Bill Text: HI SB2264 | 2014 | Regular Session | Amended
Bill Title: Lay Caregiver; After-care; Discharge Plan
Spectrum: Partisan Bill (Democrat 7-0)
Status: (Engrossed - Dead) 2014-03-21 - Passed Second Reading as amended in HD 1 and referred to the committee(s) on FIN with Representative(s) Hanohano, Har, Jordan, Oshiro voting aye with reservations; none voting no (0) and Representative(s) Tokioka, Ward, Yamane excused (3). [SB2264 Detail]
Download: Hawaii-2014-SB2264-Amended.html
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THE SENATE |
S.B. NO. |
2264 |
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TWENTY-SEVENTH LEGISLATURE, 2014 |
S.D. 2 |
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STATE OF HAWAII |
H.D. 1 |
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A BILL FOR AN ACT
RELATING TO CAREGIVING.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that Hawaii's population of older adults is rapidly increasing, and the State relies heavily on unpaid lay caregivers, such as family and friends, to provide long-term services and support. In 2012, Hawaii had the highest percentage in the nation of residents age eighty-five and older. This population is projected to grow sixty-five per cent over the next twenty years and is the population most likely to need long-term care. The AARP Public Policy Institute estimates that in 2009, there were 247,000 lay caregivers in Hawaii, and that the 162,000,000 hours of unpaid care the lay caregivers provided would be valued at $2,000,000,000.
The legislature further finds that the role of lay caregivers is expanding. While lay caregivers have traditionally assisted with bathing, dressing, eating, and household tasks such as shopping and managing finances, it is now common for lay caregivers to perform medical and nursing tasks that historically were only provided in hospitals and nursing homes or by home care professionals. The most commonly performed medical and nursing tasks are medication management, help with assistive mobility devices, preparing food for special diets, and wound care. The rise of lay caregivers providing medical or nursing tasks is attributed to an increased prevalence of chronic conditions in older adults, economic pressures to reduce hospital stays, and reduction of formal home care services due to the growth of in-home technology.
Under federal law, hospitals are required to have a patient discharge planning process with written policies and procedures. Federal law states that the discharge planning process may include preparing lay caregivers to care for soon-to-be discharged patients.
The legislature also recognizes hospitals' concerns about potential liability. Hospitals have expressed their trepidation about the potential for increasing their exposure to civil liability if hospitals are required to provide patients' lay caregivers with training prior to discharge. The legislature understands this legitimate concern and further stresses its intent to avoid the creation of additional causes of action against hospitals that are voluntarily training lay caregivers to provide care for their loved ones. Thus, this Act includes a provision that clearly states that nothing in this Act shall be construed to give rise to a cause of action against a hospital or hospital employee.
The purpose of this Act is to:
(1) Allow a patient an opportunity to designate, upon entry to a hospital, a lay caregiver in the patient's medical record;
(2) Support hospitals that notify and meet with the designated lay caregiver to discuss the patient's plan of care prior to the patient's discharge or transfer to another facility; and
(3) Affirm that nothing in this Act shall be construed to give rise to a cause of action against hospitals and their employees that voluntarily train lay caregivers.
SECTION 2. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:
"Chapter
Hospital requirements regarding LAY Caregivers
§ -1 Definitions. For the purpose of this chapter:
"After-care" means any assistance provided by a lay caregiver to a patient after the patient's discharge from a hospital. Such assistance may include assisting with basic activities of daily living and instrumental activities of daily living and carrying out medical or nursing tasks such as managing wound care, assisting in administering medications, and operating medical equipment.
"Discharge" means a patient's exit or release from a hospital to the patient's residence following any medical care, treatment, or observation.
"Entry" means a patient's entrance into a hospital for the purposes of medical care, treatment, or observation. "Entry" includes but is not limited to formal admittance to a hospital.
"Hospital" means a facility licensed under section 321‑14.5.
"Lay caregiver" means any individual who is duly designated by a patient to provide after-care to the patient in the patient's residence, but does not receive compensation for providing the after-care. A designated lay caregiver may include a relative, partner, friend, or neighbor who has a significant relationship with the patient.
"Residence" means a dwelling that the patient considers to be the patient's home. "Residence" shall not include any rehabilitation facility, hospital, nursing home, assisted living facility, or group home licensed by the State.
§ -2 Opportunity to designate a lay caregiver. (a) A hospital may provide each patient or, if applicable, the patient's legal guardian with at least one opportunity to designate one or more lay caregivers no later than twenty-four hours following the patient's entry into a hospital and prior to the patient's discharge or transfer to another facility; provided that in the event that the patient is unconscious or otherwise incapacitated upon entry into a hospital, the hospital may provide the patient or the patient's legal guardian with an opportunity to designate a lay caregiver within twenty-four hours following the patient's recovery of consciousness or capacity.
(b) If the patient or the patient's legal guardian declines to designate a lay caregiver pursuant to subsection (a), the hospital may promptly document this in the patient's medical record.
(c) If the patient or the patient's legal guardian designates an individual as a lay caregiver under this chapter, the hospital may:
(1) Promptly request the written consent of the patient or the patient's legal guardian to release medical information to the patient's lay 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 release medical information to the patient's lay caregiver, the hospital is not required to provide notice to the lay caregiver under section -3 or provide information contained in the patient's discharge plan under section -4; and
(2) Record the patient's designation of a lay caregiver, the relationship of the lay caregiver to the patient, and the name, telephone number, and address of the patient's lay caregiver in the patient's medical record.
(d) A patient may elect to change the patient's designated lay caregiver at any time. The hospital may record this change in the patient's medical record within twenty-four hours of notification by the patient.
(e) A designation of a lay caregiver by a patient or a patient's legal guardian under this section obligates the individual to perform after-care for the patient.
(f) This section shall not be construed to require a patient or a patient's legal guardian to designate any individual as a lay caregiver.
§ -3 Notice to a lay caregiver. A hospital shall notify the patient's lay caregiver of the patient's discharge or transfer to another licensed facility at least hours before the patient's actual discharge or transfer.
§ -4 Discharge plan for patients. (a) As soon as possible and not later than twenty-four hours prior to a patient's discharge from a hospital, the hospital may consult with the patient's lay caregiver regarding the lay caregiver's capabilities and limitations and issue a discharge plan that describes the patient's after-care at the patient's residence. At a minimum, the discharge plan may include:
(1) The name and contact information of the designated lay caregiver;
(2) A description of all after-care necessary to maintain the patient's ability to reside at home, taking into account the capabilities and limitations of the lay caregiver; and
(3) Contact information for any health care, community resources, and long-term services and support necessary to successfully carry out the patient's discharge plan.
(b) The department of health may adopt rules pursuant to chapter 91 to carry out the purpose of this chapter.
§ -5 Non-interference with existing health care directives. (a) Nothing in this chapter shall be construed to interfere with the rights of an agent operating under a valid health care directive under Hawaii law.
(b) No health care directive may claim to be in conflict with this chapter unless it had been in existence prior to the patient's entry into a hospital.
§ -6 Immunity. Nothing in this chapter shall be construed to give rise to a cause of action against a hospital or hospital employee."
SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2014-2015 for the Hawaii health systems corporation to implement lay caregiving as provided in this Act in its facilities.
The sum appropriated shall be expended by the Hawaii health systems corporation for the purposes of this Act.
SECTION 4. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.
SECTION 5. This Act shall take effect on July 1, 2150.
Report Title:
Lay Caregiver; After-care; Discharge Plan
Description:
Allows patients the opportunity to designate a lay caregiver upon entry to a hospital. Establishes hospital requirements regarding lay caregivers, including designation of a lay caregiver, notification to a lay caregiver, and a discharge plan for patients. Provides immunity to hospitals and their employees regarding lay caregiving. Appropriates funds for the Hawaii Health Systems Corporation to implement lay caregiving in its facilities. Effective July 1, 2150. (SB2264 HD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
