Elections 2021Statewide NewsNursing Home Essential Caregiver Protection on the November Ballot as Constitutional Amendment

On November 2, Texans will vote on a constitutional amendment that would cement the right to have at least one family member designated as an essential caregiver who can not be prohibited from visitation.
October 12, 2021
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For over 200 days in 2020, the elderly and infirm were isolated from loved ones as nursing homes and other long-term care facilities in Texas were closed to all visitation. The Texas Department of Health and Human Services said the restrictions were “to protect older, medically fragile individuals from COVID-19.”

Next month, Texas voters will have a chance to vote on eight constitutional amendments. Among them is Proposition 6, an amendment “establishing a right for residents of certain facilities to designate an essential caregiver for in-person visitation.”

Texas Caregivers for Compromise, a group that has worked over the course of the COVID-19 pandemic to establish caregivers’ right to visit their loved ones in long-term care facilities, wants to ensure that never happens again by supporting the passage of Proposition 6.

“We are a small group but we want to make sure our voice gets out there. We are not hearing opposition, but we don’t want to take anything for granted,” Mary Nichols, who helps lead the group, told The Texan.

The group has printed thousands of yard signs and distributed them around the state to push for the proposition’s passage.

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“There is still a misunderstanding in the state that Texas is 100 percent open, but it is not,” Nichols said, pointing out that there are still visitation restrictions in many nursing homes and other long-term care facilities.

Photo courtesy of Stephanie Kirby.

The Texas legislature passed Senate Bill (SB) 25, authored by Lois Kolkhorst (R-Brenham), which provides for essential caregiver visitation even when other visitation is prohibited. But Nichols is concerned that the same disaster powers that have given officials leeway to suspend laws throughout the pandemic would be used to suspend the visitation guarantees of  SB 25. She believes a constitutional amendment is a stronger guarantee of those visitation rights. 

The measure, passed by the legislature as Senate Joint Resolution (SJR) 19, declares that residents of long-term care facilities have the right to designate an essential caregiver “with whom the facility, residence, or center may not prohibit in-person visitation.”

SJR 19 allows the long-term care facilities to provide guidelines for the essential caregiver visits. 

Brian Lee, president of Families for Better Care, believes Proposition 6 “galvanizes protection for a designated essential caregiver going forward.” 

As of late May, the state’s long-term care ombudsman, Patty Ducayet, could only locate one instance where a case of COVID-19 exposure in a long-term care facility could be traced to an essential caregiver. 

“No one has a greater vested interest in not bringing disease into the facility than a family member,” Nichols added.

Both Nichols and Lee remarked that the pandemic restrictions had a terrible impact on the vulnerable population who live in long-term care facilities. 

Nichols pointed out that residents suffer “cognitive decline and despondency, fear and paranoia in just a few days of separation.”

She also said that keeping essential caregivers out increases the burdens on an already overburdened staff.

That is another reform that Lee would like the Texas legislature to address: staffing standards.

In a letter to Governor Abbott requesting that long-term care facilities be considered for distribution of the American Rescue Plan Act funds, Leading Age Texas pointed to staffing issues that have been exacerbated by the pandemic.

“Compared to other healthcare settings,” the letter reads, “Texas nursing facilities have struggled with a severe direct-care workforce shortage for many years according to the Texas Center for Nursing Workforce Studies. 

“COVID-19 has increased demand for direct care staff across the health care sector, making an already challenging situation crippling for long-term care. As COVID-19 swept across the nation, and nursing homes became one of the deadliest jobs in America, recruiting and retaining staff became even more difficult.” 

“Today, providers have no other choice but to utilize temporary staffing agencies and pay inflated rates to ensure safety and continuity of care for residents,” it concludes.

Nichols is alarmed by the number of temporary employees being used because there is no long-term relationship between them and the residents. “That is yet another reason why essential caregivers are so critical,” Nichols emphasized.

When asked about the source of her support for the proposition, Nichols said, “The number of people that still get told no [for visitation] and the possibility that they can’t get in to visit a loved one for 200 days.”

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Kim Roberts

Kim Roberts is a reporter for the Texan in the DFW metroplex area where she has lived for over twenty years. She has a Juris Doctor from Baylor University Law School and a Bachelor's in government from Angelo State University. In her free time, Kim home schools her daughter and coaches high school extemporaneous speaking and apologetics. She has been happily married to her husband for 23 years, has three wonderful children, and two dogs.