Researcher: ND Page 1 5/28/21
OLR Bill Analysis
sSB 1030 (File 457, as amended by Senate "A")*
AN ACT CONCERNING LONG -TERM CARE FACILITIES.
TABLE OF CONTENTS:
SUMMARY
§ 1 — INFECTION PREVENTIONISTS
Requires nursing homes and dementia special care units to employ a full-time infection
and prevention control specialist; requires this specialist to work a rotating schedule that
covers each eight-hour shift at least once monthly
§ 2 — LOCAL EMERGENCY OPER ATIONS PLAN
Requires a nursing home’s and dementia special care unit’s administrative head to
provide its emergency operations plan to the municipality where it is located to assist the
municipality in developing the local emergency operations plan required under the
Interstate Mutual Aid Compact
§ 3 — PERSONAL PROTECTIVE EQUIPMENT
Requires nursing homes to maintain at least a two-month supply of personal protective
equipment for their staff
§ 4 — INTRAVENOUS LINES
Requires a nursing home’s administrative head to ensure there is at least one staff
member or contracted professional available on-call during each shift who is licensed or
certified to start an intravenous line
§ 5 — NURSING HOME INFECTION PREVENTION AND CONTROL
COMMITTEES
Generally, requires a nursing home’s infection prevention and control committee to meet
at least monthly, and, during an infectious disease outbreak, daily
§ 6 — INFECTIOUS DISEASE TESTING IN NURSING HOMES
Requires nursing homes to test staff and residents for an infectious disease during an
outbreak at an appropriate frequency determined by DPH
§ 7 — FAMILY COUNCILS
Requires each nursing home’s and dementia special care unit’s administrative head, by
January 1, 2022, to encourage and assist in the establishment of a family council to
encourage and support open communication between the facility and residents’ families
and friends
§ 8 — RESIDENT VISITATION AT NURSING HOMES
Requires nursing homes, 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-R01-BA.DOCX
Researcher: ND Page 2 5/28/21
§ 9 — 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 nursing homes and dementia special care units and providers of
community-based services to their residents
§ 10 — NURSING HOME MINIMUM STAFFING LEVELS
Requires DPH, by January 1, 2022, to modify minimum nursing home daily staffing levels
to require at least three hours of direct care per resident
§ 11 — FUNDING FOR NURSING HOME INFRASTRUCTURE
IMPROVEMENTS
Requires DPH to seek available federal or state funds for nursing home infrastructure
improvements and report to the Public Health Committee by January 1, 2022
BACKGROUND
SUMMARY
This bill makes various unrelated changes concerning nursing
homes and dementia special care units and the delivery of long-term
care (LTC) services. Under the bill, a “dementia special care unit” is a
unit in an assisted living facility that locks, secures, segregates, or
provides special programs or units for residents diagnosed with
probable Alzheimer’s disease, dementia, or another similar disorder.
The unit or program must be one that prevents or limits access by a
resident outside the designated or separated area or advertises or
markets itself as providing specialized care or services for those with
Alzheimer’s disease or dementia.
*Senate Amendment “A” applies the bill’s provisions to nursing
homes, and in some cases, dementia special care units, instead of all
LTC facilities. It also removes the provisions in the underlying bill on
the (1) CDC’s Nursing Home Infection Preventionist Training Course,
(2) essential caregiver program, (3) LTC facility resident
communication devices, and (4) resident electronic monitoring devices
in nursing homes. Lastly, it adds the definition of “dementia special
care unit,” and modifies several provisions in the underlying bill.
EFFECTIVE DATE: October 1, 2021, except the provisions requiring
(1) the Public Health Preparedness Advisory Committee to amend its
public health emergency response plan and (2) DPH to seek available
state and federal funding for nursing home infrastructure 2021SB-01030-R01-BA.DOCX
Researcher: ND Page 3 5/28/21
improvements take effect upon passage.
§ 1 — INFECTION PREVENTION ISTS
Requires nursing homes and dementia special care units to employ a full-time infection
and prevention control specialist; requires this specialist to work a rotating schedule that
covers each eight-hour shift at least once monthly
The bill requires each nursing home and dementia special care unit
(hereafter “facility”) to employ a full-time infection and prevention
control specialist responsible for:
1. ongoing administrator and employee training on infection
prevention and control using multiple training methods,
including in-person training and providing written materials in
English and Spanish;
2. (a) including information on infection prevention and control in
the documentation the facility provides to residents regarding
their rights while in the facility and (b) posting the information
in areas visible to residents;
3. participating as a member of the facility’s infection prevention
and control committee and reporting to the committee at its
regular meetings on the administrator and employee training he
or she provided as described above;
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; and
5. any other duties or responsibilities the facility deems
appropriate.
Under the bill, each nursing home and dementia special care unit
must require its infection and prevention control specialist to work on
a rotating schedule that ensures he or she covers each eight-hour shift
at least once monthly to ensure compliance with relevant infection
control standards. 2021SB-01030-R01-BA.DOCX
Researcher: ND Page 4 5/28/21
§ 2 — LOCAL EMERGENCY OPER ATIONS PLAN
Requires a nursing home’s and dementia special care unit’s administrative head to provide
its emergency operations plan to the municipality where it is located to assist the
municipality in developing the local emergency operations plan required under the
Interstate Mutual Aid Compact
The bill requires the administrative head of each nursing home and
dementia special care unit to provide its emergency operations plan to
the municipality in which the facility is located. The facility must do
this by January 1, 2022, to assist the municipality in developing its
emergency operations plan required under the Interstate Mutual Aid
Compact. This compact, 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 nursing homes to maintain at least a two-month supply of personal protective
equipment for their staff
The bill requires each nursing home’s administrative head to ensure
that the (1) home maintains at least a two-month supply of personal
protective equipment (PPE) for its staff and (2) PPE is of various sizes
based on staff’s needs.
Under the bill, PPE cannot be shared among 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 staff fittings for
N95 masks or higher rated masks certified by the National Institute for
Occupational Safety and Health, at a frequency the Department of
Public Health (DPH) determines.
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 nursing homes in a public health emergency.
§ 4 — INTRAVENOUS LINES 2021SB-01030-R01-BA.DOCX
Researcher: ND Page 5 5/28/21
Requires a nursing home’s administrative head to ensure there is at least one staff member
or contracted professional available on-call during each shift who is licensed or certified to
start an intravenous line
The bill requires each nursing home’s administrative head to ensure
that there is at least one staff member or contracted professional
available on-call during each shift who is licensed or certified to start
an intravenous line.
§ 5 — NURSING HOME INFECTI ON PREVENTION AND CO NTROL
COMMITTEES
Generally, requires a nursing home’s infection prevention and control committee to meet
at least monthly, and, during an infectious disease outbreak, daily
The bill requires a nursing home’s infection prevention and control
committee to meet at least monthly and, during an infectious disease
outbreak, daily. But if daily meetings disrupt the home’s operations,
the committee must instead meet at least weekly.
Under the bill, the committee is responsible for establishing
infection prevention and control protocols for the nursing home and
monitoring the home’s infection prevention and control specialist. It
must also evaluate (1) the implementation and outcome of these
protocols and (2) whether the specialist is satisfactorily performing his
or her responsibilities. The committee must conduct this evaluation at
least annually and after every infectious disease outbreak at the home.
§ 6 — INFECTIOUS DISEASE TESTING IN NURSING HOMES
Requires nursing homes to test staff and residents for an infectious disease during an
outbreak at an appropriate frequency determined by DPH
The bill requires nursing homes 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.
§ 7 — FAMILY COUNCILS
Requires each nursing home’s and dementia special care unit’s administrative head, by
January 1, 2022, to encourage and assist in the establishment of a family council to
encourage and support open communication between the facility and residents’ families
and friends
The bill requires each nursing home’s and dementia special care 2021SB-01030-R01-BA.DOCX
Researcher: ND Page 6 5/28/21
unit’s administrative head, by January 1, 2022, to encourage and assist
in the establishment of a family council to 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.
§ 8 — RESIDENT VISITATION AT NURSING HOMES
Requires nursing homes, 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 nursing home’s administrative head, by
January 1, 2022, to ensure that each resident’s care plan includes the
following:
1. measures to address the resident’s social, emotional, and mental
health needs, including opportunities for social connection and
strategies to minimize social isolation;
2. visitation protocols and any other information relevant to
visitation written in plain language and in a form and manner
that may be reasonably understood by the resident and his or
her family and friends; and
3. information on the role of the Office of the State Long-Term
Care Ombudsman, including the office’s contact information.
The bill also requires each administrative head, by this date, to
ensure that the home’s staff is educated on best practices for
addressing residents’ social, emotional, and mental health needs and
all components of person-centered care.
§ 9 — PUBLIC HEALTH PREPAREDNESS ADVI SORY 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 nursing homes and dementia special care units and providers of community-
based services to their residents
The bill requires the state’s Public Health Preparedness Advisory 2021SB-01030-R01-BA.DOCX
Researcher: ND Page 7 5/28/21
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 nursing homes and dementia special
care units and providers of community-based services to their
residents.
By law, the 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.
§ 10 — NURSING HOME MINIMUM STAFFING LEVELS
Requires DPH, by January 1, 2022, to modify minimum nursing home daily staffing
levels to require at least three hours of direct care per resident
The bill requires DPH, by January 1, 2022, to modify minimum
staffing levels in nursing homes as follows:
1. establish at least three hours of direct care per resident per day;
2. modify staffing level requirements for social workers and
recreational staff to require (a) one full-time social worker per 60
residents and (b) recreational staffing levels lower than current
requirements, as the DPH commissioner deems appropriate;
and
3. adopt regulations to implement the above requirements.
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).
§ 11 — FUNDING FOR NURSING HOME INFRASTRUCTURE
IMPROVEMENTS
Requires DPH to seek available federal or state funds for nursing home infrastructure
improvements and report to the Public Health Committee by January 1, 2022
The bill requires DPH to seek available federal or state funds for 2021SB-01030-R01-BA.DOCX
Researcher: ND Page 8 5/28/21
infrastructure improvements to the state’s nursing homes. It requires
the commissioner, by January 1, 2022, to report to the Public Health
Committee on her success in accessing such funding.
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 RHNSs 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.
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 LTC facility conditions.
SB 1057, favorably reported by the Human Services Committee,
requires DPH to establish nursing home minimum staffing levels of 4.1 2021SB-01030-R01-BA.DOCX
Researcher: ND Page 9 5/28/21
hours of direct care, including 0.75 hours by a registered nurse, 0.54
hours by a licensed practical nurse, and 2.81 hours by a certified
nurse’s assistant.
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).
COMMITTEE ACTION
Public Health Committee
Joint Favorable Substitute
Yea 32 Nay 1 (03/29/2021)