Amendment #21 to H4617

Relative to Basic Health Services for Residents of Assisted Living Facilities

Miss Gregoire of Marlborough moves to amend the bill by inserting after the definition for “elderly housing,” the following new definition:-

“Basic Health Services”, injections; application or replacement of simple non-sterile dressings, including wound dressing application for up to and including Stage 2 pressure wounds; management of oxygen on a regular and continuing basis when the resident's medical condition warrants;  or application of ointments or drops.

SECTION 2. Section 10 of chapter 19D, is hereby amended by striking subsection (5), and inserting in place thereof, the following subsection: -

(5) For all residents whose service plans so specify, either or both self-administered medication management or basic health services by personnel meeting standards for professional qualifications and training set forth in the regulations.

SECTION 3.  Section 10 of chapter 19D, is hereby further amended in subsection (c) by inserting after the words, “for the provisions of,” the following: - “basic health services, or.”

SECTION 4. Section 10 of chapter 19D, is hereby further amended by inserting after subsection (7) (d), the following new subsections:-

(e) The sponsor may advertise, market, and otherwise promote or provide or arrange for the provision of basic health services for assisted living residents and shall administer such care and services in accordance with the requirements set forth herein. A sponsor may not provide basic health services without submitting an operating plan to the Executive Office of Elder Affairs for its approval that explains how the Residence’s basic health services will meet the needs of its resident population or individual residents therein, and the staff qualifications and training for providing such services. Said operating plan shall specify whether all, or certain, of the enumerated basic health services will be offered, steps taken to provide adequate support and training of nurses who will provide such care, oversight and evaluation of basic health services, provided, however, that no such plan shall restrict resident choice in the delivery of said services by outside health professionals.

(f) The sponsor shall disclose to each resident the costs associated with provision of basic health services in the care plan of the resident.  This disclosure shall be made upon initial implementation of the resident’s care plan and upon all revisions of the plan.  Residents shall have the opportunity to discontinue receiving basic health services from the sponsor upon written request to the sponsor and shall not be charged a cancellation fee or a fee for services not provided due to discontinuation of said services.

(g) The Executive Office of Elder Affairs, in consultation with the Department of Public Health, is, hereby, authorized and directed to promulgate appropriate regulations governing the application, criteria for approval or disapproval, and ongoing oversight of basic health services authorized in this section, which shall include, but not be limited to, the requirement that any facility offering such basic health services shall have a registered nurse on-site at all times.

(h) To ensure patient safety and clinical competence in the application of subsections (e)-(g), the Executive Office of Elder Affairs and the Department of Public Health shall establish and implement a plan to facilitate communication between the department and the executive office and create a list of required components necessary for operating plans.  The Executive Office of Elder Affairs shall make available electronic copies of the required components of operating plans on its website.              The Executive Office of Elder Affairs may conduct annual compliance reviews on the documentation created and maintained by the assisted living facility for any assisted living resident who receives or has received basic health services within the previous twelve month period.

SECTION 5. Section 11 of said chapter 19D, is hereby further amended by inserting after the first sentence the following:-

“Except as permitted for residences which opt to provide basic health services,”.