In overwhelmingly voting for nursing home residents to designate an essential caregiver for in-person visitation, Texas voters aligned themselves with a critical balance the Texas Medical Association helped lawmakers strike between the need for crucial emotional support in those settings and keeping public health threats at bay.
During this month’s statewide election, Proposition 6 passed with nearly 87% of the vote. Just under 1.3 million Texans voted to amend the state Constitution to allow residents of assisted living facilities, nursing homes, and certain other facilities to designate one caregiver who can’t ever be denied in-person visitation, not even during a public health emergency such as the COVID-19 pandemic.
In the 2021 regular session of the Texas Legislature, TMA had a hand in finalizing both what became Proposition 6 and a similar piece of legislation applying to hospitals’ ability to restrict visitors. Prop 6 reached the November ballot via the passage of Senate Joint Resolution 19 by Sen. Lois Kolkhorst (R-Brenham) and Rep. James Frank (R-Wichita Falls).
Clare Gentry, MD, chair of TMA’s Committee on Infectious Diseases, says while the lockdown-type restrictions on visitation earlier in the pandemic made sense – with a novel virus with a transmissibility and mortality rate unlike anything health care workers had dealt with before – the availability of vaccines has been a game-changer.
“It’s pretty clear that residents that live in these facilities need and benefit from family members around them on a routine basis, whenever we can do that safely,” Dr. Gentry said. The new law strikes that balance by designating a single essential caregiver while “still allow[ing] you to limit, in settings where you need to, the number of people in and out of the building, as opposed to an unlimited number of people coming in and out for each visitor. … We’ve always had the ability to temporarily restrict visitation for other infections, not just COVID. That’s still important, and the measure still allows us to do that.”
TMA Director of Legislative Affairs Troy Alexander says the authors of Proposition 6 did a good-faith job of navigating the competing priorities at play. He says TMA supports patients having the emotional support of a loved one during a stressful time.
“The proof will be in the pudding of how it plays out,” Mr. Alexander said. “Hopefully this pandemic will eventually end, but the reality is that there’ll be another one behind it, and incidents of infectious disease outbreak will continue to be an issue, whether they’re small or large, in facilities at future dates.”
TMA had been working on similar infection-control issues before the pandemic ever began. In 2019, TMA contributed key input to House Bill 1848 by Rep. Stephanie Klick (R-Fort Worth), which advanced to become law. HB 1848 required long-term care facilities to include “monitoring of key infectious agents, including multidrug-resistant organisms” in the facility’s infection prevention and control program.