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A01999 Summary:

BILL NOA01999A
 
SAME ASSAME AS S01783, SAME AS A06057
 
SPONSORGottfried
 
COSPNSRWallace, Meeks, Dinowitz, Bronson, Rivera J, Gonzalez-Rojas, Jacobson, Richardson, Cusick, Steck, Anderson, Colton, Simon, Cook, Forrest, Buttenschon, Santabarbara
 
MLTSPNSR
 
 
Directs the department of health to establish and implement an infection inspection audit and checklist on residential care facilities, nursing homes and long-term care facilities.
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A01999 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         1999--A
 
                               2021-2022 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 14, 2021
                                       ___________
 
        Introduced  by  M. of A. GOTTFRIED, WALLACE -- read once and referred to
          the Committee on Health -- committee discharged, bill amended, ordered
          reprinted as amended and recommitted to said committee
 
        AN ACT directing the department of health to establish and implement  an
          infection  inspection  audit and checklist on residential care facili-
          ties, nursing homes and long-term care facilities
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Definitions.  For the purposes of this act, the following
     2  terms shall have the following meanings:
     3    (a) "Department" means the department of health.
     4    (b) "Facility" means a nursing home or residential health care facili-
     5  ty as defined in article 28 of the public health law.
     6    (c) "Nursing home" means a facility providing therein nursing care  to
     7  sick,  invalid,  infirm, disabled or convalescent persons in addition to
     8  lodging and board or health-related service, or any combination  of  the
     9  foregoing,  and  in addition thereto, providing nursing care and health-
    10  related service, or either of them, to persons who are not occupants  of
    11  the facility.
    12    (d)  "Audit"  means  the infection control competency audit created by
    13  the department under this act.
    14    (e) "Checklist" means the infection control competency audit checklist
    15  created by the department under this act.
    16    § 2. Establishing the infection  control  competency  audit.  (a)  The
    17  department  shall  promulgate  rules  and  regulations  establishing  an
    18  infection control competency audit for a facility  consistent  with  the
    19  provisions  of  this act. The audit shall include a competency checklist
    20  which incorporates specific core  competencies  based  on  guidance  set
    21  forth in this act.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02904-03-1

        A. 1999--A                          2
 
     1    (b)  The  department  shall commence audits of facilities on and after
     2  October 1, 2021 and such audits shall be conducted on  an  annual  basis
     3  thereafter.
     4    §  3.  Audit  evaluation.  (a)  The infection control competency audit
     5  shall utilize a checklist to evaluate the  competency  of  the  facility
     6  being  audited.   Facilities subject to the infection control competency
     7  audit shall be required to fulfill the required criteria of a minimum of
     8  eighty-five percent of the audit checklist.
     9    (b) If a facility meets at least eighty-five percent of  the  criteria
    10  within the checklist, the facility will be scored as "in adherence" with
    11  the infection control competency audit.
    12    (c)  If a facility meets between sixty percent and eighty-four percent
    13  of the required criteria within the  checklist,  the  facility  will  be
    14  scored  as "in adherence but warrants reinspection."  Such facility will
    15  be subject to reinspection by the department at least  once  before  the
    16  next annual inspection.
    17    (d) If a facility meets less than sixty percent of the criteria within
    18  the checklist, the facility will be scored as "not in adherence".
    19    §  4.  Facilities  not  in adherence with infection control competency
    20  audit. (a) The department shall establish a penalty framework for  those
    21  facilities  determined  to  be  "not  in  adherence" with the inspection
    22  control checklist. A facility being found "not in adherence" may  result
    23  in  revocation or suspension of the facility's license; provided, howev-
    24  er, that no such revocation shall be ordered unless the  department  has
    25  provided  the  facility  with  a fourteen day grace period, solely for a
    26  facility's first time being found "not in adherence", to meet  at  least
    27  eighty percent of the criteria within the checklist.
    28    (b) Audits shall continue at monthly intervals for facilities that are
    29  found  to  be  "not  in  adherence" by the established infection control
    30  competency checklist until such facilities meet at least eighty  percent
    31  of the criteria within the checklist.
    32    § 5. Audit standards core competencies. The department shall establish
    33  an infection control competency audit and checklist for facilities which
    34  shall include, but not be limited to:
    35    (a)  Infection  control. (i) The facility shall have an infection lead
    36  staff person to:
    37    (A) address and improve infection control based on federal  and  state
    38  public health advisories and review and implement the facility's pandem-
    39  ic  emergency  plan as required by subdivision 12 of section 2803 of the
    40  public health law; and
    41    (B) spend an adequate time at the facility focused on activities dedi-
    42  cated to infection control.
    43    (ii) The facility shall have an infection control program with written
    44  policies and procedures which includes, but is not limited to:
    45    (A) A written plan to investigate, control and take action to  prevent
    46  infections in the facility;
    47    (B)  Written  procedures  to allow for isolation and universal precau-
    48  tions for residents suspected or  confirmed  to  have  a  contagious  or
    49  infectious disease; and
    50    (C)   A  record  of  incidences  and  corrective  actions  related  to
    51  infections at the facility.
    52    (iii) During recognized periods of contagious  or  infectious  disease
    53  outbreaks,  the  facility  shall  have  screening requirements for every
    54  individual entering the facility, including staff, for symptoms  associ-
    55  ated with the infectious disease outbreak.

        A. 1999--A                          3
 
     1    (iv)  The facility shall establish  dedicated distinct areas for resi-
     2  dents confirmed or suspected to be infected with an  infectious  disease
     3  or  are  recovering from an infectious disease.  Policies and procedures
     4  shall be developed to isolate residents suspected to be infected with an
     5  infectious  disease  in  quarantine  until their infection status can be
     6  determined.
     7    (v) The facility shall have a staffing plan to limit transmission that
     8  shall include, but not be limited to:
     9    (A) Dedicated, consistent staffing teams who  directly  interact  with
    10  residents  that  are confirmed or suspected to be infected with a conta-
    11  gious or infectious disease; and
    12    (B) Limiting clinical and other staff who have direct resident contact
    13  to specific areas of the facility. There should be no rotation of  staff
    14  between various areas of the facility during the period they are working
    15  each day during periods of recognized outbreaks.
    16    (vi)  The  facility  shall  ensure  ongoing  access  to  the necessary
    17  supplies for hand hygiene for staff and residents.
    18    (vii) The facility shall ensure ongoing access to federally registered
    19  hospital disinfectants or centers for disease control acceptable  alter-
    20  natives to allow for necessary and appropriate cleaning and disinfecting
    21  of high traffic surfaces and shared resident care equipment.
    22    (b)  Personal protective equipment. (i) The facility shall possess and
    23  maintain or contract to have at least a two month supply of  all  neces-
    24  sary items of personal protective equipment in line with the most recent
    25  department guidance and statutes.
    26    (ii)  The  facility shall develop a contingency plan to address supply
    27  shortages of personal protective equipment.
    28    (iii) The facility shall  train  staff  and  establish  protocols  for
    29  selecting, donning and doffing appropriate personal protective equipment
    30  and  demonstrate competency during resident care. The facility must keep
    31  a record of this staff training.
    32    (iv) The facility shall ensure  availability  of  personal  protective
    33  equipment  throughout the facility and outside resident rooms when there
    34  are units with separate cohorted spaces for both positive  and  negative
    35  infectious disease residents.
    36    (v) The facility shall require the use of recommended personal protec-
    37  tive  equipment  for  all  front-line staff in line with the most recent
    38  department guidance.
    39    (vi) The facility must designate a staff  member  who  is  present  at
    40  every  shift  who is responsible for ensuring the proper use of personal
    41  protective equipment by all staff.
    42    (c) Staffing. (i) The facility shall demonstrate that there  has  been
    43  advanced  planning, in alignment with the facility's emergency prepared-
    44  ness plans and pandemic emergency plan, for contingent staffing needs in
    45  the case of staff quarantines.
    46    (ii) The facility shall have an employee responsible for conducting  a
    47  daily  assessment  of  staffing  status  and needs during an outbreak of
    48  infectious or contagious diseases.
    49    (iii) The facility shall institute a sick-leave policy that  does  not
    50  punish  staff  with  disciplinary  action  if  they are absent from work
    51  because they are exhibiting symptoms, or test positive,  for  an  infec-
    52  tious disease. Such policies shall offer the maximum amount of flexibil-
    53  ity to staff and be consistent with state guidance.
    54    (d)  Clinical  care.  (i)  The  facility shall shave infection control
    55  policies that outline  the  recommended  transmission-based  precautions
    56  that   should  be  used  when  caring  for  residents  with  respiratory

        A. 1999--A                          4
 
     1  infection. These policies shall accommodate for department  and  centers
     2  for  disease control guidance on personal protective equipment conserva-
     3  tion methods.
     4    (ii)  The  facility  shall  ensure all health care professionals which
     5  enter the facility have been trained to recognize the signs and symptoms
     6  of infectious diseases.
     7    (iii) The facility  has  written  requirements  for  residents  to  be
     8  screened  for  symptoms  and have their vital signs monitored, including
     9  oxygen saturation and temperature checks in  accordance  with  the  most
    10  recent  state  or  federal  guidance  and and documented in the clinical
    11  record  during  a  recognized  outbreak  of  contagious  or   infectious
    12  diseases.
    13    (iv)  The  facility  shall  ensure  that  residents with any suspected
    14  respiratory or infectious illnesses are  assessed  at  a  more  frequent
    15  rate.
    16    (e)  Written  communication  plan.   The facility shall have a written
    17  plan for daily communications with staff, residents, and the  residents'
    18  families  regarding the status of infections at the facility.  Such plan
    19  shall be consistent with the requirements set forth in paragraph (a)  of
    20  subdivision  12  of  section 2803 of the public health law. The facility
    21  must designate a staff member who  is  responsible  for  these  communi-
    22  cations with staff, residents and residents' families.
    23    § 6. This act shall take effect ninety days after it shall have become
    24  a law.
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