Bill Text: TX HB3903 | 2015-2016 | 84th Legislature | Comm Sub


Bill Title: Relating to a requirement that a hospital allow a patient to designate a caregiver to receive aftercare instruction regarding the patient.

Spectrum: Slight Partisan Bill (Republican 2-1)

Status: (Introduced - Dead) 2015-05-13 - Committee report sent to Calendars [HB3903 Detail]

Download: Texas-2015-HB3903-Comm_Sub.html
  84R12522 MEW-D
 
  By: Sheffield, Miller of Fort Bend, Giddings H.B. No. 3903
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a requirement that a hospital allow a patient to
  designate a caregiver to receive aftercare instruction regarding
  the patient.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle F, Title 4, Health and Safety Code, is
  amended by adding Chapter 317 to read as follows:
  CHAPTER 317. DESIGNATION OF CAREGIVER FOR RECEIPT OF AFTERCARE
  INSTRUCTION
         Sec. 317.001.  DEFINITIONS. In this chapter:
               (1)  "Aftercare" means assistance provided by a
  designated caregiver to a person after that person's discharge from
  a hospital, as described by this chapter. The term includes
  assistance with tasks that are related to the person's condition at
  the time of that person's discharge from a hospital but does not
  include those tasks required to be performed by a licensed health
  care professional.
               (2)  "Designated caregiver" means an individual
  designated by a patient, including a relative, partner, friend, or
  neighbor, who:
                     (A)  is at least 18 years of age;
                     (B)  has a significant relationship with the
  patient; and
                     (C)  will provide aftercare to the patient.
               (3)  "Discharge" means a patient's release from a
  hospital following an inpatient admission.
               (4)  "Hospital" means a general or special hospital
  licensed under Chapter 241 or exempt from licensure under Section
  241.004(3).
               (5)  "Surrogate decision-maker" has the meaning
  assigned by Section 313.002.
         Sec. 317.002.  DESIGNATION OF CAREGIVER. (a)  On admission
  to a hospital or at the time the patient is discharged or
  transferred to another facility, the hospital shall provide the
  patient, the patient's legal guardian, or the patient's surrogate
  decision-maker the opportunity to designate a caregiver. 
         (b)  If a patient, a patient's legal guardian, or a patient's
  surrogate decision-maker designates a caregiver, a hospital shall:
               (1)  document in the patient's medical record:
                     (A)  the name, telephone number, and address of
  the patient's designated caregiver; and
                     (B)  the relationship of the designated caregiver
  to the patient; and
               (2)  request written authorization from the patient,
  the patient's legal guardian, or the patient's surrogate
  decision-maker to disclose health care information to the patient's
  designated caregiver.
         (c)  If a patient, a patient's legal guardian, or a patient's
  surrogate decision-maker declines to designate a caregiver, the
  hospital shall promptly record in the patient's medical record that
  the patient, the patient's legal guardian, or the patient's
  surrogate decision-maker did not wish to designate a caregiver.
         (d)  If a patient, a patient's legal guardian, or a patient's
  surrogate decision-maker declines to give authorization to a
  hospital to disclose health care information to the designated
  caregiver, a hospital is not required to comply with Sections
  317.003 and 317.004.
         (e)  A patient, a patient's legal guardian, or a patient's
  surrogate decision-maker may change the patient's designated
  caregiver at any time, and the hospital must document the change in
  the patient's medical record.
         (f)  The designation of a person as the patient's caregiver
  does not obligate the person to serve as the patient's designated
  caregiver or to provide aftercare to the patient. 
         Sec. 317.003.  NOTICE TO DESIGNATED CAREGIVER. (a)  Except
  as provided by Section 317.002(d), as soon as possible before a
  patient's discharge or transfer to another facility but not later
  than the time the patient's attending physician issues a discharge
  order, a hospital shall notify the designated caregiver of the
  patient's discharge or transfer. The inability of the hospital to
  contact the designated caregiver may not interfere with, delay, or
  otherwise affect any medical care provided to the patient or the
  discharge of the patient.
         (b)  If the hospital is unable to contact the designated
  caregiver, the hospital shall promptly record in the patient's
  medical record that the hospital attempted to contact the
  designated caregiver.
         Sec. 317.004.  DISCHARGE PLAN. (a)  Except as provided by
  Section 317.002(d), as soon as possible, but not later than 24 hours
  before a patient's discharge from a hospital, the hospital shall
  consult with the designated caregiver and the patient regarding the
  designated caregiver's capabilities and limitations and issue a
  discharge plan that describes the patient's aftercare needs.
         (b)  A discharge plan must include:
               (1)  the name and contact information of the designated
  caregiver;
               (2)  a description of the aftercare tasks included in
  the discharge plan, taking into account the capabilities and
  limitations of the caregiver; and
               (3)  the contact information for any health care
  services, community resources, and long-term services and supports
  necessary to implement the patient's discharge plan.
         Sec. 317.005.  INSTRUCTION IN AFTERCARE TASKS. (a)  The
  hospital shall provide the designated caregiver instruction in the
  aftercare tasks described in the discharge plan under Section
  317.004 in a manner that is culturally competent and in accordance
  with applicable requirements to provide language access services.  
  The instruction may be provided in person or by video or other
  technology-based method. If a hospital offers instruction using a
  method other than in-person instruction, the designated caregiver
  may choose the method by which the designated caregiver receives
  the instruction.
         (b)  Training and instruction provided to a designated
  caregiver under Subsection (a) must:
               (1)  to the extent practicable, be provided using
  clear, nontechnical language; and
               (2)  include:
                     (A)  a demonstration of each aftercare task that
  is performed by a hospital employee or a person in a contractual
  relationship with the hospital who is authorized by the hospital to
  perform the task; and
                     (B)  an opportunity for the designated caregiver
  and patient to ask questions and receive answers regarding the
  aftercare tasks.
         (c)  The hospital shall document in the patient's medical
  record the instruction given under Subsection (a), including the
  date and time the instruction was given to the patient and
  designated caregiver.
         Sec. 317.006.  RULES. The executive commissioner of the
  Health and Human Services Commission shall adopt rules necessary to
  implement this chapter.
         Sec. 317.007.  RIGHTS AND REMEDIES. (a)  This chapter may
  not be construed to:
               (1)  interfere with the rights of an agent operating
  under a valid advance directive in accordance with Chapter 166; or
               (2)  alter, amend, or revoke any existing right or
  remedy granted under any other provision of law.
         (b)  This chapter does not create a private right of action
  against a hospital, a hospital employee, or a person in a
  contractual relationship with a hospital.
         (c)  A hospital, a hospital employee, or a person in a
  contractual relationship with a hospital may not be held liable in
  any way for services rendered or not rendered by a patient's
  designated caregiver to the patient.
         (d)  A designated caregiver may not be reimbursed by a
  government or commercial payer for aftercare assistance provided
  under this chapter.
         (e)  Nothing in this chapter may be construed:
               (1)  to alter the obligation of an insurance company,
  health service corporation, hospital service corporation, medical
  service corporation, health maintenance organization, or other
  entity issuing health benefit plans to provide coverage required
  under a health benefit plan;
               (2)  to affect, impede, or otherwise disrupt or reduce
  the reimbursement obligations of an insurance company, health
  service corporation, hospital service corporation, medical service
  corporation, health maintenance organization, or other entity
  issuing health benefit plans; or
               (3)  to affect the time at which a patient may be
  discharged or transferred from a hospital to another facility.
         SECTION 2.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2015.
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