SB 1030 — AN ACT CONCERNING NURSING HOMES AND DEMENTIA SPECIAL CARE UNITS.

(2) Visitation protocols and any other information relevant to visitation that shall be written in plain language and in a form that may be reasonably understood by the resident and the resident's family members and friends;

and (3) Information on the role of the Office of the Long-Term Care Ombudsman established under section 17a-405 of the general statutes including, but not limited to, the contact information for said office.

(b) On or before January 1, 2022, the administrative head of each nursing home shall ensure that its staff is educated regarding (1) best practices for addressing the social, emotional and mental health needs of residents, and (2) all components of person-centered care.

(NEW) (Effective Octoberfrom 1,passage) 2021) (a) On or before JanuaryOctober 1, 2022,2021, the administrativePublic headHealth ofPreparedness eachAdvisory long-termCommittee careestablished facilitypursuant shallto (1)section ensure19a-131g thatof eachthe resident'sgeneral carestatutes planshall addressesamend (A) the resident'splan potential for isolation,emergency abilityresponses to interacta withpublic familyhealth membersemergency andprepared friendspursuant andto risksaid forsection depression, (B) how the resident's social and emotional needs will be met, and (C) measures to ensureinclude thata theplan resident has regular opportunities for in-personemergency andresponses virtual visitation, (2) disclose the facility's visitation protocols, any changes to sucha protocolspublic andhealth anyemergency other information relevant to visitation in arelation form and manner that is easily accessible to residentsnursing andhomes their family members and friends,dementia (3)special advisecare residentsunits and theirproviders family members and friends of theircommunity-based rightservices to seekresidents redress with the Office of thesuch Long-Termhomes Care Ombudsman under section 17a-410 of the general statutes when the resident or a family member or friend ofthe resident believes the facility has not complied with its visitation protocols, and (4)units. establish a timeline by which the facility will ensure the safe and prompt reinstatementofvisitationfollowingthe terminationofthepublichealth emergency declared by the Governor in response to the COVID-19 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-0104 of 11 R02-SB.docx } Substitute Bill No.

1030 pandemic and a program to monitor compliance with such timeline.

As used in this section "COVID-19" means the respiratory disease designated by the World Health Organization on February 11, 2020, as coronavirus 2019, and any related mutation thereof recognized by the World Health Organization as a communicable respiratory disease.

(b)OnorbeforeJanuary1,2022,theadministrativeheadofeachlong- term care facility shall ensure that its staff is educated regarding (1) best practices for addressing the social, emotional and mental health needs of residents, and (2) all components of person-centered care.

(NEW) (Effective October 1, 2021) (a) On or before January 1, 2022, the Department of Public Health shall (1) establish anminimum essentialstaffing caregiverlevel programrequirements for implementationnursing byhomes eachof long-termthree hours of direct care facility.per resident per day, and (2) modify staffing level requirements for social work and recreational staff of nursing homes such that the Public Act No.

The21-185 program5 shall (1) set forth visitation requirements for essential caregivers of long-term6 careSubstitute facilitySenate residents,Bill andNo. (2) require the same infection prevention and control training and testing standards for an essential caregiver of a resident of the facility that are required for the facility's staff.

As1030 usedrequirements in(A) thisfor sectionsocial "essentialwork caregiver"are meansone afull-time personsocial deemedworker critical,per assixty determinedresidents, byand a(B) long-termfor carerecreational facility,tostaff are lower than the dailycurrent carerequirements, andas emotionaldeemed well-beingappropriate ofby athe residentCommissioner of thePublic facility.Health.

(b) The commissioner shall adopt regulations in accordance with the provisions of chapter 54 of the general statutes that set forth nursing home staffing level requirements to implement the provisions of this section.

(Effective from passage) OnThe orDepartment beforeof OctoberPublic 1,2021, thePublic Health Preparedness Advisory Committee established pursuant to section 19a-131g of the general statutes shall amendseek theany planfederal foror emergencystate responsesfunds toavailable a public health emergency prepared pursuant to said section to include a plan for emergencyimprovements responses to athe publicinfrastructure health emergency in relation to long-term care facilities and providers of community-basednursing serviceshomes toin residentsthe ofstate. such facilities.

Sec.Not later than January 1, 2022, the Commissioner of Public Health shall report, in accordance with the provisions of section 11-4a of the general statutes, regarding the commissioner's success in accessing such federal or state funds available for infrastructure improvement to the joint standing committee of the General Assembly having cognizance of matters relating to public health.

12.Approved July 13, 2021 Public Act No.

(NEW)21-185 (Effective6 from passage) (a) On and after July 1, 2021, each long-term care facility shall permit a resident to use a communication device, including a cellular phone, tablet or computer, in his or her room, in accordance with the requirements established under subsection (b) of this6 section, to remain connected with their family members and friends and to facilitate the participation of a LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-0105 of 11 R02-SB.docx } Substitute Bill No.

1030 resident's family caregiver as a member of the resident's care team.

(b) On or before June 30, 2021, the Commissioner of Public Health shall (1) establish requirements regarding the use of communication devices by long-term care facility residents under subsection (a) of this section to ensure the privacy of other long-term care facility residents, and (2) communicate such requirements to each long-term care facility.

Sec.

13.

(NEW) (Effective October 1, 2021) (a) As used in this section, "nursing home" means (1) any chronic and convalescent nursing home or any rest home with nursing supervision that provides nursing supervision under a medical director twenty-four hours per day, or (2) any chronic and convalescent nursing home that provides skilled nursing care under medical supervision and direction to carry out nonsurgical treatment and dietary procedures for chronic diseases, convalescent stages, acute diseases or injuries.

(b) On or before January 1, 2022, the Department of Public Health shall (1) establish minimum staffing level requirements for nursing homes of at least four and one-tenth hours of direct care per resident per day, including three and three-quarter hours of care by a registered nurse, fifty-four hundredth hours of care by a licensed practical nurse and two and eighty-one hundredth hours of care by a certified nurse's assistant, (2) modify staffing level requirements for social work and recreational staff of nursing homes such that the requirements are lower than the current requirements, as deemed appropriate by the Commissioner of Public Health, and (3) eliminate the distinction between a chronic and convalescent nursing home and a rest home, as defined in section 19a-490 of the general statutes, as such distinction relates to nursing supervision, for purposes of establishing a single, minimum direct staffing level requirement for all nursing homes.

(c)Onandafter January 1,2022,eachnursinghome shalloffer itsstaff the option to work twelve-hour shifts.

(d) The commissioner shall adopt regulations in accordance with the LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-0106 of 11 R02-SB.docx } Substitute Bill No.

1030 provisions of chapter 54 of the general statutes that set forth nursing home staffing level requirements to implement the provisions of this section.

Sec.

14.

(NEW) (Effective October 1, 2021) (a) For purposes of this section:

(1) "Ombudsman" means the Office of the Long-Term Care Ombudsman established pursuant to section 17a-405 of the general statutes;

(2) "electronic monitoring" means the placement and use of an electronic monitoring device by a nonverbal resident or his or her resident representative in the resident's room or private living unit in accordance with this section;

(3) "electronic monitoring device" means a cameraorotherdevicethatcaptures,recordsorbroadcastsaudio,video, or both, and may offer two-way communication over the Internet that is placed in a nonverbal resident's room or private living unit and is used to monitor the nonverbal resident or activities in the room or private living unit;

(4) "nursing home facility" has the same meaning as provided in section 19a-490 of the general statutes;

(5) "nonverbal resident" means a resident of a nursing home facility who is unable to verbally communicate due to physical or mental conditions, including, but not limited to, Alzheimer's disease and dementia;

and (6) "resident representative" means (A) a court-appointed guardian, (B) a health care representative appointed pursuant to section 19a-575a of the general statutes, or (C) a person who is not an agent of the nursing home facility and who is designated in a written document signed by the nonverbal resident and included in the resident's records on file with the nursing home facility.

(b) A nonverbal resident or his or her resident representative may install an electronic monitoring device in the resident's room or private living unit provided:

(1) The purchase, installation, maintenance, operation and removal of the device is at the expense of the resident, (2) theresidentandanyroommateoftheresident,ortherespectiveresident representatives, sign a written consent form pursuant to subsection (c) of this section, (3) the resident or his or her resident representative places a clear and conspicuous note on the door of the room or private LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-0107 of 11 R02-SB.docx } Substitute Bill No.

1030 living unit that the room or private living area is subject to electronic monitoring, and (4) the consent form is filed with the nursing home facility not less than seven days before installation of the electronic monitoring device except as provided in subsection (e) of this section.

(c) No electronic monitoring device shall be installed in a nonverbal resident's room or living unit unless the resident and any roommate of the resident, or a resident representative, has signed a consent form that includes, but is not limited to:

(1) (A) The signed consent of the nonverbal resident and any roommate of the resident;

or (B) the signed consent of a resident representative of the nonverbal resident or roommate if the nonverbal resident or roommate lacks the physical or mental capacity to sign the form.

If a resident representative signs the consent form, the form must document the following:

(i) The date the nonverbal resident or any roommate was asked if the resident or roommate wants electronic monitoring to be conducted;

(ii) Who was present when the nonverbal resident or roommate was asked if he or she consented to electronic monitoring;

(iii) An acknowledgment that the nonverbal resident or roommate did not affirmatively object to electronic monitoring;

and (iv) The source of the authority allowing the resident representative of the nonverbal resident or roommate to sign the consent form on behalf of the nonverbal roommate or resident.

(2) A waiver of liability for the nursing home facility for any breach of privacy involving the nonverbal resident's use of an electronic monitoring device, unless such breach of privacy occurred because of unauthorized use of the device or a recording made by the device by nursing home facility staff.

(3) The type of electronic monitoring device to be used.

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1030 (4) A list of conditions or restrictions that the nonverbal resident or any roommate of the resident may elect to place on the use of the electronic monitoring device, including, but not limited to:

(A) Prohibiting audio recording, (B) prohibiting video recording, (C) prohibiting broadcasting ofaudio orvideo,(D)turning offtheelectronic monitoring device or blocking the visual recording component of the electronic monitoring device for the duration of an exam or procedure by a health care professional, (E) turning off the electronic monitoring device or blocking the visual recording component of the electronic monitoring device while the nonverbal resident or any roommate of the resident is dressing or bathing, and (F) turning off the electronic monitoring device for the duration of a visit with a spiritual advisor, ombudsman, attorney, financial planner, intimate partner or other visitor to the nonverbal resident or roommate of the resident.

(5)An acknowledgment thatthenonverbalresident, roommateor the respective resident representative shall be responsible for operating the electronic monitoring device in accordance with the conditions and restrictions listed in subdivision (4) of this subsection unless the resident, roommate or the respective resident representative have signed a written agreement with the nursing home facility under which nursing home facility staff operate the electronic monitoring device for this purpose.

Such agreement may contain a waiver of liability for the nursing home facility related to the operation of the device by nursing home facility staff.

(6) A statement of the circumstances under which a recording may be disseminated.

(7) A signature box for documenting that the nonverbal resident or roommate of the resident, or the respective resident representative, has consented to electronic monitoring or withdrawn consent.

(d) The ombudsman, within available appropriations, shall make available on the ombudsman's Internet web site a downloadable copy of a standard form containing all of the provisions required under LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-01039 of 11 R02-SB.docx } Substitute Bill No.

1030 subsection (c) of this section.

Nursing home facilities shall (1) make the consent formavailable to nonverbalresidents andinformsuch residents and the respective 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 entry to the nursing home facility stating that some rooms and living areas may be subject to electronic monitoring.

(e) Notwithstanding subdivision (4) of subsection (b) of this section, a nonverbal resident or his or her resident representative may install an electronic monitoring device without submitting the consent form to a nursing home facility if:

(1) The nonverbal resident or the resident representative (A) reasonably fears retaliation against the nonverbal resident by the nursing home facility for recording or reporting alleged abuse or neglect of the resident by nursing home facility staff, (B) submits a completed consent form to the ombudsman, and (C) submits a report to the ombudsman, the Commissioner of Social Services, the Commissioner of Public Health or appropriate law enforcement agency, with evidence from an electronic monitoring device that suspected abuse or neglect of the nonverbal resident has occurred;

(2) (A) the nursing home facility has 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 concernthat prompted theresident's desire for installation of an electronic monitoring device, and (B) the nonverbal resident or his or her resident representative has submitted a consent form to the ombudsman;

or (3) (A) the nonverbal resident or his or her resident representative has already submitted a report to the ombudsman, Commissioner of Social Services, Commissioner of Public Health or appropriate law enforcement agency regarding concerns about the nonverbal resident's safety or well-being that prompted the resident's desire for electronic monitoring, and (B) the nonverbal resident or his or her resident representative has submitted a consent form to the ombudsman.

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1030 (f) If a nonverbal resident is conducting electronic monitoring and a new roommate moves into the room or living unit, the nonverbal resident shall cease use of the electronic monitoring device unless and until the new roommate signs the consent form and the nonverbal resident or his or her resident representative files the completed form with the roommate's consent to electronic monitoring with the nursing home facility.

If any roommate of a nonverbal resident wishing to use electronicmonitoringrefusestosigntheconsentform,thenursinghome facility shall reasonably accommodate the nonverbal resident's request to move into a private room or a room with a roommate who has agreed to consent to such monitoring, if available, not later than thirty days after therequest.

The nonverbal resident requesting theaccommodation shall pay any difference in price if the new room is more costly than the resident's previous room.

(g) Subject to applicable rules of evidence and procedure, any video or audio recording created through electronic monitoring under this section may be admitted into evidence in a civil, criminal or administrative proceeding.

This act shall take effect as follows and shall amend the following sections:

Section 1 October 1, 2021 New section Sec.

2 October 1, 2021 New section Sec.

3 October 1, 2021 New section Sec.

4 October 1, 2021 New section Sec.

5 October 1, 2021 New section Sec.

6 October 1, 2021 New section Sec.

7 October 1, 2021 New section Sec.

8 October 1, 2021 New section Sec.

9 October 1, 2021 New section Sec.

10 October 1, 2021 New section Sec.

11 from passage New section Sec.

12 from passage New section Sec.

13 October 1, 2021 New section Sec.

14 October 1, 2021 New section LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-01030-11 of 12 R02-SB.docx } Substitute Bill No.

1030 PH Joint Favorable Subst.

APP Joint Favorable LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-01030- 12 of 12 R02-SB.docx }