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N.C. Senate 'no patient left behind' legislation added to House bill

N.C. Senate 'no patient left behind' legislation added to House bill

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A state House bill has been amended this week in an attempt to move forward bipartisan Senate legislation that would secure visitation for hospital patients and long-term care residents during a state public-health emergency.

Senate Bill 191, titled “The No Patient Left Alone Act,” cleared the Senate by a 40-9 vote May 6. Among its primary sponsors is Sen. Joyce Krawiec, R-Forsyth.

That bill has sat in the House Rules and Operations committee since May 11.

On Wednesday, the Senate Health Care committee inserted language from SB191 into House Bill 351. The committee approved the insertion Thursday, sending it to Senate Judiciary committee.

The initial version of HB391, titled “Clifford’s Law,” would direct the state’s health secretary to establish visitation protocols for long-term care and Hospice care facilities during declared disasters and emergencies, such as the COVID-19 pandemic.

Meanwhile, the inserted SB191 language would secure a patient’s right to have a designated visitor during a declared disaster or public-health emergency, such as the COVID-19 pandemic.

SB191 affects hospitals, nursing homes, Hospice care, residential treatment facilities and other long-term care facilities.

There has been a significant decline in the number of COVID-19 outbreaks in Triad long-term care facilities in recent months.

However, the N.C. Department of Health and Human Services’ COVID-19 dashboard listed, as of Tuesday, The Citadel at Winston-Salem with an outbreak of at least 139 cases comprised of 102 residents, including five related deaths, and 37 staff.

The House would be required to approve the addition of the SB191 language or reject it. Rejection likely would send the amended bill to a concurrence committee to attempt a compromise.

Krawiec said Thursday there could be additional changes to the SB191 element of the bill in the expected concurrence committee.

“We must make sure that no patient in North Carolina is ever left alone in a hospital or nursing home while their spouse or family members are forced to wait at home or in the parking lot while their loved one is receiving care,” said Sen. Warren Daniel, R-Burke, and co-primary sponsor, during the Senate’s floor debate on SB191.

“A video call to a hospitalized patient, many who don’t know how to use a computer, cannot become a substitute for having a family member present during potentially life- and-death health care situations.”

The latest version of SB191 has been broadened to apply the same patient’s rights protections to most long-term care facilities, Hospice facilities and certain residential treatment facilities.

Krawiec has said that non-COVID-19 patients are being adversely affected by the visitor restriction as well.

“There are a multitude of cases where residents are still not allowed to have visitors,” Krawiec said. “It should never happen again where patients are dying alone in facilities.

“There are also those who have diminished cognitive abilities who don’t understand why they are abandoned without loved ones or caregivers being allowed to visit them.”

“Isolation is a reason many residents in facilities ‘fail to thrive,’ ” she said.

SB191’s primary focus remains on concerns that emergency visitor restrictions can keep family members from being with loved ones and hampering their ability to serve as an advocate with hospital staff.

Family members are defined as a spouse, child, sibling, parent, grandparent, grandchild, spouse of an immediate family member, stepparent, stepchildren, stepsiblings and adoptive relationships.

The patient can designate the visitor “if they have the capacity to make decisions.”

On March 12, the N.C. Department of Health and Human Services issued an order that long-term care facilities can allow in-person visitations — indoor and outdoor — “in most circumstances” based on changes made by the federal Centers of Medicare and Medicaid Services and the federal Centers for Disease Control and Prevention.

Those agencies cited “rapidly improving trends in long-term care facilities” for allowing more visitations.

DHHS cautioned in its updated guidance that outdoor visitations still remain the best option.

Sen. Jim Perry, R-Lenoir, said in June that the latest version of SB191 incorporates recent changes in federal law that allows for more compassionate care visits.

“What we’re doing is creating a state law that says you have to adhere to federal guidance,” Perry said.

“We know now that many families were kept apart unlawfully regardless of any health-care guidelines or the governor’s executive orders.

“Now, we have clarity and direction that comes from President Biden’s CMS team to fix what has been a heartbreaking issue.”




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