated support persons would include the right to leave the facility on outings, so long as reasonable infection control precautions are taken, as specified.The bill would authorize a facility to require designated support persons to adhere to infection control protocols not greater than required of care staff during a public health emergency. The bill would require a facility to provide personal protective equipment and testing resources to designated support persons if those resources have been made readily available to the facility by state or local entities.The bill would require a facility to provide certain infection control protocols to the residents, resident representatives, and designated support persons orally and in writing, as specified. The bill would prohibit a facility from requiring a designated support person to adhere to infection control protocols that have not been communicated.The bill would require the State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, to convene a working group, as specified, which will develop and make recommendations regarding long-term care facilities during public health emergencies to the Assembly Committee on Aging and Long Term-Care no later than November 30, 2023.Under the bill, a violation of these provisions would be treated as a violation of certain provisions relating to health facilities, long-term health care facilities, and residential care facilities for the elderly, as specified. By expanding the scope of existing crimes, the bill would impose a state-mandated local program.The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.This bill would declare that it is to take effect immediately as an urgency statute.Digest Key Vote: TWO_THIRDSMAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESNO Bill TextThe people of the State of California do enact as follows:SECTION 1. Chapter 2.47 (commencing with Section 1439.70) is added to Division 2 of the Health and Safety Code, to read: CHAPTER 2.47. Long-Term Care Facilities During Public Health Emergencies1439.70. For the purposes of this chapter, the following definitions apply:(a) Designated support person means an individual designated by a resident or resident representative to provide in-person, onsite support for a resident.(b) Long-term care facility means any of the facilities listed in Section 1418 of this code or subdivision (b) of Section 9701 of the Welfare and Institutions Code, unless excluded by either of those provisions.(c) Public health emergency means a public health-related condition that results in the declaration of a state of emergency or local emergency, as defined in Section 8558 of the Government Code, or the declaration of a health emergency or local health emergency, as described in Section 101080. A public health-related condition may include, but is not limited to, a natural disaster, an outbreak of an infectious disease, or a bioterrorist attack, if within the scope of Section 101080 of this code or Section 8558 of the Government Code.(d) Resident means a resident or patient of a long-term care facility.(e) Resident representative means an individual who has authority to act on behalf of the resident, including, but not limited to, a conservator, guardian, person authorized as agent in the residents advance health care directive, the residents spouse, registered domestic partner, or family member, a person designated by the resident to act as a representative, or other surrogate decisionmaker designated in accordance with statutory and case law.1439.71. (a) The State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, shall convene a working group comprised of stakeholders representing long-term care facility residents, consumer advocates, and long-term care facilities no later than May 1, 2023. (b) The working group shall develop recommendations regarding best practices for public health officials and long-term care facilities when developing policies related to long-term care facilities during public health emergencies. The recommendations shall include, but not be limited to, best practices for family and designated support person visitation policies, including the effects of limiting visitation on the health of long-term care residents.(c) The working group shall provide the recommendations to the Assembly Committee on Aging and Long-Term Care no later than November 30, 2023.SECTION 1.The Legislature finds and declares all of the following:(a)The COVID-19 pandemic has had a devastating impact on residents of long-term care facilities. In addition to sickness and death due to COVID-19 infections, residents suffered incalculable loss due to draconian visitation restrictions that separated residents from their families, friends, and essential support persons.(b)It is essential, at all times, for individuals residing in long-term care facilities to have access to family members and friends who provide critical supportive services, which may include, but are not limited to, emotional, mental, social, and physical support. The Legislature affirms that a resident having physical access to family members or friends who provide support is necessary to mitigating a decline in the residents physical, mental, and emotional well-being. Therefore, when a public health emergency precipitates government-ordered visitation restrictions, we deem it necessary to allow residents to have immediate and unscheduled physical access to designated support persons without restriction on time, frequency, physical contact, or proximity, with certain exceptions.(c)Support persons with access to in-person contact provide, among other things, companionship, psychosocial support, cognitive stimulation, communication assistance, assistance with daily living tasks, such as eating, dressing, and hygiene support, meaningful connection, relational continuity, decisionmaking assistance, transportation, and physical activities, and fulfill other personal needs for long-term care facility residents.(d)While designated support persons provide essential support to long-term care residents, their access should not be seen as a substitute for consistent, ongoing care from facility staff.SEC. 2.Chapter 2.47 (commencing with Section 1439.70) is added to Division 2 of the Health and Safety Code, to read:2.47.Resident-Designated Support Persons Act1439.70.For the purposes of this chapter, the following definitions apply:(a)Designated support person means an individual designated by a resident or resident representative to provide in-person, onsite support for a resident.(b)Facility staff means all individuals employed by, or contracted directly with, the long-term care facility and who provide care to residents.(c)Long-term care facility or facility means any of the facilities listed in Section 1418 of this code and subdivision (b) of Section 9701 of the Welfare and Institutions Code, unless excluded by either of those provisions.(d)Public health emergency means a public health-related condition that results in the declaration of a state of emergency or local emergency, as defined in Section 8558 of the Government Code, or the declaration of a health emergency or local health emergency, as described in Section 101080, and that triggers a state or local government order to restrict residents visitation rights in a long-term care facility. A public health-related condition may include, but is not limited to, a natural disaster, an outbreak of an infectious disease, or a bioterrorist attack, if within the scope of Section 101080 of this code or Section 8558 of the Government Code.(e)Resident means a resident or patient of a long-term care facility.(f)Resident representative means an individual who has authority to act on behalf of the resident, including, but not limited to, a conservator, guardian, person authorized as agent in the residents advance health care directive, the residents spouse, registered domestic partner, or family member, a person designated by the resident to act as a representative, or other surrogate decisionmaker designated in accordance with statutory and case law.1439.71.Subject to Section 1439.72, the following shall apply:(a)(1)Each long-term care resident shall have the right to in-person, onsite access to a minimum of two designated support persons during any public health emergency in which residents visitation rights are curtailed by a state or local order.(2)At the discretion of the resident or their representative, the designated support person shall have the right to enter the residents dwelling at any time and provide private support. The long-term care facility may limit the designated support persons access within the facility to the resident and to the areas in which the resident resides or receives care.(3)A long-term care facility shall allow individual residents to have, at any given time, at least one of their designated support persons be physically present.(b)A residents right to visitation by designated support persons includes the right to leave the facility on outings, so long as reasonable infection control precautions are taken. A resident who exercises this right to outings shall not be subject to quarantine upon their return to the facility, unless they fail to follow the same infection control protocols as staff or the resident has had a known exposure or has symptoms relative to the contagious disease related to the public health emergency.(c)A resident or their representative shall have the right to designate support persons immediately upon admission to a facility and anytime thereafter. A resident or their representative shall have the right to modify their designations at any time.(d)Selecting or modifying designated support persons shall in no way limit a residents right to other types of visitation accommodations if available at the facility during a public health emergency. This may include, but is not limited to, expansive end-of-life or compassionate care visits, socially distanced visits, virtual visits, or telephonic visits.1439.72.(a)A facility may require designated support persons to adhere to infection control protocols not greater than required of facility staff during a public health emergency for the duration of their visit. The facility shall provide personal protective equipment and testing resources to the designated support persons, to the extent that those resources have been made readily available to the facility by state or local entities for their use.(b)(1)A facility shall provide infection control protocols required of care staff, designated support persons, and other visitors to the residents, resident representatives, and residents designated support persons orally and in writing.(2)(A)The facility shall provide the required infection control protocols in the individuals primary or preferred language, to the extent practicable.(B)If the individual is hearing impaired or vision impaired, the facility shall provide the required protocols in an accessible format.(c)Any changes in infection control protocols shall be communicated, as soon as practically possible, to the residents, resident representatives, and residents designated support persons orally and in writing in the individuals primary or preferred language, to the extent practicable.(d)A facility may not require designated support persons to adhere to infection control protocols that have not been communicated as set forth in subdivisions (b) and (c). This does not preclude a long-term care facility from informing a designated support person upon their arrival of updated protocols or recent changes in protocols that impact their role as a designated support person.1439.73.The State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, shall convene a working group comprised of stakeholders representing long-term care facility residents, consumer advocates, and long-term care facilities no later than May 1, 2023. The working group shall develop recommendations regarding best practices for public health officials and long-term care facilities when developing policies related to long-term care facilities during public health emergencies. The recommendations shall include, but not be limited to, best practices for family and designated support person visitation policies, including the effects of limiting visitation on the health of long-term care residents. The workgroup shall provide recommendations to the Assembly Committee on Aging and Long Term-Care no later than November 30, 2023.1439.74.A violation of this chapter shall be treated as a violation under Chapter 2 (commencing with Section 1250), Chapter 2.4 (commencing with Section 1417), or Chapter 3.2 (commencing with Section 1569). For purposes of civil penalties, a violation of this chapter shall constitute a class B violation as defined in subdivision (e) of Section 1424 for long-term health care facilities, or shall be subject to a civil penalty as described in subdivision (a) of Section 1569.49 for residential care facilities for the elderly.SEC. 3.Section 1569.3185 is added to the Health and Safety Code, immediately following Section 1569.318, to read:1569.3185.Every residential care facility for the elderly shall abide by the provisions of the Resident-Designated Support Persons Act (Chapter 2.47 (commencing with Section 1439.70)).SEC. 4.No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.SEC. 5.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:To protect the visitation rights of residents of long-term care facilities and their ability to receive essential support from designated support persons during the COVID-19 state of emergency, it is necessary for this act to take effect immediately.
Amended IN Assembly May 19, 2022 Amended IN Assembly April 28, 2022 Amended IN Assembly April 20, 2022 Amended IN Assembly March 23, 2022 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Assembly Bill No. 2546Introduced by Assembly Member NazarianFebruary 17, 2022An act to add Section 1569.3185 to, and to add Chapter 2.47 (commencing with Section 1439.70) to Division 2 of, the Health and Safety Code, relating to long-term care facilities, and declaring the urgency thereof, to take effect immediately. Chapter 2.47 (commencing with Section 1439.70) to Division 2 of the Health and Safety Code, relating to long-term care facilities.LEGISLATIVE COUNSEL'S DIGESTAB 2546, as amended, Nazarian. Resident-Designated Support Persons Act. Long-term care facilities during public health emergencies.Existing law provides for the licensure and regulation of health facilities, including skilled nursing facilities and intermediate care facilities, by the State Department of Public Health. Existing law provides for the licensure and regulation of residential care facilities for the elderly by the State Department of Social Services. A violation of those provisions is generally a crime. Existing law establishes the Office of the State Long-Term Care Ombudsman, under the direction of the State Long-Term Care Ombudsman, in the California Department of Aging. Under existing law, the office has the responsibility of protecting and advocating for the rights and health and safety of long-term care facility residents, and in providing leadership, direction, and support to local long-term care ombudsman programs.Existing law sets forth the conditions for declaring a state of emergency by the Governor, a local emergency by the governing body of a local government, a health emergency by the State Public Health Officer, or a local health emergency by a local health officer, and the powers resulting from those declarations.This bill would require the State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, to convene a working group, with a specified composition, no later than May 1, 2023. The bill would require the working group to develop recommendations regarding best practices for public health officials and long-term care facilities, as defined, when developing policies, including certain visitation policies involving designated support persons, related to long-term care facilities during public health emergencies, as defined. The bill would require the working group to provide the recommendations to the Assembly Committee on Aging and Long-Term Care no later than November 30, 2023.This bill would enact the Resident-Designated Support Persons Act for purposes of residents of long-term care facilities, defined to include skilled nursing facilities and intermediate care facilities, among other specified health facilities, and to include residential care facilities for the elderly. Under the bill, each long-term care resident would have the right to in-person, onsite access to a minimum of 2 designated support persons during any public health emergency, as defined, in which residents visitation rights are curtailed by a state or local order. The bill would grant the designated support person certain rights to access the facility to visit the resident, as specified. Under the bill, a residents right to visitation by designated support persons would include the right to leave the facility on outings, so long as reasonable infection control precautions are taken, as specified.The bill would authorize a facility to require designated support persons to adhere to infection control protocols not greater than required of care staff during a public health emergency. The bill would require a facility to provide personal protective equipment and testing resources to designated support persons if those resources have been made readily available to the facility by state or local entities.The bill would require a facility to provide certain infection control protocols to the residents, resident representatives, and designated support persons orally and in writing, as specified. The bill would prohibit a facility from requiring a designated support person to adhere to infection control protocols that have not been communicated.The bill would require the State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, to convene a working group, as specified, which will develop and make recommendations regarding long-term care facilities during public health emergencies to the Assembly Committee on Aging and Long Term-Care no later than November 30, 2023.Under the bill, a violation of these provisions would be treated as a violation of certain provisions relating to health facilities, long-term health care facilities, and residential care facilities for the elderly, as specified. By expanding the scope of existing crimes, the bill would impose a state-mandated local program.The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.This bill would declare that it is to take effect immediately as an urgency statute.Digest Key Vote: TWO_THIRDSMAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESNO
Amended IN Assembly May 19, 2022 Amended IN Assembly April 28, 2022 Amended IN Assembly April 20, 2022 Amended IN Assembly March 23, 2022
Amended IN Assembly May 19, 2022
Amended IN Assembly April 28, 2022
Amended IN Assembly April 20, 2022
Amended IN Assembly March 23, 2022
CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION
Assembly Bill
No. 2546
Introduced by Assembly Member NazarianFebruary 17, 2022
Introduced by Assembly Member Nazarian
February 17, 2022
An act to add Section 1569.3185 to, and to add Chapter 2.47 (commencing with Section 1439.70) to Division 2 of, the Health and Safety Code, relating to long-term care facilities, and declaring the urgency thereof, to take effect immediately. Chapter 2.47 (commencing with Section 1439.70) to Division 2 of the Health and Safety Code, relating to long-term care facilities.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 2546, as amended, Nazarian. Resident-Designated Support Persons Act. Long-term care facilities during public health emergencies.
Existing law provides for the licensure and regulation of health facilities, including skilled nursing facilities and intermediate care facilities, by the State Department of Public Health. Existing law provides for the licensure and regulation of residential care facilities for the elderly by the State Department of Social Services. A violation of those provisions is generally a crime. Existing law establishes the Office of the State Long-Term Care Ombudsman, under the direction of the State Long-Term Care Ombudsman, in the California Department of Aging. Under existing law, the office has the responsibility of protecting and advocating for the rights and health and safety of long-term care facility residents, and in providing leadership, direction, and support to local long-term care ombudsman programs.Existing law sets forth the conditions for declaring a state of emergency by the Governor, a local emergency by the governing body of a local government, a health emergency by the State Public Health Officer, or a local health emergency by a local health officer, and the powers resulting from those declarations.This bill would require the State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, to convene a working group, with a specified composition, no later than May 1, 2023. The bill would require the working group to develop recommendations regarding best practices for public health officials and long-term care facilities, as defined, when developing policies, including certain visitation policies involving designated support persons, related to long-term care facilities during public health emergencies, as defined. The bill would require the working group to provide the recommendations to the Assembly Committee on Aging and Long-Term Care no later than November 30, 2023.This bill would enact the Resident-Designated Support Persons Act for purposes of residents of long-term care facilities, defined to include skilled nursing facilities and intermediate care facilities, among other specified health facilities, and to include residential care facilities for the elderly. Under the bill, each long-term care resident would have the right to in-person, onsite access to a minimum of 2 designated support persons during any public health emergency, as defined, in which residents visitation rights are curtailed by a state or local order. The bill would grant the designated support person certain rights to access the facility to visit the resident, as specified. Under the bill, a residents right to visitation by designated support persons would include the right to leave the facility on outings, so long as reasonable infection control precautions are taken, as specified.The bill would authorize a facility to require designated support persons to adhere to infection control protocols not greater than required of care staff during a public health emergency. The bill would require a facility to provide personal protective equipment and testing resources to designated support persons if those resources have been made readily available to the facility by state or local entities.The bill would require a facility to provide certain infection control protocols to the residents, resident representatives, and designated support persons orally and in writing, as specified. The bill would prohibit a facility from requiring a designated support person to adhere to infection control protocols that have not been communicated.The bill would require the State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, to convene a working group, as specified, which will develop and make recommendations regarding long-term care facilities during public health emergencies to the Assembly Committee on Aging and Long Term-Care no later than November 30, 2023.Under the bill, a violation of these provisions would be treated as a violation of certain provisions relating to health facilities, long-term health care facilities, and residential care facilities for the elderly, as specified. By expanding the scope of existing crimes, the bill would impose a state-mandated local program.The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.This bill would declare that it is to take effect immediately as an urgency statute.
Existing law provides for the licensure and regulation of health facilities, including skilled nursing facilities and intermediate care facilities, by the State Department of Public Health. Existing law provides for the licensure and regulation of residential care facilities for the elderly by the State Department of Social Services. A violation of those provisions is generally a crime.
Existing law establishes the Office of the State Long-Term Care Ombudsman, under the direction of the State Long-Term Care Ombudsman, in the California Department of Aging. Under existing law, the office has the responsibility of protecting and advocating for the rights and health and safety of long-term care facility residents, and in providing leadership, direction, and support to local long-term care ombudsman programs.
Existing law sets forth the conditions for declaring a state of emergency by the Governor, a local emergency by the governing body of a local government, a health emergency by the State Public Health Officer, or a local health emergency by a local health officer, and the powers resulting from those declarations.
This bill would require the State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, to convene a working group, with a specified composition, no later than May 1, 2023. The bill would require the working group to develop recommendations regarding best practices for public health officials and long-term care facilities, as defined, when developing policies, including certain visitation policies involving designated support persons, related to long-term care facilities during public health emergencies, as defined. The bill would require the working group to provide the recommendations to the Assembly Committee on Aging and Long-Term Care no later than November 30, 2023.
This bill would enact the Resident-Designated Support Persons Act for purposes of residents of long-term care facilities, defined to include skilled nursing facilities and intermediate care facilities, among other specified health facilities, and to include residential care facilities for the elderly. Under the bill, each long-term care resident would have the right to in-person, onsite access to a minimum of 2 designated support persons during any public health emergency, as defined, in which residents visitation rights are curtailed by a state or local order. The bill would grant the designated support person certain rights to access the facility to visit the resident, as specified. Under the bill, a residents right to visitation by designated support persons would include the right to leave the facility on outings, so long as reasonable infection control precautions are taken, as specified.
The bill would authorize a facility to require designated support persons to adhere to infection control protocols not greater than required of care staff during a public health emergency. The bill would require a facility to provide personal protective equipment and testing resources to designated support persons if those resources have been made readily available to the facility by state or local entities.
The bill would require a facility to provide certain infection control protocols to the residents, resident representatives, and designated support persons orally and in writing, as specified. The bill would prohibit a facility from requiring a designated support person to adhere to infection control protocols that have not been communicated.
The bill would require the State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, to convene a working group, as specified, which will develop and make recommendations regarding long-term care facilities during public health emergencies to the Assembly Committee on Aging and Long Term-Care no later than November 30, 2023.
Under the bill, a violation of these provisions would be treated as a violation of certain provisions relating to health facilities, long-term health care facilities, and residential care facilities for the elderly, as specified. By expanding the scope of existing crimes, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
This bill would declare that it is to take effect immediately as an urgency statute.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Chapter 2.47 (commencing with Section 1439.70) is added to Division 2 of the Health and Safety Code, to read: CHAPTER 2.47. Long-Term Care Facilities During Public Health Emergencies1439.70. For the purposes of this chapter, the following definitions apply:(a) Designated support person means an individual designated by a resident or resident representative to provide in-person, onsite support for a resident.(b) Long-term care facility means any of the facilities listed in Section 1418 of this code or subdivision (b) of Section 9701 of the Welfare and Institutions Code, unless excluded by either of those provisions.(c) Public health emergency means a public health-related condition that results in the declaration of a state of emergency or local emergency, as defined in Section 8558 of the Government Code, or the declaration of a health emergency or local health emergency, as described in Section 101080. A public health-related condition may include, but is not limited to, a natural disaster, an outbreak of an infectious disease, or a bioterrorist attack, if within the scope of Section 101080 of this code or Section 8558 of the Government Code.(d) Resident means a resident or patient of a long-term care facility.(e) Resident representative means an individual who has authority to act on behalf of the resident, including, but not limited to, a conservator, guardian, person authorized as agent in the residents advance health care directive, the residents spouse, registered domestic partner, or family member, a person designated by the resident to act as a representative, or other surrogate decisionmaker designated in accordance with statutory and case law.1439.71. (a) The State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, shall convene a working group comprised of stakeholders representing long-term care facility residents, consumer advocates, and long-term care facilities no later than May 1, 2023. (b) The working group shall develop recommendations regarding best practices for public health officials and long-term care facilities when developing policies related to long-term care facilities during public health emergencies. The recommendations shall include, but not be limited to, best practices for family and designated support person visitation policies, including the effects of limiting visitation on the health of long-term care residents.(c) The working group shall provide the recommendations to the Assembly Committee on Aging and Long-Term Care no later than November 30, 2023.SECTION 1.The Legislature finds and declares all of the following:(a)The COVID-19 pandemic has had a devastating impact on residents of long-term care facilities. In addition to sickness and death due to COVID-19 infections, residents suffered incalculable loss due to draconian visitation restrictions that separated residents from their families, friends, and essential support persons.(b)It is essential, at all times, for individuals residing in long-term care facilities to have access to family members and friends who provide critical supportive services, which may include, but are not limited to, emotional, mental, social, and physical support. The Legislature affirms that a resident having physical access to family members or friends who provide support is necessary to mitigating a decline in the residents physical, mental, and emotional well-being. Therefore, when a public health emergency precipitates government-ordered visitation restrictions, we deem it necessary to allow residents to have immediate and unscheduled physical access to designated support persons without restriction on time, frequency, physical contact, or proximity, with certain exceptions.(c)Support persons with access to in-person contact provide, among other things, companionship, psychosocial support, cognitive stimulation, communication assistance, assistance with daily living tasks, such as eating, dressing, and hygiene support, meaningful connection, relational continuity, decisionmaking assistance, transportation, and physical activities, and fulfill other personal needs for long-term care facility residents.(d)While designated support persons provide essential support to long-term care residents, their access should not be seen as a substitute for consistent, ongoing care from facility staff.SEC. 2.Chapter 2.47 (commencing with Section 1439.70) is added to Division 2 of the Health and Safety Code, to read:2.47.Resident-Designated Support Persons Act1439.70.For the purposes of this chapter, the following definitions apply:(a)Designated support person means an individual designated by a resident or resident representative to provide in-person, onsite support for a resident.(b)Facility staff means all individuals employed by, or contracted directly with, the long-term care facility and who provide care to residents.(c)Long-term care facility or facility means any of the facilities listed in Section 1418 of this code and subdivision (b) of Section 9701 of the Welfare and Institutions Code, unless excluded by either of those provisions.(d)Public health emergency means a public health-related condition that results in the declaration of a state of emergency or local emergency, as defined in Section 8558 of the Government Code, or the declaration of a health emergency or local health emergency, as described in Section 101080, and that triggers a state or local government order to restrict residents visitation rights in a long-term care facility. A public health-related condition may include, but is not limited to, a natural disaster, an outbreak of an infectious disease, or a bioterrorist attack, if within the scope of Section 101080 of this code or Section 8558 of the Government Code.(e)Resident means a resident or patient of a long-term care facility.(f)Resident representative means an individual who has authority to act on behalf of the resident, including, but not limited to, a conservator, guardian, person authorized as agent in the residents advance health care directive, the residents spouse, registered domestic partner, or family member, a person designated by the resident to act as a representative, or other surrogate decisionmaker designated in accordance with statutory and case law.1439.71.Subject to Section 1439.72, the following shall apply:(a)(1)Each long-term care resident shall have the right to in-person, onsite access to a minimum of two designated support persons during any public health emergency in which residents visitation rights are curtailed by a state or local order.(2)At the discretion of the resident or their representative, the designated support person shall have the right to enter the residents dwelling at any time and provide private support. The long-term care facility may limit the designated support persons access within the facility to the resident and to the areas in which the resident resides or receives care.(3)A long-term care facility shall allow individual residents to have, at any given time, at least one of their designated support persons be physically present.(b)A residents right to visitation by designated support persons includes the right to leave the facility on outings, so long as reasonable infection control precautions are taken. A resident who exercises this right to outings shall not be subject to quarantine upon their return to the facility, unless they fail to follow the same infection control protocols as staff or the resident has had a known exposure or has symptoms relative to the contagious disease related to the public health emergency.(c)A resident or their representative shall have the right to designate support persons immediately upon admission to a facility and anytime thereafter. A resident or their representative shall have the right to modify their designations at any time.(d)Selecting or modifying designated support persons shall in no way limit a residents right to other types of visitation accommodations if available at the facility during a public health emergency. This may include, but is not limited to, expansive end-of-life or compassionate care visits, socially distanced visits, virtual visits, or telephonic visits.1439.72.(a)A facility may require designated support persons to adhere to infection control protocols not greater than required of facility staff during a public health emergency for the duration of their visit. The facility shall provide personal protective equipment and testing resources to the designated support persons, to the extent that those resources have been made readily available to the facility by state or local entities for their use.(b)(1)A facility shall provide infection control protocols required of care staff, designated support persons, and other visitors to the residents, resident representatives, and residents designated support persons orally and in writing.(2)(A)The facility shall provide the required infection control protocols in the individuals primary or preferred language, to the extent practicable.(B)If the individual is hearing impaired or vision impaired, the facility shall provide the required protocols in an accessible format.(c)Any changes in infection control protocols shall be communicated, as soon as practically possible, to the residents, resident representatives, and residents designated support persons orally and in writing in the individuals primary or preferred language, to the extent practicable.(d)A facility may not require designated support persons to adhere to infection control protocols that have not been communicated as set forth in subdivisions (b) and (c). This does not preclude a long-term care facility from informing a designated support person upon their arrival of updated protocols or recent changes in protocols that impact their role as a designated support person.1439.73.The State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, shall convene a working group comprised of stakeholders representing long-term care facility residents, consumer advocates, and long-term care facilities no later than May 1, 2023. The working group shall develop recommendations regarding best practices for public health officials and long-term care facilities when developing policies related to long-term care facilities during public health emergencies. The recommendations shall include, but not be limited to, best practices for family and designated support person visitation policies, including the effects of limiting visitation on the health of long-term care residents. The workgroup shall provide recommendations to the Assembly Committee on Aging and Long Term-Care no later than November 30, 2023.1439.74.A violation of this chapter shall be treated as a violation under Chapter 2 (commencing with Section 1250), Chapter 2.4 (commencing with Section 1417), or Chapter 3.2 (commencing with Section 1569). For purposes of civil penalties, a violation of this chapter shall constitute a class B violation as defined in subdivision (e) of Section 1424 for long-term health care facilities, or shall be subject to a civil penalty as described in subdivision (a) of Section 1569.49 for residential care facilities for the elderly.SEC. 3.Section 1569.3185 is added to the Health and Safety Code, immediately following Section 1569.318, to read:1569.3185.Every residential care facility for the elderly shall abide by the provisions of the Resident-Designated Support Persons Act (Chapter 2.47 (commencing with Section 1439.70)).SEC. 4.No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.SEC. 5.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:To protect the visitation rights of residents of long-term care facilities and their ability to receive essential support from designated support persons during the COVID-19 state of emergency, it is necessary for this act to take effect immediately.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Chapter 2.47 (commencing with Section 1439.70) is added to Division 2 of the Health and Safety Code, to read: CHAPTER 2.47. Long-Term Care Facilities During Public Health Emergencies1439.70. For the purposes of this chapter, the following definitions apply:(a) Designated support person means an individual designated by a resident or resident representative to provide in-person, onsite support for a resident.(b) Long-term care facility means any of the facilities listed in Section 1418 of this code or subdivision (b) of Section 9701 of the Welfare and Institutions Code, unless excluded by either of those provisions.(c) Public health emergency means a public health-related condition that results in the declaration of a state of emergency or local emergency, as defined in Section 8558 of the Government Code, or the declaration of a health emergency or local health emergency, as described in Section 101080. A public health-related condition may include, but is not limited to, a natural disaster, an outbreak of an infectious disease, or a bioterrorist attack, if within the scope of Section 101080 of this code or Section 8558 of the Government Code.(d) Resident means a resident or patient of a long-term care facility.(e) Resident representative means an individual who has authority to act on behalf of the resident, including, but not limited to, a conservator, guardian, person authorized as agent in the residents advance health care directive, the residents spouse, registered domestic partner, or family member, a person designated by the resident to act as a representative, or other surrogate decisionmaker designated in accordance with statutory and case law.1439.71. (a) The State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, shall convene a working group comprised of stakeholders representing long-term care facility residents, consumer advocates, and long-term care facilities no later than May 1, 2023. (b) The working group shall develop recommendations regarding best practices for public health officials and long-term care facilities when developing policies related to long-term care facilities during public health emergencies. The recommendations shall include, but not be limited to, best practices for family and designated support person visitation policies, including the effects of limiting visitation on the health of long-term care residents.(c) The working group shall provide the recommendations to the Assembly Committee on Aging and Long-Term Care no later than November 30, 2023.
SECTION 1. Chapter 2.47 (commencing with Section 1439.70) is added to Division 2 of the Health and Safety Code, to read:
### SECTION 1.
CHAPTER 2.47. Long-Term Care Facilities During Public Health Emergencies1439.70. For the purposes of this chapter, the following definitions apply:(a) Designated support person means an individual designated by a resident or resident representative to provide in-person, onsite support for a resident.(b) Long-term care facility means any of the facilities listed in Section 1418 of this code or subdivision (b) of Section 9701 of the Welfare and Institutions Code, unless excluded by either of those provisions.(c) Public health emergency means a public health-related condition that results in the declaration of a state of emergency or local emergency, as defined in Section 8558 of the Government Code, or the declaration of a health emergency or local health emergency, as described in Section 101080. A public health-related condition may include, but is not limited to, a natural disaster, an outbreak of an infectious disease, or a bioterrorist attack, if within the scope of Section 101080 of this code or Section 8558 of the Government Code.(d) Resident means a resident or patient of a long-term care facility.(e) Resident representative means an individual who has authority to act on behalf of the resident, including, but not limited to, a conservator, guardian, person authorized as agent in the residents advance health care directive, the residents spouse, registered domestic partner, or family member, a person designated by the resident to act as a representative, or other surrogate decisionmaker designated in accordance with statutory and case law.1439.71. (a) The State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, shall convene a working group comprised of stakeholders representing long-term care facility residents, consumer advocates, and long-term care facilities no later than May 1, 2023. (b) The working group shall develop recommendations regarding best practices for public health officials and long-term care facilities when developing policies related to long-term care facilities during public health emergencies. The recommendations shall include, but not be limited to, best practices for family and designated support person visitation policies, including the effects of limiting visitation on the health of long-term care residents.(c) The working group shall provide the recommendations to the Assembly Committee on Aging and Long-Term Care no later than November 30, 2023.
CHAPTER 2.47. Long-Term Care Facilities During Public Health Emergencies1439.70. For the purposes of this chapter, the following definitions apply:(a) Designated support person means an individual designated by a resident or resident representative to provide in-person, onsite support for a resident.(b) Long-term care facility means any of the facilities listed in Section 1418 of this code or subdivision (b) of Section 9701 of the Welfare and Institutions Code, unless excluded by either of those provisions.(c) Public health emergency means a public health-related condition that results in the declaration of a state of emergency or local emergency, as defined in Section 8558 of the Government Code, or the declaration of a health emergency or local health emergency, as described in Section 101080. A public health-related condition may include, but is not limited to, a natural disaster, an outbreak of an infectious disease, or a bioterrorist attack, if within the scope of Section 101080 of this code or Section 8558 of the Government Code.(d) Resident means a resident or patient of a long-term care facility.(e) Resident representative means an individual who has authority to act on behalf of the resident, including, but not limited to, a conservator, guardian, person authorized as agent in the residents advance health care directive, the residents spouse, registered domestic partner, or family member, a person designated by the resident to act as a representative, or other surrogate decisionmaker designated in accordance with statutory and case law.1439.71. (a) The State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, shall convene a working group comprised of stakeholders representing long-term care facility residents, consumer advocates, and long-term care facilities no later than May 1, 2023. (b) The working group shall develop recommendations regarding best practices for public health officials and long-term care facilities when developing policies related to long-term care facilities during public health emergencies. The recommendations shall include, but not be limited to, best practices for family and designated support person visitation policies, including the effects of limiting visitation on the health of long-term care residents.(c) The working group shall provide the recommendations to the Assembly Committee on Aging and Long-Term Care no later than November 30, 2023.
CHAPTER 2.47. Long-Term Care Facilities During Public Health Emergencies
CHAPTER 2.47. Long-Term Care Facilities During Public Health Emergencies
1439.70. For the purposes of this chapter, the following definitions apply:(a) Designated support person means an individual designated by a resident or resident representative to provide in-person, onsite support for a resident.(b) Long-term care facility means any of the facilities listed in Section 1418 of this code or subdivision (b) of Section 9701 of the Welfare and Institutions Code, unless excluded by either of those provisions.(c) Public health emergency means a public health-related condition that results in the declaration of a state of emergency or local emergency, as defined in Section 8558 of the Government Code, or the declaration of a health emergency or local health emergency, as described in Section 101080. A public health-related condition may include, but is not limited to, a natural disaster, an outbreak of an infectious disease, or a bioterrorist attack, if within the scope of Section 101080 of this code or Section 8558 of the Government Code.(d) Resident means a resident or patient of a long-term care facility.(e) Resident representative means an individual who has authority to act on behalf of the resident, including, but not limited to, a conservator, guardian, person authorized as agent in the residents advance health care directive, the residents spouse, registered domestic partner, or family member, a person designated by the resident to act as a representative, or other surrogate decisionmaker designated in accordance with statutory and case law.
1439.70. For the purposes of this chapter, the following definitions apply:
(a) Designated support person means an individual designated by a resident or resident representative to provide in-person, onsite support for a resident.
(b) Long-term care facility means any of the facilities listed in Section 1418 of this code or subdivision (b) of Section 9701 of the Welfare and Institutions Code, unless excluded by either of those provisions.
(c) Public health emergency means a public health-related condition that results in the declaration of a state of emergency or local emergency, as defined in Section 8558 of the Government Code, or the declaration of a health emergency or local health emergency, as described in Section 101080. A public health-related condition may include, but is not limited to, a natural disaster, an outbreak of an infectious disease, or a bioterrorist attack, if within the scope of Section 101080 of this code or Section 8558 of the Government Code.
(d) Resident means a resident or patient of a long-term care facility.
(e) Resident representative means an individual who has authority to act on behalf of the resident, including, but not limited to, a conservator, guardian, person authorized as agent in the residents advance health care directive, the residents spouse, registered domestic partner, or family member, a person designated by the resident to act as a representative, or other surrogate decisionmaker designated in accordance with statutory and case law.
1439.71. (a) The State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, shall convene a working group comprised of stakeholders representing long-term care facility residents, consumer advocates, and long-term care facilities no later than May 1, 2023. (b) The working group shall develop recommendations regarding best practices for public health officials and long-term care facilities when developing policies related to long-term care facilities during public health emergencies. The recommendations shall include, but not be limited to, best practices for family and designated support person visitation policies, including the effects of limiting visitation on the health of long-term care residents.(c) The working group shall provide the recommendations to the Assembly Committee on Aging and Long-Term Care no later than November 30, 2023.
1439.71. (a) The State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, shall convene a working group comprised of stakeholders representing long-term care facility residents, consumer advocates, and long-term care facilities no later than May 1, 2023.
(b) The working group shall develop recommendations regarding best practices for public health officials and long-term care facilities when developing policies related to long-term care facilities during public health emergencies. The recommendations shall include, but not be limited to, best practices for family and designated support person visitation policies, including the effects of limiting visitation on the health of long-term care residents.
(c) The working group shall provide the recommendations to the Assembly Committee on Aging and Long-Term Care no later than November 30, 2023.
The Legislature finds and declares all of the following:
(a)The COVID-19 pandemic has had a devastating impact on residents of long-term care facilities. In addition to sickness and death due to COVID-19 infections, residents suffered incalculable loss due to draconian visitation restrictions that separated residents from their families, friends, and essential support persons.
(b)It is essential, at all times, for individuals residing in long-term care facilities to have access to family members and friends who provide critical supportive services, which may include, but are not limited to, emotional, mental, social, and physical support. The Legislature affirms that a resident having physical access to family members or friends who provide support is necessary to mitigating a decline in the residents physical, mental, and emotional well-being. Therefore, when a public health emergency precipitates government-ordered visitation restrictions, we deem it necessary to allow residents to have immediate and unscheduled physical access to designated support persons without restriction on time, frequency, physical contact, or proximity, with certain exceptions.
(c)Support persons with access to in-person contact provide, among other things, companionship, psychosocial support, cognitive stimulation, communication assistance, assistance with daily living tasks, such as eating, dressing, and hygiene support, meaningful connection, relational continuity, decisionmaking assistance, transportation, and physical activities, and fulfill other personal needs for long-term care facility residents.
(d)While designated support persons provide essential support to long-term care residents, their access should not be seen as a substitute for consistent, ongoing care from facility staff.
For the purposes of this chapter, the following definitions apply:
(a)Designated support person means an individual designated by a resident or resident representative to provide in-person, onsite support for a resident.
(b)Facility staff means all individuals employed by, or contracted directly with, the long-term care facility and who provide care to residents.
(c)Long-term care facility or facility means any of the facilities listed in Section 1418 of this code and subdivision (b) of Section 9701 of the Welfare and Institutions Code, unless excluded by either of those provisions.
(d)Public health emergency means a public health-related condition that results in the declaration of a state of emergency or local emergency, as defined in Section 8558 of the Government Code, or the declaration of a health emergency or local health emergency, as described in Section 101080, and that triggers a state or local government order to restrict residents visitation rights in a long-term care facility. A public health-related condition may include, but is not limited to, a natural disaster, an outbreak of an infectious disease, or a bioterrorist attack, if within the scope of Section 101080 of this code or Section 8558 of the Government Code.
(e)Resident means a resident or patient of a long-term care facility.
(f)Resident representative means an individual who has authority to act on behalf of the resident, including, but not limited to, a conservator, guardian, person authorized as agent in the residents advance health care directive, the residents spouse, registered domestic partner, or family member, a person designated by the resident to act as a representative, or other surrogate decisionmaker designated in accordance with statutory and case law.
Subject to Section 1439.72, the following shall apply:
(a)(1)Each long-term care resident shall have the right to in-person, onsite access to a minimum of two designated support persons during any public health emergency in which residents visitation rights are curtailed by a state or local order.
(2)At the discretion of the resident or their representative, the designated support person shall have the right to enter the residents dwelling at any time and provide private support. The long-term care facility may limit the designated support persons access within the facility to the resident and to the areas in which the resident resides or receives care.
(3)A long-term care facility shall allow individual residents to have, at any given time, at least one of their designated support persons be physically present.
(b)A residents right to visitation by designated support persons includes the right to leave the facility on outings, so long as reasonable infection control precautions are taken. A resident who exercises this right to outings shall not be subject to quarantine upon their return to the facility, unless they fail to follow the same infection control protocols as staff or the resident has had a known exposure or has symptoms relative to the contagious disease related to the public health emergency.
(c)A resident or their representative shall have the right to designate support persons immediately upon admission to a facility and anytime thereafter. A resident or their representative shall have the right to modify their designations at any time.
(d)Selecting or modifying designated support persons shall in no way limit a residents right to other types of visitation accommodations if available at the facility during a public health emergency. This may include, but is not limited to, expansive end-of-life or compassionate care visits, socially distanced visits, virtual visits, or telephonic visits.
(a)A facility may require designated support persons to adhere to infection control protocols not greater than required of facility staff during a public health emergency for the duration of their visit. The facility shall provide personal protective equipment and testing resources to the designated support persons, to the extent that those resources have been made readily available to the facility by state or local entities for their use.
(b)(1)A facility shall provide infection control protocols required of care staff, designated support persons, and other visitors to the residents, resident representatives, and residents designated support persons orally and in writing.
(2)(A)The facility shall provide the required infection control protocols in the individuals primary or preferred language, to the extent practicable.
(B)If the individual is hearing impaired or vision impaired, the facility shall provide the required protocols in an accessible format.
(c)Any changes in infection control protocols shall be communicated, as soon as practically possible, to the residents, resident representatives, and residents designated support persons orally and in writing in the individuals primary or preferred language, to the extent practicable.
(d)A facility may not require designated support persons to adhere to infection control protocols that have not been communicated as set forth in subdivisions (b) and (c). This does not preclude a long-term care facility from informing a designated support person upon their arrival of updated protocols or recent changes in protocols that impact their role as a designated support person.
The State Department of Public Health, the State Department of Social Services, and the State Long-Term Care Ombudsman, or their designee, shall convene a working group comprised of stakeholders representing long-term care facility residents, consumer advocates, and long-term care facilities no later than May 1, 2023. The working group shall develop recommendations regarding best practices for public health officials and long-term care facilities when developing policies related to long-term care facilities during public health emergencies. The recommendations shall include, but not be limited to, best practices for family and designated support person visitation policies, including the effects of limiting visitation on the health of long-term care residents. The workgroup shall provide recommendations to the Assembly Committee on Aging and Long Term-Care no later than November 30, 2023.
A violation of this chapter shall be treated as a violation under Chapter 2 (commencing with Section 1250), Chapter 2.4 (commencing with Section 1417), or Chapter 3.2 (commencing with Section 1569). For purposes of civil penalties, a violation of this chapter shall constitute a class B violation as defined in subdivision (e) of Section 1424 for long-term health care facilities, or shall be subject to a civil penalty as described in subdivision (a) of Section 1569.49 for residential care facilities for the elderly.
Every residential care facility for the elderly shall abide by the provisions of the Resident-Designated Support Persons Act (Chapter 2.47 (commencing with Section 1439.70)).
No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.
This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:
To protect the visitation rights of residents of long-term care facilities and their ability to receive essential support from designated support persons during the COVID-19 state of emergency, it is necessary for this act to take effect immediately.