Updated on October 22, 2021
Nursing Homes New Policy from Department of Public Health Restores Some Visitation Rights
On June 26, the California Department of Public Health released a new policy regarding visitation that, for the first time since March, REQUIRES senior living communities to permit visitors for outdoor and indoor visits. Facilities with no current COVID-19 outbreak must permit outdoor visitation. Indoor visits must be permitted if a facility meets six criteria: 1. no current COVID-19 outbreak, 2. a decline in cases in the community, 3. no new COVID-19 cases in the facility for the past 14 days, 4. no staffing shortages and not using a COVID-19 staffing waiver, 5) an adequate testing plan per AFL 20-53, and 6) an approved COVID-19 Mitigation Plan. For indoor visits, only one designated visitor allowed per resident (per visit – more than one visitor may visit, just not at the same time). All visits (indoor or outdoor) must be scheduled in advance with visitors screened for fever or COVID-19 symptoms. All visitors must comply with social distancing (6 feet or more physical distancing), wear facial coverings, and permit staff monitoring to ensure compliance with infection control guidelines.
Exception to Visitation Restrictions
The following are exceptions to a skilled nursing facility visitation restrictions:
- Healthcare workers: Facilities should follow CDC guidelines for restricting access to healthcare workers. Healthcare workers, including those from the local county public health offices, should be permitted to come into the facility if they meet the CDC guidelines for healthcare workers.
- Surveyors: CMS and CDPH are constantly evaluating their surveyors to ensure they do not pose a transmission risk when entering the facility. Any surveyor entering the facility are subject to screening for fever and COVID-19 symptoms and must wear appropriate PPE.
- Ombudsman: Facilities not experiencing an outbreak (i.e., one or more confirmed positive cases) should permit ombudsman representatives in the facility. Any ombudsman representative entering the facility is subject to screening for fever and COVID-19 symptoms and must wear appropriate PPE.
- Nursing students: Students obtaining their clinical experience as part of an approved nurse assistant, vocational nurse or registered nurse training program should be permitted to come into the facility if they meet the CDC guidelines for healthcare workers.
- End of life visitation: For permitted visitors for end of life situations, those individuals:
- Must be screened for COVID-19 symptoms
- Must wear a surgical facemask while in the building
- Restrict their visit to the resident’s room or other location designated by the facility
- Should be reminded by the facility to frequently perform hand hygiene
Resuming Other Visitation
To resume visitation, facilities should refer to the “Recommended Nursing Homes Phased Reopening for States” attachment in QSO 20-30 (PDF) and work with their local health department in determining the general community’s current reopening phase. Due to the elevated risk COVID-19 poses to SNF residents, CMS recommends that facility reopening should lag behind the general community by 14 days. Facilities experiencing an outbreak (i.e. one or more confirmed positive cases) should not resume visitation.
Facilities that meet the following conditions shall allow residents to designate one visitor per resident for inside facility visitation:
- Case conditions in the community – There is a decline in the number of new cases, hospitalizations or deaths in the community.
- Case status in the facility – Absence of any new COVID-19 cases in the facility for 14 days, either residents or staff.
- Adequate staffing – No staffing shortages and the facility is not using a COVID-19 staffing waiver.
- Access to adequate testing – The facility has a testing plan in place in compliance with AFL-20-53.
- An approved COVID-19 Mitigation Plan- The facility must maintain good regulatory compliance for safety.
Facilities unable to meet the conditions specified above may not resume in room facility visitation, but they shall provide outdoor and other visitation options, including but not limited to:
- Allow scheduled visits on the facility premises where there is 6-feet or more physical distancing, and both residents and visitors where facial coverings with staff monitoring infection control guidelines. (i.e. large communal spaces, outdoor visits, drive-by visits or visit through a person’s window).
- Offering alternative means of communication for people who would otherwise visit, such as virtual communications (phone, video-communication, etc.).
- Creating/increasing listserv communication to update families, such as advising not to visit.
- Assigning staff as primary contact to families for inbound calls and conduct regular outbound calls to keep families up to date.
- Offering a phone line with a voice recording updated at set times (i.e. daily) with the facility’s general operating status, such as when it is safe to resume visits.
Visitation Guidance
- For all visitations, facilities should make efforts to allow for safe visitation for residents and loved ones.
- Ensure visitor screening for fever and COVID-19 symptoms
- Visitors and residents should have facial coverings (cloth masks or surgical face masks)
- Staff should monitor to physical distancing is practiced with no hand-shaking, hugging, and remaining six feet apart.
- If possible (i.e. pending design of building), creating dedicated visiting areas near the entrance to the facility where residents can meet with visitors in a sanitized environment. Facilities should disinfect rooms after each resident-visitor meeting.
- Advise visitors, and any individuals who entered the facility (e.g., hospice staff), to monitor for signs and symptoms of respiratory infection for at least 14 days after exiting the facility. If symptoms occur, advise them to self-isolate at home, contact their healthcare provider, and immediately notify the facility of the date they were in the facility, the individuals they were in contact with, and the locations within the facility they visited. Facilities should immediately screen the individuals of reported contact, and take all necessary actions based on findings.
- For medically necessary trips away from the facility, the resident must wear a cloth face covering or a surgical facemask and the facility must share the resident’s COVID-19 status with the transportation service and entity with whom the resident has the appointment.
- All staff must wear appropriate PPE when they are interacting with residents, to the extent PPE is available and consistent with CDC guidance on optimization of PPE. Staff should wear cloth face covering if surgical facemask is not indicated.
- Once baseline testing is complete implement either surveillance or response driven testing based on the conditions at the facility in accordance with AFL-20-53.
- Have dedicated space in the facility for cohorting and managing care for residents with COVID-19; plan to manage new/readmission with an unknown COVID-19 status and residents who develop symptoms.
Additional Guidance
The following are additional CMS guidance to prevent the spread of COVID-19. This guidance is subject to revision by CMS at any time.
- Cancel communal dining and all group activities, such as internal and external group activities. For COVID-19 negative or asymptomatic residents, communal dining should be limited, but residents may eat in the same room with social distancing (limited number of people at tables and spaced by at least 6 feet).
- Remind residents to practice social distancing and perform frequent hand hygiene. Residents must wear cloth face covering or facemasks as mandated in CDPH’s Guidance for the Use of Face Coverings (PDF).
- Facilities should identify staff that work at multiple facilities (e.g., agency staff, regional or corporate staff, etc.) and actively screen and restrict them appropriately to ensure they do not place individuals in the facility at risk for COVID-19.
- Facilities should review and revise how they interact with vendors and receiving supplies, agency staff, EMS personnel and equipment, transportation providers, and other non-health care providers (e.g., food delivery, etc.), and take necessary actions to prevent any potential transmission.
CDPH understands the importance of maintaining contact with family and friends to LTC residents. If you have any questions about this AFL, please contact your local district office.
Sincerely,
Original signed by Heidi W. Steinecker
Heidi W. Steinecker
Deputy Director
Updated on October 29, 2020
Miami Expungement Program Gives Second Chance
A program started last year in Miami-Dade has helped over 600 local residents have their criminal records sealed or expunged. Sealed cases are closed and can only be reopened with a court-ordered subpoena. Expunged cases are erased completely.
A “One-Stop” Program
The Sealing and Expungement One-Stop Program was implemented in December 2006 by Katherine Fernandez Rundle, State Attorney for Miami-Dade, and workshops are held monthly for residents who want to learn more about qualifying for the program.
According to public information officer Ed Griffith, the workshops are popular—one held in September drew nearly 1,000 residents. More than 3,000 people have applied to the program since it began, but the process is not a simple one.
“It’s not as easy as signing up for your driver’s license,” said Griffith.
Guidelines & Qualifications
Each case is handled individually, and the qualifications for having a record sealed are different than those for having a record expunged. Generally, people who qualify for either are those who have been charged with an offense but have not received a conviction.
Program guidelines also require a person to have completed probation and/or paid any court costs or court-ordered fines.
Individuals who attend the workshops can receive counseling from the public defender’s office to learn which option might be best for them.
The American Civil Liberties Union also attends to help those who are not eligible for the program but who need help having their civil rights restored. For those who need job-placement assistance, the South Florida Workforce is on hand to help.
(Source: Miami Herald online)
Interested in learning more about expungement? Contact an experienced criminal defense attorney near you to discuss your options.
Updated on October 29, 2020
Sheriff Hopes Pink Chain Gang Will Deter DUIs
A sheriff in Arizona is hoping a new tactic will act as a deterrent to driving under the influence—those who are convicted on charges of DUI will end up on a chain gang, wearing pink, and conducting burials for alcoholics.
“Maybe this will warn people – knock it off, don’t drink and drive,” said Maricopa County Sheriff Joe Arpaio, who already has a reputation for housing convicts in military tents.
“Clean(ing) and Sober”
Last Tuesday, 15 DUI inmates donned pink shirts with “Clean(ing) and Sober” printed on the front and “Sheriff D.U.I. Chain Gang” on the back. On Thursday, the inmates conducted burials at a local indigent cemetery where many homeless alcoholics are laid to rest.
One inmate said the uniform was a “little embarrassing,” but added optimistically, “Hopefully it keeps someone from drinking and driving.”
Increase in DUI Deaths
The number of alcohol-related deaths in Arizona increased 15 percent last year, with a total of 585, according to statistics from the National Highway Traffic Safety Administration.
Legislators strengthened the state’s DUI laws in June, mandating harsher penalties for first-time offenders, including increased fines and ignition interlock devices.
(Source: Associated Press)
Charged with DUI? An experienced criminal defense attorney can help you plan a course of action. Contact us today to arrange a free consultation with a lawyer near you.
Updated on October 29, 2020
NJ Governor To Sign Law Abolishing Death Penalty
The governor of New Jersey is expected to sign a bill approved by the state legislature to abolish the death penalty. Once signed into law, New Jersey will be the 14 states without capital punishment.
The state has not put anyone to death since 1963. In January 2007, a legislative commission concluded that the death penalty was “inconsistent with evolving standards of decency” and recommended it be abolished.
First Legislative Ban in Decades
This week both the state Assembly and Senate voted in favor of the ban, making New Jersey the first state to legislatively end capital punishment since it was reinstated by the U.S. Supreme Court in 1976.
Governor Jon Corzine, a Democrat, is an opponent of capital punishment and will likely sign the bill into law. In lieu of the death penalty, those convicted of the most serious crimes will receive life imprisonment without the possibility of parole.
Declining Use of Capital Punishment
Thirty-six states, the federal government, and the military still retain the death penalty, though its use is declining. In 2006, executions reached the lowest they’ve been in the past decade, with 53 total. That total is expected to fall even lower this year.
(Source: Reuters)
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Updated on October 29, 2020
19,500 Convicted Crack Offenders Await Commission Decision
Approximately 19,500 federal inmates serving time on crack cocaine-related charges could see a reduction in their sentences if the U.S. Sentencing Commission decides to make recently implemented punishment guidelines of drug possession retroactive.
The commission made new guidelines effective November 1, 2007. The revised guidelines were implemented as part of an attempt to reduce the disparity in punishment between crack cocaine and powder cocaine crimes.
100-to-1 Disparity
In the 1980s, Congress wrote into law harsher penalties for crack offenses. Commonly referred to as the 100-to-1 disparity law, it mandates a five year minimum prison sentence for trafficking in 500 grams of powder cocaine compared to 5 grams of crack.
The law has been criticized as racist because crack is a drug predominantly used by blacks and powder cocaine primarily used by whites. Of the 19,500 inmates who could be affected by the commission’s decision, 86 percent are black.
Supreme Court Decision
On Monday, the Supreme Court upheld the right of judges to impose more lenient sentences for crack cocaine offenses than those outlined by the sentencing commission. The high court ruling could affect the outcome of today’s commission meeting.
In recent years, the seven-member commission has revised the sentencing guidelines, making the penalties less harsh, for drug crimes involving LSD, marijuana, and Oxycontin. Those drugs are largely used by whites, and the commission’s decision was made retroactive.
(Source: Associated Press)
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Updated on October 29, 2020
Nation’s Busiest Crime Lab Reviewed after Mistakes
A New York state official has asked the district attorney of Queens to consider criminal charges against four former employees of the New York Police Department’s crime lab because of mistakes made in 2002 that could have skewed evidence in drug cases.
“The integrity of evidence is a cornerstone of law enforcement. These lapses were a threat not only to the prosecution of drug crimes but to the public’s trust in our criminal justice system,” said Kristine Hamann, the state inspector general.
Appeals Expected
Prosecutors use drug evidence collected during raids and seizures to secure a conviction, and the amount or weight of drug found has a bearing on the severity of sentencing.
Criminal defense attorney and co-founder of the Innocence Project, Peter Neufeld, said the findings “undermine God knows how many convictions,” and legal experts said the review could prompt appeals by those who want their sentences reevaluated or their convictions overturned.
Incompetent Lab Analysts
The police department acknowledged the sloppy work by three of the lab’s analysts, all of whom were either transferred or dismissed when they failed lab accuracy tests five years ago. The lab has since been overhauled with new staff and procedures.
However, the lab failed to disclose the drug testing errors to state officials until 2007 and also failed to report the mistakes to the Laboratory Accreditation Board of the American Society of Crime Laboratory Directors.
According to Hamann, much of the original evidence has been destroyed or tainted in the five-year lapse, making new testing extremely difficult. She added that it is also now impossible to know if any other of the lab’s 100 analysts took shortcuts during the tedious drug testing process.
In addition to the three former analysts, Hamann has recommended that the former director, W. Mark Dale, of the lab also be charged. Dale retired in 2004.
(Source: The New York Times online)
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