Legislation

N.J.A.P.A

LEGISLATION REPORT September 29th 2017

Committee Chair:  Joan Marie Granato

SUMMARY:

There is movement in the Health Care Industry due to a variety of incidences that will lead to major changes in policy , procedures and protocols.

The traumatic effects of severe hurricanes and other forms of earth shaking catastrophic events will force governments around the world to demand more stringent emergency plans for all health care facilities. The goal is to protect and secure safe havens for seniors prior to these emergency evacuations. The severity of those inflicted by extreme neglect of professionals managing nursing homes and assisted living facilities have brought a new light to the industry as a whole. Those fragile seniors that lost their lives while their blood was baking in a facility in Florida was more than neglect, it was downright murder….Only steps away from a hospital, managers still did not make the right decision. The bottom line is we all have a right to voice our concerns, even when management does not. This will be evident by reporting laws that exist now in our country to protect our elderly and disabled population. We must make it more than awareness in our facilities to give our caregivers, our employees and others a voice to be heard without being penalized for such gruesome decisions. We all have a voice and our efforts as an industry must be heard.

AGENDA:

• New Legislation
• NCCAP Overview
• NAAP Overview
• Attachments for Legislation
• Memorial Tribute

NEW LEGISLATION:

• CACFP
• Peggy’s Law:
• Cullen’s Act:
• The Health Care Professional Responsibility and Reporting Enhancement Act

NCCAP Overview:

Legislation Chair, Joan Marie Granato will join NCCAP in North Carolina for “Call For Action”

This is truly an exciting time for NCCAP and its Future Mission, Vision and Goals. The Board is working diligently to revitalize the NCCAP’s purpose and direction. This is not a minor feet, this is hard work done by all volunteers.

On a personal note and representing NJAPA’s Legislation Committee, Joan Marie Granato has been asked by the new Executive Director, to assist in the overall planning and re-structuring of the NCCAP Mepap courses as well as the New Certification for Adult Day Care. ADSC (Adult Day Services Certification) They are rolling out a Home Care Certification and looking to revamp the MEPAP Class Structure. This is going to be Great! Please go on their website for more information and join their email blasts, there is always good information. Look in the future for Website changes also. NCCAP.org

MemberClicks, Renewals, and Call To Action

Memberclicks— We are happy to announce that coming late fall early winter that there will be a new website and database that will be your one stop shop for everything NCCAP!  We listened to your need for being able to do everything online which will include uploading your renewals and so much more! Expired Certification— We are also happy to announce that if your certification is currently expired and your renewal date was due in 2016-June 30th 2017 that we are offering to waive the late fee/reinstatement fee for a limited time. If your renewal date was during the noted time frame, your renewal must be postmarked between July 1, 2017-Oct 31, 2017 for the fees to be waived. Fees are not waived if your renewal was postmarked prior to July 1, 2017. Call To Action— November 4th, 2017, Embassy Suites, Raleigh NC, More Information Coming Soon!

NEW EXECUTIVE DIRECTOR FOR NCCAP

As Legislative Chair, Joan Marie Granato extended a warm welcome from NJAPA as the #1 State in the World for Certified Individuals…..Communications from Peter J. Illig, Esq. Chief Executive Officer

Dear Members,
Greetings! It is with great enthusiasm that I pen my first words to you as your new Chief Executive Officer. Having just returned from the 2017 Symposium in my hometown of Buffalo, NY, joining NCCAP is in many ways both a personal and professional homecoming. Having worked across healthcare sectors domestic and globally I am excited to apply my unique mix of legal, management and external relations functions to advance the mission of NCCAP.

You have my commitment that NCCAP will be revitalized with Good Governance and Best Practices to ensure the highest quality of education and certification for Activity Professionals. You, as members, possess the subject matter expertise necessary to lead and influence the mosaic that is the Activity Profession. My initial task is to listen to you, the Board and our partners to understand the needs and opportunities for growth. The objective is to re-assert NCCAP as the recognized leader in providing best-in-class educational content and certification for quality of care and quality of life. Please feel free to reach out to share your thoughts, concerns and suggestions with me. I look forward to serving you and our overall profession.

With kind regards,
Peter J. Illig, Esq. Chief Executive Officer Email: peter.illig@nccap.org

NAAP Overview:

Legislation Chair, Joan Marie Granato has been asked to join a new committee on NAAP,
The International Committee. Our mission is to incorporate NAAPs awareness in other countries while integrating Activity Professionals from around the world to join forces as an industry.

NAAP is the only national organization that exclusively represents Activity Professionals working in primarily geriatric settings. This association provides opportunities for professional development and personal growth.

NAAP really provides its members with BENEFITS galore….For only $75.00 per year it is well all the FREE….FREE….FREE….YES FREE DOWNLOADS of documents, inservices and articles…this is so valuable for any Activity Professional NAAP provides you with this information so you can look good….

Some of the many benefits of a NAAP Membership includes:
(Click HERE to join)

• Support with the most current regulatory and government issues
• eLearning with a library of educational videos that can be viewed at your leisure
• Timely articles about issues facing the Activity Professional
• Annual National Conference and Education Summit
• Monthly education opportunities with live Lunch & Learn
• Networking
• Monthly Program Ideas
• Vendor Partnerships
• Organizational Partnerships
• Job Board
• NAAP Helpline
• Resources for purchase include Exam Study book, Resource Book and P&P manual

Child and Adult Care Food Program (CACFP)

CACFP provides aid to child and adult care institutions and family or group day care homes for the provision of nutritious foods that contribute to the wellness, healthy growth, and development of young children, and the health and wellness of older adults and chronically impaired disabled persons.

Through CACFP, more than 4.2 million children and 130,000 adults receive nutritious meals and snacks each day as part of the day care they receive.

See how CACFP can make a difference in the quality of your program! Whether you are a provider in your home, at a day care center, in an afterschool care program, or in an emergency shelter, you will find many useful resources for serving nutritious meals and snacks.

New changes have been adopted and training is occurring monthly for meal pattern planning, documents, electronic implementation and adherence by October 2018.

It has been more than 50 years since any of these regulatory standards have changed in the Food Program. The CACFP team continues to provide valuable support to organizations who are in contract with CACFP, continues to audit facilities and provide training.

PEGGY’S LAW:

TRENTON, NJ — Seven years after a 93-year-old Brick Township woman died after what her family was told was the result of slipping on powder in her room at an assisted care living facility, the elder abuse regulations her daughter has campaigned for are finally law.

Peggy’s Law (S-1219), named for Peggy Marzolla, who died in 2010, was signed into law by Gov. Chris Christie on Monday. It aims to protect senior citizens in assisted living facilities from abuse by requiring suspected abuse be reported to law enforcement.

“I started to cry I was so happy,” said her daughter, Maureen Marzolla-Persi, who has been fighting for passage of Peggy’s Law since her mother’s death in April 2010. It’s taken Hundreds of phone calls and emails pushing, prodding, nagging legislators. She’s spent hours spent talking to others whose family members were abused, and testifying before the Legislature. And more calls nagging the governor’s office about signing the bill since it was passed by both houses at last on June 29.

It’s bittersweet, she admits.

“It’s too late to help my mother,” Marzolla-Persi said, but she’s hopeful it will protect other elderly patients and prevent others families from suffering the anguish she faced. In February 2010 Marzolla-Persi received a call late one night that her mother, an Alzheimer’s patient, had slipped on some powder and been taken to Ocean Medical Center in Brick. Hospital staff, however, raised questions about the injuries Peggy Marzolla had suffered, Marzolla-Persi told the Patch. Peggy Marzolla, who didn’t retire from her job in the Paterson police department until age 81, had sustained a broken eye socket, a broken cheekbone, a broken jaw, a broken wrist, a badly bruised elbow, a gash on her left shin and welts on her back.

“The doctors and medical personnel who came into her room said, ‘Well, what do you think really happened?'” Marzolla-Persi, of Toms River, has said.

Peggy Marzolla died 65 days after she was taken to the hospital. The incident eventually was investigated by the state Office of the Ombudsman for the Institutionalized Elderly, but it was never investigated by law enforcement. The ombudsman’s office accepted the explanation the staff at the nursing facility gave.

Maureen Marzolla-Persi did not, and began her fight to ensure that future situations were investigated by someone outside the facility’s staff.

>> READ MORE: Brick Case Inspires Bill to Protect Elderly Patients

The law requires any caretaker, social worker, physician, nurse or other staff member of a care facility who has reasonable cause to suspect that an elderly person is being abused or exploited to report it to local law enforcement. It also requires them to report such incidents to the Ombudsman of the Institutionalized Elderly within certain periods of time, depending on the kind of abuse.

“When families put their loved ones in the care of a nursing home or other assisted living facility, they expect that they’ll be treated properly and with respect,” said Sen. Jim Holzapfel (R-Ocean), who co-sponsored the legislation. “If an employee of one of these homes even has the slightest suspicion that something might be awry, it should be their duty to report it.”

“Employees have to be the first line of defense against abuse,” said Sen. Diane Allen (R-Burlington), the other co-sponsor. “They see their residents every day, and they will know when something isn’t right. The families of these seniors have always counted on the employees to do the right thing. Now the State of New Jersey demands it.”

Marzolla-Persi told the Patch in 2015 that the eventual investigation of her mother’s death by the ombudsman’s office did not result in any criminal charges nor any sanctions against the facility. It did, however, prompt her to mount the campaign that led to the passage and signing of Peggy’s Law, though it took three introductions and six years to do it.

>> READ MORE: Five Years After Brick Woman’s Death, Elder Abuse Bill Languishes

“I was a good girl; I did what they told me to do,” Marzolla-Persi said of the efforts she made to get her mother’s case investigated. She never thought to call the police, she said, and no one suggested it.

Now, calling the police about suspected abuse will be the first step, one she hopes will spare other families the anguish she faced.

“They said it couldn’t be done but I did it,” Marzolla-Persi said of what amounted to a one-woman lobbying effort.

“I didn’t have donors, I didn’t have an organized committee,” she said. “But I got it done. It’s going to help the elderly of New Jersey.”

“I feel like I can finally sleep peacefully tonight,” Marzolla-Persi said.

Peggy Marzolla, the 93-year-old Brick Township woman for whom Peggy’s Law is named, in the hospital in 2010. She suffered a broken eye socket, cheekbone, jaw, and wrist, as well as other injuries that nursing home staff claimed was the result of a fall. Photo courtesy of Maureen Marzolla-Persi

CULLEN ACT

Requirements and Protections The State of New Jersey Health Care Professional Responsibility and Reporting Act (also known as Chapter 83 or more commonly as the Cullen Act) (the “Act”), was enacted in July of 2005 in response to the news accounts of Charles Cullen, a nurse who confessed to killing at least 29, and as many as 40, patients under his care while working at several hospitals in New Jersey and Pennsylvania. Cullen was able to move from hospital to hospital for 16 years in spite of a questionable employment record. The objective of the Act is to facilitate the sharing of information about health care professionals who may present a risk of harm to patients. The Act protects New Jersey health care entities by allowing them to report the impairment, incompetence, negligence and professional misconduct of health care professionals to the New Jersey Division of Consumer Affairs or other health care entities without the fear of legal reprisal by the health care professional at issue. The Act pertains to both health care entities as well as healthcare professionals employed by said entities. Home care services agencies, such as Homecare Options, are included in the definition of a health care entity under the Act. Healthcare professionals are defined as: “Individuals, whether paid or unpaid, licensed or authorized to practice a healthcare profession regulated by the Division of Consumer Affairs and other professional and occupational licensing boards including physicians, podiatrists, nurses, pharmacists, physical, occupational and respiratory therapists, nurses aides and personal assistants, psychologists, psychoanalysts, social workers, professional counselors, drug and alcohol counselors, speech and language pathologists, optometrists, opticians, dentists, orthotics and prosthetic providers, marriage and family therapists, veterinarians and chiropractors, ophthalmic dispensers and ophthalmic technicians, audiologists, and acupuncturists.” Summary 1. Health care entities and health care professionals must notify the New Jersey Division of Consumer Affairs in the Department of Law and Public Safety (DCA) when they have information regarding the incompetence or negligence of a health care worker which would endanger patients. 2. Health care entities must report to other health care entities disciplinary actions taken against an employee for professional misconduct, improper 1 patient care or other actions that negatively affect the health care professional’s ability to treat patients. 3. Criminal background checks are required of health care professionals who apply for licensure or license renewal. Notification and reporting requirements are limited to professional deficiencies which directly relate to patient care and safety, such as impairment, incompetence or professional misconduct. They do not include personal misconduct and poor performance such as tardiness, insubordination, harassment of co-workers, theft or similar behavior. Specific Requirements HomeCareOptions Notification Requirements 1. With respect to a healthcare professional who is either employed by, under contract to render professional services to, has privileges granted by HomeCare Options, or who provides services pursuant to an agreement with a healthcare services firm or staffing registry, HomeCare Options must notify DCA in writing if, for reasons relating to impairment, incompetency or professional misconduct which relates adversely to patient care or safety, one of the following events occur: The healthcare professional has had full or partial privileges summarily or temporarily revoked or suspended, or permanently reduced, suspended or revoked; The healthcare professional has been removed from the list of eligible employees of a health services firm or staffing agency; The healthcare professional has been discharged; The healthcare professional has had a contract to render professional services terminated or rescinded; The healthcare professional has had conditions or limitations placed on his/her exercise of clinical privileges or practice including, but not limited to, limitations with respect to second opinion requirements, non-routine concurrent or retrospective review of admissions or care, non-routine supervision by one or more members of the staff, or the completion of remedial education or training; 2 The healthcare professional has voluntarily resigned or has relinquished any partial privilege or authorization to perform a specific procedure if the healthcare professional’s conduct is being reviewed by the healthcare entity or the healthcare entity has expressed an intention to do such a review; While under, or subsequent to, a review by the healthcare entity of the healthcare professional’s patient care or professional conduct, is granted a leave of absence relating to a physical, mental or emotional condition or drug or alcohol use which impairs the healthcare professional’s ability to practice with reasonable skill and safety. (No report is required for pregnancy-related leaves of absence or if the healthcare professional has sought assistance from a professional assistance or intervention program approved or designated by the division or a board to provide confidential oversight of the healthcare professional, and is following the treatment regimen or monitoring as that program requires. 2. HomeCare Options shall notify DCA in writing about all malpractice lawsuits resolved by settlement, judgment or arbitration award in which both the healthcare professional and HomeCareOptions are parties. 3. HomeCare Options shall notify DCA in writing if it is in possession of information that indicates that a healthcare professional has failed to comply with a request to seek assistance from a professional assistance or intervention program approved or designated by DCA or a licensing board to provide confidential oversight of the healthcare professional, or has failed to follow the treatment regimen or monitoring program required by that program. 4. HomeCare Options shall notify DCA in writing if any healthcare professional who has been the subject of a report to DCA has had conditions or limitations on the exercise of clinical privileges or practice within the healthcare entity altered, or privileges restored, or has resumed exercising clinical privileges that had been voluntarily relinquished. 5. HomeCare Options, pursuant to an agreement with a healthcare services firm or staffing agency regarding a healthcare professional, shall provide a copy of the notice to the healthcare services firm or staffing agency, when the notice is submitted to DCA. 6. HomeCare Options shall provide the healthcare professional who is the subject of a notice to DCA a copy of the notice provided to DCA, when the notice is submitted to the DCA. 3 7. HomeCare Options shall notify DCA within seven days of the date of the reportable action, settlement, judgment or arbitration award, including such information as may be required by DCA. Healthcare Professionals Notification Requirements 1. HomeCare Options’ healthcare professionals shall promptly notify DCA if they have information that another professional has demonstrated impairment, gross incompetence or unprofessional conduct, which would present an imminent danger to an individual patient, the public health, safety or welfare. (No notification is required if knowledge of the other healthcare professional’s impairment or incompetence was obtained from treating the professional.) 2. HomeCare Options’ healthcare professionals shall inform HomeCare Options, if they have information that another professional has demonstrated impairment, gross incompetence or unprofessional conduct which would present an imminent danger to an individual patient, the public health, safety or welfare. The obligation to report this information to HomeCare Options is in addition to the requirement to report this information to DCA. Exchange of Information between HomeCareOptions and Other Healthcare Entities 1. Upon inquiry, HomeCare Options shall inform other healthcare entities if it has submitted any notices to DCA, Medical Practitioner Review Panel, or professional or occupational licensing board within the prior seven years preceding the inquiry about a healthcare professional. HomeCare Options will provide the other entity with a copy of the notification and any supporting documentation that was submitted to DCA, Medical Practitioner Review Panel, or professional or occupational licensing board. 2. Upon inquiry, HomeCare Options shall provide information about a current or former employee’s job performance as it relates to patient care and the reasons for the former employee’s separation. The job performance information shared shall relate to the suitability of the employee for re-employment at a healthcare entity, and the employee’s skills and abilities as they relate to suitability for future employment at a healthcare entity. The job performance information will be based on the employee’s performance evaluation and provided to another healthcare entity only under the following conditions: a. The evaluation has been signed by the evaluator and shared with the employee; b. The employee has had the opportunity to respond; and 4 c. The employee’s response has been taken into consideration when providing information to another healthcare entity. Maintenance of Records 1. HomeCare Options shall maintain all records of all disciplinary proceedings or actions involving affiliated or employed healthcare professionals as well as all documented complaints of patient care-related incidents for a seven (7) years. 2. HomeCare Options shall maintain for a period of four (4) years all records and source data relating to mortality, morbidity, complication, infection and readmission. 3. Upon request, HomeCare Options shall make such information available to DCA, the professional’s licensing board, the Medical Practitioner Review Panel and the Department of Health and Senior Services (DHSS). Criminal History Background Checks Professional boards require criminal history background checks as a condition of initial licensure and prior to renewal of licenses. All such professionals must have submitted to a background check no later than four (4) years from the effective date of the Act, or by October 2009 in accordance with the process mandated by the New Jersey Division of Consumer Affairs. If a licensed professional fails to affect the background check, his/her license shall not be renewed. (Refer to the Division of Consumer Affairs at http://www.njconsumeraffairs.gov/chbcfaq.htm for information on the background checks.) Sanctions Failure to comply with the provisions of the Act may subject HomeCare Options and its healthcare professionals to possible disciplinary action and civil penalties and cause HomeCareOptions to be subject to penalties as determined by the DHSS or DCA Any individual who violates any provision of this policy may be subject to discipline up to and including termination. Suggests and Observation 1. HomeCare Options should designate a single individual responsible for notifying DCA or licensing boards as required by this policy and the Act and to receive reports from HomeCare Options healthcare professionals. 5 6 2. A procedure should be set up governing the exchange of information between healthcare entities (reference checks) designating an individual to be responsible for responding to reference checks. 3. The Event Reporting Form can be found online and should be used by all HomeCare Options designees and healthcare professionals responsible for notifying DCA and/or licensing boards in order to be in compliance with this policy and the Act and by the Department of Human Resources in responding to reference checks. To access the Event Reporting Form: go to www.njconsumeraffairs.gov, click on the reference to the Act on the left. The form can be obtained by clicking on the fifth item on the page. 4. The best source of practical information on meeting the requirements of the Act is other health care entities or associations. 5. There has been criticism of the Cullen Act, principally with respect to (1) the 7 day notification requirement as too short a period of time; (2) the lack of clear guidelines; and (3) the fact that the requirements persist even if the healthcare professional has been investigated and cleared of any wrongdoing.

The Health Care Professional Responsibility and Reporting Enhancement Act requires New Jersey health care entities licensed pursuant to pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), a health maintenance organization authorized to operate pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.), a carrier which offers a managed care plan regulated pursuant to P.L.1997, c.192 (C.26:2S-1 et seq.), a State or county psychiatric hospital, a State developmental center, a staffing registry, and a home care services agency as defined in section 1 of P.L.1947, c.262 (C.45:11-23) to report health care professionals licensed or certified by the New Jersey Division of Consumer Affairs or are certified by the Department of Health and Senior Services who are employed by, under contract to render professional services to, or have clinical privileges granted by that health care entity, or who provides such services pursuant to an agreement with a health care services firm or staffing registry to notify the New Jersey Division of Consumer Affairs, Health Care Professional Information Clearing House Coordinator regarding the health care professional’s conduct relating to impairment, incompetence or professional misconduct which relates to patient safety and the health care entity has taken action against them.

A health care professional shall file a report with the Health Care Professional Information Clearing House Coordinator if that health care professional is in possession of information which reasonably indicates that another health care professional has demonstrated an impairment, gross incompetence or unprofessional conduct which would present an imminent danger to an individual patient or to the public health, safety or welfare of the patient.

Statutes

• Health Care Professional Responsibility and Reporting Enhancement Act

Regulations

• New Jersey Division of Consumer Affairs Chapter 45E Health Care Professional Reporting Responsibility Regulations
• New Jersey Department of Health Rules Implementing the Health Care Professional Responsibility and Reporting Enhancement Act

Reporting Form

• NJ Division of Consumer Affairs Health Care Professional Responsibility and Reporting Enhancement Act Reporting Form

NJ Department of Health Facility Disclosure Form

• NJ Department of Health Instructions for Completing the Health Care Facility Inquiry Regarding Health Care Professional (CN-9) Form
• NJ Department of Health Health Care Facility Inquiry Regarding Health Care Professional CN-9 Form

Outreach To request a speaker, please call (973) 504 – 6310

Memorial Tribute:  Joseph Tumaneng

In Honor of one of our favorite Activity Professionals Joseph Tumaneng, I would like include him in our minutes. He was a great Activity Professional advocate and though the Mepap training classes with Joan Marie Granato, Future Focus Inc, Joe provided students with so much information and educational experience, especially with legislation, NCCAP and NAAP. I thought it pertinent to mention him in the Legislation Report. He will be greatly missed by all.

In honor of him, the facility he worked with will be naming a room after him. His replacement, who is also called Joe, is a student of Future Focus Inc.
Thank you Joe….

José “Joey” Benigno Tumaneng

José “Joey” Benigno Tumaneng was born in 1948 in Jones, a small village in the Philippines, and passed away close to his home in Dumont, NJ on May 5, 2017. Joey was the loving husband of Josephine for 40 years; the proud father of Marvin and Felicia; the nurturing brother of Leonor, Lynden, and Evelyn; and Tito Joe (Uncle Joe in Tagalog) to countless friends he considered his own family.

Through his accomplished professional career, his charismatic and jovial nature brightened everyone with whom he worked. In 1967, Joey joined the La Salette Seminary to study theology and explore the possibility of a life in the priesthood. He decided to take a hiatus and started as a professor at The Philippine Women’s University and The Lyceum of the Philippines. In his French and Philosophy class, he fell in love with one of his students, Josephine. After they were married in 1977, they left the Philippines to build a new life together in New York City. Disenchanted by the size of his Queens apartment, he shifted his career to finance, where he spent 20+ years working for Smith Barney, Lehman Brothers, American Express, and Dresdner Bank. After leaving the industry, he discovered his true calling as a caretaker at a local nursing home. As the Director of Life Enrichment at Windsor Garden Care Center, he ran health and wellness programs for his senior patients and truly loved his work.

In his personal life, Joey was an active member of the Catholic church, an excellent chef, and a passionate ballroom dancer. We will remember his contagious laugh, warmth, and love for family, friends, colleagues, and most importantly, life.