A4594

An Act concerning technology in long-term care settings, and amending and supplementing various parts of statutory law.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. Section 6 of P.L.2020, c.87 (C.26:2H-12.95) is amended to read as follows:

6. a. No later than 270 days after the effective date of [this act] P.L.2020, c.87 (C.26:2H-12.90 et seq.), each long-term care facility, and no later than 270 days after the effective date of P.L. , c. (C. ) (pending before the Legislature as this act), each home and community based services provider shall implement or upgrade to an electronic health record system certified by the Office of the National Coordinator for Health Information Technology in the U.S. Department of Health and Human Services that is capable of information sharing through industry standard data interoperability, including application programming interface Health Level 7 or fast healthcare interoperability technology. Use cases built on this technology shall include the bi-directional capability for admission discharge and transfer and continuity of care through the clinical data architecture. Long-term care facilities and home and community based services providers interoperability for these use cases shall be achieved by connecting to the New Jersey Health Information Network.

b. Subject to the availability of funding for this purpose, the Department of Health shall make grants available to long-term care facilities and home and community based services providers:

(1) to provide assistance in implementing or upgrading to an electronic health record system that meets the requirements of subsection a. of this section, which grants shall be distributed to long-term care facilities and home and community based services providers based on demonstrated need; and

(2) to support the exchange of user-friendly clinical information via an electronic health record system that meets the requirements of subsection a. of this section with State hospitals, which grants shall be distributed based on an evaluation of the long-term care facility or home and community based services provider’s plan to utilize the grant award to allow for timely and well-informed clinical decisions across settings.

(cf: P.L.2020, c.87, s.6)

2. Section 11 of P.L.2021, c.310 is amended to read as follows:

11. a. For the period beginning on the effective date of P.L.2021, c.310 and ending on December 31, 2024, a health benefits plan in this State shall provide coverage and payment for health care services, including those services provided in a long-term care setting, delivered to a covered person through telemedicine or telehealth at a provider reimbursement rate that equals the provider reimbursement rate that is applicable, when the services are delivered through in-person contact and consultation in New Jersey, provided the services are otherwise covered by the health benefits plan when delivered through in-person contact and consultation in New Jersey. The requirements of this subsection shall not apply to:

(1) a health care service provided by a telemedicine or telehealth organization that does not provide the health care service on an in-person basis in New Jersey; or

(2) a physical health care service that was provided through real-time, two-way audio without a video component, whether or not utilized in combination with asynchronous store-and-forward technology, including through audio-only telephone conversation. The reimbursement rate for a physical health care service that is subject to this paragraph shall be determined under the contract with the provider; provided that the reimbursement rate for a physical health care service when provided through audio-only telephone conversation shall be at least 50 percent of the reimbursement rate for the service when provided in person.

(3) The provisions of paragraph (2) of this subsection shall not apply to a behavioral health service that was provided through real-time, two-way audio without a video component, whether or not utilized in combination with asynchronous store-and-forward technology, including audio-only telephone conversation. A behavioral health care service described in this paragraph shall be reimbursed at a rate that equals the provider reimbursement rate for the service when provided in person.

b. For the purposes of this section:

“Carrier” means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State.

“Covered person” means the same as that term is defined in section 2 of P.L.1997, c.192 (C.26:2S-2); a “benefits recipient” as that term is defined under section 7 of P.L.2017, c.117 (C.30:4D-6k); and a person covered under a contract purchased by the State Health Benefits Commission or the School Employees’ Health Benefits Commission.

“Health benefits plan” means a benefits plan which pays hospital or medical expense benefits for covered services, and is delivered or issued for delivery in this State by or through a carrier or a contract purchased by the State Health Benefits Commission or the School Employees’ Health Benefits Commission. The term shall include the State Medicaid program established pursuant to P.L.1968, c.410 (C.30:4D-1 et seq.) and the NJ FamilyCare program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.).

“Long-term care setting” means the variety of locations in which health care services are provided to covered persons with prolonged illnesses, disabilities, or cognitive disorders that support independent and safe living according to the clinical needs of the person, and includes home-based care, community-based care, and residential-based care.

(cf: P.L.2023, c.199, s.1)

3. (New section) a. Commencing six months following the effective date of P.L. , c. (C. ) (pending before the Legislature as this act), the Department of Health shall require each long-term care facility in the State, as a condition of facility licensure, to provide internet, television, and telephone services within each residential room of the facility. To the extent possible, and in compliance with the social isolation prevention policies adopted by a long-term care facility pursuant section 2 of P.L.2020, c.113 (C.26:2H-12.98), the long-term care facility shall additionally provide residents with the necessary equipment to utilize these services.

b. The department shall distribute civil monetary penalty funds, as approved by the federal Centers for Medicare and Medicaid Services, and any other available federal and State funds, upon request, to facilities in order to comply with this section.

c. Whenever the department conducts an inspection of a long-term care facility, the department's inspector shall determine whether the long-term facility is in compliance with the provisions of this section.

d. In addition to any other applicable penalties provided by law, a long-term care facility that fails to comply with the provisions of this section:

(1) shall be liable to pay an administrative penalty, the amount of which shall be determined in accordance with a schedule established by department regulation, which schedule shall provide for an enhanced administrative penalty in the case of a repeat or ongoing violation; and

(2) may be subject to adverse licensure action, as deemed by the department to be appropriate.

4. (New section) a. The Department of Health, in collaboration with the Department of Human Services, the Office of Long-Term Care Resiliency, the Office of the State Long Term Care Ombudsman, and provider and community stakeholders, shall evaluate and review the use of technology in long-term care settings within the State. The goal of this review shall be to identify existing uses of technology within long-term care settings in the State, as well as potential uses of technology that have demonstrated high success rates in improving service and quality of care in long-term care settings, either in this State or other states, that have yet to be broadly adopted in the State. The review shall include recommendations for the expansion and integration of technology within long-term care settings. As used in this section, “long-term care setting” means the variety of locations in which services are provided to persons with prolonged illnesses, disabilities, or cognitive disorders that support independent and safe living according to the clinical needs of the person, and includes home-based care, community-based care, and residential-based care.

b. The review at a minimum shall include an assessment of, and recommendations for implementation regarding:

(1) best practices in long-term care settings for the use of artificial intelligence and smart systems that improve administration and service delivery by reducing paperwork documentation time, lowering the risk of falls, improving patient monitoring, facilitating early intervention to address changes in the condition of chronically ill patients, maximizing patient independence, and providing for any other applicable positive clinical or administrative outcome;

(2) the availability of Wi-Fi services in long-term care facilities, and the extent to which residents can access those services in private bedrooms, common areas, and corridors;

(3) the provision of after-hours and weekend support through telemedicine and technology-based solutions; and

(4) remote pharmacy dispensing systems utilized at long-term care facilities.

c. Following the completion of the review pursuant to subsection a. of this section, the department shall encourage and support long-term care providers in implementing the department’s recommendations regarding the uses of technology in long-term care settings via the following:

(1) distributing civil monetary penalty funds, as approved by the federal Centers for Medicare and Medicaid Services, and any other available federal and State funds, upon request;

(2) establishing grant or low interest loan programs to distribute available federal or State funds via a competitive process;

(3) implementing performance incentives for long-term care providers that comply with the department’s recommendations; or

(4) providing for any other aid deemed appropriate and necessary by the Commissioner of Health.

d. No later than 18 months after the effective date of this act, the department shall submit a report to the Legislature, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), that summarizes the department’s findings and recommendations pursuant subsection a. of this section and describes the department’s actions pursuant to subsection c. of this section.

5. This act shall take effect immediately, and section 4 shall expire upon the submission of the report pursuant to subsection d. of that section.

STATEMENT

This bill implements a variety of provisions regarding technology in long-term care settings. As used in the bill, long-term care settings include home-based care, community-based care, and residential-based care.

First, the bill requires the Department of Health (DOH), in collaboration with the applicable State entities and provider stakeholders, to evaluate, review, and provide recommendations for the use of technology in long-term care settings within the State, and to report the findings of the review, and subsequent department actions, to the Legislature within 18 months after the effective date of the bill. The goal of this review is to identify existing uses, and potential new and expanded uses, of technology within long-term care settings.

Following the review, the department will encourage and support providers in implementing the department’s recommendations regarding the uses of technology via the distribution of available federal and State funds, the establishment of grant or low interest loan programs, the implementation of performance incentives, or the provision of other aid deemed appropriate and necessary by the Commissioner of Health.

Second, the bill expands an existing law requiring long-term care facilities to implement an electronic medical records requirement, and that provides need-based grants via the DOH to implement this requirement, to also include home and community-based service providers. The bill also requires the DOH to provide grants to long-term care providers to support the exchange of user-friendly clinical information via an electronic health record system with State hospitals.

Third, commencing six months following the effective date of the bill, the DOH is to require each long-term care facility in the State, as a condition of licensure, to provide internet, television, and telephone services within each residential room. To the extent possible, the long-term care facility will also provide residents with the necessary equipment to utilize these services. The department will distribute federal and State funds to facilities in compliance with this provision, and to determine compliance with the provision during facility inspections. In addition to any other applicable penalties provided by law, a long-term care facility that fails to comply with these provisions is liable to pay an administrative penalty and may be subject to adverse licensure action.

Finally, this bill amends section 11 of P.L.2021, c.310 to clarify that the provisions of that law requiring a health benefits plan to provide coverage and payment parity for health care services delivered to a covered person from December 31, 2023 to December 31, 2024 through telemedicine or telehealth at a provider reimbursement rate that equals the in-person provider reimbursement rate, includes those health care services provided in a long-term care setting.