senate Bill S7676

Identification of caregivers

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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  • 28 / May / 2014
    • REFERRED TO HEALTH

Summary

Relates to the identification of caregivers; creates the CARE Act.

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Bill Details

See Assembly Version of this Bill:
A9816
Versions:
S7676
Legislative Cycle:
2013-2014
Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Add Art 29-CCCC §§2994-hh - 2994-mm, Pub Health L

Sponsor Memo

BILL NUMBER:S7676

TITLE OF BILL: An act to amend the public health law, in relation to
identification of caregivers

PURPOSE:

This bill would require a general hospital as defined in § 2801(10) of
the public health law to allow a patient an opportunity to designate,
upon entry to a hospital, a caregiver in the patient's medical record;
to require a hospital to notify and offer to meet with the designated
caregiver to discuss the patient's plan of care prior to the patient's
discharge or transfer to another facility; to require a hospital to
offer to adequately train the designated caregiver in certain
after-care tasks upon a patient's discharge to his or her current
residence.

SUMMARY OF PROVISIONS:

Section 1 adds a new section 29-CCCC to the public health law and sets
forth definitions.

Section 2 sets forth the effective date.

JUSTIFICATION:

At any given time, an estimated 4.1 million New Yorkers provide
varying degrees of unreimbursed care to adults with limitations in
daily activities. The total value of the unpaid care provided to
individuals in need of long-term services and supports amounts to an
estimated $32 billion every year, based on 2009 data. Caregivers are
often members of the individual's immediate family, but friends and
other community members also serve as caregivers. While most
caregivers are asked to assist an individual with basic activities of
daily living, such as mobility, eating, and dressing, many are
expected to perform complex tasks on a daily basis such as
administering multiple medications, providing wound care, and
operating medical equipment.

Despite the vast importance of caregivers in the individual's
day-to-day care, many caregivers find that they are often left out of
discussions involving a patient's care while in the hospital and, upon
the patient's discharge, receive little to no instruction on the tasks
they are expected to perform. The federal Centers for Medicare &
Medicaid Services (CMS) estimates that $17 billion in Medicare funds
is spent each year on unnecessary hospital readmissions. Additionally,
hospitals desire to avoid the imposition of new readmission penalties
under the federal Patient Protection and Affordable Care Act (ACA).

In order to successfully address the challenges of a surging
population of older adults and others who have significant needs for
long-term services and supports, the state must develop methods to
enable caregivers to continue to support their loved ones at home and
in the community, and avoid costly hospital readmissions. Therefore,
it is the intent of the New York State Assembly that this Act enables
caregivers to provide competent post-hospital care to their family and
other loved ones, at minimal cost to the taxpayers of this State.


LEGISLATIVE HISTORY:

New bill.

FISCAL IMPLICATIONS:

None.

EFFECTIVE DATE:

This act shall take effect immediately.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  7676

                            I N  S E N A T E

                              May 28, 2014
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law, in relation to identification  of
  caregivers

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The public health law is amended by adding  a  new  article
29-CCCC to read as follows:
                             ARTICLE 29-CCCC
           CARE ACT (CAREGIVER ADVISE, RECORD AND ENABLE ACT)
SECTION 2994-HH. SHORT TITLE.
        2994-II. DEFINITIONS.
        2994-JJ. CAREGIVER, OPPORTUNITY TO IDENTIFY.
        2994-KK. NOTICE TO IDENTIFIED CAREGIVER.
        2994-LL. INSTRUCTION TO IDENTIFIED CAREGIVER.
        2994-MM. EFFECT ON OTHER RIGHTS.
  S  2994-HH. SHORT TITLE.  THIS ARTICLE SHALL BE KNOWN AND MAY BE CITED
AS THE "CARE ACT".
  S 2994-II. DEFINITIONS.   WHEN USED IN  THIS  ARTICLE,  THE  FOLLOWING
WORDS  OR PHRASES SHALL HAVE THE FOLLOWING MEANINGS: 1. "HOSPITAL" SHALL
MEAN ANY "HOSPITAL" AS DEFINED IN SECTION TWENTY-EIGHT  HUNDRED  ONE  OF
THIS CHAPTER.
  2. "AFTER-CARE" SHALL MEAN ANY ASSISTANCE PROVIDED BY A CAREGIVER TO A
PATIENT  UNDER  THIS ARTICLE AFTER THE PATIENT'S DISCHARGE FROM A HOSPI-
TAL. SUCH ASSISTANCE SHALL INCLUDE, BUT IS  NOT  LIMITED  TO,  ASSISTING
WITH BASIC ACTIVITIES OF DAILY LIVING (ADLS), INSTRUMENTAL ACTIVITIES OF
DAILY  LIVING  (IADLS)  OR  CARRYING  OUT MEDICAL/NURSING TASKS, SUCH AS
MANAGING WOUND CARE, ASSISTING IN ADMINISTERING MEDICATIONS, AND OPERAT-
ING MEDICAL EQUIPMENT.
  3. "CAREGIVER" SHALL MEAN ANY INDIVIDUAL DULY IDENTIFIED AS A CAREGIV-
ER BY A PATIENT UNDER THIS ARTICLE WHO PROVIDES AFTER-CARE ASSISTANCE TO
A PATIENT LIVING IN HIS OR HER RESIDENCE. AN IDENTIFIED CAREGIVER  SHALL
INCLUDE, BUT IS NOT LIMITED TO, A RELATIVE, PARTNER, FRIEND, OR NEIGHBOR
WHO HAS A SIGNIFICANT RELATIONSHIP WITH THE PATIENT.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15096-02-4

S. 7676                             2

  4.  "DISCHARGE" SHALL MEAN A PATIENT'S EXIT OR RELEASE FROM A HOSPITAL
TO THE PATIENT'S RESIDENCE FOLLOWING ANY  MEDICAL  CARE,  TREATMENT,  OR
OBSERVATION.
  5.  "ENTRY"  SHALL  MEAN  A PATIENT'S ENTRANCE INTO A HOSPITAL FOR THE
PURPOSES OF MEDICAL CARE, TREATMENT, OR OBSERVATION. A PATIENT NEED  NOT
BE FORMALLY ADMITTED TO A HOSPITAL FOR THE PROVISIONS OF THIS ARTICLE TO
APPLY.
  6.  "RESIDENCE" SHALL MEAN A DWELLING THAT THE PATIENT CONSIDERS TO BE
HIS OR HER HOME. A "RESIDENCE" FOR THE PURPOSES OF  THIS  ARTICLE  SHALL
NOT   INCLUDE  ANY  REHABILITATION  FACILITY,  HOSPITAL,  NURSING  HOME,
ASSISTED LIVING FACILITY, GROUP HOME OR OTHER  RESIDENTIAL  HEALTH  CARE
FACILITY  AS DEFINED IN SECTION TWENTY-EIGHT HUNDRED ONE OF THIS CHAPTER
OR ANY INPATIENT FACILITY REGULATED BY THE OFFICE OF MENTAL HEALTH.
  S 2994-JJ. CAREGIVER, OPPORTUNITY TO IDENTIFY.  1.  A  HOSPITAL  SHALL
PROVIDE  EACH  PATIENT  OR,  IF APPLICABLE, THE PATIENT'S LEGAL GUARDIAN
WITH AT LEAST ONE OPPORTUNITY TO IDENTIFY AT LEAST ONE  CAREGIVER  UNDER
THIS  ARTICLE  NO  LATER  THAN TWENTY-FOUR HOURS FOLLOWING THE PATIENT'S
ENTRY INTO A HOSPITAL AND PRIOR TO THE PATIENT'S  ENTRY INTO A  HOSPITAL
AND PRIOR TO THE PATIENT'S DISCHARGE OR TRANSFER TO ANOTHER FACILITY.
  (A) IN THE EVENT THAT THE PATIENT IS UNCONSCIOUS OR OTHERWISE INCAPAC-
ITATED UPON HIS OR HER ENTRY INTO A HOSPITAL, THE HOSPITAL SHALL PROVIDE
SUCH PATIENT OR HIS/HER LEGAL GUARDIAN WITH AN OPPORTUNITY TO IDENTIFY A
CAREGIVER  WITHIN  TWENTY-FOUR HOURS FOLLOWING THE PATIENT'S RECOVERY OF
HIS OR HER CONSCIOUSNESS OR CAPACITY.
  (B) IN THE EVENT THAT THE PATIENT  OR  THE  PATIENT'S  LEGAL  GUARDIAN
DECLINES  TO IDENTIFY A CAREGIVER UNDER THIS ARTICLE, THE HOSPITAL SHALL
PROMPTLY DOCUMENT THIS IN THE PATIENT'S MEDICAL RECORD.
  (C) IN THE EVENT THAT THE PATIENT  OR  THE  PATIENT'S  LEGAL  GUARDIAN
IDENTIFIES AN INDIVIDUAL AS A CAREGIVER UNDER THIS ARTICLE:
  (I)  THE  HOSPITAL  SHALL  PROMPTLY REQUEST THE WRITTEN CONSENT OF THE
PATIENT OR THE PATIENT'S LEGAL GUARDIAN TO RELEASE  MEDICAL  INFORMATION
TO  THE  PATIENT'S  IDENTIFIED CAREGIVER FOLLOWING THE HOSPITAL'S ESTAB-
LISHED PROCEDURES FOR  RELEASING  PERSONAL  HEALTH  INFORMATION  AND  IN
COMPLIANCE WITH ALL FEDERAL AND STATE LAWS.
  (II)  IF  THE  PATIENT  OR  THE  PATIENT'S  LEGAL GUARDIAN DECLINES TO
CONSENT TO RELEASE MEDICAL INFORMATION TO THE PATIENT'S IDENTIFIED CARE-
GIVER, THE HOSPITAL IS NOT REQUIRED TO PROVIDE NOTICE TO  THE  CAREGIVER
UNDER  SECTION  TWENTY-NINE  HUNDRED  NINETY-FOUR-KK  OF THIS ARTICLE OR
PROVIDED INFORMATION CONTAINED IN THE  PATIENT'S  DISCHARGE  PLAN  UNDER
SECTION TWENTY-NINE HUNDRED NINETY-FOUR-LL OF THIS ARTICLE.
  (III)  THE HOSPITAL SHALL RECORD THE PATIENT'S IDENTIFICATION OF CARE-
GIVER, THE RELATIONSHIP OF THE IDENTIFIED CAREGIVER TO THE PATIENT,  AND
THE  NAME,  TELEPHONE  NUMBER,  AND  ADDRESS OF THE PATIENT'S IDENTIFIED
CAREGIVER IN THE PATIENT'S MEDICAL RECORD.
  (D) A PATIENT MAY ELECT TO CHANGE HIS OR HER IDENTIFIED  CAREGIVER  AT
ANY  TIME,  AND  THE  HOSPITAL  MUST RECORD THIS CHANGE IN THE PATIENT'S
MEDICAL RECORD WITHIN TWENTY-FOUR HOURS.
  (E) PRIOR TO  NOTIFYING  THE  PATIENT'S  CAREGIVER  OF  THE  PATIENT'S
DISCHARGE  OR TRANSFER TO ANOTHER HOSPITAL OR FACILITY AS REQUIRED UNDER
SECTION TWENTY-NINE HUNDRED NINETY-FOUR-KK OF THIS ARTICLE, THE HOSPITAL
SHALL ASK THE PATIENT TO  VERIFY  THE  PATIENT'S  CAREGIVER  CHOICE  AND
PROVIDE  THE  PATIENT  THE  OPPORTUNITY  TO CHANGE HIS OR HER IDENTIFIED
CAREGIVER.
  2. AN IDENTIFICATION OF A CAREGIVER BY A PATIENT OR A PATIENT'S  LEGAL
GUARDIAN  UNDER THIS SECTION DOES NOT OBLIGATE ANY INDIVIDUAL TO PERFORM
ANY AFTER-CARE TASKS FOR ANY PATIENT.

S. 7676                             3

  3. THIS SECTION SHALL NOT BE CONSTRUED  TO  REQUIRE  A  PATIENT  OR  A
PATIENT'S  LEGAL  GUARDIAN  TO IDENTIFY ANY INDIVIDUAL AS A CAREGIVER AS
DEFINED BY THIS ARTICLE.
  S 2994-KK. NOTICE TO IDENTIFIED CAREGIVER. A HOSPITAL SHALL NOTIFY THE
PATIENT'S IDENTIFIED CAREGIVER OF THE PATIENT'S DISCHARGE OR TRANSFER TO
ANOTHER HOSPITAL OR FACILITY LICENSED BY THE DEPARTMENT OR THE OFFICE OF
MENTAL  HEALTH AS SOON AS THE DATE AND TIME OF DISCHARGE OR TRANSFER CAN
BE ANTICIPATED PRIOR TO THE PATIENT'S ACTUAL DISCHARGE  OR  TRANSFER  TO
SUCH FACILITY.
  S  2994-LL. INSTRUCTION TO IDENTIFIED CAREGIVER.  1. AS SOON AS POSSI-
BLE AND NOT LATER THAN TWENTY-FOUR HOURS PRIOR TO A PATIENT'S  DISCHARGE
FROM A HOSPITAL, THE HOSPITAL SHALL CONSULT WITH THE IDENTIFIED CAREGIV-
ER  ALONG  WITH  THE  PATIENT REGARDING THE CAREGIVER'S CAPABILITIES AND
LIMITATIONS AND ISSUE  A  DISCHARGE  PLAN  THAT  DESCRIBES  A  PATIENT'S
AFTER-CARE  NEEDS AT HIS OR HER RESIDENCE.  AT MINIMUM, A DISCHARGE PLAN
SHALL INCLUDE:
  (A) THE NAME AND CONTACT INFORMATION OF THE CAREGIVER IDENTIFIED UNDER
THIS ARTICLE;
  (B) A DESCRIPTION OF ALL AFTER-CARE TASKS NECESSARY  TO  MAINTAIN  THE
PATIENT'S  ABILITY  TO RESIDE AT HOME, TAKING INTO ACCOUNT THE CAPABILI-
TIES AND LIMITATIONS OF THE CAREGIVER; AND
  (C) CONTACT INFORMATION FOR ANY HEALTH CARE, COMMUNITY RESOURCES,  AND
LONG-TERM  SERVICES AND SUPPORTS NECESSARY TO SUCCESSFULLY CARRY OUT THE
PATIENT'S DISCHARGE PLAN.
  2. THE HOSPITAL ISSUING THE DISCHARGE  PLAN  MUST  PROVIDE  CAREGIVERS
WITH  INSTRUCTION  IN  ALL  AFTER-CARE  TASKS DESCRIBED IN THE DISCHARGE
PLAN.
  (A) AT MINIMUM, SUCH INSTRUCTION SHALL INCLUDE:
  (I) A LIVE DEMONSTRATION OF THE TASKS PERFORMED BY A HOSPITAL EMPLOYEE
AUTHORIZED TO PERFORM THE AFTER-CARE  TASK,  PROVIDED  IN  A  CULTURALLY
COMPETENT  MANNER  AND IN ACCORDANCE WITH THE HOSPITAL'S REQUIREMENTS TO
PROVIDE LANGUAGE ACCESS SERVICES UNDER STATE AND FEDERAL LAW;
  (II) AN OPPORTUNITY FOR THE CAREGIVER AND  PATIENT  TO  ASK  QUESTIONS
ABOUT THE AFTER-CARE TASKS; AND
  (III) ANSWERS TO THE CAREGIVER'S AND PATIENT'S QUESTIONS PROVIDED IN A
CULTURALLY  COMPETENT  MANNER  AND  IN  ACCORDANCE  WITH  THE HOSPITAL'S
REQUIREMENTS TO PROVIDE LANGUAGE ACCESS SERVICES UNDER STATE AND FEDERAL
LAW.
  (B) ANY INSTRUCTIONS REQUIRED UNDER THIS ARTICLE SHALL  BE  DOCUMENTED
IN  THE PATIENT'S MEDICAL RECORD, INCLUDING, AT MINIMUM, THE DATE, TIME,
AND CONTENTS OF THE INSTRUCTION.
  3. THE DEPARTMENT IS AUTHORIZED TO PROMULGATE REGULATIONS TO IMPLEMENT
THE PROVISIONS OF THIS ARTICLE, INCLUDING  BUT  NOT  LIMITED  TO,  REGU-
LATIONS  TO  FURTHER  DEFINE  THE  CONTENT  AND SCOPE OF ANY INSTRUCTION
PROVIDED TO CAREGIVERS UNDER THIS ARTICLE.
  S 2994-MM. EFFECT ON OTHER RIGHTS. NOTHING IN THIS  ARTICLE  SHALL  BE
CONSTRUED  TO  INTERFERE  WITH  THE RIGHTS OF AN AGENT OPERATING UNDER A
VALID HEALTH CARE DIRECTIVE CREATED UNDER  SECTION  TWENTY-NINE  HUNDRED
EIGHTY-TWO OF THIS CHAPTER.
  S 2. This act shall take effect immediately.

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