Researcher: ND Page 1 4/14/21
OLR Bill Analysis
sSB 1030
AN ACT CONCERNING LONG -TERM CARE FACILITIES.
TABLE OF CONTENTS:
SUMMARY
§1 — INFECTION PREVENTIONISTS
Requires LTC facilities to employ a full-time infection and prevention control specialist
§2 — LOCAL EMERGENCY OPER ATIONS PLAN
Requires a LTC facility’s administrative head to participate in developing the local
emergency operations plan required under the Intrastate Mutual Aid Compact
§3 — PERSONAL PROTECTIVE EQUIPMENT
Requires, within six months after the governor terminates a declared public health
emergency, (1) DPH to maintain at least a three-month supply of personal protective
equipment for LTC facilities and (2) facilities’ administrative heads to ensure they acquire
the supply from DPH and maintain it for their staff
§4 — INTRAVENOUS LINES
Requires a LTC facility’s administrative head to ensure there is at least one staff member
during each shift who is licensed or certified to start an intravenous line
§5 — INFECTION PREVENTION AND CONTROL COMMITTE ES
Generally, requires a LTC facility’s infection prevention and control committee to meet at
least monthly, and, during an infectious disease outbreak, daily
§6 — NURSING HOME INFECTION PREVENTIONIST TRAINING
Requires every LTC facility’s administrator and supervisor, by January 1, 2022, to
complete the Nursing Home Infection Preventionist Training Course produced by the
CDC in collaboration with the Centers for Medicare and Medicaid Services
§7 — INFECTIOUS DISEASE TESTING IN LTC FACILITIES
Requires LTC facilities to test staff and residents for an infectious disease during an
outbreak at an appropriate frequency determined by DPH
§8 — FAMILY COUNCILS
Requires a LTC facility’s administrative head, by January 1, 2022, to facilitate the
establishment of a family council to encourage and support open communication between
the facility and residents’ families and friends
§9 — RESIDENT VISITATION AT LTC FACILITIES
Requires LTC facilities, by January 1, 2022, to take certain actions to ensure residents
have regular opportunities for in-person and virtual visitation with family members and
friends and that their social and emotional needs are met 2021SB-01030-R000457-BA.docx
Researcher: ND Page 2 4/14/21
§10 — ESSENTIAL CAREGIVER PROGRAM
Requires DPH, by January 1, 2022, to establish an essential caregiver program for LTC
facilities to implement
§11 — PUBLIC HEALTH PREPAREDNESS ADVISORY COMM ITTEE
Requires the Public Health Preparedness Advisory Committee, by October 1, 2021, to
amend the plan for emergency responses to public health emergencies to include
responses related to LTC facilities and providers of community-based services to facility
residents
§12 — RESIDENT COMMUNICATI ON DEVICES
Starting July 1, 2021, requires LTC facilities to allow residents to use communication
devices (e.g., phones and tablets) in their rooms to remain connected with family and
friends and facilitate the participation of family caregivers in their care team
§13 — NURSING HOME MINIMUM STAFFING LEVELS
Requires DPH, by January 1, 2022, to modify minimum nursing home daily staffing levels
to require at least 4.10 hours of direct care per resident; requires nursing homes to offer
staff the option to work 12-hour shifts
§14 — ELECTRONIC MONITORIN G DEVICES IN NURSING HOMES
Allows a non-verbal nursing home resident, or his or her resident representative, to install
an electronic monitoring device in the resident’s room or private living unit under certain
conditions
BACKGROUND
SUMMARY
This bill makes various unrelated changes concerning long-term
care (LTC) facilities and the delivery of long-term care services. Under
the bill, a “long-term care facility” includes a nursing home, residential
care home, assisted living facility, home health agency, chronic disease
hospital, hospice agency, and intermediate care facility for individuals
with intellectual disability, except those operated by a Department of
Developmental Services program subject to comprehensive
background checks under existing law.
EFFECTIVE DATE: October 1, 2021, except the provisions (1)
allowing facility residents to use communication devices in their
rooms and (2) requiring the Public Health Preparedness Advisory
Committee to amend its public health emergency response plan, take
effect upon passage.
§1 — INFECTION PREVENTION ISTS
Requires LTC facilities to employ a full-time infection and prevention control specialist 2021SB-01030-R000457-BA.docx
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The bill requires each LTC facility to employ a full-time infection
and prevention control specialist responsible for:
1. ongoing employee training on infection prevention and control
using multiple training methods, including in-person training
and providing written materials in English and Spanish;
2. including information on infection prevention and control in the
documentation the facility provides to residents regarding their
rights while in the facility;
3. participating as a member of the facility’s infection prevention
and control committee; and
4. providing training on infection prevention and control methods
to the facility’s supplemental or replacement staff in the event of
an infectious disease outbreak or other situation reducing the
facility’s staffing levels.
§2 — LOCAL EMERGENCY OPER ATIONS PLAN
Requires a LTC facility’s administrative head to participate in developing the local
emergency operations plan required under the Intrastate Mutual Aid Compact
The bill requires each LTC facility’s administrative head to
participate in developing the local emergency operations plan for the
municipality in which the facility is located. The plan is required under
the Intrastate Mutual Aid Compact, which by law, provides a legal
framework for municipalities to request and provide mutual aid when
any member municipality declares a local civil preparedness
emergency.
§3 — PERSONAL PROTECTIVE EQUIPMENT
Requires, within six months after the governor terminates a declared public health
emergency, (1) DPH to maintain at least a three-month supply of personal protective
equipment for LTC facilities and (2) facilities’ administrative heads to ensure they acquire
the supply from DPH and maintain it for their staff
The bill requires, within six months after the governor terminates a
declared public health emergency:
1. the Department of Public Health (DPH) to have and maintain at 2021SB-01030-R000457-BA.docx
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least a three-month stockpile of personal protective equipment
(PPE) for LTC facility use, including gowns, masks, full-face
shields, goggles, and disposable gloves as a barrier against
infectious materials, and
2. each LTC facility’s administrative head to ensure that the
facility acquires from DPH and maintains at least a three-month
supply of PPE for its staff.
For the latter, the bill requires administrative heads to ensure that
the PPE is of various sizes based on the facility staff’s needs. PPE
cannot be shared amongst facility staff and may only be used in
accordance with the federal Centers for Disease Control and
Prevention’s (CDC) strategies to optimize PPE supplies in health care
settings.
The bill also requires administrative heads to hold quarterly staff
fittings for N95 masks or higher rated masks certified by the National
Institute for Occupational Safety and Health.
The bill requires the Department of Emergency Management and
Homeland Security, by January 1, 2022, to consult with DPH and
establish a process to evaluate, provide feedback on, approve, and
distribute PPE for use by LTC facilities in a public health emergency.
§4 — INTRAVENOUS LINES
Requires a LTC facility’s administrative head to ensure there is at least one staff member
during each shift who is licensed or certified to start an intravenous line
The bill requires the administrative head of each LTC facility to
ensure that there is at least one staff member during each shift who is
licensed or certified to start an intravenous line.
§5 — INFECTION PREVENTION AND CONTROL COMMITTE ES
Generally, requires a LTC facility’s infection prevention and control committee to meet at
least monthly, and, during an infectious disease outbreak, daily
The bill requires a LTC facility’s infection prevention and control
committee to meet at least monthly and, during an infectious disease
outbreak, daily. But if daily meetings disrupt the facility’s operations, 2021SB-01030-R000457-BA.docx
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the committee must instead meet at least weekly.
Under the bill, the committee is responsible for establishing
infection prevention and control protocols for the LTC facility. It must
also evaluate the implementation and outcome of these protocols at
least biannually and after every infectious disease outbreak at the
facility.
§6 — NURSING HOME INFECTION PREVENTIONI ST TRAINING
Requires every LTC facility’s administrator and supervisor, by January 1, 2022, to
complete the Nursing Home Infection Preventionist Training Course produced by the
CDC in collaboration with the Centers for Medicare and Medicaid Services
The bill requires every LTC facility administrator and supervisor, by
January 1, 2022, to complete the Nursing Home Infection Preventionist
Training Course produced by the CDC in collaboration with the
Centers for Medicare and Medicaid Services.
§7 — INFECTIOUS DISEASE TESTING IN LTC FACILITIES
Requires LTC facilities to test staff and residents for an infectious disease during an
outbreak at an appropriate frequency determined by DPH
The bill requires LTC facilities to test staff and residents for an
infectious disease during an outbreak. They must do so at an
appropriate frequency determined by DPH based on the circumstances
surrounding the outbreak and the impact of testing on controlling it.
§8 — FAMILY COUNCILS
Requires a LTC facility’s administrative head, by January 1, 2022, to facilitate the
establishment of a family council to encourage and support open communication between
the facility and residents’ families and friends
The bill requires a LTC facility’s administrative head, by January 1,
2022, to facilitate the establishment of a family council to encourage
and support open communication between the facility and each
resident’s family members and friends. Under the bill, a “family
council” is an independent, self-determining group of residents’ family
members and friends that is geared to meeting the needs and interests
of residents and their families and friends
§9 — RESIDENT VISITATION AT LTC FACILITIES 2021SB-01030-R000457-BA.docx
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Requires LTC facilities, by January 1, 2022, to take certain actions to ensure residents
have regular opportunities for in-person and virtual visitation with family members and
friends and that their social and emotional needs are met
The bill requires each LTC facility’s administrative head, by January
1, 2022, to do the following:
1. ensure that each resident’s care plan addresses (a) the resident’s
potential for isolation, ability to interact with family and friends,
and risk for depression; (b) how the resident’s social and
emotional needs will be met; and (c) measures to ensure that the
resident has regular opportunities for in-person and virtual
visitation;
2. disclose the facility’s visitation protocols, and changes to them,
and any other information relevant to visitation in a form and
manner that is easily accessible to residents and their family and
friends;
3. advise residents and their family and friends on their right to
seek redress with the Office of the State Long-Term Care
Ombudsman when any of these individuals believe the facility
has not complied with its visitation protocols;
4. establish a (a) timeline by which the facility will ensure the safe
and prompt reinstatement of visitation after the governor
terminates the declared public health emergency in response to
the COVID-19 pandemic and (b) program to monitor
compliance with the timeline; and
5. ensure that facility staff is educated on best practices for
addressing residents’ social, emotional, and mental health needs
and all components of person-centered care.
§10 — ESSENTIAL CAREGIVER PROGRAM
Requires DPH, by January 1, 2022, to establish an essential caregiver program for LTC
facilities to implement
The bill requires DPH, by January 1, 2022, to establish an essential
care program for LTC facilities to implement. The program must (1) set
visitation requirements for essential caregivers of LTC facility residents 2021SB-01030-R000457-BA.docx
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and (2) require the same infection prevention and control training and
testing standards for essential caregivers that are required for facility
staff.
Under the bill, an “essential caregiver” is a person the LTC facility
deems critical to a resident’s daily care and emotional well-being.
§11 — PUBLIC HEALTH PREPAR EDNESS ADVISORY
COMMITTEE
Requires the Public Health Preparedness Advisory Committee, by October 1, 2021, to
amend the plan for emergency responses to public health emergencies to include responses
related to LTC facilities and providers of community-based services to facility residents
The bill requires the state’s Public Health Preparedness Advisory
Committee, by October 1, 2021, to amend the plan for emergency
responses to public health emergencies to include a plan for
emergency responses related to LTC facilities and providers of
community-based services to facility residents.
By law, the advisory committee advises DPH on responses to public
health emergencies. It consists of the DPH and emergency services and
public protection commissioners; six top legislative leaders; the chairs
and ranking members of the Public Health, Public Safety, and
Judiciary Committees; representatives of municipal and district health
directors appointed by the DPH commissioner; and any other
organizations or individuals the DPH commissioner deems relevant to
the effort.
§12 — RESIDENT COMMUNICATI ON DEVICES
Starting July 1, 2021, requires LTC facilities to allow residents to use communication
devices (e.g., phones and tablets) in their rooms to remain connected with family and
friends and facilitate the participation of family caregivers in their care team
Starting July 1, 2021, the bill requires LTC facilities to allow a
resident to use communication devices (e.g., cell phone, tablet, or
computer) in his or her room to (1) remain connected with family
members and friends and (2) facilitate the participation of a family
caregiver as a member of the resident’s care team.
Residents must use the communication devices in accordance with
DPH requirements, which the bill requires the commissioner to 2021SB-01030-R000457-BA.docx
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establish by June 30, 2021. She must communicate the requirements to
LTC facilities and ensure that the requirements safeguard the privacy
of other LTC facility residents.
§13 — NURSING HOME MINIMUM STAFFING LEVELS
Requires DPH, by January 1, 2022, to modify minimum nursing home daily staffing
levels to require at least 4.10 hours of direct care per resident; requires nursing homes to
offer staff the option to work 12-hour shifts
The bill requires DPH, by January 1, 2022, to modify minimum
staffing levels in nursing homes as follows:
1. establish at least 4.10 hours of direct care per resident per day,
including 3.75 hours of care by a registered nurse, 0.54 hours of
care by a licensed practical nurse, and 2.81 hours of care by a
certified nurse’s assistant;
2. modify staffing level requirements for social worker and
recreational staff so that they are lower than current
requirements, as deemed appropriate by the DPH
commissioner;
3. eliminate the nursing supervision-related distinction between a
chronic and convalescent nursing home and a rest home with
nursing supervision in order to establish a single, minimum
direct staffing level requirement for all nursing homes; and
4. adopt regulations to implement the above requirements.
The bill also requires nursing homes to offer staff the option to work
12-hour shifts starting January 1, 2022.
Current law requires nursing homes to maintain aggregate licensed
nurse and nurse's aide staffing levels of at least 1.9 hours of direct care
per resident per day (see BACKGROUND).
§14 — ELECTRONIC MONITORIN G DEVICES IN NURSING HOMES
Allows a non-verbal nursing home resident, or his or her resident representative, to install
an electronic monitoring device in the resident’s room or private living unit under certain
conditions
The bill allows a non-verbal nursing home resident, or his or her 2021SB-01030-R000457-BA.docx
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resident representative, to install an electronic monitoring device in the
resident’s room or private living unit, provided:
1. the resident pays for the device and its installation,
maintenance, operation, and removal;
2. the resident and any roommate, or their resident
representatives, sign a written consent form, which must be
filed with the nursing home within seven days before installing
the device; and
3. the resident, or his or her resident representative, places a clear
and conspicuous note on the door of the room or private living
unit stating that it is subject to electronic monitoring.
Under the bill, any video or audio recording from the electronic
monitoring device may be admitted into evidence in a civil, criminal,
or administrative proceeding.
Consent Form Content
Under the bill, the resident consent form must include:
1. the signed consent of the nonverbal resident and any roommate
or, if either individual is physically or mentally incapable of
signing the form, the signature of their resident representative;
2. a waiver of liability for the nursing home for any breach of
privacy involving the nonverbal resident’s use of an electronic
monitoring device, unless the breach occurred because of the
unauthorized use of the device or a recording it made by facility
staff;
3. the type of electronic monitoring device to be used;
4. a list of conditions or restrictions that the nonverbal resident or
roommate may place on the device’s use, including (a)
prohibiting audio or video recording or broadcasting or (b)
turning off or blocking the device’s visual recording when the
resident or roommate is undergoing a health care exam or 2021SB-01030-R000457-BA.docx
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procedure, dressing or bathing, or visiting with a guest (e.g.,
attorney, partner, ombudsman, or spiritual advisor);
5. an acknowledgement that the nonverbal resident, roommate, or
their resident representatives, are responsible for operating the
device in accordance with these conditions unless they have a
signed written agreement with the nursing home for the facility
staff to operate the device, which may include a liability waiver
for the facility related to the operation;
6. a statement of the circumstances under which a recording from
the device may be disseminated; and
7. a signature box for documenting that the nonverbal resident or
roommate, or their representatives, have consented to the
electronic monitoring or withdrawn consent.
If a resident representative signs the consent form, the bill requires
the consent form to also document:
1. the date the nonverbal resident or roommate was asked if the
resident or roommate wants electronic monitoring to be
conducted, and who was present when asked;
2. an acknowledgement that the nonverbal resident or roommate
did not affirmatively object to electronic monitoring; and
3. the source of the authority allowing the resident representative
to sign the consent form on behalf of the nonverbal resident or
roommate.
Consent Form Availability
The bill requires the state’s long-term care ombudsman, within
available appropriations, to make available on the office’s website, a
downloadable copy of a standard consent form containing all
provisions required under the bill.
It requires nursing homes to: 2021SB-01030-R000457-BA.docx
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1. make the consent form available to nonverbal residents and
inform them and their resident representatives of their option to
conduct electronic monitoring of their rooms or private living
units,
2. maintain a copy of the consent form in the nonverbal resident’s
records, and
3. place a notice in a conspicuous place near the facility’s entrance
stating that some rooms and living areas may be subject to
electronic monitoring.
Consent Exceptions
The bill allows a nonverbal resident, or his or her resident
representative, to install an electronic monitoring device without
submitting a written consent form to the nursing home if:
1. the nonverbal resident or resident representative (1) reasonably
fears the nursing home will retaliate against the resident for
recording or reporting alleged abuse or neglect by nursing
home staff, (b) submits a completed consent form to the long-
term care ombudsman, and (c) submits a report to the
ombudsman, social services or public health commissioners, or
police with evidence from an electronic monitoring device that
suspected abuse or neglect of the resident has occurred;
2. the (a) nursing home failed to respond for more than two
business days to a written communication from the nonverbal
resident or his or her resident representative about a concern
that prompted the resident’s desire to install an electronic
monitoring device and (b) resident or resident representative
submitted a consent form to the ombudsman; or
3. the nonverbal resident or his or her resident representative
already submitted a report to the ombudsman, social services or
public health commissioners, or police regarding concerns
about the resident’s safety or wellbeing that prompted the
resident’s desire for electronic monitoring and the resident or 2021SB-01030-R000457-BA.docx
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resident’s representative has submitted a consent form to the
ombudsman.
New Roommate Consent
Under the bill, if a nonverbal resident is using electronic monitoring
and a new roommate moves in, the resident must stop using the device
unless and until the new roommate signs the consent form, and the
resident or his or her resident representative files the consent form
with the nursing home.
If a roommate refuses to consent, the bill requires the nursing home
to reasonably accommodate the resident’s request to move into a
private room or another room with a roommate who has agreed to
consent to the monitoring. The nursing home must do this within 30
days after the resident’s request and only if a room is available and the
resident is able to pay any price difference.
BACKGROUND
Current Minimum Nurse Staffing Standards for Nursing Homes
DPH licenses nursing homes at two levels of care: (1) chronic and
convalescent nursing homes (CCNHs), which provide skilled nursing
care, and (2) rest homes with nursing supervision (RHNS), which
provide intermediate care. (Nursing homes generally have been
phasing out RHNS beds or converting them to CCNH beds.)
Minimum staffing requirements for CCNHs and RHNS are set by
regulation and depend on the time of day, as shown in the table below
(Conn. Agencies Reg. § 19-13-D8t(m)).
Table 1: Minimum Nurse Staffing Requirements for Nursing Homes
Direct Care
Personnel
CCNH RHNS
7 a.m. to 9 p.m. 9 p.m. to 7 a.m. 7 a.m. to 9 p.m. 9 p.m. to 7 a.m. 2021SB-01030-R000457-BA.docx
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Licensed Nursing
Personnel
0.47 hours per
patient (hpp)*
(28 min.)
0.17 hpp
(10 min.)
0.23 hpp
(14 min.)
0.08 hpp
(5 min.)
Total Nurses and
Nurse Aide
Personnel
1.40 hpp
(1 hr. 24 min.)
0.50 hpp
(30 min.)
0.70 hpp
(42 min.)
0.17 hpp
(10 min.)
Related Bills
SB 973, favorably reported by the Aging Committee, requires the
long-term care ombudsman and executive director of the Commission
on Women, Children, Seniors, Equity, and Opportunity to seek
testimony from family councils on statewide policies, legislative
proposals, or regulations on long-term care facility conditions.
sSB 975, favorably reported by the Aging Committee, adds to the
nursing home patients’ bill of rights, the right to treat their living
quarters as their own home, including purchasing and using
technology they choose that facilitates virtual visitation with family
and others
SB 1057, favorably reported by the Human Services Committee,
requires DPH to establish nursing home minimum staffing levels of 4.1
hours of direct care, including 0.75 hours by a registered nurse, 0.54
hours by a LPN, and 2.81 hours from a CNA
sHB 6552, favorably reported by the Aging Committee, allows
nursing home residents to use the technology of their choosing that
facilitates virtual monitoring or virtual visitation, under certain
conditions.
sHB 6595 and sSB 1002, both reported favorably by the Labor and
Public Employees Committee, contain provisions that generally
require (1) the DPH commissioner to amass stockpiles of PPE (§ 8 in
both bills) and (2) LTC providers to maintain an unexpired inventory
of new PPE sufficient for 90 days of surge consumption during a state
of emergency (§ 10 in both bills). 2021SB-01030-R000457-BA.docx
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HB 6634, favorably reported by the Human Services Committee,
allows long-term care facility residents to designate an essential
support person who may visit the resident despite general visitation
restrictions imposed on other visitors and requires DPH to establish a
state-wide visitation policy
COMMITTEE ACTION
Public Health Committee
Joint Favorable Substitute
Yea 32 Nay 1 (03/29/2021)