New Law Compromised Care of Nursing Home Residents

New Law Compromised Care of Nursing Home Residents

Why You Should Be Worried and Questions Families Should Ask About Long-Term Care Background: Last year, Governor DeSantis declared a state of emergency in response to challenges brought on by the COVID-19 pandemic. Meant as a temporary solution, the order allowed nursing homes to bring on personnel with minimal nursing education and training to augment staff in caring for residents. During the 2021 Legislative Session, House Bill 485 made this solution permanent.

The implications: To help fill some gaps in nursing-to-resident ratio needs, the new law relating to personal care attendants (PCAs) permits people with 16 hours of training to support to nursing home residents on activities of daily living. While PCAs are prohibited from clinical tasks performed by Certified Nursing Assistants, who receive 120 hours of classroom and supervised clinical training, this new law effectively reduces the quality of care to residents in favor of cheaper PCA labor. Nursing-to-resident ratios are critical to ensure patient well-being where regular ongoing interactions can better address a resident’s overall medical needs. With an ongoing pandemic, these considerations take on increased importance when nurses become ill with coronavirus, and PCAs can’t medically fill gaps in care.

SENATE BILL 485:

CS/CS/HB 485 — Personal Care Attendants

by Health and Human Services Committee; Finance and Facilities Subcommittee; Reps. Garrison; Rayner and others (CS/CS/SB 1132 by Appropriations Committee; Health Policy Committee; and Senator Bean)

This summary is provided for information only and does not represent the opinion of any Senator, Senate Officer, or Senate Office.

Prepared by: Health Policy Committee (HP)

The bill establishes in law a personal care attendant (PCA) program for nursing homes. The bill authorizes a nursing home to hire PCAs who are participating in the training program developed by the Agency for Health Care Administration (AHCA) in accordance with federal requirements for nurse aide training. Each PCA may only work for a single nursing home for a period of four consecutive months before becoming a certified nursing assistant. During the four month period, the nursing home may count the hours worked by the PCA as CNA hours for the purposes of staffing requirements; however, the bill specifies that a PCA may not perform any task that requires clinical assessment, interpretation, or judgement.

Prior to having direct contact with a resident, the PCA must complete 16 hours of required education developed by the AHCA. The bill specifies what topics, at a minimum, must be covered by such education and allows the AHCA to add to the content areas covered. The bill requires the AHCA to develop the PCA training program and adopt rules to implement the provisions of the bill.

The bill specifies that should the Governor’s Executive Order 20-52 (related to COVID-19) be terminated before the AHCA adopts rules to implement the PCA program that the current PCA program, which is authorized on an emergency basis, be allowed to continue until the adoption of such rules.

If approved by the Governor, these provisions take effect upon becoming law.

Vote: Senate 32-7; House 106-11