ASSEMBLY, No. 4430

STATE OF NEW JERSEY

219th LEGISLATURE

 

INTRODUCED JULY 20, 2020

 


 

Sponsored by:

Assemblyman  HERB CONAWAY, JR.

District 7 (Burlington)

Assemblywoman  VALERIE VAINIERI HUTTLE

District 37 (Bergen)

Assemblywoman  ANGELA V. MCKNIGHT

District 31 (Hudson)

 

Co-Sponsored by:

Assemblyman Benson, Assemblywoman Downey, Assemblymen Caputo, Giblin and Assemblywoman Speight

 

 

 

 

SYNOPSIS

     Establishes uniform requirements on submission of outbreak response plans to DOH by long-term care facilities.

 

CURRENT VERSION OF TEXT

     As introduced.

  


An Act concerning long-term care facilities and amending P.L.2019, c.243.

 

     Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

     1.    Section 1 of P.L.2019, c.243 (C.26:2H-12.87) is amended to read as follows:

     1.    a.  As used in this section:

     "Cohorting" means the practice of grouping patients who are or are not colonized or infected with the same organism to confine their care to one area and prevent contact with other patients.

     "Department" means the Department of Health.

     "Endemic level" means the usual level of given disease in a geographic area.

     "Isolating" means the process of separating sick, contagious persons from those who are not sick.

     "Long-term care facility" means a nursing home, assisted living residence, comprehensive personal care home, residential health care facility, or dementia care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).

     ["Long-term care facility that provides care to ventilator-dependent residents" means a long-term care facility that has been licensed to provide beds for ventilator care.]

     "Outbreak" means any unusual occurrence of disease or any disease above background or endemic levels.

     b.    Notwithstanding any provision of law to the contrary, as a condition of licensure, the department shall require long-term care facilities to develop an outbreak response plan within 180 days after the effective date of this act, which plan shall be customized to the facility, based upon national standards and developed in consultation with the facility's infection control committee, if the facility has established an infection control [committee2] committee.  At a minimum, each facility's plan shall include, but shall not be limited to: 

     (1)   a protocol for isolating and cohorting infected and at-risk patients in the event of an outbreak of a contagious disease until the cessation of the outbreak;

     (2)   clear policies for the notification of residents, residents' families, visitors, and staff in the event of an outbreak of a contagious disease at a facility;

     (3)   information on the availability of laboratory testing, protocols for assessing whether facility visitors are ill, protocols to require ill staff to not present at the facility for work duties, and processes for implementing evidence-based outbreak response measures;

     (4)   policies to conduct routine monitoring of residents and staff to quickly identify signs of a communicable disease that could develop into an outbreak; and

     (5)   policies for reporting outbreaks to public health officials in accordance with applicable laws and regulations.

     c.     (1)  In addition to the requirements set forth in subsection b. of this section, the department shall require long-term care facilities [that provide care to ventilator-dependent residents] to include in the facility's outbreak response plan written policies to meet staffing, training, and facility demands during an infectious disease outbreak to successfully implement the outbreak response plan, including either employing on a full-time or part-time basis, or contracting with on a consultative basis, the following individuals:

     (a)   an individual certified by the Certification Board of Infection Control and Epidemiology; and

     (b)   a physician who has completed an infectious disease fellowship.

     (2)   Each long-term care facility [that provides care to ventilator-dependent residents] shall submit to the department the facility's outbreak response plan within 180 days after the effective date of this act.

     (3)   The department shall verify that the outbreak response plans submitted by long-term care facilities [that provide care to ventilator-dependent residents] are in compliance with the requirements of subsection b. of this section and with the requirements of paragraph (1) of this subsection.

     d.    (1)  Each long-term care facility that submits an outbreak response plan to the department pursuant to subsection c. of this section shall review the plan on an annual basis.

     (2)   If a long-term care facility [that provides care to ventilator-dependent residents] makes any material changes to its outbreak response plan, the facility shall, within 30 days after completing the material change, submit to the department an updated outbreak response plan.  The department shall, upon receiving an updated outbreak response plan, verify that the plan is compliant with the requirements of subsections b. and c. of this section.

     e.     (1)  The department shall require a long-term care facility [that provides care to ventilator-dependent residents] to assign to the facility's infection control committee on a full-time or part-time basis, or on a consultative basis:

     (a)   [an who is] a physician who has completed an infectious disease fellowship; and

     (b)   an individual designated as the infection [control coordinator,] preventionist who has [education, training, completed course work, or experience in infection control or] primary professional training in medicine, nursing, medical technology, microbiology, epidemiology, [including] or a related field, is qualified by education, training, experience, or certification in infection control by the Certification Board of Infection Control and Epidemiology , and has completed specialized training in infection prevention and control.  The infection control committee shall meet on at least a quarterly basis and both individuals assigned to the committee pursuant to this subsection shall attend at least half of the meetings held by the infection control committee.

     f.     (1)  An infection preventionist assigned to a long-term care facility's infection control committee pursuant to subsection e. of this section shall be a managerial employee and shall be employed at least part-time at a long-term care facility with a licensed bed capacity equal to 100 beds or less or full-time at a long-term care facility with a licensed bed capacity equal to 101 beds or more.  The infection preventionist shall report directly to the chief executive officer and the board of the long-term care facility, as applicable, and shall provide the chief executive officer and board, as applicable, quarterly reports detailing the effectiveness of the long-term care facility’s infection prevention policies. 

     (2)   The infection preventionist shall be responsible for:

     (a)   developing policies, procedures, and a training curriculum for long-term care facility staff based on best practices and clinical expertise; and

     (b)   monitoring the implementation of infection prevention policies and instituting disciplinary measures for staff who routinely violate those policies.

     g.    A long-term care facility, which develops an outbreak response plan pursuant to this section, shall publish the plan on its Internet website.

     h.    A long-term care facility, which develops an outbreak response plan pursuant to this section, shall annually perform preparedness drills to evaluate the effectiveness of its outbreak response plan.

(cf: P.L.2019, c.243, s.1)

 

     2.    This act shall take effect immediately.

 

 

STATEMENT

 

     This bill establishes uniform requirements on the submission of outbreak response plans to the Department of Health (DOH) by long-term care facilities. 

     P.L.2019, c.243 applied additional requirements on long-term care facilities with ventilator dependent patients regarding the submission of outbreak response plans.  This bill amends P.L.2019, c.243 to apply the additional requirements to all long-term care facilities, irrespective of whether the long-term care facilities treat ventilator dependent patients.  In addition, this bill requires the DOH to approve submitted plans and provides that the submission of the plans is to be a condition of licensure.  P.L.2019, c.243 only required the DOH to verify submitted plans.

     Under the bill, the DOH is to require long-term care facilities to include in the facility's outbreak response plan written policies to meet staffing, training, and facility demands during an infectious disease outbreak to successfully implement the outbreak response plan, including either employing on a full-time or part-time basis, or contracting with on a consultative basis, the following individuals: an individual certified by the Certification Board of Infection Control and Epidemiology; and a physician who has completed an infectious disease fellowship.  Each long-term care facility is to submit to the DOH the facility's outbreak response plan within 180 days after the effective date of this bill.

     The bill provides that the DOH is to verify that the outbreak response plans submitted by long-term care facilities are in compliance with the bill’s requirements.  If a long-term care facility makes any material changes to its outbreak response plan, the facility is to, within 30 days after completing the material change, submit to the DOH an updated outbreak response plan.  The DOH is to, upon receiving an updated outbreak response plan, verify that the plan is compliant with the bill’s requirements.

     Further, the DOH is to require a long-term care facility to assign to the facility's infection control committee on a full-time or part-time basis, or on a consultative basis: a physician who has completed an infectious disease fellowship; and an individual designated as the infection preventionist, as provided for in the bill.

     Under the bill, an infection preventionist assigned to a long-term care facility's infection control committee is to be a managerial employee and is to be employed at least part-time at a long-term care facility with a licensed bed capacity equal to 100 beds or less or full-time at a long-term care facility with a licensed bed capacity equal to 101 beds or more.  The infection preventionist is to report directly to the chief executive officer and the board of the long-term care facility, as applicable, and is to provide the chief executive officer and board, as applicable, quarterly reports detailing the effectiveness of the long-term care facility’s infection prevention policies. 

     The infection preventionist is to be responsible for:  developing policies, procedures, and a training curriculum for long-term care facility staff based on best practices and clinical expertise; and monitoring the implementation of infection prevention policies and instituting disciplinary measures for staff who routinely violate those policies.

     The bill provides that a long-term care facility is to publish its outbreak response on its Internet website and annually perform preparedness drills to evaluate the effectiveness of its outbreak response plan.