Aging Committee

JOINT FAVORABLE REPORT

Bill No.:

SB-290

Title:

AN ACT CONCERNING PATIENT-DESIGNATED CAREGIVERS.

Vote Date:

3/5/2015

Vote Action:

Joint Favorable Substitute

PH Date:

2/10/2015

File No.:

SPONSORS OF BILL:

Aging Committee

Sen. Looney

Sen. Duff

Sen. Bye

Sen. Bartolomeo

Sen. Cassano

Sen. Coleman

Sen. Crisco

Sen. Flexer

Sen. Gerratana

Sen. Larson

Sen. Moore

Sen. Osten

Sen. Winfield

REASONS FOR BILL:

To support family caregivers and promote aging in place.

***Substitute language, as contained in LCO 4781, inserts language agreed to between the CT Hospital Association and AARP regarding definitions and elaboration on the fact that the act creates no separate private right of action against hospitals or staff.***

RESPONSE FROM ADMINISTRATION/AGENCY:

Senator Martin Looney:

“…Senate Bill 290 would support our state's efforts to promote aging in place because the bill would implement the core principles of the CARE (Caregiver Advise, Record and Enable) Act.

The CARE Act, a concept developed by the AARP, will help ensure caregivers receive the information and training they need to care for their loved ones at home. Specifically, the bill would require hospitals to do the following:

1. Provide each patient with the opportunity to designate a caregiver upon the patient's admission to the hospital,

2. Notify the designated caregiver if the patient is to be discharged to another facility or back to his or her home, and

3. Provide the caregiver with instructions on how to perform medication management, wound care, injections or other medical tasks for the patient when the patient returns home.”

Senator Tony Hwang:

“…According to the Legislative Commission on Aging, there are more than 500,000 Connecticut residents who provide care every day to their loved with tasks such as bathing, dressing, finances, transportation and medical care. The total economic impact of this unpaid care is estimated to be $5.8 billion.

The unfortunate reality is that many of these caregivers feel unprepared to perform the medical tasks necessary to keep their loved ones out of the hospital and in the community at home where they want to be.

SB 290, known as the Caregiver, Advise, Record and Enable (CARE) Act, is designed to change that, and to empower and educate these individuals who work tirelessly to care for their loved ones. Importantly, this bill comes at no cost to the state or taxpayers.”

Deb Migneault, Connecticut's Legislative Commission on Aging:

“Connecticut's caregivers are an integral and frequently unrecognized part of the health care team. An estimated 700,000 people provide $5.9 billion in unpaid care to family members, friends and loved ones. Connecticut caregivers are the foundation of our system of care yet, according to AARP's State Scorecard, Connecticut ranks 30th in nation for our support of caregivers.”

Jewel Mullen, CT Department of Public Health:

“…Family support is an integral component in a patient's recovery. Requiring hospitals to record names of family caregivers with subsequent notification and instructions for follow up care is patient centered and reinforces the importance of family as caregivers in the plan of care/discharge plan. Acknowledging family caregivers as a critical tool and providing them instruction in after care will only lead to better outcomes.

Even in situations where home health agency services are contracted to assist with after care, those services in many cases are time limited, in not only the hours per week, but in duration. The family or a designated caregiver is often heavily relied upon to participate in the plan of care.”

Elizabeth B. Ritter, State Department on Aging:

“…According to a survey by the AARP, 61% of CT residents age 40 and older are currently providing or have provided unpaid care to an adult loved one who is ill, frail, elderly or has a physical or mental disability. This number will rise as the baby boomers continue to age.

…We support the patient's choice to designate a caregiver so that: 1) the caregiver be informed of discharge to another facility or back home; 2) the hospital consults with the caregiver about his/her ability to provide the care, treatment of services that the loved one requires; and 3) the hospital offers the family caregiver an opportunity to receive instruction on the medical/nursing tasks they will need to perform at home, including an opportunity for live demonstrations, and allow time for questions.”

NATURE AND SOURCES OF SUPPORT:

American Cancer Society Cancer Action Network (ACS CAN):

“…Cancer patients often rely on caregivers to help them coordinate their care, manage their medications, provide transportation to outpatient treatment and help with activities of daily living. In particular, for older patients undergoing chemotherapy at home, patients and their designated caregivers need to understand the prescribed chemotherapy medications and any medications given to alleviate pain or nausea, as well as the signs and symptoms associated with adverse reactions.”

Pamela Atwood, Hebrew HealthCare, Inc.:

“…Caregivers need to be contacted and kept up to date. They need to have instruction on how to implement the interventions and medications and follow up care that people have. If we really want to reduce re-hospitalization rates, reduce health care costs, and improve compliance with care recommendations, we need to ensure that the right people have access to that information and instruction.”

Richard Bright, AARP:

“…When it comes to performing complex, medically-oriented tasks for their loved ones, caregivers are often left to their own devices; presented with a flurry of information and then shown the door.

When it comes to supporting family caregivers, I believe that educating them is essential.”

Connecticut Hospital Association (CHA):

“…CHA knows the transition from the hospital to home can be difficult. We also know patients benefit when families and friends are engaged in their recovery. SB 290 and HB 5455 recognize the critical role caregivers play every day in the health of their families and friends.”

Jean Horn Caron, AARP:

“…I remember when my mother left the nursing home. I was given a form that said: “take these meds and see a primary care physician”. I received no instructions on how to perform these tasks, just this one sheet. I was quite anxious since it seemed that so much was suddenly expected of me. This is one of the reasons I support the concepts outlined in proposed S.B. 290 and proposed H.B. 5455.”

Joanne Davis:

“…As a nurse, I have the advantage of knowing what to look for, what questions to ask, where to find resources. Not having this background and experience puts the individual and the caregiver at a serious disadvantage because they may not be confident of their abilities or aware of services from which they can benefit to stay safely in the home.”

Ian MacDonald, AARP:

“…It seems that no one is ever quite prepared to be a caregiver, though most have some idea of what it might look like: meals, daily chores, rides to appointments, etc. However, it has been found that a caregiver's role is evolving, and the tasks they are asked to perform are becoming more complex and medically-oriented. Because of this, it is essential that family caregivers are adequately prepared when their loved one is discharged from a hospital or other health facility.

A study done in the journal of healthcare quality states that when hospitals adopt proactive, enhanced care transition interventions, assuring that family caregiver are prepared when their loved ones are discharged, the likelihood of re-hospitalization is reduced significantly.”

Melinda Montovani, Brain Injury Alliance of Connecticut:

“…Working at the Brain Injury Alliance of CT I hear numerous stories about individuals with brain injuries being discharged from hospitals to the community without proper preparation. Caregivers are not being given the information that would allow them to support their loved one in the community. Instead brain injury survivors and family members are sent home without education and resources.

…SB 290 would ensure that each brain injury survivor could have someone who is informed of their discharge and instructed on how to provide proper support upon return to the community. It would also save money by helping reduce the numbers of hospital readmissions that can result from caregivers not being informed on how to best provide care when their loved one leaves the hospital.”

NATURE AND SOURCES OF OPPOSITION:

None expressed.

Reported by: Richard Ferrari/Art Mongillo

Date: 3/9/15