Rep. Kathy Rapp, R-Warren, is pictured discussing House Bill 649 on the floor of the House Health Committee recently.

Rep. Kathy Rapp’s essential caregiver bill is one-third of the way to becoming law.

House Bill 649 passed unanimously in the House of Representatives and has been referred to the state Senate. Rapp attempted to get the legislation passed late in 2020 to open nursing homes to essential caregivers when facilities were still locked down due to COVID-19. The Warren Republican said the legislation is still necessary despite Centers for Disease Control guidance that allows families back into congregate care buildings.

Rapp proposes to create an essential caregiver position in long-term care facilities through a regulation that mirrors those passed in Minnesota and Indiana. The legislation has been amended three times.

“I don’t know if other states have passed it, but this bill is modeled from those other states and we do know now that the CDC has said the facilities can be open,” Rapp said during a March 17 House Health Committee meeting where the bill was approved. “However this bill will address if we have another lockdown that families will be able to be with their loved one — with necessary precautions and CDC guidelines — and I believe this is timely even though the CDC has said we’re going to move forward and all families can visit. I do not believe in good conscience that we should allow this situation to happen again.”

Rapp proposes to create an essential caregiver position in long-term care facilities through a regulation that mirrors those passed in Minnesota and Indiana. The legislation has been amended three times.

Essential caregivers would be allowed to be designated for those in a long-term care nursing facility, a skilled nursing facility, an assisted living facility, a personal care home, congregate care facility or an intermediate care facility for those with intellectual disabilities. The caregiver would be designated by the resident or someone with decision-making authority for the resident to provide physical or emotional support during a disaster emergency.

Essential caregivers would have to meet state restrictions on travel, enhanced testing for communicable diseases and use of safety equipment to protect facility residents. The law also includes a 45-day period after a disaster emergency declaration when a facility can be locked down and essential caregivers not be allowed in so that safety measures for residents can be established.

Facilities could limit the length of visits, number of visits a week, location of visits and the spacing of visitors. Essential caregivers would be required to pay the costs of personal protective equipment.

The most controversial aspect of the legislation for Health Committee members was an amendment that allows facilities to extend the 45-day lockdown once a disaster emergency is declared — but only if staff remain in the facilities along with residents.

“As we have heard from the Department of Health, staff brought COVID into these facilities, quite inadvertently though, because they were able to move around the general public without restrictions,” Whitney Metzler, a staff member who works for Rapp, said while discussing amendments to the bill during a March 17 Health Committee meeting. “If the procedures are necessary to keep essential caregivers to meet high health and safety standards out for safety reasons, those would also exist to keep the staff in and safe from transmission as well.”

The amendment drew comments from two committee members. Rep. Dan Frankel, D-Allegheny, who opposed the amendment because it would place too many limits on workers in the facilities.

“Despite the faith effort to address some of the issues I’m going to oppose the amendment and I appreciate trying to make some of these adjustments. I do believe we can make some other improvements. But the requirement to limit free movement of the staff is problematic. I look forward to working with you to enhance the bill as it gets to the floor,” Frankel said.

Committee members approved the amendment, 15-10. Rep. Valerie Gaydos, R-Allegheny, spoke in support of the change.

“I think this is just way overdue,” she said. “I think it’s important to proceed with this. Having had a senior in a senior living home in years past, understanding that there were residents that were locked down so badly when staff were going in and out and in and out, I think this amendment is a terrific amendment and I think it’s overdue and we must move this now.”