Senate considers bill to force hospitals to allow visitors
Senate Bill 730, the "No Patient Left Alone Act," would guarantee patients the ability to designate one visitor with "the unrestricted privilege of being present" while the patient is in a hospital's care.
I just wanna let the committee now thank you again for hearing the bill. We've continue to have discussions with the hospital associations, and I know that they're not completely comfortable with the bill at this point. But we will continue Teoh work with them as the bill moves forward and in an effort to try to get full consensus from from everyone. Do you know there were some comments that were suggestions that were made in the committee two days ago? So we've prepared a couple amendments that we think will clarify some things. And so I'll just defer to my co sponsor, Senator Perry, to explain this Senator Perry placing for your amendment here. I think everyone has copies of the amendments. And the 1st 1 I'm going to reference is 46 Version two. It's the shortest Amendment, and it is regarding visitors. And we had discussion about where would they wait? Would it just be one? Would it be to you are you know, could you rotate between different people? So this just clarifies that the visitor will have access in a waiting area. And if the patient has capacity to make the decision, they can Designate Who? The one visitor Waas. Thank you, Senator. Peering any questions on the amendment? Senator Hice the German just asking for clarification purposes. I know yesterday with minors we had gotten into that. If there was a court order that that would designate, does that apply? That this is well, that because if a patient then has the capacity to make a decision, they could two days or whatever could choose somebody who was not the designee to be there. One visitor, Senator Perry. Um, Madam cheer. My understanding of the intent of the amendment is that that would be for adults and the minors section is in is expressed in a separate area of the legislation. Thank you, Sintra. Peary. Any other questions regarding the amendment? Seeing none. All those in favor of you, An amendment. Police say I any opposed the amendment passes. I believe we have a Second Amendment. Senator Perry as well. Thank you, Madam Cheer. This amendment is an attempt to begin to address the concerns about infection in the hospital. And what would happen if someone had tested positive for infectious disease? So these were recommendations or concerns brought by the committee and I just want to clarify that these amendments and the tone of the conversation, or to continue to improve the legislation and buying consensus so we appreciate your support as we continue to work on this issue. Thank you, Senator. Period. Any questions regarding the amendment seeing non the amendment? Senator Van Dine? Ask a question, man chair. You have the full. Could you tell me how this changes? How this is different from the original Bill, Senator? Period. I'll defer to center Daniel or staff that they want to explain the change. Senator Daines. So I'll try. And if I'm not precise enough than Theresa might be ableto assist. But the intent of this amendment is so that if a visitor a health screening is done and the person test positive not only for Cove it but for any infectious disease that they could be excluded from the hospital and then a different visitor would have to be chosen. I guess that's there was some concern about Should we let a visitor in whose covert positive and this is attempt to try to to keep that from happening? Thank you. Thank you, Senator. Van Dine, Senator. Period, Madam Chair I just want to point out that this was a topic brought up by the hospital association as an area of concern. And it was an attempt to address one of the concerns that brought up Thank you, Senator Peary. Any further questions from the committee seeing none. The amendment is before the committee. All those in favor police say I in your post. The bill is back before us as amended. It's in a drain. You'll any further comments? Just, I guess. Maybe a final comment. Um, you know, this issue is still I mean, it hasn't abated. I've had probably six additional situations that have been related to me by email in the last two days. I spent a lot of my time yesterday working with a wife who was trying to be able to stay in the hospital with her husband, who had a 10 hour surgery, had his jaw wired shut, had a trick in and, you know, I was raising the issue to the highest levels of hospital management So far. She's still there, but she's wondering at any moment they could come in and tell her toe leave. So I think the issue is still right on. And then we have work to do on the bill. But I just appreciate the committee can consider Thank you, Senator Daniel. And members and guests I neglected to welcome. And thank our sergeant at arms. We have Dwight Green, Jim Hamilton, Frank Urban, Francis Paterson. Linda Matthews. Terry Edmonson. Thank you, ladies and gentlemen, for taking care of a sorry that I didn't get you when we began. But we do want to recognize you and thank you for your service to us. Um, we have any other comments regarding the bill from the committee members. Senator Hice, I think, Madam Chairman, I just, uh it may be your next in TM, but I just wondered if how we get the opportunity to hear from the hospitals and others. What some of their concerns are with where we are in this bill so we can see what we need to address to get it ready to go. We will recognize them. Senator Isis, when we finished members questions Senator Bergen, your recognized thank you chair. Um personal. Think all the sponsors were working on this. I know this has been very tragic for a lot of families. And I think all of us have gotten calls from folks that are dealing with with not being able to see their loved ones, but one of things that's come up. And I've had numerous calls from facilities about liability, and I know we've addressed liability and some other some other bills, and I understand we're working on another one. But but that is a big concern. Is people won't don't want to take on additional liability based on something we've done. So, Sir Daniel Feed would mind just coming in a little bit on that. Thank you, Senator Daniel. I'm thank you, Madam Chair and thank you, Senator Bergen, for the question. So that issue is actually one that hospitals have not raised recently. I'm not saying they're not concerned about it, but it's not one that has been brought to the forefront. I'll let you know that yesterday in the Judiciary Committee, there was a PCs heard that the intent of which is to provide immunity for covert related issues to all businesses across the state, from so proprietor nonprofit to for profit corporations. I'm pretty confident that hospitals would be included in that bill as if it moves forward. Um, it's supposed to be heard again, a two next Judiciary Committee meeting for a vote. But in the event that somehow that bill gets stalled, then I think that sponsors air. Definitely willing to include that aspect to this bill. Thank you, Senator Daniel. Senator Van Dine. Thank you, man. Sure. I would just like to make a comment and acknowledge that a Senator Daniels indignation around this issue is righteous. And in fact, I have vowed that no member of my family no one that I love, we'll go to the hospital on accompanied. We have staffing issues at our hospitals, and I think under normal circumstances, I would be welcome. But I think this legislation is is too blunt an instrument to actually address this problem. Um, it And as much as I appreciate Europe, your amendment, um, Cove in 19 is a great example. There is not. There is not a screening that you can do. Too many people are they can carry this disease are not symptomatic. And I would just like to point out that, um uh, we did not have PPE when this I mean that that was a reality. and it will be a reality again, just like with the 100 year hurricanes that happen every year. We don't know that it will be 100 years until the next pandemic. But we will forget about this pandemic, and we will let our guard down. And when it does happen, we will probably not be prepared. And it doesn't allow for that. And finally, what I want to say. And I prepared a rather hyperbolic speech, though I won't do that. But 600 health care workers have been killed taking care of patients. The the vision of the sterile hospital where we can protect people from infection, particularly an infection that we don't understand just isn't a reality. And I think when we ask our health care professionals to take care of people who are sick at the risk to their own lives, they deserve the ability to set the constraints around that to protect not just their patients and visitors, but themselves as well. And so what? What? You know, but But this is a problem. I'm not saying it's not and trying to think of how how we could address it, I think we need to address it the way we address most medical problems. And that is to bring medical professionals together with other stakeholders. Don't really know who that is. Maybe U N C. Or the medical Society or the Health Care Association. I'm to take a serious look at this and come up with, um, you know, did was this necessary? Maybe it wasn't, but I don't know that. And And as as as tragic assist, the stories were, we cannot say that they also protected. We cannot say that they also did not protect the spread of infection. And, um, uh, you know, maybe if you put this in the context of Ebola instead of cove it because we've all come to think that cove, it isn't deadly. For some reason, I don't know why, but we have. Maybe we would feel differently about this. But this is a health care decision, and, um, we are not healthcare professionals. Thank you. Thank you, Senator Vanda and several Horner question to Bill sponsor. I just listen to sooner. Van Dine discussed her concerns with this and and let's say ah hospital feels that she does and fails to comply. Where's the what's the penalty in this bill. Center Daniel, or suggestion. The bill doesn't have, Ah, a civil or criminal remedy. So So they let follow up, I would conclude it. So, like whether you want to wear a mask or not, We strongly recommend you do this, but we can't wait. We don't have a way. The force, this issue. I don't believe with this bill. And as long as there's no major stick in here, I can't see how anyone would be opposed to. Well, you know that safe. If you studied the North Carolina general statute, you'd probably find the number, maybe even hundreds of places where we I mean, our society works, but because people voluntarily choose to obey the law, that's what's different about America. We don't have police like China is to enforce every does to have every blow in force. So I mean, that's how these things work. And not I think hospitals there there used to complying with mounds of regulations. And obviously, this is something that I feel like they would in good faith comply with Senator Van Dine. Um, I think you bring up a good, uh uh, point center Horner, but I would also suggest that hospitals in particular, um, have a legislation before the General Assembly all the time. And in fact, a significant amount of their income comes from the General Assembly through Medicaid on DSO I think we do have, um, influence. And again, I'm just going to reiterate we are not physicians. This is a medical decision, and we need to We need to hope, Teoh toe, hold them accountable. But we do not need to tell them how to do their business. Thank you, Senator. Van Down center ice. Thank you, Madam Chairman, Sindh Daniels just wanted covet what we're dealing with right now spreads through water droplets and others. Andi, I think there's definite ways that can be controlled, but there are other viruses out there on it's not a zone. Usual is one might think for a individual hospital tow have a Mercer issue coming out. We have seen a bola, but two years ago come in a a missionary that had it. What are the conditions outside of this that a hospital can shut down and say no visitors? I mean, if if they start getting multiple cases of Mercer coming in or a community has that spreading. Could they then say that? Wait, this is different. Um, you come in here, you're going to catch this center, Daniel. So now that I've learned just a little bit about hospital regulations, I understand Senator Perry may gnome or that there are joint commission guidelines that hospitals follow. I think there may be developed by CMS, but in any event, you know, they've got a section that mandates you have a patient, has these rights will provide the visitation Well, it also has a section regarding infectious diseases that may in some instances, supersede that staff might be able to give you, based on a specific scenario, how that would be implemented or should be implemented. But as I understand it, those regulations would allow a hospital to have infectious disease protocols that could contravene the visitation protocols For what? So it is your understanding that there are scenarios on which I even with this statue in place, that the hospital could say no one except patients is coming in, and that would be still allowed under this statute. I think I would defer to staff on that question. And if the bill needs to be clarified than Maybe that would be a point of clarification. Staff apologies. I was, uh, looking at something else. Can you repeat the question, please? So I think the question from Senator Heist is if let's say that a particular hospital had a very bad outbreak, that's 80% of their patients were positive for cove, it or some other virus. If this bill became law under their joint commission guidelines, would they still be it? Would that take precedence over this statute so that they could still locked down the hospital under some sort of dire circumstance? So this bill does not speak to that situation, and I don't know, hospital regulations well enough. That might be something that, um, the Health Care Association could answer. I don't know if they have the authority. Thank you, Senator Daniel. We do have someone from the health care association here that's going to speak later. So follow up, Senator. Heis Thank you, Senator Perry. Thank you, Madam Chair. I just want to clarify for everyone what I believe the intent of this is and we've seen various policies that a lot of variation across the state, different locations we've seen some shining examples. I spoke to the individual weight cone, who is responsible for the patient experience, and they have adjusted their policies according to her, maybe three or four times during this, because they understand there's an issue right and that patients need to have someone with them and indeed to have that that caregiver in that loved one. So I think we've got some shining examples out there of things being done very well. But we also have other examples that we all know about. So I don't see this as any attempt, any forceful attempt by Senator Daniel at all. I think we're just looking for some standardization that's in the best interest of people. And I think the hospital association wants that, too. So you know, I'm reading this and he's taken so many steps to say, Hey, they're normal visitation guidelines would apply. They'd still be able to do everything they can. I think this legislation is forcing the conversation about the issue that we all know exist, and we're trying to find a way to have some standardization. I don't think anyone in here would vote for something that they fail, put people in jeopardy or harm them in any way. And no one wants to play doctor and and make decisions that the medical community should be making. This is just an attempt to find some standardization in acknowledgement of the issue that we all know exist. Thank you sent appearing any other questions or comments from the committee members. The chair has a couple of comments to dress a little bit of Senator Van Dines concerns. Some of the hospitals have already made these adjustments. Some of them have made arrangements for the end of life. Um, protocol for the family to come in, be with the family, and they're working with the families and the patients that are in these critical situations. So I think if a few hospitals conduce what the others do it so and I don't think those hospitals that are doing it would do anything that would put those patients or those hospital those medical providers in jeopardy. So I think that can be done. Also, one of the hospital soc associations or one of the representatives told me that they do have a test for Covad that they can get results back in 2 to 3 hours. I don't think any of us have a problem with them monitoring those folks going into the hospital to visit with their with their loved ones. But we definitely have a problem. We have all heard it from riel. People rial people who are going to live with the fact that their loved one died alone. We had a situation in my family. My husband's brother died alone. His wife was with him every day until all this happened, and for two months he was there all alone and finally passed away. He has 10 Children, and they all are living with the fact that their dad died alone and they never got to see him. They never got to say goodbye, and those are examples all over North Carolina, and we just can't let that happen. I made a comment this morning that if that were my loved one, the hospital would call the police because I would be going in unless they stopped me physically, which they could certainly do. I would be going in. Senator Daniel is a lawyer. He told me the story. If it were Hiss wife or his Children, he could go. He's a lawyer. He could draft up the language. He could go knock on the judge's door that he knows in his town and he could go in. Ordinary people can't do that, But I think ordinary people should have the same capability of seeing their loved ones as Senator Daniel would have, or any other lawyer or judge or whoever the case might be. So we have to find a solution. We're gonna work with everybody to try to make it try to make it right. But we are definitely gonna fix it because this cannot happen. We cannot allow our citizens in North Carolina to have to go through that indefinitely. So at this time, we have some speakers and we want to recognize first Leo Burns, who so patiently waited in our last meeting and never got to speak. So thank you, Leah, for being here from the North Carolina Health Care Association. Good morning, Madam Chair members of the committee. My name is Leah Burns on the senior director of government relations for the North Carolina Health Care Association. And we're the trade association that represents all of the hospitals across the state. Thank you so much. for this opportunity and thank you to the bill sponsors. We have been in a lot of conversations as this bill has moved forward and I also want to say that I've personally experienced this. I didn't think I was gonna talk about that today because I'm really here and a lobbying role. But I would love to talk to all of you outside of this, about my personal experience about my own mother and her time when she was receiving treatment during Cove it. But how? Her immune system was so weak that when there was not not enough PPE and not enough test to go around, that it may have been best for her that there were not people around her at that time. So But I'm really here today. Teoh again thank the bill sponsors for the continued conversation because we believe in the intent of the bill. But this is 100 year pandemic that none of us have ever seen before. CMS guidelines change on a daily basis. We're doing anything and everything we can to protect our patients and our staff. And so sometimes hard decisions have to be made. We're making Excuse me getting used to wearing this mask. We're making exemptions for people in a lot of different scenarios. And I'm not discrediting any of the stories that have been told during this committee because they are awful and they're sad. Um, and I appreciate that because I I have felt that way, too, during this. But our role in health care is to keep people safe and to protect them. And we have some of the best infectious disease physicians in the country right here in North Carolina, and they have shaped these policies based on the PPE that we have based on the testing you, Senator Krolicki ripped reference rapid testing. Those rapid tests were so happy that they're here, but a lot of them are false negatives still. So when we have a way that we can safely bring people in, we know it's at the patient's best interest for them to have their family. I would have loved to be with my mother. She had her third surgery and nine months, just a week and 1/2 ago. So I get that. However, this bill put something in statute that way, we need more flexibility. We don't know what's gonna happen. We may have a huge PPE shortage a month from now, we may have a huge Covic influx. A month from now, we don't know what's gonna happen. So my suggestion to all of you is that we form a committee at N. C. H. A with patients and with clinicians who write these policies to get them to understand how you know we can tie the medicine and what we have best from a scientific perspective with what's best for the patient, cause I promise you talking to the clinicians that I represent. This is hard for them to make those decisions, and this is just it's hard for them. You know, Teoh have to call a patient's family toe, let them know about the situation that they're in. So I really do want to thank the sponsors for the work. But I think that a better solution is to actually get patient advocates, patients who have been in the hospital during this time, and medical providers and people who really understand the science behind this. It has been being developed and come together with best practices moving forward as it was mentioned. Our hospitals are already start starting to loosen the restrictions. And pretty much all of the major systems are going to have their restrict their visitor policies loosened within the next two weeks. And so But I think, as Senator Van Dine mentioned, this is not going to go away. We're likely gonna have another wave of cove it We may have another pandemic and so that work needs to be done. And instead of legislating something that is potentially dangerous, this language does conflict with the joint commission language and does conflict with other federal regulations that we do have to abide by to maintain our licenses, hospitals. So I just hope that we can continue working together and bring people together from both sides of the issue for them to make the best decisions for patients and our staff moving forward. I'm happy to answer any questions, Madam Chair, Thanks so much for your time today. Thank you. Leah Burns. We appreciate it. We have one other speaker who has signed up. And this is Carlton Page. Madam Chair. Thank you for allowing me to be here, Senators. Thank you. Uh, I appreciate the comments that we had just made as well as I I can say that I am in the health care for you. I am a paramedic. Um, but I'm here to tell you that my daughter, who is 20 years old, has just spent three times in the hospital in the last month of half shares history of Crone's disease. Um, she had major surgery for that. We were not allowed to be with her when we took her in. There were signs posted, said it be made on the case by case basis where someone could allow big with her. We fall through their complaint lines at the hospital. People telephone call us back. We never hear nothing back from BM twice this past week, for my daughter was back in the hospital again. We kind of their complaint line. People call us back and say We would call you back. It's been five or six days now since I called. Nobody called me back to explain the situation. Talk to me about the situation. My wife's in a e mail in. They called her back, said, Give us to a 12 oclock On Tuesday, we will respond back to you. We still have heard nothing from them. So as we're looking and I could go into more details of things that happened to my daughter, how things worked against her. But I feel like that if we don't put something in place, the hospitals will continue to do things that they're doing that no visitors allowed, which is again. It breaks my heart when I have to go out and pick someone up to look at them and say, I'm sorry, you cannot get with your loved one to the hospital when very critical condition. Someone needs that support. A couple of times, While my daughter was in the hospital, she pressed her nurse cow, bell butting, and for 30 minutes no one came to help her. She had to unplug herself from some of her equipment by herself to try to get up and go to the bathroom. Whereas if we had a support person with her, that wouldn't have happened. They could have assisted her in going to the restroom. Um, I understand what they're saying about trying to protect staff, trying to protect families, trying to protect patients, but staff when they go home. At the end of the day, they don't stay at home. They go well, They go toe grocery stores. They go to convenience stores. They go to different places when they come in the next morning. All you're doing is scanning the patients for a temp. And Dean, you're saying OK, answer these questions. Any changes since, And no travel? No, no, no. And they go right on back to work. So if they are contagious or asymptomatic about being contagious, they're going right back into my patient, my daughter's room, where I cannot were being in the same situation. But I'm not allowed to go in and stay with my daughter. I understand it's a difficult time, and it's hard for the hospital to make this decisions. But patients need an advocate. You can tell him Hey, you can go in. You stay with them from the time they get there till the time they leave. If you leave the hospital at that point, you're not allowed back in. I don't how you can fix it, but if we don't pass this bill, it's not gonna work. We need to have this bill path in order to make sure that the House Bill friends and there's also guidelines on the CDC website as to how hospitals can assist in allowing advocates to be with patients during this time. But no one seems to follow their. All they want to do is allowed at allow to keep us out. I appreciate anything you do. Thank you again for allowing me to be here. And if I can help you in any other way, talk to anyone, I'll be glad to do it. Thank you, Mr Page. We appreciate that. Just a note for you, Mr Page. I have a daughter who suffers from crimes disease as well. So I understand what you're going through. That's just one of many stories that we have heard in all of our offices. Any other questions or comments from the committee sort of water. Thank you, Madam Chair occurred to me, um, yesterday just after. I mean here in this, and I won't disclose who this is. But one of our colleagues Father had surgery recently, which was very severe and included the loss of a portion of his body and talking with him and praying with him during this time. You know, his mother had to drop his father off and came back four days later. Very, very difficult. So I think we all have those stories. I guess I appreciate Miss Burns offering the opportunity to have more stakeholder conversation because I think it's it should be a broader conversation and have some or so I think I heard Senator Daniels say earlier that the sponsors were willing to continue some dialogue about this in the coming days. I know where the waning weeks of sessions, so you all feel the need to try to move this bill quickly. But I'm encouraged, and I'm hopeful that we can have a conversation. I think there's a sweet spot on this. I'm not sure we have found it yet. Appreciate center and dines comments as well on center periods. Comments on this. I'm not sure we have found it quite yet on. I hope you all can remain open and work with the health care professional stakeholder groups toe continue to have some more dialogue around this, so that's my encouragement. I don't want us to be who have a lot of thoughts about this to being difficult positions on a bill we feel uncomfortable with. Thank you Senator would appreciate those comments at this time we have. I need a motion for a favorable report since excuse me, Senator Brian has some comments. Thank you, Madam Chair. I'll keep my unlimited first. Only just thank the bill sponsors. I think we realized in situations like this and look, I share some of Senator Woodard and Van Dines questions and concerns. But we realize the significance of the issue, and I think even by filing the bill and raising it, we're already seeing attention placed on this in a way that is helpful to patients and their families. And I appreciate that even though the last speaker raised the point of there. Also, there always risk toe a little more freedom, but they're also benefits to it as well. And a lot of the stories we heard about families that by being present with them new, knew what the situation was, were able to help their lives saved clearly as well from people being present. So I just want to thank the bill sponsors for the work. I think it's important and just appreciate everyone's, uh, input. Thank you. I have a motion for a favorable report from Senator Bergen, Senator Bergen I believe your motion waas favorable report to the PCs as amended road into a new PCs unfavourable to the original bill. Serial referral to appropriations. Exactly what you say it All those in favor of the motion. Police say I any opposed the bill passes. Thank you, everyone. Our meeting is adjourned. Interesting art.