COVID visitor restrictions curbed under new Missouri laws ensuring access to patients

Borne out of frustrations over healthcare facilities’ visitor restrictions during the pandemic, a pair of bills signed by Gov. Mike Parson Thursday will give patients’ caregivers and family clearer means to access their loved ones.

Dubbed the “No Patient Left Alone Act” and “Compassionate Care Visitation Act,” the bills establish rules by which patients’ caregivers can visit, including during states of emergency.

The issue was deeply personal for some lawmakers and a priority of House Majority Leader Dean Plocher, R-Des Peres. In a statement Thursday, Plocher said the bill will help the state’s most vulnerable citizens at critical moments in their lives, as “there is no greater advocate for a patient than members of their own family.”

“This is a victory for patient advocates who no longer have to jump through administrative hoops to stand beside and comfort their family members during a hospital stay,” Plocher said. “Access to family or loved ones during medical care is not a privilege, it is a right, and I thank the bill sponsors for their leadership, my colleagues in the House, and to Governor Parson for signing it into law today.”

Both bills passed unanimously out of the House on the final day of the legislative session in May. The provisions regarding patient visitation will go into effect Aug. 28.

Over the course of the session, provisions that would have prohibited health care facilities from requiring patients be vaccinated against any disease to receive treatment or visitors were removed from the bill.

Dave Dillon, a spokesman for the Missouri Hospital Association, said the group was ultimately accepting of the final shape the legislation took.

“Hospitals believe that having the type of support system that in essence is being codified in place while a person’s healing is helpful, but we have to obviously balance that against infection control,” Dillon said. “This law will set some standards for doing that in a way that may have been more opaque before.”

Under the new law, health care facilities — which include hospitals, nursing homes and hospice facilities — must permit at least two visitors to be able to see a patient in-person during visiting hours, which must span at least six hours a day. Visitation policies at a minimum must allow 24-hour attendance by a visitor when “reasonably appropriate” and for them to leave and return during visiting hours. 

Health care facilities would still be permitted to impose certain restrictions on visitors, like if they are showing symptoms of an infection or while emergency care is being administered.

Any alleged violations can be reported to the state health department, which will begin investigating the complaint within 36 hours.

During a state of emergency relating to an infectious disease, at least two “essential caregivers” may also be designated for in-person visitation of at least four hours per day. That includes at facilities operated by the Department of Mental Health. While facilities are permitted to limit visits to one caregiver at a time, they cannot impose stricter testing, screening or personal protective equipment procedures than what is required of facility employees.

Facilities may request from the state health department or Department of Mental Health a suspension of in-person visits for seven days. Additional extensions must be approved by the department and cannot total more than 14 consecutive days or 45 total in a year.

Faced with severe staffing shortages, Department of Mental Health officials anticipate that to allow 24-hour access to clients in their facilities would cost over $1.5 million to cover overtime costs of current staff, according to a fiscal analysis of the bill.

Health care organizations who had been faced with federal regulations they were also required to comply with amid the pandemic urged state lawmakers not to make hospitals and nursing homes have to choose between complying with state versus federal rules.

The bill explicitly notes that the Department of Health and Senior Services and Department of Mental Health can suspend in-person visits by essential caregivers if necessary to comply with federal law.

Dillon said one of the lessons learned for hospital systems as they adapted and learned more about coronavirus during the pandemic, is “you certainly can never over communicate.”

“I don’t know that we always did a good job during the early days of COVID in communicating not just what our policies are, but why our policies existed,” Dillon said, “so that individuals could have a good sense that these were not simply arbitrary.”

Rep. Ed Lewis, a Moberly Republican who worked on the legislation, previously said if the law had been in place in March of 2020 when his mother was sent to the hospital after a fall, then perhaps she wouldn’t have later passed away.

“My sister could have advocated for my mom, and my mom might still be here today,” Lewis said on the House floor in May. “Might be sitting up in the gallery. I might have been able to wish her happy mother’s day yesterday.”