by Kristin Rowan | May 10, 2024 | Admin, Caring for the Caregiver, Clinical, Regulatory
by Kristin Rowan, Editor
Last week, we reported on the proposed Bill in the Connecticut Senate and House to provide additional precautions for home care worker safety. In wake of the 
Joyce Grayson murder during a home health visit, leadership in Connecticut aimed to safeguard home health and home health aide workers and collect risk assessment data on the same.
On May 6, 2024, CT legislature passed bills in both the Senate and House of Representatives. Instead of the proposed bills that we reported on previously, both branches added amendments to previous bills. The bills include provisions for cyberattack readiness, child safety, and other items not related to care in the home.
First Stage of Home Care Worker Safety
Some of the provisions in the final bill are effective July 1, 2024. As we previously reported, hospice agencies are currently exempt from these provisions and the CT legislature will address hospice agencies in their next session.
On and after July 1, 2024
The Commissioner shall increase the fee payable to a home health care or home health aide agency that provides escorts for safety purposes to staff conducting a home visit to cover the costs of providing such escorts.
The Commission of Public Health will establish and administer a home care staff safety grant program to provide grants to home health and home health aide agencies for staff safety technology, including, but not limited to :
- A mobile application for staff to access safety information about a client
- A method for staff to communicate with either local police or other staff in the event of an emergency
- A global positioning system-enabled, wearable device that allows staff to contact local police
Effective July 1, 2024
The sum of one million dollars is appropriated to the Department of Public Health for the the fiscal year ending June 30, 2025, to establish and administer the aforementioned grant program.
The Commissioner of Public Health and the Commission on Community Gun Violence Intervention and Prevention, will develop or find educational material about gun safety practices and provide such to primary care providers to give to patients who are 18 years of age or older.
Second Stage of Home Care Worker Safety
Some of the provisions in the final bill are effective October 1, 2024. Home health and home health aide agencies have five months to comply with these measures.
Effective October 1, 2024, home health and home health aide agency must collect and provide to assigned workers information about:
The client, including as applicable;
- psychiatric history
- history of violence
- history of substance use
- history of domestic abuse
- current infections, if any, and treatment received
- whether diagnoses or symptoms have remained stable over time
Other persons present or anticipated to be present at the location of care including, if known to the agency:
- name and relationship to client
- psychiatric history
- history of violence or domestic abuse
- criminal record
- history of substance use
Location where employee will provide services including, if know to the agency:
- the crime rate for the municipality in which employee will provide services
- the presence of any hazardous materials, including, but not limited to used syringes
- the presence of firearms or other weapons
- the status and of the fire alarm system
- the presence of any safety hazards, including, but not limited to, electrical hazards
By October 1, 2024, each home health and home health aide agency must:
Provide staff training consistent with the health and safety training curriculum for home care workers, including but not limited to:
- Training to recognize hazards commonly encountered in home care workplaces
- Applying practical solutions to manage risks and improve safety
Conduct monthly safety assessments with each staff member and
Provide staff with a mechanism to perform safety checks, which may include, but need not be limited to:
- A mobile application that allows staff to access safety information about the client
- A means of communicating with local police or other staff in the event of an emergency
- A global positioning system-enabled, wearable device that allows staff to contact local police by pressing a button or through another mechanism
Effective October 1, 2024
Each home health and home health aide agency shall, in a manner prescribed by the Commissioner of Public Health:
- Report each instance of verbal abuse that is perceived as a threat or danger to the staff
- Report each instance of physical, sexual, or any other abuse by a client against a staff member
Third Stage of Home Care Worker Safety
No later than January 1, 2025
Beginning January 1, 2025 and annually therafter, the commissioner shall report to the joint standing committee:
- The number of reports of violence and abuse received
- The actions taken to ensure the safety of the staff member about whom the report was made
Effective January 1, 2025
Each individual health insurance policy shall provide coverage for escorts for the safety of home health care agency or home health aide agency staff
The joint standing committee of the General Assembly will convene a working group to study staff safety issues affecting home health and home health aide agencies, including but not limited to the following members:
- Three employees of a home health care or home health aide agency
- Two representatives of a home health care or home health aide agency
- One representative of a collective bargaining unit representing home health care or home health aide agency employees
- One representative of a mobile crisis response services provider
- One representative of an assertive community treatment team
- One representative of a police department; and
- One representative of an association of hospitals in the state
As we mentioned before, these regulations will become mandates across the country soon. OSHA has found the home care agency in Connecticut at fault for failing to implement safety procedures and precautions in the death of Joyce Grayson. The nurse’s family is suing the home health agency for wrongful death. Connecticut has established a protocol for safety measures, committees, reporting, and grant programs to implement immediate safety procedures across home health and home health aide agencies in the state. Before these provisions are passed on a national level, and before you have to tell the family of one of your staff that they aren’t coming home…
We urge you to:
- Create a safety committee within your agency
- Invest in training on de-escalation, workplace violence prevention, and self-defense
- Research and invest in a GPS-enabled emergency alert system for your staff. We recommend POM Safe and Katana Safety
- Insist on background information on all clients and others living in the home upon intake and BEFORE the first home visit
- Create a safe and comfortable way for your staff to report verbal abuse, violence, or uneasiness from any in-home visit
- Invest in escort and/or paired visits for high-risk clients, first-time clients, or any other situation that warrants it
We will continue to follow this story and provide updates as we receive them.
Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com
©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com
by Kristin Rowan | May 2, 2024 | Clinical, Regulatory
Home health agency failed to protect Joyce Grayson
History
We’ve been following the story of Joyce Grayson since her death in October of 2023. The news was first published in The Rowan Report here on November 8th, 2023.On April 14th, we reported on the pending Senate Bill in Connecticut that would require home health agencies to provide additional information and safety precautions prior to a home visit. The safety of solo workers is now even more important to home health and hospice agencies with the most recent update.
Today
May 1, 2024, the U.S. Department of Labor (DOL) posted a news release on their investigation into the death of Joyce Grayson, a home health nurse in Connecticut. According to the Department of Labor, OSHA has determined that Elara Caring exposed their employees to workplace violence from patients who were known to pose a risk to others. Jordan Health Care Inc. and New England Home Care Inc., both doing business as Elara Caring, have been cited for willful violation of the agency’s general duty clause. OSHA cited them for not developing and implementing safety measures to protect employees from workplace violence. They also cited the agency for failure to report work-related injury and illness records within four business hours.
Repercussions
OSHA has proposed more than $163,000 in penalties against Elara Caring. Elara Caring has 15 days from receipt of the citations to respond, request a hearing, or contest the findings.
“Elara Caring failed its legal duty to protect employees from workplace injury by not having effective measures in place to protect employees against a known hazard and it cost a worker her life,” said OSHA Area Director Charles D. McGrevy in Hartford, Connecticut. “For its employees’ well-being, Elara must develop, implement and maintain required safeguards such as a comprehensive workplace violence prevention program. Workplace safety is not a privilege; it is every worker’s right.”
OSHA found that Elara Caring could have reduced the potential for workplace violence by looking at the root causes of violent incidents and “near misses.” They could also have provided clinicians with background information on patients prior to a home visit. Other recommendations from OSHA include providing emergency panic alert buttons and using safety escorts for visits with high-risk patients.
Future Recommendations
The DOL states that employers should have a comprehensive workplace violence program. This program should include both management and employee involvement. Further, the DOL says this plan should have a written program with a committee. Elements of a workplace violence program include:
- Analysis of a home upon new patient admission
- Hazard prevention and control
- Training and Education
- Resources for Impacted Employees
- Recordkeeping
- Employee Feedback
Implications
If Elara Caring is fined for failure to keep their clinicians safe as a result of the investigation into Joyce Grayson’s murder, state and national level regulations are sure to follow. However, even if the laws in your area don’t change, investing now in workplace safety for your clinicians could save you from similar allegations and fines. As we mentioned in last week’s article about the Senate Bill, we have been in touch with several emergency alert companies and will be providing product reviews in the next few weeks. Start a workforce safety committee, develop a written plan for mitigating dangerous situations, and issue emergency response systems to all of your clinicians before it is your agency under investigation. More importantly, take these steps before your team loses one of its own to workplace violence.
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Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com
©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com
by Kristin Rowan | Oct 25, 2023 | Admin, Regulatory
by Kristin Rowan, Editor
Marking a significant victory for the HCAOA Connecticut Chapter and the home care industry, in the legislative session that ended last week, lawmakers unanimously passed a bill to reverse the policy guidance issued by the Department of Consumer Protection in January that banned use of the word “care” by home care agencies. In response to the guidance that directly harmed the industry, the Chapter and its members engaged in a strong lobbying effort to reverse it.
The guidance had caused significant concern and confusion for agencies, caregivers, consumers and lawmakers. Indeed, the Department had recently begun enforcing the ban against HCAs, requiring them to remove the word “care” from websites and other advertising.
On June 2, the state Senate gave final legislative approval to House Bill 5781, which allows HCAs to use the word “care” in their business names and advertising and advertise having employees trained to provide services to individuals experiencing memory difficulties as long as the agency prominently advertises that it solely provides nonmedical care, and doesn’t use any words, such as those related to medical or health care licensure or services, to describe services beyond the scope of those a HCA is authorized to provide. Also, HCAs must give consumers written notice that the agency provides nonmedical care and obtain the consumer’s signature on the notice before providing services. The Governor is expected to sign Public Act 23-48 shortly.
Chapter leaders and many members testified in support of the legislation, contacted the Governor and met with lawmakers and other officials, engaged in grass roots support, and advocated for the change. “It was a significant effort by the Chapter but our strategy and the work of members paid off,” said Marlene Chickerella, Chapter Chair and owner of B&M Homemaking Services in West Haven. “We are very grateful to lawmakers for changing the policy and appreciate all the support and assistance of our member-home care agency owners. They stepped up and clearly made a difference.”
Additionally, House Bill 5781, which originally arose out of the Homemaker-Companion Task Force recommendations:
• Requires the Office of Policy and Management to develop a plan and proposed timeline to transfer oversight of HCAs from Consumer Protection to the Department of Public Health; the plan will include recommendations on training standards and appropriate use of the term “care” to describe home care services.
• Adds failure to give a consumer written notice that the agency provides nonmedical care to a list of violations for which DCP may revoke, suspend, or refuse to issue or renew a HCA’s registration; requires DCP to revoke a HCA’s registration if the agency is found to have violated any revokable provisions three times in a calendar year.
• Requires HCAs to develop in consultation with the consumer a service plan or contract that includes (1) a person-centered plan of care, (2) anticipated oversight by the agency of the caregiver assigned to the consumer, and (3) how often the person who oversees the agency’s caregiver and consumer will meet.
• Requires DCP to post on its website a guide detailing the process for consumers to file complaints against a HCA; and requires agencies to give consumers a printed copy of this guide with their contract or service plan.
• Requires HCAs to create a brochure and maintain a website detailing the services it provides.
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Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com
