NY Department of Health Issues Guidance requiring all Hospitals to allow Patient Support Persons (PS

On April 10th the NY DOH issued a guidance (notification # 103139) requiring all hospitals to immediately allow Patient Support Persons (PSPs) access to the patients under the following circumstances:

• Patients in labor and delivery; • Pediatric patients; • Patients for whom a support person has been determined to be essential to the care of the patient (medically necessary) including patients with intellectual and/or developmental disabilities and patients with cognitive impairments including dementia.

I understand this to mean that a PSP is warranted for any patient that needs a support person for medical reasons, including if the patient is bedridden and/or needs help with eating and drinking, as well as for patients with dementia and other disabilities. Recognizing the extreme stress that the regular hospital staff is under, it is of paramount importance that bedridden patients have someone at their bedside.

The guidance was sent as an email notification entitled "Health Advisory: COVID-19 Updated Guidance for Hospital Operators Regarding Visitation" on letterhead of Governor Cuomo, Howard A. Zucker, M.D., J.D., Commissioner of DOH and Sally Dreslin, M.S., R.N., Executive Deputy Commissioner of DOH. Clearly, this guidance must prevail over any conflicting individual hospital policy.

For pregnant moms, the guidelines states that a support person must be allowed in the delivery room as well as postpartum and recovery.

For patients for whom a support person has been determined to be essential to the care of the patient DOH considers one support person at a time as essential to patient care in the emergency room or during hospitalization.

The determination is made the patient and the support person, in consultation with the healthcare provider after full disclose of risk and benefits.

This is what the guidance says (my comments added in square brackets):

“During this unprecedented time, a support person for the patients described above may be critical to avoid negative health outcomes unrelated to the COVID-19 public health emergency [i.e. patient starving or becoming dehydrated!!], … healthcare providers should thoroughly discuss the potential risks and benefits of a support person’s presence at the bedside with both the patient (if 18 years of age or older) [i.e. if the patient is capable of consent the patient can also say that they Want and Need a support person then they must be included in the Discussion of the request for a PSP] and the support person. For those patients and support persons who through informed decision making determine a support person at the bedside is essential for the patient’s care, hospitals should develop protocols for ensuring a support person at bedside minimizes risk of potential COVID—19 transmission, including when the patient is confirmed or suspects to have COVID-19.”

For these hospitalized patients, especially with prolonged hospitalizations, the patient or family/caregiver may designate two support people; but only one support person may be present at a time.

For end of life situations, during the last 24 hours of the patient's life the family may designate two support people, with them being present one at a time.

The memo includes specific requirements for PPE for support persons and requires hospitals to develop "clear protocols for communicating with family members or caregivers of any patient who do not have a support person at the bedside. This should include considerations for assisting patient and family member communication through remote methods when possible, for example, via phone or video call."

If a hospital or facility denies your request for a support person, you may file a complaint with the NY Department of Health here: https://apps.health.ny.gov/surveyd8/facility-complaint-form