Nursing home advocates seek changes to essential caregiver bill
Before the COVID-19 pandemic, Niantic resident Valerie Marcella’s family was with her grandmother — whom Marcella described as “smiling, sociable and fun loving” — every day in a long-term care facility.
They ate dinner with her every night, encouraged her to drink fluids and helped her get to the restroom. Marcella would cut her grandmother’s nails, lotion her skin and wash her laundry. But after the lockdown, she said being 6 feet apart and wearing masks made it difficult to communicate, and her grandmother became confused, scared and depressed from the isolation.
Marcella shared her story in written testimony to the legislature’s Human Services Committee, testifying on a bill addressing “essential support persons” and visitation in nursing homes.
Like other advocates for nursing home residents, Marcella supports the intent of the bill but has issues with the language. She said it “does not show much transparency” and noted that a lot of the guidance that has come out during the pandemic was confusing and left too much for facilities to interpret incorrectly.
In its September report on how Connecticut long-term care facilities responded to COVID-19, policy research company Mathematica recommended the state work with facilities to designate essential caregivers, who would have increased access — beyond regular visitation — “to fill a defined role for specific residents.”
The Human Services Committee heard testimony Thursday on H.B. 6634, which defines an “essential support person,” or ESP, as 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.”
The bill says this person “may visit the resident despite general visitation restrictions imposed on other visitors.” But it later says that during a public health emergency, the Department of Public Health commissioner shall set forth the circumstances under which a facility may restrict visitors, including essential support persons.
Stonington resident Liz Stern, a member of the Nursing Home and Assisted Living Oversight Working Group that formed last year, said an essential support person is not a visitor, and the language of the bill makes it difficult to distinguish the two.
Stern wants to see ESPs allowed unrestricted access to the residents and treated as employees for infection control purposes, in terms of routine testing and personal protective equipment requirements.
She said the bill as written “opens the door, but it does not walk into the room,” and she objects to making a “leap of faith” in sanctioning the DPH commissioner to write the rules after the bill is passed.
Rep. Kathleen McCarty, R-Waterford, also stressed that a caregiver is not a visitor, and said a caregiver should be treated in the same fashion as employees and allowed to enter facilities even during a public health emergency. She said she supports the bill and establishing an essential caregiver program is one of her top priorities this session, but she is asking the committee to look at some of the language. She also noted such a program doesn’t cost anything and can be enacted now.
Rep. Michelle Cook, D-Torrington, noted that with low staffing levels in nursing homes, allowing access to essential caregivers would offset some of the workload of certified nursing assistants.
In written testimony, AARP Connecticut voiced concern that the bill “will not do enough or be enacted quickly enough” to address ongoing issues, and recommended adding a way for residents and families to hold facilities accountable if they believe they have been inappropriately denied visitation.
Clinton resident Beth Scully said the bill “fails to recognize the true nature of essential caregivers by equating them with mere ‘visitors’, the kind of people who drop by occasionally for 15 minutes with a plate of cookies or the poorly defined ‘essential support person’ which sounds like someone who offers encouragement, not essential anything.”
Irma Rappaport said she prefers the term “essential caregiver,” saying that essential support person “sounds more like a therapy dog.”
“I support the spirit of this bill but it is so vague and non-transparent I cannot even imagine what you will be voting on,” Old Greenwich resident Amy Badini wrote. She added, “There is a desperate need for a statewide visitation policy but it must not be confused with the development of an essential support person policy.”