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Lawmaker: During pandemic ‘compassionate care’ needed in health facility visitor policies

By MARY SELL, Alabama Daily News

On Oct. 21, Bonnie and Harold Sachs entered a north Alabama emergency room because despite a negative test, Harold Sachs’ COVID-19 symptoms, including decreased blood oxygen levels, were worsening. 

He was tested again and when the results were positive, he was admitted to the hospital. Bonnie Sachs kissed her husband of 50 years before he was taken to the COVID unit. She wouldn’t see him in person again until he died on Nov. 9.

“He didn’t know me, he was on a ventilator,” Bonnie Sachs told Alabama Daily News.

Harold and Bonnie Sachs’ and many similar stories in the last year are the reason Sen. Garlan Gudger said he filed Senate Bill 307, which says during public health emergencies, health care facilities shall continue to allow visitors under certain conditions.

“I think everyone needs compassionate care at the end of life,” Gudger, R-Cullman, told Alabama Daily News. “And I think they need their family to be there to help patients get over whatever illness or virus.”

According to the Alabama Department of Public Health, more than 10,100 Alabamians have died from COVID-19 complications.

“More and more people have called me saying, ‘We have got a story,’” said Gudger, whose mother was hospitalized with COVID-19 last year and recovered  “… This bill states that there are certain visitation rights that should happen for patients.”

The bill says that visitation should happen “consistent with all applicable federal laws and regulations of the Centers for Medicare and Medicaid Services or Centers for Disease Control and Prevention, or any limitations set by a state or federal public health order.”

Hospital and nursing home officials know there are heartbreaking scenarios of patients dying alone during the pandemic, but they say the rules are beyond their control. Guidelines from the Centers of Medicare and Medicaid Services, which oversees health care facilities that get federal funding, aren’t arbitrary and not following them could mean citations and even loss of licenses.

“Over the last year, restricting visitors has been traumatic for patients, families, and healthcare workers alike,” the Alabama Hospital Association said in a written statement to ADN. “We have not experienced the world-wide spread of an unknown, highly contagious virus like COVID-19 in more than 100 years. Following the Center for Medicare and Medicaid Services direction, extraordinary measures had to be implemented to protect patients, families, health care workers, and our communities. 

The CMS directives issued last summer are still in place and they include requirements hospitals must follow regarding limited visitation for patients who are COVID-19 negative.  Visitation for patients who are suspected of having COVID-19 or who have tested positive for the virus is still not recommended and is only possible on a limited basis after the evaluation of many circumstances, such as the community’s virus positivity rate, medical staffing levels, and the ability to follow all federally mandated infection control and prevention measures.”

Nurses and medical staff make their way through the seventh floor COVID-19 unit at East Alabama Medical Center Thursday, Dec. 10, 2020, in Opelika, Ala. COVID-19 patients occupy most of the beds in ICU in addition to the non-critical patients on the seventh floor. (AP Photo/Julie Bennett)

Alabama Nursing Home Association President and CEO Brandon Farmer said the organization appreciates Gudger recognizing the importance of residents and patients in various health care settings, including nursing homes, being able to visit their families. 

“Our members are doing their best to facilitate in-person visits while meeting all of the stringent visitation restrictions placed on us by the Centers for Medicare and Medicaid Services,” Farmer told Alabama Daily News. “We’re thankful the updated Safer at Home order allows two family members to visit a resident at the same time as long as the nursing home meets all of the federal restrictions. We hope the federal government will revise these restrictions that were put in place in September 2020 – before a COVID-19 vaccine was approved. Until then, we will continue to do all we can to keep our residents and their family members connected.”

Gov. Kay Ivey last week in her extension of the Safer At Home order said hospital and nursing home patients could have two visitors, but the ANHA said it is advising members to continue to follow federal guidelines. And those restrictions say that before nursing homes allow in-door visitors, they must have no new COVID-19 cases in the last 14 days.  No visits are allowed if the county’s positivity rate is more than 10%.

Senate Bill 307 says visitors would have to comply with reasonable safety protocols. Visitations could be restricted if a patient or resident’s ”likelihood of exposing someone to an infectious disease is not controllable despite using reasonable safety practices, such as personal protective equipment.”

The bill also says a facility acting in good faith to comply with the act will be immune from civil liability for any actions taken under the law.

Co-sponsors on the bill include President Pro Tem Greg Reed, R-Jasper; Sen. Randy Price, R-Opelika; Sen. Chris Elliott, R-Daphne; Sen. Andrew Jones, R-Centre; Sen. Dan Roberts, R-Mountain Brook; Sen. Sam Givhan, R-Huntsville; Sen. Will Barfoot, R-Pike Road,  and Sen. Jabo Waggoner, R-Vestavia Hills. It’s assigned to the Senate Health Committee.

Harold Sachs was the chief-of-staff for the Alabama Republican Party. He was 71.

The Sachs’ daughter, Debbie Alvis is a former ICU nurse, worked at Crestwood Medical Center.  She was allowed to see her dad regularly and pray with him. She’s helped Gudger with legislation. Both of them say it’s not a criticism of health care workers.

“And this hopefully can help them because, I can tell you, having spent all the three-and-a-half weeks that I spent with my dad going into the ICU, those nurses were phenomenal, but they were so tired, not just of the work, but the emotional drain,” Alvis said. “They were having to be the spiritual caretaker of these patients, the physical caretaker patients and help with their emotional stability and they just couldn’t do it. You just can’t do it, especially when you have loved ones begging to see their family.”

Before he was put on the ventilator, Alvis was able to arrange a FaceTime call so that her dad could see his family, including his granddaughters and the family’s pastor.

“We had that, but we should have been there with him,” Bonnie Sachs said.

She said she knows of others who lost loved ones in the last year and didn’t get the access that she did because of her daughter. 

“It’s just so unfair, and in my opinion unconstitutional, that these families cannot have anyone (with their loved one),” she said. “It’s just a horrible thing that they’re dying alone.”

The hospital association’s statement said it looks forward to the day we can once again safely welcome all visitors.  

“In the meantime, we encourage everyone to get vaccinated as soon as there is an opportunity, continue wearing a mask, practice social distancing and avoid large gatherings in closed settings,” it said.

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