Connecticut Senate and House Pass Home Care Worker Safety Bill

by | 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 Elara Caring at Fault Joyce Grayson Home Care Worker Safety 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 :

  1. A mobile application for staff to access safety information about a client
  2. A method for staff to communicate with either local police or other staff in the event of an emergency
  3. 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;

  1. psychiatric history
  2. history of violence
  3. history of substance use
  4. history of domestic abuse
  5. current infections, if any, and treatment received
  6. whether diagnoses or symptoms have remained stable over time
Home Care Worker Safety
Other persons present or anticipated to be present at the location of care including, if known to the agency:

  1. name and relationship to client
  2. psychiatric history
  3. history of violence or domestic abuse
  4. criminal record
  5. history of substance use

Location where employee will provide services including, if know to the agency:

  1. the crime rate for the municipality in which employee will provide services
  2. the presence of any hazardous materials, including, but not limited to used syringes
  3. the presence of firearms or other weapons
  4. the status and of the fire alarm system
  5. 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:

  1. Training to recognize hazards commonly encountered in home care workplaces
  2. 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:

  1. A mobile application that allows staff to access safety information about the client
  2. A means of communicating with local police or other staff in the event of an emergency
  3. 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:

  1. Report each instance of verbal abuse that is perceived as a threat or danger to the staff
  2. 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:

  1. The number of reports of violence and abuse received
  2. 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:

  1. Three employees of a home health care or home health aide agency
  2. Two representatives of a home health care or home health aide agency
  3. One representative of a collective bargaining unit representing home health care or home health aide agency employees
  4. One representative of a mobile crisis response services provider
  5. One representative of an assertive community treatment team
  6. One representative of a police department; and
  7. One representative of an association of hospitals in the state

Implications

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:
  1. Create a safety committee within your agency
  2. Invest in training on de-escalation, workplace violence prevention, and self-defense
  3. Research and invest in a GPS-enabled emergency alert system for your staff. We recommend POM Safe and Katana Safety
  4. Insist on background information on all clients and others living in the home upon intake and BEFORE the first home visit
  5. Create a safe and comfortable way for your staff to report verbal abuse, violence, or uneasiness from any in-home visit
  6. 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.

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Kristin Rowan, Editor
Kristin Rowan, Editor

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

Home Care Worker Safety: Aftermath of Home Health Nurse Death

by | Apr 18, 2024 | Caring for the Caregiver, Clinical, Regulatory

by Kristin Rowan, Editor

In October of 2023, nurse Joyce Grayson went to the home (halfway house) of a released convict. She was later found dead in the basement of the house. In addition to adding focus to home care worker safety, the immediate response to this tragic event was an increase in nurses being afraid to do their jobs. Lawmakers in Connecticut vowed to increase protection for visiting nurses to ensure health care worker safety. The nurses requested additional reporting requirements for assaults while lawmakers suggested requiring an escort for high-risk situations.

Elara Caring at Fault Joyce Grayson Home Care Worker Safety

Home Care Worker Safety by Law

Connecticut Senator Saud Anwar recognizes the growing segment of people wanting to age at home. “We want people to be able to get treatment at home,” he said. However, he also recognized the need for more information about potentially dangerous homes. He said at-home health care workers should be aware of what they’re walkin into “if there’s a high-risk situation.” Conn. lawmakers introduced Senate Bill One for Session Year 2024. The bill would require agencies to provide patient information, as applicable, including:

  • Medical History
    • Psychiatric history
    • History of violence
    • History of substance abuse
    • History of domestic abuse,
    • Current infections and treatments
    • Stability of diagnoses or symptoms over time
Joyce Grayson Lone worker safety
  • Housing Information
    • Other persons in the home
    • Name and relationship to patient
    • Psychiatric history
    • History of violence or domestic violence
    • Criminal records
    • History of substance abuse
  • Location of Service
    • Crime rate
    • Presence of hazardous materials
    • Presence of firearms or other weapons
    • Status of location’s fire alarm system
    • Presence of any other safety hazards

The bill also included ongoing safety training, safety assessments, and safety checks including:

  • A mobile app with patient information
  • A GPS enabled wearable device that allows staff to contact law enforcement

The Bill included payment rates to offset the cost of implementing all safety items to ensure cost-neutrality.

Implications for Hospice Agencies

Barbara Pearce, interim CEO of Connecticut Hospice, raised some legitimate concerns over the bill. Pearce warns that the background screenings required are lengthy and would result in many patients not receiving hospice care at all. According to Pearce, Connecticut Hospice “had 300 people die within three days, 200 people within two days, and 100 people within one day of entering home hospice care.” None of these patients would have been cared for if the bill had been in place at the time. Pearce discussed her concerns with Conn. lawmakers, who have since changed their approach.

Senate Bill One "Home Care Worker Safety" Moving Forward

Connecticut lawmakers are opting to exclude hospices from the bill for now. Sen Anwar said they plan to write a hospice-tailored bill “in the future” to ensure safety of hospice workers. Anwar continued, “We will have a plan of action to see what can be done to reduce the risk for hospice care workers too because…we want to make sure they’re safe too.”

The Connecticut 2024 legislative session is scheduled to adjourn on May 8. Senate and House representatives are racing the clock to modify the bill before the session ends.

Implication for Home Health

Few, if any, states have laws for home health worker safety. Alaska and Idaho have strict penalties for violence against health care workers. Wyoming introduced a similar bill in 2013, but it was defeated. Oregon passed a law in 2007 to require hospitals and surgery centers to implement safety strategies. Washington state established a law in 1999 that requires the development and implementation of a work-place violence plan. The law includes home health, hospice, and home care agencies, but does not have the detailed measures included in Connecticut’s bill.

If Senate Bill One passes in Connecticut, it could pave the way for additional state or federal regulations for in-home care safety precautions. Violence in home health, hospice, and home care has increased and steps need to be taken to ensure the safety and well-being of caregivers. Keep an eye out for some upcoming product reviews on mobile apps and hand-held emergency devices that allow home care workers to alert the agency, law enforcement, and/or family members before, during, and after a care visit.

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Kristin Rowan, Editor
Kristin Rowan, Editor

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