HB1430: HB1430 Community Health, Department of; license supportive senior housing communities; provide

26 LC 52 1000 House Bill 1430 By: Representatives Taylor of the 173rd, Dempsey of the 13th, Burchett of the 176th, Newton of the 127th, and Cooper of the 45th A BILL TO BE ENTITLED AN ACT To amend Article 1 of Chapter 7 of Title 31 of the Official Cod e of Georgia Annotated,1 relating to the regulation of hospitals and related institution s, so as to provide for the2 Department of Community Health to license supportive senior hou sing communities; to3 provide for definitions; to provide for type of residents; to p rovide for the employment of4 certified medication aides; to provide for a written care plan for residents; to provide for5 staffing and training requirements; to provide for financial stability requirements; to provide6 for the development of rate methodology; to provide for a waive r request to be submitted;7 to amend Titles 10, 16, 25, 26, 31, and 33, relating to commerc e and trade, crimes and8 offenses, fire protection and safety, food, drugs, and cosmetic s, health, and insurance,9 respectively, so as to provide for supportive senior housing co mmunities in certain10 definitions, protections, and procedures; to provide for unfair or deceptive practices; to11 provide for the protection of elder persons and identity fraud; to provide for fire and safety12 requirements; to provide for durable medical equipment supplier license requirements; to13 provide for communications with ombudsman; to provide for notice of deficiency; to provide14 for the Department of Community Health to establish meaningful distinctions between the15 levels of care at licensed facilities; to provide for COVID-19 requirements; to provide for16 employer based programs; to provide for influenza education inf ormation; to provide for17 residential care facilities for the elderly; to provide for hospice and palliative care; to provide18 H. B. 1430 - 1 - 26 LC 52 1000 background checks; to provide for the ombudsman program; to pro vide for remedies and19 protections of residents; to provide for the drug repository program; to provide for continuing20 care providers and facilities; to provide for related matters; to provide for an effective date;21 to repeal conflicting laws; and for other purposes.22 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:23 PART I24 SECTION 1-1.25 Article 1 of Chapter 7 of Title 31 of the Official Code of Georgia Annotated, relating to the26 regulation of hospitals and related institutions, is amended by revising Code27 Section 31-7-12.6, which is reserved, as follows:28 "31-7-12.6.29 (a) As used in this Code section, the term:30 (1) 'Direct care staff person' shall have the same meaning as set forth in Code31 Section 31-7-12.2.32 (2) 'Limited nursing services' shall have the same meaning as set forth in Code33 Section 31-7-12.2.34 (3) 'Nursing staff person' means a certified nurse aide, certified medication aide, licensed35 practical nurse, registered nurse, registered professional nurs e, or advanced practice36 registered nurse.37 (4) 'Supportive senior care' means and includes:38 (A) Personal services, which includes, but is not limited to, individual assistance with39 or supervision of self-administered medication and essential activities of daily living40 such as eating, bathing, grooming, dressing, and toileting;41 H. B. 1430 - 2 - 26 LC 52 1000 (B) The administration of medications by a medication aide in accordance with this42 Code section;43 (C) The provision of limited nursing services;44 (D) Weekly laundry and housekeeping services;45 (E) Periodic scheduled medical transportation; and46 (F) Social and recreational programming.47 (5) 'Supportive senior housing community' means a facility with a minimum of 25 beds48 and a maximum of 150 units in which each resident has his or her own apartment that is49 leased under a separate agreement and where more than 50 percen t of the resident50 population is composed of recipients of medical assistance as d efined in Code Section51 49-4-141 and that is licensed as a supportive senior housing community pursuant to this52 article.53 (b) The department is authorized to license supportive senior housing communities to54 provide supportive senior care to individuals as established in this Code section.55 (c) A supportive senior housing community shall not admit or retain an individual who is56 in need of 24 hour per day comprehensive nursing care or continuous medical or nursing57 care; provided, however, that supportive senior care may be provided by direct care staff58 persons, limited nursing services may be provided by direct care staff persons or nursing59 staff persons, and certain medications may be administered by certified medication aides60 pursuant to subsection (d) of this Code section.61 (d)(1) A supportive senior housing community may employ certified medication aides62 for the purpose of performing the technical aspects of the admi nistration of certain63 medications in accordance with this subsection. A supportive senior housing community64 that employs one or more certified medication aides shall have a safe medication and65 treatment administration system that meets all the requirements of this subsection.66 (2) A supportive senior housing community shall not employ an individual as a certified67 medication aide unless such individual is listed in the medication aide registry established68 H. B. 1430 - 3 - 26 LC 52 1000 and maintained by the department pursuant to paragraph (2) of s ubsection (g) of Code69 Section 31-7-12.2, is in good standing with the department, and h a s m e t a l l o f t h e70 qualifications in paragraph (3) of such subsection.71 (3) A supportive senior housing community shall annually condu ct a comprehensive72 clinical skills competency review of each certified medication aide employed by such73 community.74 (4) A certified medication aide who meets the criteria establi shed in this Code section75 shall be permitted to perform the following tasks in a supporti ve senior housing76 community in accordance with the written instructions of a physician:77 (A) Administer physician ordered oral, ophthalmic, topical, ot ic, nasal, vaginal, and78 rectal medications;79 (B) Administer insulin, epinephrine, and B12 pursuant to physi cian direction and80 protocol;81 (C) Administer medications via a metered dose inhaler;82 (D) Conduct finger stick blood glucose testing following established protocol;83 (E) Administer a commercially prepared disposable enema as ordered by a physician;84 (F) Assist residents in the supervision of self-administration of medications; and85 (G) Administer liquid morphine to a resident of such community who is the patient of86 a licensed hospice, pursuant to a hospice physician's written order that contains specific87 instructions for indication, dosage, frequency, and route of administration, provided that88 the licensed hospice consents to the use and administration of liquid morphine as89 described in this subparagraph. The certified medication aide shall observe and90 document the resident's need for all 'as needed' (PRN) liquid m orphine in such91 resident's record, and such indications of need may include ver balizations of pain,92 groaning, grimacing, or r estlessness. The initial dose of any liquid morphine93 administered pursuant to this subparagraph shall be administere d and assessed by a94 licensed hospice healthcare professional to observe and address any adverse reactions95 H. B. 1430 - 4 - 26 LC 52 1000 to such medication. Such community shall ensure that any certified medication aides96 who will be administering liquid morphine to any hospice patients in such community97 pursuant to this subparagraph receive adequate training from a licensed hospice on the98 safe and proper administration of liquid morphine prior to such administration and on99 an annual basis thereafter. Such community shall maintain docu mentation of all100 training provided and shall adhere to all security and storage requirements for liquid101 morphine required under state and federal law, including but no t limited to any rules102 promulgated by the department. Notwithstanding the foregoing, the supply of liquid103 morphine on-site at such community shall be limited to no more than 50 ml for each104 hospice patient in the assisted living community and shall only be administered under105 limited circumstances when a licensed hospice healthcare professional is not otherwise106 available. The department shall promulgate rules and regulatio ns to implement this107 subparagraph.108 (5) A certified medication aide shall record in a medication a dministration record all109 medications that such medication aide has personally administer ed to a resident of a110 supportive senior housing community and any refusal of a resident to take a medication. 111 A certified medication aide shall observe a resident to whom me dication has been112 administered and shall report any changes in the condition of such resident to the personal113 representative or legal surrogate of such resident.114 (6) All medication administered by a certified medication aide in accordance with this115 subsection shall be in unit or multidose packaging.116 (7) A supportive senior housing community that employs one or more certified117 medication aides to administer medications in accordance with t his subsection shall118 secure the services of a licensed pharmacist to perform the following duties:119 (A) Perform a quarterly review of the drug regimen of each res ident of such120 community and report any irregularities to the administrator of such community;121 H. B. 1430 - 5 - 26 LC 52 1000 (B) Remove for proper disposal any drugs that are expired, dis continued, in a122 deteriorated condition, or when the resident for whom such drug s were ordered is no123 longer a resident;124 (C) Establish or review policies and procedures for safe and e ffective drug therapy,125 distribution, use, and control; and126 (D) Monitor compliance with established policies and procedure s for medication127 handling and storage.128 (8) A supportive senior housing community that employs one or more certified129 medication aides to administer medications in accordance with t his subsection shall130 ensure that each certified medication aide receives ongoing med ication training as131 prescribed by the department. A registered professional nurse or pharmacist shall132 conduct random medication administration observations on a quarterly basis and report133 any issues to the administrator of such community.134 (e) A supportive senior housing community shall establish a wr itten care plan for each135 resident. Such care plan shall describe the needs of the resident and how such needs will136 be met.137 (f) A supportive senior housing community shall be required to meet the following staffing138 and training requirements:139 (1) Each direct care staff person in the supportive senior hou sing community receives140 initial and annual training covering topics specified by the de partment to ensure a141 demonstrated knowledge and understanding of caring for elderly and disabled adults; and142 (2) Staff at the supportive senior housing community shall be sufficient in number,143 qualifications, and training to meet the 24 hour scheduled and unscheduled needs of the144 residents at such community and to provide supportive senior ca re and limited nursing145 services provided at such community. The number, qualifications, and training of staff146 shall depend on skills required to provide for the specific needs of the residents; provided,147 H. B. 1430 - 6 - 26 LC 52 1000 however, that the supportive senior housing community meets the following minimum148 staffing requirements:149 (A) At least two on-site direct care staff persons at all times;150 (B) An average monthly minimum on-site staffing ratio of one direct care staff person151 for every 25 residents during all waking hours and one direct c are staff person for152 every 40 residents during all nonwaking hours; and153 (C) A registered professional nurse or licensed practical nurse available as follows:154 (i) A minimum of eight hours per week when such community has up to 30 residents;155 (ii) A minimum of 16 hours per week when such community has between 31 and 60156 residents;157 (iii) A minimum of 24 hours per week when such community has between 61 and 90158 residents; and159 (iv) A minimum of 40 hours per week when such community has mo re than 90160 residents.161 (g) All supportive senior housing communities shall be required to meet certain financial162 stability requirements. An applicant or a licensee shall:163 (1) Upon initial application for a supportive senior housing community license or upon164 a change of ownership, provide a financial stability affidavit from a certified public165 accountant affirming the applicant's or licensee's financial status. The department shall166 establish a mandatory financial stability affidavit form pursuant to rules and regulations167 to be used for purposes of this paragraph and shall assess the applicant's or licensee's168 financial status, in its own discretion, based on such financial stability affidavit;169 (2) Provide a minimum of 60 days' written notice to the department and all residents of170 any impending bankruptcy or property eviction that may force discharge or relocation of171 residents or otherwise adversely impact the provision of safe care and oversight; and172 H. B. 1430 - 7 - 26 LC 52 1000 (3) Provide a minimum of 14 days' written notice to the department and all residents of173 any impending change of ownership that may force discharge or relocation of residents174 or otherwise adversely impact the provision of safe care and oversight.175 (h) The department shall:176 (1) Collaborate with industry stakeholders to develop a rate m ethodology to ensure177 wide-scale access to supportive senior housing communities. In creating a rate178 methodology, the department shall verify the adequacy of the rate to support supportive179 senior housing communities financed with low-income housing tax credits and to satisfy180 the requisite underwriting metrics for financial viability; and181 (2) No later than June 30, 2026, prepare and submit a waiver request to the Centers for182 Medicare and Medicaid Services of the United States Department of Health and Human183 Services. Further, upon approval of the waiver, the department shall be authorized to184 take all necessary steps to implement the terms and conditions of the waiver without any185 further legislative action.186 (i) The waiver provided for in paragraph (2) of subsection (h) of this Code section shall187 be targeted and limited to individuals who satisfy the followin g requirements for age,188 residency status, financial eligibility, and level of care:189 (1) Individuals who are 65 years of age or older at the time o f initial eligibility190 determination;191 (2) Individuals who are residents of this state and eligible for the state Medicaid program192 under an approved eligibility category;193 (3) Individuals whose countable income does not exceed 300 percent of the benefit rates194 determined pursuant to Title XVI of the federal Social Security Act for supplemental195 security income, as adjusted annually, and who meet all other a pplicable Medicaid196 financial eligibility requirements, including resource limits, pursuant to federal law and197 regulation; and198 H. B. 1430 - 8 - 26 LC 52 1000 (4) Individuals who meet the nursing facility level of care criteria as defined under the199 state Medicaid program and in accordance with 42 U.S.C. Section 1396r, 42 C.F.R.200 Sections 440.40 and 441.301, and other applicable federal regulations. Reserved."201 PART II202 SECTION 2-1.203 Title 10 of the Official Code of Georgia, relating to commerce and trade, is amended in204 Part 2 of Article 15 of Chapter 1, the "Fair Business Practices Act of 1975," by revising205 paragraph (26) of subsection (b) of Code Section 10-1-393, rela ting to unfair or deceptive206 practices in consumer transactions unlawful and examples, as follows:207 "(26) With respect to any individual or facility providing pers onal care services, or208 assisted living care, or supportive senior care:209 (A) Any person or entity not duly licensed or registered as a personal care home, or210 assisted living community, or supportive senior housing communi ty formally or211 informally offering, advertising to, or soliciting the public for residents or referrals; or212 (B) Any personal care home, as defined in subsection (a) of Code Section 31-7-12, or213 any assisted living community, as defined in Code Section 31-7-12.2, or any supportive214 senior housing community, as defined in Code Section 31-7-12.6, offering, advertising,215 or soliciting the public to provide services:216 (i) Which are outside the scope of personal care services, or assisted living care, or217 supportive senior care, respectively; and218 (ii) For which it has not been specifically authorized.219 Nothing in this subparagraph prohibits advertising by a personal care home, or assisted220 living community, or supportive senior housing community for services authorized by221 the Department of Community Health under a waiver or variance p ursuant to222 subsection (b) of Code Section 31-2-7.223 H. B. 1430 - 9 - 26 LC 52 1000 As used in this paragraph, the term: For purposes of this paragraph, 'personal care' means224 protective care and watchful oversight of a resident who needs a watchful environment225 but who does not have an illness, injury, or disability which r equires chronic or226 convalescent care including medical and nursing services, and 'assisted living care'227 includes services provided for in Code Section 31-7-12.2, and ' supportive senior care'228 includes services provided for in Code Section 31-7-12.6 . The provisions of this229 paragraph shall be enforced following consultation with the Department of Community230 Health which shall retain primary responsibility for issues rel ating to licensure of any231 individual or facility providing personal care services;"232 SECTION 2-2.233 Title 16 of the Official Code of Georgia Annotated, relating to crimes and offenses, is234 amended in Article 8 of Chapter 5, relating to protection of el der persons, by revising235 paragraph (7) of Code Section 16-5-100, relating to definitions, as follows:236 "(7) 'Long-term care facility' means any skilled nursing facility, intermediate care home,237 assisted living community, supportive senior housing community, or personal care home238 subject to regulation and licensure by the Department of Commun ity Health and any239 community living arrangement licensed by the Department of Beha vioral Health and240 Developmental Disabilities pursuant to Article 1 of Chapter 13 of Title 37."241 SECTION 2-3.242 Said title is further amended in Article 8 of Chapter 9, relating to identity fraud, by revising243 paragraph (4) of Code Section 16-9-120, relating to definitions, as follows:244 "(4) 'Health care records' means records however maintained and in whatever form245 regarding an individual's health, including, but not limited to , doctors' and nurses'246 examinations and other notes, examination notes of other medical professionals, hospital247 records, rehabilitation facility records, nursing home records, assisted living facility248 H. B. 1430 - 10 - 26 LC 52 1000 records, supportive senior housing community records, results of medical tests, X-rays,249 CT scans, MRI scans, vision examinations, pharmacy records, pre scriptions, hospital250 charts, surgical records, mental health treatments and counseli ng, dental records, and251 physical therapy notes and evaluations."252 SECTION 2-4.253 Title 25 of the Official Code of Georgia Annotated, relating to fire protection and safety, is254 amended in Chapter 2, relating to regulation of fire and other hazards to persons and property255 generally, by revising subparagraph (b)(1)(J) of Code Section 25-2-13, relating to fire safety256 requirements for buildings or structures presenting special hazards, as follows:257 "(J) Personal care homes, a n d assisted living communities, and supportive senior258 housing communities required to be licensed as such by the Department of Community259 Health and having at least seven beds for nonfamily adults, and the Commissioner shall,260 pursuant to Code Section 25-2-4, by rule adopt state minimum fire safety standards for261 those homes, and any structure constructed as or converted to a personal care home on262 or after April 15, 1986, shall be deemed to be a proposed build ing pursuant to263 subsection (d) of Code Section 25-2-14 and that structure may b e required to be264 furnished with a sprinkler system meeting the standards establi shed by the265 Commissioner if he deems this necessary for proper fire safety."266 SECTION 2-5.267 Title 26 of the Official Code of Georgia Annotated, relating to food, drugs, and cosmetics,268 is amended in Article 1 of Chapter 4, relating to general provisions relative to pharmacists269 and pharmacies, by revising paragraph (18.1) of Code Section 26-4-5, relating to definitions,270 as follows:271 "(18.1) 'Institution' means any licensed hospital, nursing home , assisted living272 community, personal care home, hospice, health clinic, or prison clinic. Such term shall273 H. B. 1430 - 11 - 26 LC 52 1000 include a supportive senior housing community for the limited purpose of state licensure;274 provided, however, that such community shall not be deemed an i nstitution excluded275 from home and community based settings under 42 C.F.R. Section 441.530."276 SECTION 2-6.277 Said title is further amended in Article 3 of Chapter 4, relating to practice of pharmacy, by278 adding a new paragraph to subsection (g) of Code Section 26-4-5 1, relating to durable279 medical equipment supplier license, requirements, exemptions, and rules and regulations, to280 read as follows:281 "(6.1) Supportive senior housing communities;"282 SECTION 2-7.283 Said title is further amended in Article 13 of Chapter 4, relating to safe medications practice,284 by revising paragraph (3) of Code Section 26-4-212, relating to definitions, as follows:285 "(3) 'Institution' means any licensed hospital, nursing home, assisted living community,286 personal care home, or hospice. Such term shall include a supp ortive senior housing287 community for the limited purpose of state licensure; provided, however, that such288 community shall not be deemed an institution excluded from home and community based289 settings under 42 C.F.R. Section 441.530."290 SECTION 2-8.291 Title 31 of the Official Code of Georgia Annotated, relating to health, is amended in Article 1292 of Chapter 7, relating to regulation of hospitals and related institutions, by revising paragraph293 (4) of Code Section 31-7-1, relating to definitions, as follows:294 "(4) 'Institution' means:295 (A) Any building, facility, or place in which are provided two or more beds and other296 facilities and services that are used for persons received for examination, diagnosis,297 H. B. 1430 - 12 - 26 LC 52 1000 treatment, surgery, maternity care, nursing care, assisted living care, supportive senior298 care, or personal care for periods continuing for 24 hours or longer and which is299 classified by the department, as provided for in this chapter, as either a hospital, nursing300 home, assisted living community, or personal care home; such te rm shall include a301 supportive senior housing community for the limited purpose of state licensure;302 provided, however, that such community shall not be deemed an institution excluded303 from home and community-based settings under 42 C.F.R. Section 441.530;304 (B) Any health facility wherein abortion procedures under subsections (b) and (c) of305 Code Section 16-12-141 are performed or are to be performed;306 (C) Any building or facility, not under the operation or control of a hospital, which is307 primarily devoted to the provision of surgical treatment to pat ients not requiring308 hospitalization and which is classified by the department as an ambulatory surgical309 treatment center;310 (D) Any fixed or mobile specimen collection center or health t esting facility where311 specimens are taken from the human body for delivery to and examination in a licensed312 clinical laboratory or where certain measurements such as heigh t and weight313 determination, limited audio and visual tests, and electrocardi ograms are made,314 excluding public health services operated by the state, its counties, or municipalities;315 (E) Any building or facility where human births occur on a regular and ongoing basis316 and which is classified by the department as a birthing center;317 (F) Any building or facility which is devoted to the provision of treatment and318 rehabilitative care for periods continuing for 24 hours or longer for persons who have319 traumatic brain injury, as defined in Code Section 37-3-1; or320 (G) Any freestanding imaging center where magnetic resonance i maging, computed321 tomography (CT) scanning, positron emission tomography (PET) sc anning, positron322 emission tomography/computed tomography, and other advanced imaging services as323 defined by the department by rule, but not including X-rays, fluoroscopy, or ultrasound324 H. B. 1430 - 13 - 26 LC 52 1000 services, are conducted in a location or setting not affiliated or attached to a hospital or325 in the offices of an individual private physician or single group practice of physicians326 and conducted exclusively for patients of that physician or group practice.327 Such term shall exclude all physicians' and dentists' private offices and treatment rooms328 in which such physicians or dentists primarily see, consult with, and treat patients."329 SECTION 2-9.330 Said title is further amended in said article by revising subsection (d) of Code Section 31-7-3,331 relating to requirements for permits to operate institutions, as follows:332 "(d)(1) When an application for licensure to operate a personal care home, as defined in333 subsection (a) of Code Section 31-7-12, or an assisted living community, as defined in334 Code Section 31-7-12.2, or a supportive senior housing community, as defined in Code335 Section 31-7-12.6, has been made, the department shall inform the office of the s tate336 long-term care ombudsman of the name and address of the applica nt prior to issuing337 authority to operate or receive residents and shall provide to the ombudsman program an338 opportunity to provide to the department information relevant t o the applicant's fitness339 to operate as a licensed personal care home, o r an assisted living community, or a340 supportive senior housing community.341 (2) The department may consider any information provided under this subsection, where342 verified by appropriate licensing procedures, in determining whether an applicant meets343 the requirements for licensing.344 (3) The department shall promulgate regulations setting forth the procedures by which345 the long-term care ombudsman program shall report information to the department or its346 designee as required by this subsection, including a consistent format for the reporting347 of information, safeguards to protect confidentiality, and specified types of information348 which shall be routinely provided by the long-term care ombudsman program.349 H. B. 1430 - 14 - 26 LC 52 1000 (4) Nothing in this subsection shall be construed to provide a ny authority to the350 long-term care ombudsman program to license or refuse to licens e the operation of a351 personal care home, or an assisted living community, or a supportive senior housing352 community."353 SECTION 2-10.354 Said title is further amended in said article by revising subse ction (a) of Code355 Section 31-7-3.2, relating to notice requirements for cited def iciency, use of regulatory356 violations in civil actions, and use of survey results in advertisements, as follows:357 "(a) A personal care home, assisted living community, supportiv e senior housing358 community, nursing home, or intermediate care home licensed under this article shall give359 notice in the event that such facility has been cited by the de partment for any deficiency360 for which the facility has received notice of the imposition of any sanction available under361 federal or state laws or regulations, except where a plan of correction is the only sanction362 to be imposed."363 SECTION 2-11.364 Said title is further amended in said article by revising Code Section 31-7-12.3, relating to365 rules, regulations, and waivers for personal care homes and assisted living communities, as366 follows:367 "31-7-12.3.368 The department shall adopt rules and regulations to implement Code Sections 31-7-12, and369 31-7-12.2, and 31-7-12.6. Notwithstanding the provision of limited nursing services by370 assisted living communities and supportive senior housing commu nities, such rules and371 regulations shall establish meaningful distinctions between the levels of care provided by372 personal care homes, assisted living communities, supportive senior housing communities,373 and nursing homes but shall not curtail the scope or levels of services provided by personal374 H. B. 1430 - 15 - 26 LC 52 1000 care homes or nursing homes as of June 30, 2011; provided, however, that nothing in this375 chapter shall preclude the department from issuing waivers or variances to personal care376 homes of the rules and regulations established pursuant to this Code section. 377 Notwithstanding Code Section 31-7-12.2, the department shall no t grant a waiver or378 variance unless:379 (1) There are adequate standards affording protection for the health and safety of380 residents of the personal care home;381 (2) The resident of the personal care home provides a medical assessment conducted by382 a licensed health care professional who is unaffiliated with the personal care home which383 identifies the needs of the resident; and384 (3) The department finds that the personal care home can provi de or arrange for the385 appropriate level of care for the resident."386 SECTION 2-12.387 Said title is further amended in said article by revising subse ction (b) of Code388 Section 31-7-12.5, relating to notification and other requirements for COVID-19 infections389 in personal care homes, as follows:390 "(b) Each personal care home with 25 or more beds, each assisted living community,391 supportive senior housing community, and each nursing home licensed in this state shall:392 (1) Inform its residents and their representatives or legal surrogates by 5:00 P.M. the next393 calendar day following the occurrence of either a single confir med infection of394 COVID-19 or another airborne infectious disease identified by t he department or the395 federal Centers for Disease Control and Prevention as a threat to public health, or three396 or more residents or staff with new-onset of respiratory symptoms occurring within 72397 hours of each other. Such information shall:398 (A) Not include personally identifiable information;399 H. B. 1430 - 16 - 26 LC 52 1000 (B) Include information on mitigating actions implemented to p revent or reduce the400 risk of transmission, including if normal operations of the facility will be altered; and401 (C) Include any cumulative updates for residents and their rep resentatives or legal402 surrogates at least weekly or by 5:00 P.M. the next calendar da y following the403 occurrence of any subsequent confirmed infection of COVID-19, or whenever three or404 more residents or staff with new onset of respiratory symptoms occurs within 72 hours405 of each other;406 (2) Maintain a minimum of a seven-day supply of protective masks, surgical gowns, eye407 protection, and gloves sufficient to protect all residents and staff;408 (3) Maintain and publish for its residents and their represent atives or legal surrogates409 policies and procedures pertaining to infection control and mit igation within their410 facilities and update such policies and procedures annually; and411 (4) As part of the facility's disaster preparedness plan required pursuant to subsection (c)412 of Code Section 31-7-3 and department rules and regulations, include an epidemic and413 pandemic plan for influenza and other infectious diseases which conforms to department414 and federal Centers for Disease Control and Prevention standard s that contains the415 following minimum elements:416 (A) Protocols for surveillance and detection of epidemic and p andemic diseases in417 residents and staff;418 (B) A communication plan for sharing information with public h ealth authorities,419 residents, residents' representatives or their legal surrogates, and staff;420 (C) An education and training plan for residents and staff regarding infection control421 protocols;422 (D) An infection control plan that addresses visitation, cohorting measures, sick leave423 and return-to-work policies, and testing and immunization policies; and424 (E) A surge capacity plan that addresses protocols for contingency staffing and supply425 shortages."426 H. B. 1430 - 17 - 26 LC 52 1000 SECTION 2-13.427 Said title is further amended in said article by revising subse ction (b) of Code428 Section 31-7-12.8, relating to certification as nurse aide, employer sponsored training and429 competency examination programs, and provisional practice by military medical personnel,430 as follows:431 "(b) The department shall approve employer based programs sponsored by or offered in432 assisted living communities, supportive senior housing communit ies, private home care433 providers, personal care homes, or other long-term care facilit ies licensed by the434 department for certified nurse aide training and competency exa mination programs as435 determined by the department."436 SECTION 2-14.437 Said title is further amended in said article by revising subse ctions (a) and (b) of Code438 Section 31-7-21, relating to provision of influenza education information to assisted living439 community residents, as follows:440 "(a) Each assisted living community and supportive senior housi ng community shall441 annually provide to each of its residents, no later than Septem ber 1 of each year,442 educational information on influenza disease. Such information shall include, but is not443 limited to, the risks associated with influenza disease; the availability, effectiveness, and444 known contraindications of the influenza immunization; causes and symptoms of influenza;445 and the means in which it is spread. Provision of the appropri ate and current Vaccine446 Information Statement as provided by the federal Centers for Di sease Control and447 Prevention shall be deemed to comply with this subsection.448 (b) Nothing in this Code section shall be construed to require an assisted living community449 or supportive senior housing community to provide or pay for any vaccination against450 influenza for its residents."451 H. B. 1430 - 18 - 26 LC 52 1000 SECTION 2-15.452 Said title is further amended in Article 5 of Chapter 7, relating to residential care facilities453 for the elderly authorities, by revising paragraph (1) of subse ction (a) of Code454 Section 31-7-111, relating to legislative findings, as follows:455 "(1) There exists in this state a seriously inadequate supply o f and a critical need for456 facilities which can furnish the comprehensive services required by elderly persons in a457 single location, including, without limitation, residential car e and the types of services458 provided in skilled nursing homes, intermediate care homes, assisted living communities,459 supportive senior housing communities, and personal care homes (hereinafter referred to460 as 'residential care facilities for the elderly');"461 SECTION 2-16.462 Said title is further amended in said article by revising subparagraph (A) of paragraph (7) of463 Code Section 31-7-112, relating to definitions, as follows:464 "(A) Any one or more buildings or structures to be used in prov iding at a single465 location the comprehensive services required by the elderly, in cluding, without466 limitation, residential care and the types of services provided in skilled nursing homes,467 intermediate care homes, assisted living communities, supportiv e senior housing468 communities, and personal care homes supplied with all necessary or useful469 furnishings, machinery, equipment, parking facilities, landscap ing, and facilities for470 outdoor storage, all as determined by the authority, which determination shall be final471 and not subject to review; provided, however, that no single project or residential care472 facility shall be required to render all types of services and levels of care referred to473 above. There may be included as part of any such project all improvements necessary474 to the full utilization thereof, including, without limitation, site preparation; roads and475 streets; sidewalks; water supply; outdoor lighting; belt line railroad; railroad sidings and476 lead tracks; bridges; causeways; terminals for railroad, automo tive, and air477 H. B. 1430 - 19 - 26 LC 52 1000 transportation; transportation facilities incidental to the project; and the dredging and478 improving of harbors and waterways. However, none of the afore mentioned479 improvements shall be the primary purpose of any project;"480 SECTION 2-17.481 Said title is further amended in Article 9 of Chapter 7, relating to hospice care, by revising482 paragraph (4) of Code Section 31-7-172, relating to definitions, as follows:483 "(4) 'Health care facility' means hospitals; other special care units, including but not484 limited to podiatric facilities; skilled nursing facilities; in termediate care facilities;485 assisted living communities; supportive senior housing communit ies; personal care486 homes; ambulatory surgical or obstetrical facilities; health ma intenance organizations;487 home health agencies; and diagnostic, treatment, or rehabilitation centers."488 SECTION 2-18.489 Said title is further amended in Article 10 of Chapter 7, relating to palliative care, by revising490 paragraph (2) of Code Section 31-7-191, relating to definitions, as follows:491 "(2) 'Healthcare facility' means hospitals; other special care units, including but not492 limited to podiatric facilities; skilled nursing facilities; in termediate care facilities;493 assisted living communities; supportive senior housing communit ies; personal care494 homes; ambulatory surgical or obstetrical facilities; health ma intenance organizations;495 home health agencies; and diagnostic, treatment, or rehabilitation centers."496 SECTION 2-19.497 Said title is further amended in Article 14 of Chapter 7, relating to Georgia Long-term Care498 Background Check Program, by revising subparagraph (B) of parag raph (8) of Code499 Section 31-7-351, relating to definitions, as follows:500 H. B. 1430 - 20 - 26 LC 52 1000 "(B) An assisted living community required to be licensed under Code501 Section 31-7-12.2 or a supportive senior housing community requ ired to be licensed502 under Code Section 31-7-12.6;"503 SECTION 2-20.504 Said title is further amended in Article 3 of Chapter 8, relating to long-term care ombudsman505 program, by revising paragraph (2) of Code Section 31-8-51, rel ating to definitions, as506 follows:507 "(2) 'Long-term care facility' means any skilled nursing home, intermediate care home,508 private home care provider, assisted living community, supporti ve senior housing509 community, or personal care home now or hereafter subject to regulation and licensure510 by the Department of Community Health."511 SECTION 2-21.512 Said title is further amended in Article 4 of Chapter 8, relati ng to reporting abuse or513 exploitation of residents in long-term care facilities, by revi sing paragraph (3) of Code514 Section 31-8-81, relating to definitions, as follows:515 "(3) 'Long-term care facility' or 'facility' means any skilled nursing home, intermediate516 care home, assisted living community, supportive senior housing community, or personal517 care home now or hereafter subject to regulation and licensure by the department."518 SECTION 2-22.519 Said title is further amended in Article 5A of Chapter 8, relating to remedies for residents of520 personal care homes, by revising paragraph (5) of Code Section 31-8-132, relating to521 definitions, as follows:522 "(5) 'Personal care home' or 'home' means a facility as defined in Code Section 31-7-12523 and shall include any assisted living community as defined in p aragraph (3) of524 H. B. 1430 - 21 - 26 LC 52 1000 subsection (b) of Code Section 31-7-12.2 and any supportive senior housing community525 as defined in paragraph (5) of subsection (a) of Code Section 31-7-12.6 that is subject to526 regulation and licensure by the department."527 SECTION 2-23.528 Said title is further amended in Article 10 of Chapter 8, relating to drug repository program,529 by adding a new subparagraph to paragraph (7) of Code Section 3 1-8-300, relating to530 definitions, to read as follows:531 "(C.1) Supportive senior housing community licensed pursuant to Code532 Section 31-7-12.6;"533 SECTION 2-24.534 Title 33 of the Official Code of Georgia Annotated, relating to insurance, is amended in535 Chapter 45, relating to continuing care providers and facilities, by revising paragraphs (1),536 (8), and (15) of Code Section 33-45-1, relating to definitions, as follows:537 "(1) 'Continuing care' means furnishing pursuant to a continuing care agreement:538 (A) Lodging that is not:539 (i) In a skilled nursing facility, as such term is defined in Code Section 31-6-2;540 (ii) An intermediate care facility, as such term is defined in Code Section 31-6-2;541 (iii) An assisted living community, as such term is defined in C o d e S e c t i o n542 31-7-12.2, or a supportive senior housing community, as such term is defined in Code543 Section 31-7-12.6; or544 (iv) A personal care home, as such term is defined in Code Section 31-7-12;545 (B) Food; and546 (C) Nursing care provided in a facility or in another setting designated by the547 agreement for continuing care to an individual not related by consanguinity or affinity548 to the provider furnishing such care upon payment of an entrance fee including skilled549 H. B. 1430 - 22 - 26 LC 52 1000 or intermediate nursing services and, at the discretion of the continuing care provider,550 personal care services including, without limitation, assisted living care services551 designated by the continuing care agreement, including such services being provided552 pursuant to a contract to ensure the availability of such servi ces to an individual not553 related by consanguinity or affinity to the provider furnishing such care upon payment554 of an entrance fee.555 Such term shall not include continuing care at home."556 "(8) 'Limited continuing care' means furnishing pursuant to a continuing care agreement:557 (A) Lodging that is not:558 (i) In a skilled nursing facility, as such term is defined in Code Section 31-6-2;559 (ii) An intermediate care facility, as such term is defined in Code Section 31-6-2;560 (iii) An assisted living community, as such term is defined in Code561 Section 31-7-12.2, or a supportive senior housing community, as such term is defined562 in Code Section 31-7-12.6; or563 (iv) A personal care home, as such term is defined in Code Section 31-7-12;564 (B) Food; and565 (C) Personal services, whether such personal services are provided in a facility such566 as a personal care home or an assisted living community or in a nother setting567 designated by the continuing care agreement, to an individual n ot related by568 consanguinity or affinity to the provider furnishing such care upon payment of an569 entrance fee.570 Such term shall not include continuing care at home."571 "(15) 'Residential unit' means a residence or apartment in which a resident lives that is572 not a skilled nursing facility as defined in Code Section 31-6- 2, an intermediate care573 facility as defined in Code Section 31-6-2, an assisted living community as defined in574 Code Section 31-7-12.2, a supportive senior housing community, as such term is defined575 in Code Section 31-7-12.6, or a personal care home as defined in Code Section 31-7-12."576 H. B. 1430 - 23 - 26 LC 52 1000 PART III577 SECTION 3-1.578 This Act shall become effective upon its approval by the Governor or upon its becoming law579 without such approval.580 SECTION 3-2.581 All laws and parts of laws in conflict with this Act are repealed.582 H. B. 1430 - 24 -