The Alabama State Senate unanimously advanced a bill introduced by Sen. Garlan Gudger (R-DIST 4) which would require hospitals and long-term healthcare facilities — with the exception of those designated for psychiatric care — to allow for in-person visitation.

Gudger said the bill — referred to as the Harold Sachs and Ann Roberts Act — is an expansion on the original Harold Sachs Act the senator introduced two years ago and gives patients the ability to designate one person as their “essential care giver” who the bill would ensure be able to a patient facing at least one of the following situations:

• End-of-life scenarios.
• Struggling with the change of environment and lack of in-person support after being admitted.
• Making a major medical decision.
• Experiencing emotional distress or grieving the loss of a recently deceased loved one.
• Needing encouragement to eat or drink.
• No longer speaking or interacting with others, when they used to do so.
• Experiencing childbirth, including labor and delivery.
• Is a pediatric patient.

“When we passed the first Harold Sachs bill it talks about ‘visitors’ all as one. That includes family members and essential care givers, this bill separates the two. Visitors are deemed as the general public, like church groups or just somebody stopping by that’s a friend. Then you have the essential care giver, that is defined in this bill, who can be in the patients room for two hours each day, plus visiting hours,” Gudger said.

The bill defines a care giver as “a family member, friend, guardian or other individual” and gives patients the ability to designate a different caregiver each day or establish a daily rotation. Gudger said this language would give unmarried patients within a same-sex partnership — who may otherwise be restricted by a facility’s “family only” policy — a way to be with their loved ones.

“As cliche as it may sound, this bill is for anybody that loves anybody and doesn’t want them to be alone in their final moments. I think this is for everybody,” Gudger said.

If the Alabama House of Representatives approves the bill, and it is signed into law, healthcare facilities would have 30 days to establish visitation policies and procedures and make them available to view on their websites. Each facility maintains the authority to develop their own protocol, given that the policy is no more stringent than those established for their staff or require visitors to submit proof of any vaccination. Each policy must, at a minimum, include:

• Infection control and education policies for visitors.
• Screening, personal protective equipment, and other infection control protocols for visitors.
• The permissible length of visits and numbers of visitors allowed.
• The designation of an individual responsible for ensuring that staff adhere to the policies and procedures.
• Shall allow for any visitor under the age of 18 to be accompanied by an adult.

Gudger said he felt the bill should not be directly compared to similar laws passed in other states, such as Florida’s “No Patient Left Alone Act” — signed by Florida Gov. Ron DeSantis last April — despite their similarities. Alabama Hospital Association Deputy Director Danne Howard said both the AHA and the Alabama Nursing Home Association worked closely with Gudger to ensure the bill was flexible enough to allow healthcare facilities be able to react to unforeseen situations.

“This is the way good laws are made, when people sit around and talk and understand implications and unintended consequences. You can’t think of every unintended consequence, but we certainly tried,” Howard said. “Our only thing was wanting to preserve times where we wanted to be sure the physician’s orders and conditions were taken into consideration, and this bill does that. Those flexibilities are still there, it doesn’t eliminate any of that. We [the AHA] don’t have any problem at all with the bill in its current form.”

“We appreciate and understand the importance of this legislation,” ANHA President Brandon Farmer said in an emailed response to The TImes. “We worked closely with Gudger on this bill throughout the legislative process. Our association has always supported visitation for family and friends of nursing home residents. The Centers for Medicare and Medicaid Services required nursing homes and other health care facilities to close visitation at the beginning of the pandemic and our members worked to conduct visits as soon as CMS allowed. We hope this bill will further clarify visitation procedures and will benefit patients, their families and health care facilities. Our residents’ loved ones are a critical part of our ability to deliver high quality care in a home like environment.”

The bill also provides protections to prevent a healthcare facility, its employees or its contracted staff from being sued over any injuries sustained by acting in compliance with the bill and allows for the facility to suspend visitation of a specific person — visitor or care giver — who violates the provider’s policies and procedures.

“You don’t want someone who has something like the flu going into everybody’s rooms or going up and down the hall and possibly infecting other people. That’s not the point of this bill,” Gudger said.

Gudger added that the intention of the bill was not to blame healthcare workers — who he described as “heroes” — for their immediate response to the COVID-19 pandemic, but was a “proactive approach” to prevent patients from alone during times of need.

“People should not be dying alone. People should not be going through childbirth or miscarriages alone. It’s emotionally distressful and it’s a mental health issue as much as it is a physical need that we humans have,” Gudger said.