Amendment #14 to H4888

Common Sense Health Services for Residents of Assisted Living Residences

Representatives Pignatelli of Lenox and Balser of Newton move to amend the bill, as amended, by adding the following sections:

"SECTION XX. Section 1 of chapter 19D of the general laws, as appearing in the 2016 Official Edition, is hereby amended, by inserting after the definition for “elderly housing,” the following new definition:-

“Basic Health Services”, injections; application or replacement of simple non-sterile dressings; management of oxygen on a regular and continuing basis when the resident's medical condition warrants; or application of ointments or drops.

SECTION XX. 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 XX. 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 XX. Section 10 of chapter 19D, is hereby further amended by inserting after subsection (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 to Licensed Practical Nurses and Registered Nurses who will provide such care, and the oversight and evaluation of basic health services, provided 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 fees associated with provision of basic health services within the assisted living residence’s residency agreement, and shall review such fees with the resident upon implementation and any revision to a service plan which includes provision of basic health services. Residents who receive basic health services must receive an additional service plan review on a quarterly basis. 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 shall promulgate regulations governing the application, criteria for approval or disapproval, and ongoing oversight of basic health services authorized in this section. The Executive Office may impose an annual fee on participating assisted living residences to pay for oversight of basic health services.

(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, including a requirement that when a residence is offering basic health services to one or more residents, staff shall have access to a Licensed Practical Nurse or Registered Nurse for consultation at all times, and said nurse is not required to be on the premises. 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 assisted living residences for any assisted living resident who received basic health services within the previous twelve month period.

(i) The Joint Committee on Elder Affairs shall conduct a review of this law’s implementation and the use of basic health services in assisted living, five years after the law goes into effect.

SECTION XX. 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,”".

Additional co-sponsor(s) added to Amendment #14 to H4888

Common Sense Health Services for Residents of Assisted Living Residences