A09816 Summary:

BILL NO    A09816 

SAME AS    SAME AS S07676

SPONSOR    Rosenthal

COSPNSR    Lupardo, Clark

MLTSPNSR   

Add Art 29-CCCC SS2994-hh - 2994-mm, Pub Health L

Relates to the identification of caregivers; creates the CARE Act.
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A09816 Actions:

BILL NO    A09816 

05/23/2014 referred to health
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A09816 Votes:

There are no votes for this bill in this legislative session.
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A09816 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A9816
 
SPONSOR: Rosenthal
  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 SPECIFIC 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 medica- tions, 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 caregiv- ers to continue to support their loved ones at home and in the communi- ty, 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.   PRIOR LEGISLATIVE HISTORY: This is a new bill.   FISCAL IMPLICATIONS: None to the state.
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A09816 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          9816
 
                   IN ASSEMBLY
 
                                      May 23, 2014
                                       ___________
 
        Introduced  by  M.  of  A.  ROSENTHAL  --  read once and referred 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:
 
     1    Section 1. The public health law is amended by adding  a  new  article

     2  29-CCCC to read as follows:
     3                               ARTICLE 29-CCCC
     4             CARE ACT (CAREGIVER ADVISE, RECORD AND ENABLE ACT)
     5  Section 2994-hh. Short title.
     6          2994-ii. Definitions.
     7          2994-jj. Caregiver, opportunity to identify.
     8          2994-kk. Notice to identified caregiver.
     9          2994-ll. Instruction to identified caregiver.
    10          2994-mm. Effect on other rights.
    11    §  2994-hh. Short title.  This article shall be known and may be cited
    12  as the "CARE act".
    13    § 2994-ii. Definitions.   When used in  this  article,  the  following
    14  words  or phrases shall have the following meanings: 1. "Hospital" shall

    15  mean any "hospital" as defined in section twenty-eight  hundred  one  of
    16  this chapter.
    17    2. "After-care" shall mean any assistance provided by a caregiver to a
    18  patient  under  this article after the patient's discharge from a hospi-
    19  tal. Such assistance shall include, but is  not  limited  to,  assisting
    20  with basic activities of daily living (ADLs), instrumental activities of
    21  daily  living  (IADLs)  or  carrying  out medical/nursing tasks, such as
    22  managing wound care, assisting in administering medications, and operat-
    23  ing medical equipment.
    24    3. "Caregiver" shall mean any individual duly identified as a caregiv-
    25  er by a patient under this article who provides after-care assistance to

    26  a patient living in his or her residence. An identified caregiver  shall
    27  include, but is not limited to, a relative, partner, friend, or neighbor
    28  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

        A. 9816                             2
 
     1    4.  "Discharge" shall mean a patient's exit or release from a hospital
     2  to the patient's residence following any  medical  care,  treatment,  or
     3  observation.
     4    5.  "Entry"  shall  mean  a patient's entrance into a hospital for the

     5  purposes of medical care, treatment, or observation. A patient need  not
     6  be formally admitted to a hospital for the provisions of this article to
     7  apply.
     8    6.  "Residence" shall mean a dwelling that the patient considers to be
     9  his or her home. A "residence" for the purposes of  this  article  shall
    10  not   include  any  rehabilitation  facility,  hospital,  nursing  home,
    11  assisted living facility, group home or other  residential  health  care
    12  facility  as defined in section twenty-eight hundred one of this chapter
    13  or any inpatient facility regulated by the office of mental health.
    14    § 2994-jj. Caregiver, opportunity to identify.  1.  A  hospital  shall
    15  provide  each  patient  or,  if applicable, the patient's legal guardian

    16  with at least one opportunity to identify at least one  caregiver  under
    17  this  article  no  later  than twenty-four hours following the patient's
    18  entry into a hospital and prior to the patient's  entry into a  hospital
    19  and prior to the patient's discharge or transfer to another facility.
    20    (a) In the event that the patient is unconscious or otherwise incapac-
    21  itated upon his or her entry into a hospital, the hospital shall provide
    22  such patient or his/her legal guardian with an opportunity to identify a
    23  caregiver  within  twenty-four hours following the patient's recovery of
    24  his or her consciousness or capacity.
    25    (b) In the event that the patient  or  the  patient's  legal  guardian

    26  declines  to identify a caregiver under this article, the hospital shall
    27  promptly document this in the patient's medical record.
    28    (c) In the event that the patient  or  the  patient's  legal  guardian
    29  identifies an individual as a caregiver under this article:
    30    (i)  The  hospital  shall  promptly request the written consent of the
    31  patient or the patient's legal guardian to release  medical  information
    32  to  the  patient's  identified caregiver following the hospital's estab-
    33  lished procedures for  releasing  personal  health  information  and  in
    34  compliance with all federal and state laws.
    35    (ii)  If  the  patient  or  the  patient's  legal guardian declines to
    36  consent to release medical information to the patient's identified care-

    37  giver, the hospital is not required to provide notice to  the  caregiver
    38  under  section  twenty-nine  hundred  ninety-four-kk  of this article or
    39  provided information contained in the  patient's  discharge  plan  under
    40  section twenty-nine hundred ninety-four-ll of this article.
    41    (iii)  The hospital shall record the patient's identification of care-
    42  giver, the relationship of the identified caregiver to the patient,  and
    43  the  name,  telephone  number,  and  address of the patient's identified
    44  caregiver in the patient's medical record.
    45    (d) A patient may elect to change his or her identified  caregiver  at
    46  any  time,  and  the  hospital  must record this change in the patient's
    47  medical record within twenty-four hours.

    48    (e) Prior to  notifying  the  patient's  caregiver  of  the  patient's
    49  discharge  or transfer to another hospital or facility as required under
    50  section twenty-nine hundred ninety-four-kk of this article, the hospital
    51  shall ask the patient to  verify  the  patient's  caregiver  choice  and
    52  provide  the  patient  the  opportunity  to change his or her identified
    53  caregiver.
    54    2. An identification of a caregiver by a patient or a patient's  legal
    55  guardian  under this section does not obligate any individual to perform
    56  any after-care tasks for any patient.

        A. 9816                             3
 
     1    3. This section shall not be construed  to  require  a  patient  or  a

     2  patient's  legal  guardian  to identify any individual as a caregiver as
     3  defined by this article.
     4    § 2994-kk. Notice to identified caregiver. A hospital shall notify the
     5  patient's identified caregiver of the patient's discharge or transfer to
     6  another hospital or facility licensed by the department or the office of
     7  mental  health as soon as the date and time of discharge or transfer can
     8  be anticipated prior to the patient's actual discharge  or  transfer  to
     9  such facility.
    10    §  2994-ll. Instruction to identified caregiver.  1. As soon as possi-
    11  ble and not later than twenty-four hours prior to a patient's  discharge
    12  from a hospital, the hospital shall consult with the identified caregiv-

    13  er  along  with  the  patient regarding the caregiver's capabilities and
    14  limitations and issue  a  discharge  plan  that  describes  a  patient's
    15  after-care  needs at his or her residence.  At minimum, a discharge plan
    16  shall include:
    17    (a) the name and contact information of the caregiver identified under
    18  this article;
    19    (b) a description of all after-care tasks necessary  to  maintain  the
    20  patient's  ability  to reside at home, taking into account the capabili-
    21  ties and limitations of the caregiver; and
    22    (c) contact information for any health care, community resources,  and
    23  long-term  services and supports necessary to successfully carry out the
    24  patient's discharge plan.

    25    2. The hospital issuing the discharge  plan  must  provide  caregivers
    26  with  instruction  in  all  after-care  tasks described in the discharge
    27  plan.
    28    (a) At minimum, such instruction shall include:
    29    (i) a live demonstration of the tasks performed by a hospital employee
    30  authorized to perform the after-care  task,  provided  in  a  culturally
    31  competent  manner  and in accordance with the hospital's requirements to
    32  provide language access services under state and federal law;
    33    (ii) an opportunity for the caregiver and  patient  to  ask  questions
    34  about the after-care tasks; and
    35    (iii) answers to the caregiver's and patient's questions provided in a
    36  culturally  competent  manner  and  in  accordance  with  the hospital's

    37  requirements to provide language access services under state and federal
    38  law.
    39    (b) Any instructions required under this article shall  be  documented
    40  in  the patient's medical record, including, at minimum, the date, time,
    41  and contents of the instruction.
    42    3. The department is authorized to promulgate regulations to implement
    43  the provisions of this article, including  but  not  limited  to,  regu-
    44  lations  to  further  define  the  content  and scope of any instruction
    45  provided to caregivers under this article.
    46    § 2994-mm. Effect on other rights. Nothing in this  article  shall  be
    47  construed  to  interfere  with  the rights of an agent operating under a

    48  valid health care directive created under  section  twenty-nine  hundred
    49  eighty-two of this chapter.
    50    § 2. This act shall take effect immediately.
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