*Please note this blog has been updated from an earlier version.

In case you missed it, the Connecticut Department of Public Health (DPH) issued two Orders last week affecting patients with disabilities and patients who are minors in certain health care facilities. Both Orders went into effect on June 15 and are effective for the duration of the public health emergency, unless sooner modified or terminated.

The first DPH Order requires short-term hospitals (general, special, and children’s), outpatient clinics, outpatient dialysis units, and outpatient surgical facilities to permit designated “support persons” to help patients with certain disabilities.

The second DPH Order requires that nursing home facilities, residential care homes and chronic disease hospitals permit a parent, stepparent, or legal guardian to visit patients who are minors.

We have prepared answers to frequently asked questions to help facilities navigate the new Orders:

• What types of disabilities would allow a patient at a short-term hospital, outpatient clinic, outpatient dialysis unit or outpatient surgical facility to designate a support person?

The first DPH Order provides that disabilities may include, but are not limited to, “altered mental status, physical, intellectual or cognitive disability. communication barriers or behavioral concerns” that cause the patient to need assistance.

• Who can be a designated “support person” for a patient with disabilities?

Under the first DPH Order, a designated support person is an individual who will physically or emotionally assist the patient or ensure effective communication during the patient’s stay at the facility. The support person may be a family member, personal care assistant, disability service provider, or other individual knowledgeable about the management of the patient’s care.

• How many support persons may a patient with disabilities designate?

A patient with disabilities may designate only one support person, unless the patient will be in the facility longer than one day, in which case the patient may designate two support persons, but only one support person may visit at a time. The first DPH Order does not explicitly limit the amount of time a support person may stay with the patient, but the Order does permit the health care facility to impose “reasonable requirements … to minimize the potential spread of infection.”

• How many visitors are permitted for minors at nursing home facilities, residential care homes or chronic disease hospitals?

Under the second DPH Order, a parent, stepparent, or legal guardian is permitted to visit a minor patient, but only one visitor is permitted at a time. The second DPH Order provides that “[a]ny such in-person visit shall be permitted by any such visitor once per week for a minimum of twenty minutes per visit.” The Order goes on to explain that the facility may establish reasonable restrictions on visitation days and times and may require that visits be outdoors on the grounds of the facility.

• Are there any other COVID-19 related restrictions on support persons and visitors?

Both DPH Orders require that a support person/visitor be screened by the facility for COVID-19 symptoms prior to entering. The first DPH Order governing patients with disabilities also requires temperature checks prior to entering the clinical area and every 12 hours thereafter.

Both Orders also require the support person/visitor to wear Personal Protective Equipment (PPE), which the facility is required to provide. The first DPH Order governing patients with disabilities also provides that if the facility is unable to provide PPE, the support person may provide it as long as the facility agrees that the PPE brought by the support person is adequate.

• Do both Orders require the facility to inform patients of the new policies?

Yes, though the obligations differ:

For patients with disabilities at short-term hospitals, outpatient clinics, outpatient dialysis units and outpatient surgical facilities: As noted above, when the period of time that the patient will remain in the facility will be longer than one day, the patient or his or her family or caregiver may designate two support people, provided only one support person may be present at a time. The facility must explain this restriction to the patient and the support person on arrival (or, as the Order notes, “ideally, prior to arriving at the Facility”). In addition, notice of the policy regarding support persons must be posted at patient entry points to the facility and on the facility’s website, and be provided to the patient at the time services are scheduled or initiated.

For minors at nursing home facilities, residential care homes or chronic disease hospitals: The facility is required to contact the minor’s parents, stepparents, or legal representative to decide on when an in-person visit will occur.

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