It’s a delicate balancing act.
Family members who’ve been kept from sick or elderly loved ones for nearly a year are desperate to hug them again. Others fear allowing visitors into spaces such as a hospital or nursing home will only exacerbate the problem.
Lawmakers are considering legislation that would ban health care facilities from refusing visitors during a declared emergency — such as the COVID-19 pandemic that the state has grappled with since March and has killed nearly 15,000 Georgians.
“My friends, this may well be the most important bill we pass this legislative session,” House Human Relations and Aging Chairman Jesse Petrea said before a committee hearing last week, invoking a smattering of “amens” from his colleagues. His committee has held two hearings on House Bill 290.
Though the final details are still being ironed out, the most recent draft of the legislation would require hospitals and long-term care facilities to allow at least one person — who would have the right to make medical decisions for a patient — to visit a sick or elderly loved one for at least one hour a day, regardless of any health emergency or executive order from the governor. Petrea, a Savannah Republican who owns assisted living facilities, said Wednesday lawmakers were still working to amend the legislation, which could be considered next week.
“Health care is both health and care, and to say otherwise is to ignore the best we can provide our loved ones,” said House Science and Technology Chairman Ed Setzler, an Acworth Republican and the bill’s sponsor. “Without House Bill 290, the deprivation of access that we’ve seen in the last 12 months will happen again and again.”
But many in the health care industry, while lauding the benefits of patients being able to interact with loved ones, have balked at the idea of requiring that people be allowed to see patients regardless of outside circumstances.
“There are so many variables in the mix, it really makes sense to let the local experts handle these decisions as they come up,” said Dr. Marybeth Sexton, an associate professor of infectious diseases at Emory University. “If you say that, always with no exceptions, you have to allow visitation, you take away the ability for the hospitals to make those adjustments that they deem necessary for safety.”
Tony Marshall, president and CEO of the Georgia Health Care Association, which represents nursing homes and assisted living facilities across the state, said while he and providers are eager to resume family visits, he is concerned HB 290 could put nursing homes at risk of being out of compliance with guidelines set by the federal Centers for Medicare and Medicaid Services, which have specific requirements for visitation.
Those requirements include screening visitors, maintaining infection control measures and limiting visits to only compassionate care situations when the coronavirus positivity rate in a nursing home’s community is above 10%.
Though trends in Georgia are improving, about half of the state’s 159 counties reported positivity rates in the general population of 10% or greater over the past seven days through Monday, according to statistics compiled by the U.S. Department of Health and Human Services.
Public health officials also fear the United Kingdom strain, which is more contagious and potentially more lethal than the common coronavirus, could trigger another wave of severe disease.
“We would like nothing more than to open visitations,” Marshall said. “But we must do so safely without having a detrimental impact on our most vulnerable. It’s difficult to balance.”
For Deborah Malone of Rome, who has only seen her daughter Niki Malone twice briefly over the past year, resuming visits cannot come soon enough.
“Once when I was outside talking to her and she didn’t realize I was there and she kept saying when are you going to come visit me?” Malone said. “It was distressing to both her and I to be that close and not be able to touch each other.”
Niki Malone, now 43 and living in a group home in Rome, had a brain tumor as a young child. As a result of surgery and later complications, she has had lifelong physical and cognitive challenges. She functions on the level of a 6-year-old, her mother said.
Malone has advocated to make sure the bill applies to not only nursing homes and assisted living centers but also group homes.
Before the pandemic, Malone visited her daughter almost every day. She read children’s books to her daughter. She helped Niki, who uses a wheelchair, do arm exercises for strength and mobility. They went on shopping trips to the mall. Malone said she wanted to be a constant caring presence in her daughter’s life.
The abrupt stop on visits, Malone said, “is beyond cruel.”
“There are days I do OK and there are days I don’t think I can make it,” she said. “When you stop and think about it, it’s hard to believe it is happening. Our most vulnerable of our citizens and we have left them without anyone to check on them.”
Marshall said his association has recommended the bill be carefully worded to ensure that there is nothing in it that would put providers out of compliance with federal requirements by allowing these visits.
Long-term care homes reported more than 700 COVID-19 deaths in January, the highest one-month total. The number of residents reported as testing positive last month set records, too. Losses mounted even as most residents of long-term care facilities haven’t been able to have visitors for months, under federal regulations and emergency orders issued by Gov. Brian Kemp aimed at stopping outbreaks.
But the trend line has been encouraging as the number of infections and deaths sharply declined in recent weeks. Long-term care homes reported about 200 deaths in February, according to the latest figures.
Marshall said visits at long-term care homes cannot automatically resume if a resident and visitors have been vaccinated because it has yet to be proved that vaccines, while probably preventing people from getting sick, can keep the person from spreading the virus to others.
State Rep. Donna McLeod, a Lawrenceville Democrat, said while she empathizes with families who’ve been kept from their loved ones and understands the benefits of having that access, she worries about the risk of spreading a communicable disease such as COVID-19 during a pandemic.
“I absolutely understand that, with human beings, our ability to be able to touch each other is a big part of our life,” she said. “And, yes, I want a bill to come through that I’m comfortable with. ... I’m not going to vote for something that I know is going to (negatively) impact all the people in the state. We are 180 people in the House who determine how almost 11 million people live. We cannot take that lightly.”
Marshall said whether or not the bill becomes law, he believes face-to-face visits will resume over the next few months, assuming the infection rate continues to drop, and more and more people get vaccinated.
“I don’t think we can go back to full, unlimited visitation this month or next month, but I think we are close,” he said. “I think we have an avenue to get there. And I think we will have some sort of normal soon.”