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General Assembly Substitute Bill No. 6634
January Session, 2021
AN ACT CONCERNING ES SENTIAL SUPPORT PERS ONS AND A
STATE-WIDE VISITATION POLICY FOR RESIDENTS OF LONG-TERM
CARE FACILITIES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective from passage) (a) As used in this section, 1
section 2 of this act and subsection (b) of section 17a-408 of the general 2
statutes, as amended by this act, (1) "primary essential support person" 3
means a person designated by a long-term care facility resident, or a 4
resident representative, who may visit with the resident in accordance 5
with rules set by the Commissioner of Public Health to provide essential 6
support as reflected in the resident's person-centered plan of care; (2) 7
"essential support" means support that includes, but is not limited to, 8
(A) assistance with activities of daily living, and (B) physical, emotional, 9
psychological and socialization support for the resident; (3) "secondary 10
essential support person" means a person designated by the resident, or 11
resident representative, to serve as a backup to a primary essential 12
support person; (4) "person-centered plan of care" means a care plan for 13
a resident developed by a resident or resident representative in 14
consultation with health professionals that focuses on the resident's 15
physical, emotional, psychological and socialization needs and includes 16
a primary essential support person or secondary essential support 17
person designated by a resident; and (5) "long-term care facility" means 18
a nursing home facility, as defined in section 19a-490 of the general 19 Substitute Bill No. 6634
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statutes, or a managed residential community, as defined in section 19a-20
693 of the general statutes that provides services offered by an assisted 21
living services agency, as defined in section 19a-490 of the general 22
statutes. 23
(b) A long-term care facility resident, or a resident representative, 24
may designate a primary essential support person and a secondary 25
essential support person who may visit the resident despite general 26
visitation restrictions imposed on other visitors, provided the primary 27
essential support person or secondary essential support person 28
complies with any rules promulgated by the Commissioner of Public 29
Health pursuant to section 2 of this act to protect the health, safety and 30
well-being of long-term care facility residents. 31
Sec. 2. (NEW) (Effective from passage) (a) The Commissioner of Public 32
Health shall establish a state-wide policy for visitation with a long-term 33
care facility resident. The policy shall be applicable to all long-term care 34
facilities and shall incorporate a long-term care facility resident's need 35
for health, safety and well-being, including, but not limited to, the 36
essential support provided by a primary or secondary essential support 37
person. 38
(b) In the event of a public health emergency declared by the 39
Governor in accordance with section 19a-131a of the general statutes, 40
the Commissioner of Public Health shall, in accordance with applicable 41
federal requirements and guidance, set forth requirements for visitation 42
with a long-term care facility resident, provided such requirements 43
incorporate a resident's need for essential support provided by a 44
primary or secondary essential support person and other visitors. Such 45
requirements shall include, but need not be limited to, the 46
circumstances, if any, under which a long-term care facility may restrict 47
visitors, including, but not limited to, primary essential support persons 48
and secondary essential support persons designated by a long-term care 49
facility resident. The requirements shall address, at a minimum: 50
(1) Arrangements for visitation with a long-term care facility resident 51 Substitute Bill No. 6634
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through various means, including, but not limited to, (A) outdoor 52
visitation, (B) the use of technologies to facilitate virtual visitation, and 53
(C) indoor visitation that is allowed whether or not the resident is 54
nearing the end of his or her life, as determined by the resident's 55
attending health care professionals; 56
(2) The needs of a long-term care facility resident for physical, 57
emotional, psychological and socialization support based on the 58
resident's person-centered plan of care; 59
(3) Safety protocols for all visitors to a long-term care facility, 60
including, but not limited to, primary or secondary essential support 61
persons, in the event of a communicable disease outbreak or public 62
health emergency declared by the Governor in accordance with section 63
19a-131a of the general statutes; 64
(4) Permission for visitation with a long-term care facility resident by 65
a primary essential support person or secondary essential support 66
person despite general visitation restrictions, provided the primary 67
essential support person or secondary essential support person 68
complies with safety protocols established by the commissioner and the 69
commissioner determines that such visitation will benefit the health, 70
safety and well-being of the resident; and 71
(5) In the event a long-term care facility resident has not designated a 72
primary essential support person, a requirement that staff of a long-term 73
care facility work with the resident or a resident representative, a family 74
member of the resident or the State Ombudsman appointed pursuant to 75
section 17a-405 of the general statutes to identify a primary essential 76
support person and provide access by such person to the resident. 77
Sec. 3. Subsection (b) of section 17a-408 of the general statutes is 78
repealed and the following is substituted in lieu thereof (Effective from 79
passage): 80
(b) The State Ombudsman shall serve on a full-time basis, and shall 81
personally or through representatives of the office: 82 Substitute Bill No. 6634
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(1) Identify, investigate and resolve complaints that: 83
(A) Are made by, or on behalf of, residents or, as to complaints 84
involving the application for admission to a long-term care facility, by 85
or on behalf of applicants; and 86
(B) Relate to action, inaction or decisions that may adversely affect 87
the health, safety, welfare or rights of the residents, including the 88
welfare and rights of the residents with respect to the appointment and 89
activities of guardians and representative payees, of (i) providers or 90
representatives of providers of long-term care services, (ii) public 91
agencies, or (iii) health and social service agencies; 92
(2) Provide services to protect the health, safety, welfare and rights of 93
the residents, including, but not limited to, services designed to address 94
the impact of socialization, visitation and the role of primary or 95
secondary essential support persons on the health, safety and well-being 96
of residents; 97
(3) Inform the residents about means of obtaining services provided 98
by providers or agencies described in subparagraph (B) of subdivision 99
(1) of this subsection or services described in subdivision (2) of this 100
subsection; 101
(4) Ensure that the residents and, as to issues involving applications 102
for admission to long-term care facilities, applicants have regular and 103
timely access to the services provided through the office and that the 104
residents and complainants receive timely responses from 105
representatives of the office to complaints; 106
(5) Represent the interests of the residents, and of applicants in 107
relation to issues concerning applications to long-term care facilities, 108
before governmental agencies and seek administrative, legal and other 109
remedies to protect the health, safety, welfare and rights of the residents; 110
(6) Provide administrative and technical assistance to representatives 111
of the office and training in areas including, but not limited to, 112 Substitute Bill No. 6634
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Alzheimer's disease and dementia symptoms and care; 113
(7) (A) Analyze, comment on and monitor the development and 114
implementation of federal, state and local laws, regulations, and other 115
governmental policies and actions that pertain to the health, safety, 116
welfare and rights of the residents with respect to the adequacy of long-117
term care facilities and services in this state and to the rights of 118
applicants in relation to applications to long-term care facilities; 119
(B) Recommend any changes in such laws, regulations, policies and 120
actions as the office determines to be appropriate; and 121
(C) Facilitate public comment on such laws, regulations, policies and 122
actions; 123
(8) Advocate for: 124
(A) Any changes in federal, state and local laws, regulations and 125
other governmental policies and actions that pertain to the health, 126
safety, welfare and rights of residents with respect to the adequacy of 127
long-term care facilities and services in this state and to the health, 128
safety, welfare and rights of applicants which the State Ombudsman 129
determines to be appropriate; 130
(B) Appropriate action by groups or agencies with jurisdictional 131
authority to deal with problems affecting individual residents and the 132
general resident population and applicants in relation to issues 133
concerning applications to long-term care facilities; and 134
(C) The enactment of legislative recommendations by the General 135
Assembly and of regulatory recommendations by commissioners of 136
Connecticut state agencies; 137
(9) (A) Provide for training representatives of the office; 138
(B) Promote the development of citizen organizations to participate 139
in the program; and 140 Substitute Bill No. 6634
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(C) Provide technical support for the development of resident and 141
family councils to protect the well-being and rights of residents; 142
(10) Coordinate ombudsman services with the protection and 143
advocacy systems for individuals with developmental disabilities and 144
mental illnesses established under (A) Part A of the Development 145
Disabilities Assistance and Bill of Rights Act (42 USC 6001, et seq.), and 146
(B) The Protection and Advocacy for Mentally Ill Individuals Act of 1986 147
(42 USC 10801 et seq.); 148
(11) Coordinate, to the greatest extent possible, ombudsman services 149
with legal assistance provided under Section 306(a)(2)(C) of the federal 150
Older Americans Act of 1965, (42 USC 3026(a)(2)(C)) as amended from 151
time to time, through the adoption of memoranda of understanding and 152
other means; 153
(12) Create, and periodically update as needed, a training manual for 154
nursing home facilities identified in section 19a-522c that provides 155
guidance on structuring and implementing the training required by said 156
section; 157
(13) Develop policies and procedures regarding the communication 158
and documentation of informed consent in the case of resident 159
complaints, including, but not limited to, the use of auxiliary aids and 160
services or the use of a resident representative; and 161
(14) Carry out such other activities and duties as may be required 162
under federal law. 163
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage New section
Sec. 2 from passage New section
Sec. 3 from passage 17a-408(b)
Substitute Bill No. 6634
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Statement of Legislative Commissioners:
In Sections 1 to 3, inclusive, "essential support person", "an essential
support person" or "any essential support person" was changed to
"primary essential support person" or "a primary essential support
person" and "essential support persons" was changed to "primary or
secondary essential support persons" for clarity and internal
consistency.
HS Joint Favorable Subst. -LCO