2023 -- H 5436

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LC001001

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO HEALTH AND SAFETY -- ABUSE IN HEALTHCARE FACILITIES

     

     Introduced By: Representatives Serpa, Fellela, Ackerman, Costantino, Phillips, Lima,
and Shanley

     Date Introduced: February 08, 2023

     Referred To: House Judiciary

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 23-17.8-1 of the General Laws in Chapter 23-17.8 entitled "Abuse in

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Healthcare Facilities" is hereby amended to read as follows:

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     23-17.8-1. Definitions.

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     (a)(1) “Abuse” means:

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     (i) Any assault as defined in chapter 5 of title 11, including, but not limited to, hitting,

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kicking, pinching, slapping, or the pulling of hair; provided, however, unless it is required as an

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element of the offense charged, it shall not be necessary to prove that the patient or resident was

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injured by the assault;

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     (ii) Any assault as defined in chapter 37 of title 11;

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     (iii) Any offense under chapter 10 of title 11;

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     (iv) Any conduct which harms or is likely to physically harm the patient or resident except

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where the conduct is a part of the care and treatment, and in furtherance of the health and safety of

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the patient or resident; or

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     (v) Intentionally engaging Engaging in a pattern of harassing conduct which causes or is

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likely to cause emotional or psychological harm to the patient or resident, including but not limited

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to, ridiculing or demeaning a patient or resident, making derogatory remarks to a patient or resident

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or cursing directed towards a patient or resident, or threatening to inflict physical or emotional harm

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on a patient or resident.

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     (2) Nothing in this section shall be construed to prohibit the prosecution of any violator of

 

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this section under any other chapter.

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     (b) “Department” means the department of health when the incident occurs in a health care

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facility, and the department of behavioral healthcare, developmental disabilities and hospitals when

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the incident occurs in a community residence for people who are mentally retarded or persons with

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developmental disabilities.

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     (c) “Facility” means any health care facility or community residence for persons who are

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mentally retarded, or persons with developmental disabilities as those terms are defined in this

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section. “Health care facility” means any hospital or facility which provides long-term health care

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required to be licensed under chapter 17 of this title, and any assisted living residence required to

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be licensed under chapter 17.4 of this title, and any community residence whether privately or

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publicly owned. “Community residence” for persons who are mentally retarded or persons with

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developmental disabilities means any residential program licensed by the department of behavioral

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healthcare, developmental disabilities and hospitals which meets the definition of a community

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residence as defined in §  40.1-24-1(2) and provides services to people who are mentally retarded

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or persons with developmental disabilities.

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     (d) “High Managerial Agent” means an officer of a facility, the administrator and assistant

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administrator of the facility, the director and assistant director of nursing services, or any other

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agent in a position of comparable authority with respect to the formulation of the policies of the

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facility or the supervision in a managerial capacity of subordinate employees.

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     (e) “Mistreatment” means the inappropriate use of medications, isolation, or use of physical

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or chemical restraints:

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     (1) As punishment;

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     (2) For staff convenience;

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     (3) As a substitute for treatment or care;

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     (4) In conflict with a physician’s order; or

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     (5) In quantities which inhibit effective care or treatment, or which harms or is likely to

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harm the patient or resident.

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     (f) “Neglect” means the intentional failure to provide treatment, care, goods, and services

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necessary to maintain the health and safety of the patient or resident, or the intentional failure to

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carry out a plan of treatment or care prescribed by the physician of the patient or resident, or the

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intentional failure to report patient or resident health problems or changes in health problems or

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changes in health conditions to an immediate supervisor or nurse, or the intentional lack of attention

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to the physical needs of a patient or resident including, but not limited to toileting, bathing, meals,

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and safety. No person shall be considered to be neglected for the sole reason that he or she relies

 

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on or is being furnished treatment in accordance with the tenets and teachings of a well-recognized

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church or denomination by a duly-accredited practitioner of a well-recognized church or

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denomination.

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     (g) “Patient” means any person who is admitted to a facility for treatment or care, while

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“resident” means any person who maintains their residence or domicile, on either a temporary or

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permanent basis, in a facility.

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     (h) “Person” means any natural person, corporation, partnership, unincorporated

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association, or other business entity.

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     (i) “Immediate jeopardy” means a situation in which the nursing facility’s alleged

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noncompliance with one or more state or federal requirements or conditions has caused, or is likely

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to cause serious injury, harm, impairment or death to a resident; or shall be defined in accordance

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with 42 CFR 489 or any subsequent applicable federal regulations.

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     (j) “Non-immediate jeopardy — high potential for harm” means a situation in which a

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nursing facility’s alleged noncompliance with one or more state or federal requirements or

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conditions may have caused harm that negatively impacts the individual’s mental, physical and/or

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psychosocial status; or shall be defined in accordance with 42 CFR 489 or any subsequent

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applicable federal regulations.

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     (k) “Non-immediate jeopardy — medium potential for harm” means a situation in which a

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nursing facility’s alleged noncompliance with one or more state or federal requirements or

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conditions has caused or may have caused harm that is of limited consequence and does not

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significantly impair the individual’s mental, physical and/or psychosocial status to function; or shall

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be defined in accordance with 42 CFR 489 or any subsequent applicable federal regulations.

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     (l) “Non-immediate jeopardy — low potential for harm” means a situation in which a

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nursing facility’s alleged noncompliance with one or more state or federal requirements or

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conditions may have caused mental, physical and/or psychosocial discomfort that does not

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constitute injury or damage; or shall be defined in accordance with 42 CFR 489 or any subsequent

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applicable federal regulations.

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     SECTION 2. Section 42-66-4.1 of the General Laws in Chapter 42-66 entitled "Office of

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Healthy Aging" is hereby amended to read as follows:

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     42-66-4.1. Definitions.

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     As used in this chapter:

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     (1) “Abuse” means physical abuse, sexual abuse, and/or emotional abuse of an elderly

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person by a caregiver as defined in subsection (5).

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     (a) “Physical abuse” means the willful infliction of physical pain or injury (e.g. slapping,

 

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bruising or restraining) upon an elderly person.

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     (b) “Sexual abuse” means the infliction of non-consensual sexual contact of any kind upon

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an elderly person. Sexual abuse includes, but is not limited to, sexual assault, rape, sexual misuse

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or exploitation of an elder, as well as threats of sexual abuse where the perpetrator has the intent

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and the capacity to carry out the threatened abuse.

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     (c) “Emotional abuse” means a pattern of willful infliction of mental or emotional harm

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upon an elder by threat, intimidation, isolation or other abusive conduct.

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     (2) “Exploitation” means the fraudulent or otherwise illegal, unauthorized or improper act

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or process of an individual, including, but not limited to, a caregiver or fiduciary, that uses the

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resources of an elder for monetary or personal benefit, profit, gain, or that results in depriving an

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elder of rightful access to, or use of, benefits, resources, belongings, or assets by use of undue

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influence, harassment, duress, deception, false representation or false pretenses.

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     (3) “Neglect” means the willful failure by a caregiver or other person with a duty of care

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to provide goods or services necessary to avoid physical harm, mental harm or mental illness to an

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elderly person, including, but not limited to, “abandonment” (withdrawal of necessary assistance)

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and denial of food or health related services.

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     (4) “Willful” means intentional, conscious and directed toward achieving a purpose.

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     (5) “Caregiver” means a person who has assumed the responsibility for the care of the

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elderly person voluntarily, by contract or by order of a court of competent jurisdiction, or who is

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otherwise legally responsible for the care of the elderly person.

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     (6) “Self-neglect” means a pattern of behavior in an elderly person that directly,

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imminently and significantly threatens his/her own health and/or, safety. Self-neglect includes, but

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is not limited to, an inability or an incapacity to provide self with food, water, shelter, or safety to

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the point of establishing imminent risk of any of the harm(s) described in the immediately preceding

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sentence.

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     (7) “Protective services” means services and/or action intended to prevent and/or alleviate

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the abuse, neglect, exploitation or self-neglect of elderly persons. Protective services may include

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supervision, counseling, and assistance in securing health and supportive services, safe living

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accommodations and legal intervention.

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     (8) “Elderly person” or “elder” means any person sixty (60) years of age or older.

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     SECTION 3. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- ABUSE IN HEALTHCARE FACILITIES

***

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     This act would remove the intent requirement relative to the definitions of "abuse" within

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the chapter on "abuse in healthcare facilities" and would amend the definitions of "abuse" and

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"neglect" with regard to elderly affairs by deleting the element of willful conduct. This act would

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also delete the definition of willful.

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     This act would take effect upon passage.

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