SB1373 is removing the safety net EMS provides to Older Adults by shifting the duty of care from an EMT (medical professionals), and putting it on the Caregiver (non medical professionals) in a non medical care home, this will cause more harm than good to the Older Adult. 

VOTE NO on SB1373 and protect the Rights and Stability of Older Adults living in Residential Care Homes. Help us protect the rights and stability of Older Adults living in Residential Care Homes

Residents of Residential Care Homes should not be forced to do without that safety net simply because they no longer reside alone – especially given the fact that residing in a Residential Care Home usually results in their needing emergency medical services less frequently than if they were living alone. Pursuant to Arizona Department of Health Services rules and regulations regarding resident rights, Residents of Residential Care Homes have the right to receive, among other things, emergency care the same as any other member of the general public. Moving the safety net from EMTS to caregivers violates this right as it results in restricted access for them just because they are in a Residential Care Home.

In Opposition of SB1373: 

Arizona Assisted Living Homes Association, American Health Care Association, Greater Phoenix Chamber of Commerce, Arizona Leading Age, AZ Assisted Living Federation of America, Romanian American Chamber of Commerce AZ Chapter, Professional Association of Senior Referral Specialists, Residential Assisted Living National Association, INtouch Senior Services, Families Against Senior Citizen Abuse (FASCA), Quail Run, Montgomery & Associates

Explanation:

What is a Residential Care Home? The Arizona Department of Health and Human Services calls us Residential Care Homes or Assisted Living Homes. The Arizona Board of Nursing Care Institution Administrators and Assisted Living Facility Managers calls us Assisted Living Facilities. The Centers for Medicare and Medicaid Services include us under the heading of Home and Community Based Settings. Most zoning boards call us, simply, group homes (not to be confused with Group
Homes under Arizona Department of Health and Human Services rules which are homes for the developmentally disabled).
We have so many different designations and titles in so many different settings that it can be a little difficult to know exactly what is meant by Residential Care Home. We understand it to mean a home licensed to care for 10 or fewer individuals whose residents are people (mostly elderly) who, for a variety of reasons, cannot or choose not to continue living on their own. In a Residential Care Home, someone else does the cooking and cleaning. That same someone else helps residents remember to take their medicines on time and helps them remember not to take too much or too little of it. That same someone else helps residents dress, bathe, groom, and provides whatever other assistance with the activities of daily life they need. That same someone else provides companionship and may occasionally provide transportation to and from a variety of appointments. However, what that someone else does NOT do is just as important as what that someone else does do. That someone else is called a caregiver, and a caregiver does not, and is not allowed by Arizona Department of Health and Human Services rule to, provide medical care because caregivers do not have either the pre-job or on-the-job training to provide medical care. Because of this, we believe SB1373 will cause more harm than good to residents in Residential Care Homes.

There are several rules that require caregivers in Residential Care Homes to rely on medical professionals for the provision of medical care to their residents. If a resident appears to be having a reaction to a medication, a caregiver cannot, unilaterally, decide to stop said medication. The resident’s primary (medical) care provider must be consulted. A medical professional must give the
ok to alter medication orders. If a resident appears to have any kind of ailment, a caregiver cannot decide how to treat that ailment. The resident’s primary care provider must be consulted and advise on a course of treatment. A caregiver can no more diagnose, treat, or determine medical issues than any other lay person. A caregiver cannot even officially determine that a resident is deceased. Hospice nurses, primary care doctors, hospital staff, police, EMTs, and other medical professionals must make that determination. Additionally, residents in Residential Care Homes are frailer than the general public and suffer from a variety of underlying health conditions that make them less likely to be able to survive CPR. 100 compressions per minute for the average 9 minutes it takes EMS to show up means that an elderly woman with brittle bones due to advanced osteoporosis will have a healthy adult pushing on her chest 900 times while they wait for EMS. Caregivers in Residential Care Homes must take such situation into consideration before being forced to immediately perform CPR.

In the small home settings of Residential Care Homes, the performance of CPR is about as common as in the general public. It is possible that is even less common than in the general public because of two facts. First, caregivers must be in such constant contact with medical professionals that, often, residents are already on the way to the hospital before CPR is even warranted. Second, most elderly people in these settings have underlying medical issues that often result in them being placed in hospice care. When that happens, they often sign do not resuscitate orders. If there is an issue, hospice is called, and a medical professional makes the determination as to what should be done next.
Because caregivers of Residential Care Homes are required to perform it so rarely, though they are trained in it, caregivers in a Residential Care Home have about as much of a command on when (and how) to perform it as any other lay person. Placing on a caregiver an affirmative duty to act (the same affirmative duty that is placed on EMTs who perform CPR so routinely they could do it with their eyes closed) is tantamount to putting that same duty on any other lay person who happens to be trained in CPR and first aid. It will result in caregivers who are wary to perform CPR for fear that they will perform it incorrectly and suffer legal consequences. This is precisely why we have Good Samaritan laws for the general public, and this means this bill will result in CPR being performed less often – not more often.

EMTs exist to provide a safety net to the general public in emergency (and some non-emergency) situations. This bill seeks to take that safety net and move it from the shoulders of EMTs (medical professionals) and place it on the shoulders of caregivers (non-medical professionals). Being trained in CPR and first aid does not confer on caregivers the ability to provide medical care or make medical care related determinations and decisions such as when to perform CPR and when not to perform CPR in each situation. Thus, a caregiver must rely on emergency medical services to assist in an emergency, the same as any other lay person If that safety net is removed, the elderly residents in the care of caregivers will end up being the ones who suffer. Caregivers will start hesitating to call 911 for fear of failing an affirmative duty and going to jail.

Furthermore, the state has received has no reports or statistics from Fire Departments, EMS, NEMSIS or AZ Piers indicating that caregivers in Residential Care Homes (as defined above) are refusing to do CPR. All indications are that these problems are occurring in larger settings. This appears to be an education issue, not a legislation issue. Accordingly, we stand ready, willing, and able to create community meetings and educational programs to prevent this from becoming an issue in our industry.
Finally, this bill puts Residential Care Home residents’ right to stability at risk. Residential Care Homes are unique in that, most of the time, the owner is the manager, is the caregiver, is the chief cook and bottle washer. The one individual does everything and occasionally hires help to give themselves some time off. If that one individual is wrongfully accused of failing the affirmative duty of care, their fingerprint card will likely be revoked, their Residential Care Home license will be suspended, and all their residents will be relocated. If they are proven to be wrongfully accused and appropriately reinstated, even within a week, the damage will have been done. The residents in their
care will have to adjust to a major change – something that is very difficult for the frailer elderly folks often found in Residential Care Homes. Transitional trauma causes anxiety, confusion, depression, and hopelessness. It is usually best, as much as possible, in these situations to allow these folks to age in place.