CARMEN TILTON, VP OF PUBLIC POLICY - PowerPoint Presentation

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CARMEN TILTON,

VP OF PUBLIC POLICY

UNDER THE DOME

MANAGING NEW RULES AND CONFLICTING GUIDNACE

Carmen Tilton, VP of Public Policy

Carmen.Tilton@TALA.Org

Coming into a Building

Activities and Group Dining

Managing New Cases

Cohorting

Where to Find Guidance

...and new rules in the works

Points for discussion:

Topics and highlights

Entering a Building

Screening, Testing, Proof of Vaccines

Screening when

entering

Must screen all people entering for any reason (excluding emergency situations)

This includes all staff, contract personnel, all visitors, new residents, and residents returning to the community

Screen all people regardless of vaccine status

Must protect privacy of screening logs

Fev

er defined as 100.4 F and above

Signs and symptoms of COVID-19, including chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell

Contact in the previous 14 days with COVID+, is potentially COVID+, or is ill with respiratory (regardless of vaccine status)– Exemption for Dr/nurse/providers of essential services/hospice/state surveyors

Has a positive COVID-19 test from previous 10 days

Failing the Screen

Staff

Staff who fail the screen should not be admitted into the community. Staff who work with a COVID+ cohort should be wearing appropriate PPE and thus would not be considered to have close contact.

If a visitor fails the symptoms

portions of

screen, they must not be permitted to enter the community. This includes state surveyors, essential caregivers, regular/general visitors, home health, and etc.

Persons providing critical assistance may be permitted to enter despite close contact with a person who has an active case of COVID (this includes state surveyors).

Visitors

A resident who fails the screen should be quarantined and monitored according to the CDC. The CDC’s guidance says that residents with prolonged close contact exposure should be quarantined even if vaccinated. The

CDC’s guidance also says, “Although not preferred, healthcare facilities could consider waiving quarantine for fully vaccinated residents… as a strategy to address critical issues (e.g., lack of space, staff, or PPE to safely care for exposed patients or residents) when other options are unsuccessful or unavailable.”

Residents

HHSC’s Guidance through the COVID- 19 Response for Assisted Living Facilities states, “A facility may not require a visitor to provide documentation of COVID-19 negative test or COVID-19 vaccination status as a condition of visitation or to enter the facility.”

The CDC says, “Fully vaccinated HCP may be exempt from expanded screening testing. However, per recommendations above, vaccinated HCP should have a viral test if the HCP is symptomatic, has a higher-risk exposure or is working in a facility experiencing an outbreak.

Communities are still permitted to have a testing strategy for staff and may offer tests for visitors

Testing at Entrance

Activities and

Group Dining

Executive Order GA-36 overrides the COVID-19 Response Plan document regarding facemasks for both visitors and residents

The CDC recommends anyone who is unvaccinated maintain physical distancing and continue to wear a facemask if tolerated.

Activities and group dining policies should maintain medical privacy

COVID-Negative

COVID Positive

Has no

symptoms, and has had no exposure to the virus since the negative test.

H

as had known exposure or close contact with a person who

is COVID +, or who is exhibiting symptoms of COVID-19 while awaiting test results

Cohorting

Residents &

Quarantine

Confirmed positive diagnosis with test.

Need to follow isolation and quarantine guidance per HHSC and CDC.

Unknown COVID Status

Resources for Ongoing Guidance and Information

The CDC’s COVID-19 Page for Health Care Workers

https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html

HHSC’s COVID Response for ALF

https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/long-term-care/covid-response-plan-alf.pdf

DSHS COVID-19 Resources for HCPs

https://www.dshs.state.tx.us/coronavirus/healthprof.aspx#ltc

Emergency Communication System

July 9

th

, HHSC announced that all ALFs will need to enroll in emergency communication syste

m. Process and procedure to come.

This system should reduce individual phone calls by regional staff

Filed

November 9

th

, 2020

6,927 Bills Filed in both Chambers

5.4% decrease from the 86

th

Legislative Session; 4.5% increase from the 85

th

TALA tracked 126 bills with either a direct or indirect impact on assisted living communities

Topics ranged from infection control to visitation to worker’s comp to limited liability

Sine Die

January 12

th

to May 31

st

, 2021

1,052 New Laws

25% decrease from 86

th Legislative Session; 11.4% decrease from the 85

th Legislative SessionCOVID-19 and Winter Storm Uri

Historic animosity between House and Senate chambersWalkout by House Dems

Special Session

Now through ???

Redistricting

Census data expected September 30

th

American Rescue Plan Federal Funds Distribution

Governor Abbott has said he would bring the Legislature back to oversee the distribution of $16B

Election Reform

Special Session 87(1)- SB 1

Senate Bill 271- Relating to applicants for employment at assisted living facilities.

Enhancing background check process for new employees moving in from out-of-state

Closes a loophole in the name-based background check system

Requires employers to conduct a name-based background check in each state where the applicant has lived within the past 5 years

Senate Bill 6 COVID-19 Limited Liability

Does not protect gross negligence, willful misconduct or conscious indifference to resident’s welfare and safety

Begins with the start of a declared pandemic disaster

SB 25/HB 892

&

SJR 19/HJR 46

Relating to the right of certain residents to designate an essential caregiver for in-person visitation.

Establishes a resident’s right to an essential caregiver

Substantially similar to today’s current rules regarding essential caregivers

The caregivers are not required to adhere to conditions more restrictive than similar direct care staff

The caregivers are not required to have a specific caregiving duty or responsibility

HHSC will need to adopt rules, but in-person visitation cannot be suspended for more than 14 consecutive days or a total of 45 days.

The Senate Joint Resolution will be on the ballot Nov 2, 2021

The SJR would further enshrine the right to an Essential Caregiver in the Constitution

HB 3961- Relating to required posting of information regarding the office of the state long-term care ombudsman on certain long-term care facilities' Internet websites.

Requires all ALs with a website to post the LTC Ombudsman’s information somewhere on the site.

Communities without existing websites do not need to create a new one

If the community’s information is hosted on a larger company page, the Ombudsman’s information only needs to be posted one time

Websites need to be updated by 1/1/2022

HB 1681- Relating to the construction of certain assisted living facilities located within a floodplain in certain counties.

Prohibits the new construction of an assisted living community on or after Sept. 1, 2021 in the 100-year flood plain in Harris County

This bill went through significant negotiations and changes

The initial version applied to the entire state and the 500-year floodplain

The final bill language brings ALs in line with nursing homes and hospitals.

SB 199- Relating to automated external defibrillators.

Shields an owner or renter of an Automatic External Defibrillator (AED) from civil liability as long as the device appears to be reasonably ready for use and does not appear to be damaged

SB 383- Relating to disclosure requirements of certain facilities that provide care for persons with Alzheimer's disease and related disorders.

Requires all ALs which advertise as providing memory care services to disclose whether the community is Alzheimer’s Certified

The current disclosure process is sufficient, but HHSC is likely to update their required form

SB 930- Relating to the disclosure of certain information regarding the occurrence of communicable diseases in residential facilities.

Establishes that a facility’s identification and aggregate communicable disease data is not protected by HIPAA

The bill does not require communities to report any new information

HB 2325/SB 1614 (DID NOT PASS)

Would have required all ALs and nursing facilities to have a generator or comparable emergency power with sufficient fuel to maintain air temps between 68 degrees and 81 degrees for a minimum of 72 hours.

As filed, it would have been an enormous financial burden on providers with a very short window to implement.

TALA raised concerns about cost and availability of equipment and electricians

HB 1423- includes a contextualized study of assisted living communities with operational emergency generation for use during severe weather events.

Immediately

Sept 1, 2021

Jan 1, 2022

HHSC Rules

Sept 1, 2022

Limited Liability

Essential Caregivers

Vaccine Passport Prohibition

Harris Co. Flood Plain Ban

Out of State Background Checks

Post LTC Ombud. on Website

Alzheimer’s Disclosure

AED Limited Liability

In-person Religious Counselor

Report Received Federal Funds

Study Emergency Power Generation

Disclosure of Communicable Disease

Implementation Timeline

Thank you!

For additional questions:

Carmen.Tilton@TALA.org

www.tala.org