S T A T E O F N E W Y O R K
________________________________________________________________________
1323--A
2015-2016 Regular Sessions
I N A S S E M B L Y
January 9, 2015
___________
Introduced by M. of A. ROSENTHAL, LUPARDO, CLARK, ROBERTS, GALEF,
STIRPE, DINOWITZ, SKOUFIS, GUNTHER, BRAUNSTEIN, JAFFEE, RAIA, LINARES,
FAHY, BRINDISI, BRONSON, WOERNER, McDONALD, LAVINE, STECK -- Multi-
Sponsored by -- M. of A. RA, WALTER, WRIGHT -- read once and referred
to the Committee on Health -- committee discharged, bill amended,
ordered reprinted as amended and recommitted to said committee
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 S 2994-HH. SHORT TITLE. THIS ARTICLE SHALL BE KNOWN AND MAY BE CITED
12 AS THE "CARE ACT".
13 S 2994-II. DEFINITIONS. WHEN USED IN THIS ARTICLE, THE FOLLOWING
14 WORDS OR PHRASES SHALL HAVE THE FOLLOWING MEANINGS:
15 1. "HOSPITAL" SHALL MEAN ANY "GENERAL HOSPITAL" AS DEFINED IN SECTION
16 TWENTY-EIGHT HUNDRED ONE OF 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 HOSPITAL
19 THAT IS RELATED TO THE PATIENT'S CONDITION AT THE TIME OF DISCHARGE.
20 SUCH ASSISTANCE SHALL INCLUDE, BUT IS NOT LIMITED TO, ASSISTING WITH
21 BASIC ACTIVITIES OF DAILY LIVING (ADLS), INSTRUMENTAL ACTIVITIES OF
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03921-04-5
A. 1323--A 2
1 DAILY LIVING (IADLS), AND OTHER TASKS AS DETERMINED TO BE APPROPRIATE BY
2 THE DISCHARGING PHYSICIAN.
3 3. "CAREGIVER" SHALL MEAN ANY INDIVIDUAL DULY IDENTIFIED AS A CAREGIV-
4 ER BY A PATIENT UNDER THIS ARTICLE WHO PROVIDES AFTER-CARE ASSISTANCE TO
5 A PATIENT LIVING IN HIS OR HER RESIDENCE. AN IDENTIFIED CAREGIVER SHALL
6 INCLUDE, BUT IS NOT LIMITED TO, A RELATIVE, PARTNER, FRIEND OR NEIGHBOR
7 WHO HAS A SIGNIFICANT RELATIONSHIP WITH THE PATIENT.
8 4. "DISCHARGE" SHALL MEAN A PATIENT'S EXIT OR RELEASE FROM A HOSPITAL
9 TO THE PATIENT'S RESIDENCE FOLLOWING AN INPATIENT ADMISSION.
10 5. "ENTRY" SHALL MEAN A PATIENT'S ADMISSION INTO A HOSPITAL FOR THE
11 PURPOSES OF RECEIVING INPATIENT CARE.
12 6. "PATIENT" SHALL MEAN A PATIENT EIGHTEEN YEARS OF AGE OR OLDER.
13 7. "RESIDENCE" SHALL MEAN A DWELLING THAT THE PATIENT CONSIDERS TO BE
14 HIS OR HER HOME. A "RESIDENCE" FOR THE PURPOSES OF THIS ARTICLE SHALL
15 NOT INCLUDE ANY REHABILITATION FACILITY, HOSPITAL, NURSING HOME,
16 ASSISTED LIVING FACILITY, GROUP HOME OR OTHER RESIDENTIAL HEALTH CARE
17 FACILITY AS DEFINED IN SECTION TWENTY-EIGHT HUNDRED ONE OF THIS CHAPTER
18 OR ANY INPATIENT FACILITY REGULATED BY THE OFFICE OF MENTAL HEALTH.
19 S 2994-JJ. CAREGIVER; OPPORTUNITY TO IDENTIFY. 1. A HOSPITAL SHALL
20 PROVIDE EACH PATIENT OR, IF APPLICABLE, THE PATIENT'S LEGAL GUARDIAN
21 WITH AT LEAST ONE OPPORTUNITY TO IDENTIFY AT LEAST ONE CAREGIVER UNDER
22 THIS ARTICLE FOLLOWING THE PATIENT'S ENTRY INTO A HOSPITAL AND PRIOR TO
23 THE PATIENT'S DISCHARGE OR TRANSFER TO ANOTHER FACILITY. THE HOSPITAL
24 SHALL INFORM THE PATIENT THAT THE PURPOSE OF PROVIDING THE CAREGIVER'S
25 IDENTITY IS TO INCLUDE THAT CAREGIVER IN DISCHARGE PLANNING AND SHARING
26 OF POST-DISCHARGE CARE INFORMATION OR INSTRUCTION.
27 (A) IN THE EVENT THAT THE PATIENT IS UNCONSCIOUS OR OTHERWISE INCAPAC-
28 ITATED UPON HIS OR HER ENTRY INTO A HOSPITAL, THE HOSPITAL SHALL PROVIDE
29 SUCH PATIENT OR HIS/HER LEGAL GUARDIAN WITH AN OPPORTUNITY TO IDENTIFY A
30 CAREGIVER FOLLOWING THE PATIENT'S RECOVERY OF HIS OR HER CONSCIOUSNESS
31 OR CAPACITY.
32 (B) IN THE EVENT THAT THE PATIENT OR THE PATIENT'S LEGAL GUARDIAN
33 DECLINES TO IDENTIFY A CAREGIVER UNDER THIS ARTICLE, THE HOSPITAL SHALL
34 PROMPTLY DOCUMENT THIS IN THE PATIENT'S MEDICAL RECORD.
35 (C) THE HOSPITAL SHALL RECORD THE PATIENT'S IDENTIFICATION OF A CARE-
36 GIVER IF GIVEN BY THE PATIENT OR LEGAL GUARDIAN, THE RELATIONSHIP OF THE
37 IDENTIFIED CAREGIVER TO THE PATIENT, AND THE NAME, TELEPHONE NUMBER, AND
38 ADDRESS OF THE PATIENT'S IDENTIFIED CAREGIVER IN THE PATIENT'S MEDICAL
39 RECORD.
40 (D) A PATIENT MAY ELECT TO CHANGE HIS OR HER IDENTIFIED CAREGIVER AT
41 ANY TIME, AND THE HOSPITAL MUST RECORD THIS CHANGE IN THE PATIENT'S
42 MEDICAL RECORD.
43 (E) (I) THE HOSPITAL SHALL PROMPTLY REQUEST THE WRITTEN CONSENT OF THE
44 PATIENT OR THE PATIENT'S LEGAL GUARDIAN TO RELEASE MEDICAL INFORMATION
45 TO THE PATIENT'S DESIGNATED CAREGIVER FOLLOWING THE HOSPITAL'S ESTAB-
46 LISHED PROCEDURE FOR RELEASING PERSONAL HEALTH INFORMATION AND IN
47 COMPLIANCE WITH ALL STATE AND FEDERAL LAWS, INCLUDING THE FEDERAL HEALTH
48 INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 AS AMENDED, AND
49 RELATED REGULATIONS.
50 (II) IF THE PATIENT OR THE PATIENT'S LEGAL GUARDIAN DECLINES TO
51 CONSENT TO RELEASE MEDICAL INFORMATION TO THE PATIENT'S DESIGNATED CARE-
52 GIVER, THE HOSPITAL SHALL NOT BE REQUIRED TO PROVIDE NOTICE TO THE CARE-
53 GIVER UNDER SECTION TWENTY-NINE HUNDRED NINETY-FOUR-KK OF THIS ARTICLE
54 OR PROVIDE INFORMATION CONTAINED IN THE PATIENT'S DISCHARGE PLAN UNDER
55 SECTION TWENTY-NINE HUNDRED NINETY-FOUR-LL OF THIS ARTICLE.
A. 1323--A 3
1 2. AN IDENTIFICATION OF A CAREGIVER BY A PATIENT OR A PATIENT'S LEGAL
2 GUARDIAN UNDER THIS SECTION DOES NOT OBLIGATE ANY INDIVIDUAL TO PERFORM
3 ANY AFTER-CARE TASKS FOR ANY PATIENT.
4 3. THIS SECTION SHALL NOT BE CONSTRUED TO REQUIRE A PATIENT OR A
5 PATIENT'S LEGAL GUARDIAN TO IDENTIFY ANY INDIVIDUAL AS A CAREGIVER AS
6 DEFINED BY THIS ARTICLE.
7 S 2994-KK. NOTICE TO IDENTIFIED CAREGIVER. A HOSPITAL SHALL NOTIFY THE
8 PATIENT'S IDENTIFIED CAREGIVER OF THE PATIENT'S DISCHARGE OR TRANSFER TO
9 ANOTHER HOSPITAL OR FACILITY LICENSED BY THE DEPARTMENT OR THE OFFICE OF
10 MENTAL HEALTH AS SOON AS THE DATE AND TIME OF DISCHARGE OR TRANSFER CAN
11 BE ANTICIPATED PRIOR TO THE PATIENT'S ACTUAL DISCHARGE OR TRANSFER TO
12 SUCH FACILITY. IN THE EVENT THE HOSPITAL IS UNABLE TO CONTACT THE
13 DESIGNATED CAREGIVER, THE LACK OF CONTACT SHALL NOT INTERFERE WITH,
14 DELAY, OR OTHERWISE AFFECT THE MEDICAL CARE PROVIDED TO THE PATIENT OR
15 AN APPROPRIATE DISCHARGE OF THE PATIENT. THE HOSPITAL SHALL PROMPTLY
16 DOCUMENT THE ATTEMPT IN THE PATIENT'S MEDICAL RECORD.
17 S 2994-LL. INSTRUCTION TO IDENTIFIED CAREGIVER. 1. AS SOON AS POSSI-
18 BLE AND NOT LATER THAN TWENTY-FOUR HOURS PRIOR TO A PATIENT'S DISCHARGE
19 FROM A HOSPITAL, THE HOSPITAL SHALL CONSULT WITH THE IDENTIFIED CAREGIV-
20 ER ALONG WITH THE PATIENT REGARDING THE CAREGIVER'S CAPABILITIES AND
21 LIMITATIONS AND ISSUE A DISCHARGE PLAN THAT DESCRIBES A PATIENT'S
22 AFTER-CARE NEEDS AT HIS OR HER RESIDENCE. IN THE EVENT THE HOSPITAL IS
23 UNABLE TO CONTACT THE DESIGNATED CAREGIVER, THE LACK OF CONTACT SHALL
24 NOT INTERFERE WITH, DELAY, OR OTHERWISE AFFECT THE MEDICAL CARE PROVIDED
25 TO THE PATIENT OR AN APPROPRIATE DISCHARGE OF THE PATIENT. THE HOSPITAL
26 SHALL PROMPTLY DOCUMENT THE ATTEMPT IN THE PATIENT'S MEDICAL RECORD. AT
27 MINIMUM, A DISCHARGE PLAN SHALL INCLUDE:
28 (A) THE NAME AND CONTACT INFORMATION OF THE CAREGIVER IDENTIFIED UNDER
29 THIS ARTICLE;
30 (B) A DESCRIPTION OF ALL AFTER-CARE TASKS RECOMMENDED BY THE DISCHARG-
31 ING PHYSICIAN, TAKING INTO ACCOUNT THE CAPABILITIES AND LIMITATIONS OF
32 THE CAREGIVER; AND
33 (C) CONTACT INFORMATION FOR HEALTH CARE, COMMUNITY RESOURCES, AND
34 LONG-TERM SERVICES AND SUPPORTS NECESSARY TO SUCCESSFULLY CARRY OUT THE
35 PATIENT'S DISCHARGE PLAN.
36 2. THE HOSPITAL ISSUING THE DISCHARGE PLAN MUST OFFER CAREGIVERS WITH
37 INSTRUCTION IN ALL AFTER-CARE TASKS DESCRIBED IN THE DISCHARGE PLAN.
38 (A) AT MINIMUM, SUCH INSTRUCTION SHALL INCLUDE:
39 (I) A LIVE OR RECORDED DEMONSTRATION OF THE TASKS PERFORMED BY A
40 HOSPITAL EMPLOYEE AUTHORIZED TO PERFORM THE AFTER-CARE TASK, PROVIDED IN
41 A CULTURALLY COMPETENT MANNER AND IN ACCORDANCE WITH THE HOSPITAL'S
42 REQUIREMENTS TO PROVIDE LANGUAGE ACCESS SERVICES UNDER STATE AND FEDERAL
43 LAW;
44 (II) AN OPPORTUNITY FOR THE CAREGIVER AND PATIENT TO ASK QUESTIONS
45 ABOUT THE AFTER-CARE TASKS; AND
46 (III) ANSWERS TO THE CAREGIVER'S AND PATIENT'S QUESTIONS PROVIDED IN A
47 CULTURALLY COMPETENT MANNER AND IN ACCORDANCE WITH THE HOSPITAL'S
48 REQUIREMENTS TO PROVIDE LANGUAGE ACCESS SERVICES UNDER STATE AND FEDERAL
49 LAW.
50 (B) ANY INSTRUCTIONS REQUIRED UNDER THIS ARTICLE SHALL BE DOCUMENTED
51 IN THE PATIENT'S MEDICAL RECORD, INCLUDING, AT MINIMUM, THE DATE, TIME,
52 AND CONTENTS OF THE INSTRUCTION.
53 3. THE DEPARTMENT IS AUTHORIZED TO PROMULGATE REGULATIONS TO IMPLEMENT
54 THE PROVISIONS OF THIS ARTICLE, INCLUDING BUT NOT LIMITED TO, REGU-
55 LATIONS TO FURTHER DEFINE THE CONTENT AND SCOPE OF ANY INSTRUCTION
56 PROVIDED TO CAREGIVERS UNDER THIS ARTICLE.
A. 1323--A 4
1 S 2994-MM. EFFECT ON OTHER RIGHTS. 1. NOTHING IN THIS ARTICLE SHALL BE
2 CONSTRUED TO INTERFERE WITH THE RIGHTS OF AN AGENT OPERATING UNDER A
3 VALID HEALTH CARE DIRECTIVE CREATED UNDER SECTION TWENTY-NINE HUNDRED
4 EIGHTY-TWO OF THIS CHAPTER.
5 2. NOTHING IN THIS ARTICLE SHALL BE CONSTRUED TO CREATE A PRIVATE
6 RIGHT OF ACTION AGAINST A HOSPITAL OR ANY OF ITS DIRECTORS, TRUSTEES,
7 OFFICERS, EMPLOYEES OR AGENTS, OR ANY CONTRACTORS WITH WHOM A HOSPITAL
8 HAS A CONTRACTUAL RELATIONSHIP.
9 3. A HOSPITAL, ANY OF ITS DIRECTORS, TRUSTEES, OFFICERS, EMPLOYEES OR
10 AGENTS, OR ANY CONTRACTORS WITH WHOM A HOSPITAL HAS A CONTRACTUAL
11 RELATIONSHIP SHALL NOT BE HELD LIABLE, IN ANY WAY, FOR THE SERVICES
12 RENDERED OR NOT RENDERED BY THE CAREGIVER TO THE PATIENT AT THE
13 PATIENT'S RESIDENCE.
14 S 2. This act shall take effect on the one hundred eightieth day after
15 it shall have become a law.