OLR Bill Analysis
AN ACT CONCERNING PATIENT-DESIGNATED CAREGIVERS.
This bill requires a hospital, when discharging a patient to his or her home, to:
1. allow the patient to designate a caregiver at, or before, the time the patient receives a written copy of his or her discharge plan;
2. document the designated caregiver in the patient's discharge plan;
3. attempt to notify the designated caregiver of the patient's discharge home; and
4. instruct the caregiver on post-discharge tasks with which he or she will assist the patient at home.
The bill specifies that its provisions do not create a private right of action against a (1) hospital or (2) its employees, contractors, or consultants. It prohibits these entities from being held liable for services a caregiver provides or does not provide to the patient in his or her home.
Additionally, the bill's provisions do not affect (1) health insurers' benefit plan or reimbursement obligations, (2) a patient's discharge or transfer from a hospital to another facility, or (3) a patient's proxy health care rights.
By law, a hospital is an establishment for the lodging, care, and treatment of people suffering from disease or other abnormal physical or mental conditions and includes general hospitals' inpatient psychiatric services.
EFFECTIVE DATE: October 1, 2015
Under the bill, a caregiver is a person the patient designates to provide post-discharge assistance in the patient's home (e.g., a relative, spouse, neighbor, or friend). A patient's home does not include a long-term facility (e.g., a nursing home or assisted living facility), rehabilitation facility, hospital, or group home.
The bill requires caregivers to provide post-discharge assistance in accordance with the patient's written discharge plan signed by the patient or his or her representative. Such assistance includes help with basic and instrumental activities of daily living and support tasks (e.g., wound care, medication administration, and medical equipment use).
The bill prohibits a caregiver from receiving compensation for providing such assistance, including reimbursement from a private or public health insurer.
It does not require a patient to designate a caregiver nor does it obligate the caregiver to perform any post-discharge assistance for the patient.
DOCUMENTATION AND NOTIFICATION REQUIREMENTS
If an inpatient designates a caregiver before receiving his or her written discharge instructions, the bill requires the hospital to:
1. record in the patient's discharge plan the caregiver's name, address, telephone number, and relationship to the patient and
2. make reasonable attempts to notify the caregiver of the patient's discharge home as soon as practical.
The bill specifies that the hospital's inability to contact the designated caregiver must not interfere with, delay, or otherwise affect the patient's medical care or appropriate discharge.
The bill requires hospitals, prior to discharging a patient, to provide the designated caregiver with instructions in all post-discharge assistance tasks included in the patient's discharge plan.
To the extent possible, caregiver training or instruction must use nontechnical language and may be conducted in person or using video technology, at the caregiver's discretion. (The bill does not specify where the training must take place.) At a minimum, it must include:
1. a live or recorded demonstration of the post-discharge assistance tasks performed by a hospital designee authorized to perform the tasks;
2. an opportunity for the caregiver to ask questions about the tasks; and
3. answers to the caregiver's questions.
The demonstration must be conducted in a culturally competent manner according to the hospital's requirements for providing language access services under state and federal law.
The bill requires hospitals to document in the patient's medical record any training provided to the (1) patient or (2) his or her representative or designated caregiver on how to initially implement the discharge plan.
The hospital must also document in the patient's medical record any caregiver instruction provided on post-discharge assistance tasks, including the date, time, and content of such instruction.
HEALTH INSURER OBLIGATIONS
The bill specifies that its provisions must not be construed to:
1. eliminate the obligation of an insurance company; health, hospital, or medical service corporation; HMO; or any other entity issuing health benefit plans to provide required benefit coverage or
1. impact, impede, or otherwise disrupt or reduce these entities' reimbursement obligations.
PATIENTS' PROXY HEALTH RIGHTS
The bill specifies that its provisions do not affect or take precedence over an advance directive, conservatorship, or other proxy health care rights the patient delegates or applies by law.
Joint Favorable Substitute