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A BILL TO BE ENTITLED
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AN ACT
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relating to a requirement that a hospital allow a patient to |
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designate a caregiver to receive aftercare instruction regarding |
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the patient. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle F, Title 4, Health and Safety Code, is |
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amended by adding Chapter 317 to read as follows: |
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CHAPTER 317. DESIGNATION OF CAREGIVER FOR RECEIPT OF AFTERCARE |
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INSTRUCTION |
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Sec. 317.001. DEFINITIONS. In this chapter: |
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(1) "Aftercare" means the assistance provided by a |
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caregiver to a patient after the patient's discharge from a |
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hospital, including: |
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(A) assisting with basic activities of daily |
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living; |
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(B) assisting with instrumental activities of |
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daily living; and |
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(C) carrying out medical or nursing tasks, |
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including: |
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(i) wound care; |
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(ii) administering medications; and |
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(iii) operating medical equipment. |
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(2) "Designated caregiver" means an individual |
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designated by a patient, including a relative, partner, friend, or |
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neighbor, who: |
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(A) is at least 18 years of age; |
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(B) has a significant relationship with the |
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patient; and |
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(C) will provide aftercare to the patient in the |
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patient's or caregiver's residence. |
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(3) "Discharge" means a patient's release from a |
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hospital to the patient's or caregiver's residence following an |
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inpatient admission. |
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(4) "Hospital" means a general or special hospital |
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licensed under Chapter 241 or exempt from licensure under Section |
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241.004(3). |
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(5) "Residence" means the dwelling where a person |
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primarily resides. The term does not include a rehabilitation |
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facility, hospital, nursing facility, assisted living facility, or |
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group home. |
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(6) "Surrogate decision-maker" has the meaning |
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assigned by Section 313.002. |
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Sec. 317.002. DESIGNATION OF CAREGIVER. (a) Not later than |
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the time the patient is discharged or transferred to another |
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facility, the hospital shall provide the patient, the patient's |
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legal guardian, or the patient's surrogate decision-maker the |
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opportunity to designate at least one caregiver. |
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(b) If a patient, a patient's legal guardian, or a patient's |
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surrogate decision-maker designates a caregiver, a hospital shall |
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promptly: |
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(1) document in the patient's medical record: |
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(A) the name, telephone number, and address of |
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the patient's designated caregiver; and |
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(B) the relationship of the designated caregiver |
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to the patient; and |
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(2) request written authorization from the patient, |
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the patient's legal guardian, or the patient's surrogate |
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decision-maker to disclose health care information to the patient's |
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designated caregiver. |
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(c) If a patient, a patient's legal guardian, or a patient's |
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surrogate decision-maker declines to designate a caregiver, the |
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hospital shall promptly record in the patient's medical record that |
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the patient, the patient's legal guardian, or the patient's |
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surrogate decision-maker did not wish to designate a caregiver. |
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(d) If a patient, a patient's legal guardian, or a patient's |
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surrogate decision-maker declines to give authorization to a |
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hospital to disclose health care information to the designated |
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caregiver, a hospital is not required to comply with Sections |
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317.003 and 317.004. |
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(e) A patient, a patient's legal guardian, or a patient's |
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surrogate decision-maker may change the patient's designated |
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caregiver at any time, and the hospital must document the change in |
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the patient's medical record. |
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(f) The designation of a person as the patient's caregiver |
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does not obligate the person to serve as the patient's designated |
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caregiver or to provide aftercare to the patient. |
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Sec. 317.003. NOTICE TO DESIGNATED CAREGIVER. Except as |
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provided by Section 317.002(d), as soon as possible before a |
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patient's discharge or transfer to another facility, a hospital |
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shall notify the designated caregiver of the patient's discharge or |
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transfer. The inability of the hospital to contact the designated |
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caregiver may not interfere with, delay, or otherwise affect any |
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medical care provided to the patient or the discharge of the |
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patient. |
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Sec. 317.004. DISCHARGE PLAN. (a) Except as provided by |
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Section 317.002(d), as soon as possible before a patient's |
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discharge from a hospital, the hospital shall consult with the |
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designated caregiver and the patient regarding the designated |
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caregiver's capabilities and limitations and issue a discharge plan |
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that describes the patient's aftercare needs at the patient's or |
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caregiver's residence. |
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(b) A discharge plan must include: |
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(1) the name and contact information of the designated |
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caregiver; |
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(2) a description of each aftercare task necessary to |
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maintain the patient's ability to reside at home or at the |
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caregiver's home, taking into account the capabilities and |
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limitations of the caregiver; and |
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(3) the contact information for any health care |
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services, community resources, and long-term services and supports |
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necessary to successfully implement the patient's discharge plan. |
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Sec. 317.005. INSTRUCTION IN AFTERCARE TASKS. (a) The |
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hospital shall provide each designated caregiver instruction in |
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each aftercare task described in the discharge plan under Section |
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317.004 in a manner that is culturally competent and in accordance |
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with applicable requirements to provide language access services. |
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(b) The instruction under Subsection (a) must include: |
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(1) a live demonstration of each aftercare task that |
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is performed by a hospital employee or a person in a contractual |
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relationship with the hospital that is authorized by the hospital |
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to perform the task; and |
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(2) an opportunity for the designated caregiver and |
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patient to ask questions and receive satisfactory answers regarding |
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the aftercare tasks. |
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(c) The hospital shall document in the patient's medical |
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record the instruction given under Subsection (a), including the |
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date, time, and content of the instruction. |
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Sec. 317.006. RULES. The executive commissioner of the |
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Health and Human Services Commission shall adopt rules necessary to |
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implement this chapter, including requirements for the content and |
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scope of any instruction required to be provided by a hospital to a |
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designated caregiver. |
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Sec. 317.007. RIGHTS AND REMEDIES. (a) This chapter may not |
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be construed to: |
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(1) interfere with the rights of an agent operating |
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under a valid advance directive in accordance with Chapter 166; or |
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(2) alter, amend, or revoke any existing right or |
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remedy granted under any other provision of law. |
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(b) This chapter does not create a private right of action |
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against a hospital, a hospital employee, or a person in a |
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contractual relationship with a hospital. |
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SECTION 2. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2015. |