HF 210

as introduced - 89th Legislature (2015 - 2016) Posted on 01/20/2015 12:46pm

A bill for an act
relating to health care; requiring a hospital to provide a patient the opportunity to
designate a caregiver upon entry to the hospital; requiring a hospital to provide
a discharge plan and aftercare instructions to a designated caregiver prior to
discharge; proposing coding for new law in Minnesota Statutes, chapter 144.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [144.6522] DESIGNATION OF A CAREGIVER.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For purposes of this section:
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new text begin (a) "Hospital" means a facility licensed under sections 144.50 to 144.56.
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new text begin (b) "Aftercare" means any assistance provided to a patient in the patient's residence
by a caregiver designated by the patient in accordance with this section after the patient's
discharge from a hospital. Assistance may include, but is not limited to, assisting with
basic activities of daily living (ADLs), instrumental activities of daily living (IADLs),
or carrying out medical or nursing tasks, such as managing wound care, assisting in
administering medications, and operating medical equipment.
new text end

new text begin (c) "Designated caregiver" means any individual 18 years of age or older who is
designated as a caregiver by a patient to provide aftercare assistance in the patient's
residence to the patient after the patient's discharge from a hospital. A designated
caregiver may include, but is not limited to, a relative, partner, friend, or neighbor who
has a relationship with the patient.
new text end

new text begin (d) "Discharge" means a patient's exit or release from a hospital to the patient's
residence following an inpatient admission.
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new text begin (e) "Entry" means a patient's admission to a hospital for the purposes of inpatient
medical care.
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new text begin (f) "Residence" means a dwelling that the patient considers to be the patient's home.
For the purposes of this section, a residence does not include a rehabilitation facility,
hospital, nursing facility, or other health care or residential facility.
new text end

new text begin Subd. 2. new text end

new text begin Opportunity to designate a caregiver. new text end

new text begin (a) A hospital shall provide each
patient or, if applicable, the patient's legal guardian with an opportunity to designate at least
one caregiver no later than 24 hours upon the patient's entry into a hospital and before the
patient is discharged from the hospital or transferred to another health care facility. If the
patient is unconscious or otherwise incapacitated upon entry into the hospital, the hospital
shall provide the patient or the patient's legal guardian with an opportunity to designate a
caregiver within 24 hours following the patient's recovery of consciousness or capacity.
new text end

new text begin (b) If the patient or the patient's legal guardian designates an individual as a
caregiver, the hospital shall record the patient's designation of caregiver, the relationship
of the designated caregiver to the patient, and the name, telephone number, and address
of the patient's designated caregiver in the patient's medical record. If the patient or the
patient's legal guardian declines to designate a caregiver, the hospital shall document this
in the patient's medical record.
new text end

new text begin (c) If the patient designates a caregiver, the hospital shall request the written
consent of the patient or the patient's legal guardian to release medical information to the
designated caregiver following the hospital's established procedures for releasing personal
health information and in compliance with all federal and state laws. If the patient or
the patient's legal guardian declines to consent to the release of medical information to
the patient's designated caregiver, the hospital is not required to provide notice to the
designated caregiver under subdivision 3 or provide information contained in the patient's
discharge plan under subdivision 4.
new text end

new text begin (d) A patient may elect to change their designated caregiver at any time, and the
hospital shall record the change in the patient's medical record within 24 hours.
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new text begin (e) A designation of a caregiver by a patient or a patient's legal guardian does not
obligate the designated caregiver to perform any aftercare tasks for the patient.
new text end

new text begin Subd. 3. new text end

new text begin Notice to designated caregiver. new text end

new text begin (a) A hospital shall notify the patient's
designated caregiver of the patient's discharge or transfer to another hospital or health care
facility after the patient's physician issues a discharge or transfer order, but no later than
four hours prior to the patient's actual discharge or transfer to another health care facility.
new text end

new text begin (b) Failure to contact a designated caregiver or failure of the designated caregiver to
be present at the hospital to receive the discharge plan and aftercare instructions described
in subdivision 4, shall not interfere with or delay the discharge or transfer of the patient
so long as the hospital has made a good faith effort to contact the designated caregiver
within the required time period. The hospital shall document the efforts made to contact
the designated caregiver in the patient's medical record.
new text end

new text begin (c) This subdivision shall not apply if the patient is transferred to another health
care facility due to an emergency situation.
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new text begin Subd. 4. new text end

new text begin Discharge plan and aftercare instructions to designated caregiver. new text end

new text begin (a)
Prior to a patient's discharge from the hospital to the patient's residence, the hospital shall
consult with the designated caregiver and the patient, and issue a discharge plan that
describes the patient's aftercare needs and instructions for all aftercare tasks described in
the discharge plan.
new text end

new text begin (b) At a minimum, a discharge plan must include:
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new text begin (1) the name and contact information of the designated caregiver;
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new text begin (2) a description of and instructions for all aftercare tasks necessary to maintain the
patient's ability to reside at home, taking into account the capabilities and limitations of
the designated caregiver;
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new text begin (3) contact information for any health care, community resources, and long-term
services and supports necessary to successfully carry out the patient's discharge plan; and
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new text begin (4) contact information of a hospital employee who can respond to questions about
the discharge plan and instructions that are required to be provided under this subdivision
after the patient has been discharged.
new text end

new text begin (c) At a minimum, the instructions for aftercare tasks included in the discharge
plan must include:
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new text begin (1) a live demonstration or video instruction of the aftercare tasks performed by a
hospital employee or individual with whom the hospital has a contractual relationship
authorized to perform the task, in a culturally competent manner and in accordance with the
hospital's requirements to provide language access services under state and federal law; and
new text end

new text begin (2) an opportunity for the designated caregiver and patient to ask questions about
the aftercare tasks, and to provide answers to any questions in a culturally competent
manner and in accordance with the hospital's requirements to provide language access
services under state and federal law.
new text end

new text begin (d) The hospital shall document the discharge plan and a description of the
instructions provided in the patient's medical record, including, at a minimum, the date,
time, and content of the instructions provided.
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new text begin Subd. 5. new text end

new text begin Limitations. new text end

new text begin (a) Nothing in this section shall be construed to create a
private right of action against a hospital, a hospital employee, or an individual with whom
a hospital has a contractual relationship, or to otherwise supersede or replace existing
rights or remedies under any other provision of state or federal law.
new text end

new text begin (b) Nothing is this section shall be construed to require a patient or a patient's legal
guardian to designate a caregiver.
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new text begin (c) Nothing in this section shall be construed to interfere with the powers of an agent
operating under a valid health care directive under chapter 145C.
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new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end