SF 107

3rd Engrossment - 89th Legislature (2015 - 2016) Posted on 05/20/2016 02:25pm

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.
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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) "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 (b) "Agent" means a court appointed guardian, the parent of a minor child whose
authority to act on behalf of the patient as to health care decisions has not been restricted by
the court, or a health agent authorized to act on behalf of the patient under chapter 145C.
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 to the patient in the
patient's residence after the patient's discharge from a hospital and who, in the professional
opinion of the patient's health care provider, is capable of providing aftercare assistance.
A designated caregiver may include, but is not limited to, a relative, partner, friend, or
neighbor who has a relationship with the patient.
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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.
new text end

new text begin (f) "Hospital" means a facility licensed under sections 144.50 to 144.56.
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new text begin (g) "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 where health care staff
are responsible for performing necessary medical and nursing tasks for the patient.
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 agent 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 agent 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 agent 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
agent 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 be deemed to have
obtained the written consent of the patient 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. The patient or the patient's
agent may revoke prior consent to release medical information to the designated caregiver
at any time and if consent is revoked, 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 agent does not obligate the
designated caregiver to perform any aftercare tasks for the patient.
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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, as soon as
practicable, the patient's designated caregiver of the patient's discharge or transfer to
another hospital or health care facility after the patient's health care provider issues a
discharge or transfer order.
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 a reasonable 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.
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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 representative 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.
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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 an individual with whom the hospital has a contractual relationship
who has the appropriate education and competency in the task to be performed and is
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
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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
separate private cause 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 duties, rights, or remedies under any other provision of state or federal law. This
section does not establish a separate standard of care for use in an action against a hospital,
health care facility, or health care provider.
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new text begin (b) Nothing is this section shall be construed to require a patient or a patient's agent
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 a health
care agent operating under a valid health care directive in compliance with chapter 145C.
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new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2017.
new text end