Top Legislative Issues
Home Care Incident Reporting
Memo in Opposition
Bill Number: A.3792-A (Gottfried)
Summary:
HCP opposes the enactment of A. 3792 as it is currently written. The bill would require home care agencies to notify the New York State Department of Health (DOH) of the occurrence of "reportable incidents" as defined in §2805-l of the Public Health Law (PHL), and any transfer of a patient to a hospital as a result of home care services. Section 2805-l of the PHL outlines the incidents that would trigger a report by a hospital to DOH if the incident occurred in a hospital. Additionally, the proposed legislation would require home care agencies to perform investigations into the incidents within thirty days of becoming aware of such incident.
Position:
HCP opposes this legislation, which would require home care agencies to notify DOH of "reportable incidents" as defined in section 2805-l of the Public Health Law, and the transfer of a patient to a hospital as a result of home care services. While HCP commends the goal of assuring patient safety in all health care delivery settings, many of the reportable incidents under this legislation are beyond the control of a home care agency.
The home care setting is vastly different from a health care facility setting and policy decisions should be tailored to ensure that they fit the service delivery setting. Home care agencies provide services to patients in their homes, which are diverse service delivery settings, rather than in a uniform, fixed location health care facility.
HCP supports strong measures to protect patient safety. Referencing sections of law that apply to hospitals is inappropriate, however, and does not accurately reflect the setting within which home care providers deliver care. For example, this legislation would require home care agencies to report to DOH and to investigate the termination of telephone service in a patient's home. Reporting and investigating every incident involving a patient's phone service being disconnected would be infeasible for home care agencies. Additionally, many of the reportable incidents involve the loss of services patients may not have to begin with, such as air conditioning.
The home care industry has numerous health and safety requirements that must be met as required by Article 36 of the PHL and related DOH regulations. These standards require the constant re-evaluation of the ability of an agency to meet the patient's needs safely and adequately in the home and to ensure the safety of personnel providing that care. Home care agencies are currently required to keep documentation on all incidents and accidents that occur, including adverse reactions and problems within the home environment. Additionally, a reporting structure exists within the home care agency, in accordance with DOH minimum standards, for personnel to inform their supervisors of changes in conditions that affect the home care agency's ability to meet the patient's health care needs in the home setting. Home care agencies also avail themselves of the reporting process within local Protective Services for Adults when conditions in the home setting put either the patient or worker at risk.
HCP cannot support this legislation. As proposed, A. 3792-A would place an undue reporting burden on an already strained home care industry for circumstances that are, in most cases, beyond the control of the agency. HCP is interested in working with the sponsor to develop modifications to this legislation to ensure that incident reporting policies reflect the home care service delivery setting and ensure the delivery of high quality patient care.
