Connecticut Hospice has warned lawmakers it will be unable to care for gravely ill patients in their homes under a proposed law aimed at protecting home healthcare workers.
At issue is Senate Bill 1, which would require organizations that care for people in their homes to conduct background checks on the clients and anyone in the location where care is being given. The checks would include psychiatric histories, and for histories of violence, domestic abuse, substance use, and criminal records.
The bill is being considered after the death of visiting nurse Joyce Grayson at a halfway house for sex offenders.
Barbara Pearce, the chief executive officer of Connecticut Hospice, urged lawmakers to remove Connecticut Hospice from entities that would be required to conduct those background checks, noting that the organization which provides end-of-life care is typically called into homes when a patient has days left to live.
“Our national hospice organization could find no similar bill in any other state,” Pearce wrote in testimony to the Public Health Committee. “This bill is too broad, too unclear as to requirements, not guaranteed to achieve its aims, duplicative of other procedures required in hospice care, and contradictory to certain regulations of Medicare.”
Connecticut Hospice “is frequently sought at the last possible moment – Friday is by far our busiest day, we admit often at night and on weekends, and families are often dependent upon our admission to be able to bring their loved ones home to die, if that is their choice,” wrote Pearce.
“The statistics are shocking: 20% of our home care patients die within three days of admission to hospice care. Since 2020, this has only accelerated. If a law or regulation were imposed, that in any way impeded our ability to admit urgently, we would see a huge drop in patients and families served,” she wrote.
State lawmakers are aware of Hospice’s concerns and are exploring ways to satisfy the needs of patients while keeping home healthcare workers as safe as possible, said Sen. Saud Anwar, the co-chair of the Public Health Committee.
“We know that for Hospice, time is of essence,” Anwar said. “We need to keep in mind that the idea (of the legislation) is to protect workers – but not at the cost of patients in pain or discomfort.”
Pearce noted that approximately 300 patients have died in Hospice home care within three days, 200 within two days, and 100 within one day.
“The list of proposed requirements in Senate Bill 1 would mean that most, if not all, of these patients would have died in a hospital, an emergency room, or at home without nursing support or comfort measures,” she wrote.
She also argued that a provision related to the checking of neighborhood crime rates would conflict with Medicare requirements. More than 90 percent of Connecticut Hospice patients are on Medicare or Medicaid, she wrote.
“Medicare requires that we start care within 48 hours of a referral, and we would simply not be able to perform the background checks outlined in that amount of time, especially on an evening or weekend,” she wrote. “It also requires that we not discriminate, but checking neighborhood crime rates will almost surely cause some less fortunate families to experience delays.”
