Substitute House Bill No. 6634
Public Act No. 21-71
AN ACT CONCERNING ESSENTIAL SUPPORT PERSONS 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,
section 2 of this act and subsection (b) of section 17a-408 of the general
statutes, as amended by this act, (1) "primary essential support person"
means a person designated by a long-term care facility resident, or a
resident representative, who may visit with the resident in accordance
with rules set by the Commissioner of Public Health to provide essential
support as reflected in the resident's person-centered plan of care; (2)
"essential support" means support that includes, but is not limited to,
(A) assistance with activities of daily living, and (B) physical, emotional,
psychological and socialization support for the resident; (3) "secondary
essential support person" means a person designated by the resident, or
resident representative, to serve as a backup to a primary essential
support person; (4) "person-centered plan of care" means a care plan for
a resident developed by a resident or resident representative in
consultation with health professionals that focuses on the resident's
physical, emotional, psychological and socialization needs and includes
a primary essential support person or secondary essential support
person designated by a resident; and (5) "long-term care facility" means Substitute House Bill No. 6634
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a nursing home facility, as defined in section 19a-490 of the general
statutes, or a managed residential community, as defined in section 19a-
693 of the general statutes that provides services offered by an assisted
living services agency, as defined in section 19a-490 of the general
statutes.
(b) A long-term care facility resident, or a resident representative,
may designate a primary essential support person and a secondary
essential support person who may visit the resident despite general
visitation restrictions imposed on other visitors, provided the primary
essential support person or secondary essential support person
complies with any rules promulgated by the Commissioner of Public
Health pursuant to section 2 of this act to protect the health, safety and
well-being of long-term care facility residents.
Sec. 2. (NEW) (Effective from passage) (a) The Commissioner of Public
Health shall establish a state-wide policy for visitation with a long-term
care facility resident. The policy shall be applicable to all long-term care
facilities and shall incorporate a long-term care facility resident's need
for health, safety and well-being, including, but not limited to, the
essential support provided by a primary or secondary essential support
person.
(b) In the event of a public health emergency declared by the
Governor in accordance with section 19a-131a of the general statutes,
the Commissioner of Public Health shall, in accordance with applicable
federal requirements and guidance, set forth requirements for visitation
with a long-term care facility resident, provided such requirements
incorporate a resident's need for essential support provided by a
primary or secondary essential support person and other visitors. Such
requirements shall include, but need not be limited to, the
circumstances, if any, under which a long-term care facility may restrict
visitors, including, but not limited to, primary essential support persons
and secondary essential support persons designated by a long-term care Substitute House Bill No. 6634
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facility resident. The requirements shall address, at a minimum:
(1) Arrangements for visitation with a long-term care facility resident
through various means, including, but not limited to, (A) outdoor
visitation, (B) the use of technologies to facilitate virtual visitation, and
(C) indoor visitation that is allowed whether or not the resident is
nearing the end of his or her life, as determined by the resident's
attending health care professionals;
(2) The needs of a long-term care facility resident for physical,
emotional, psychological and socialization support based on the
resident's person-centered plan of care;
(3) Safety protocols for all visitors to a long-term care facility,
including, but not limited to, primary or secondary essential support
persons, in the event of a communicable disease outbreak or public
health emergency declared by the Governor in accordance with section
19a-131a of the general statutes;
(4) Permission for visitation with a long-term care facility resident by
a primary essential support person or secondary essential support
person despite general visitation restrictions, provided the primary
essential support person or secondary essential support person
complies with safety protocols established by the commissioner and the
commissioner determines that such visitation will benefit the health,
safety and well-being of the resident; and
(5) In the event a long-term care facility resident has not designated a
primary essential support person, a requirement that staff of a long-term
care facility work with the resident or a resident representative, a family
member of the resident or the State Ombudsman appointed pursuant to
section 17a-405 of the general statutes to identify a primary essential
support person and provide access by such person to the resident.
Sec. 3. Subsection (b) of section 17a-408 of the general statutes is Substitute House Bill No. 6634
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repealed and the following is substituted in lieu thereof (Effective from
passage):
(b) The State Ombudsman shall serve on a full-time basis, and shall
personally or through representatives of the office:
(1) Identify, investigate and resolve complaints that:
(A) Are made by, or on behalf of, residents or, as to complaints
involving the application for admission to a long-term care facility, by
or on behalf of applicants; and
(B) Relate to action, inaction or decisions that may adversely affect
the health, safety, welfare or rights of the residents, including the
welfare and rights of the residents with respect to the appointment and
activities of guardians and representative payees, of (i) providers or
representatives of providers of long-term care services, (ii) public
agencies, or (iii) health and social service agencies;
(2) Provide services to protect the health, safety, welfare and rights of
the residents, including, but not limited to, services designed to address
the impact of socialization, visitation and the role of primary or
secondary essential support persons on the health, safety and well-being
of residents;
(3) Inform the residents about means of obtaining services provided
by providers or agencies described in subparagraph (B) of subdivision
(1) of this subsection or services described in subdivision (2) of this
subsection;
(4) Ensure that the residents and, as to issues involving applications
for admission to long-term care facilities, applicants have regular and
timely access to the services provided through the office and that the
residents and complainants receive timely responses from
representatives of the office to complaints; Substitute House Bill No. 6634
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(5) Represent the interests of the residents, and of applicants in
relation to issues concerning applications to long-term care facilities,
before governmental agencies and seek administrative, legal and other
remedies to protect the health, safety, welfare and rights of the residents;
(6) Provide administrative and technical assistance to representatives
of the office and training in areas including, but not limited to,
Alzheimer's disease and dementia symptoms and care;
(7) (A) Analyze, comment on and monitor the development and
implementation of federal, state and local laws, regulations, and other
governmental policies and actions that pertain to the health, safety,
welfare and rights of the residents with respect to the adequacy of long-
term care facilities and services in this state and to the rights of
applicants in relation to applications to long-term care facilities;
(B) Recommend any changes in such laws, regulations, policies and
actions as the office determines to be appropriate; and
(C) Facilitate public comment on such laws, regulations, policies and
actions;
(8) Advocate for:
(A) Any changes in federal, state and local laws, regulations and
other governmental policies and actions that pertain to the health,
safety, welfare and rights of residents with respect to the adequacy of
long-term care facilities and services in this state and to the health,
safety, welfare and rights of applicants which the State Ombudsman
determines to be appropriate;
(B) Appropriate action by groups or agencies with jurisdictional
authority to deal with problems affecting individual residents and the
general resident population and applicants in relation to issues
concerning applications to long-term care facilities; and Substitute House Bill No. 6634
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(C) The enactment of legislative recommendations by the General
Assembly and of regulatory recommendations by commissioners of
Connecticut state agencies;
(9) (A) Provide for training representatives of the office;
(B) Promote the development of citizen organizations to participate
in the program; and
(C) Provide technical support for the development of resident and
family councils to protect the well-being and rights of residents;
(10) Coordinate ombudsman services with the protection and
advocacy systems for individuals with developmental disabilities and
mental illnesses established under (A) Part A of the Development
Disabilities Assistance and Bill of Rights Act (42 USC 6001, et seq.), and
(B) The Protection and Advocacy for Mentally Ill Individuals Act of 1986
(42 USC 10801 et seq.);
(11) Coordinate, to the greatest extent possible, ombudsman services
with legal assistance provided under Section 306(a)(2)(C) of the federal
Older Americans Act of 1965, (42 USC 3026(a)(2)(C)) as amended from
time to time, through the adoption of memoranda of understanding and
other means;
(12) Create, and periodically update as needed, a training manual for
nursing home facilities identified in section 19a-522c that provides
guidance on structuring and implementing the training required by said
section;
(13) Develop policies and procedures regarding the communication
and documentation of informed consent in the case of resident
complaints, including, but not limited to, the use of auxiliary aids and
services or the use of a resident representative; and Substitute House Bill No. 6634
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(14) Carry out such other activities and duties as may be required
under federal law.