|
|
|
A BILL TO BE ENTITLED
|
|
AN ACT
|
|
relating to a requirement that a hospital allow a patient to |
|
designate a caregiver to receive aftercare instruction regarding |
|
the patient. |
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
SECTION 1. Subtitle F, Title 4, Health and Safety Code, is |
|
amended by adding Chapter 317 to read as follows: |
|
CHAPTER 317. DESIGNATION OF CAREGIVER FOR RECEIPT OF AFTERCARE |
|
INSTRUCTION |
|
Sec. 317.001. DEFINITIONS. In this chapter: |
|
(1) "Aftercare" means assistance provided by a |
|
designated caregiver to a person after that person's discharge from |
|
a hospital, as described by this chapter. The term includes |
|
assistance with tasks that are related to the person's condition at |
|
the time of that person's discharge from a hospital but does not |
|
include those tasks required to be performed by a licensed health |
|
care professional. |
|
(2) "Designated caregiver" means an individual |
|
designated by a patient, including a relative, partner, friend, or |
|
neighbor, who: |
|
(A) is at least 18 years of age; |
|
(B) has a significant relationship with the |
|
patient; and |
|
(C) will provide aftercare to the patient. |
|
(3) "Discharge" means a patient's release from a |
|
hospital following an inpatient admission. |
|
(4) "Hospital" means a general or special hospital |
|
licensed under Chapter 241 or exempt from licensure under Section |
|
241.004(3). |
|
(5) "Surrogate decision-maker" has the meaning |
|
assigned by Section 313.002. |
|
Sec. 317.002. DESIGNATION OF CAREGIVER. (a) On admission |
|
to a hospital or at the time the patient is discharged or |
|
transferred to another facility, the hospital shall provide the |
|
patient, the patient's legal guardian, or the patient's surrogate |
|
decision-maker the opportunity to designate a caregiver. |
|
(b) If a patient, a patient's legal guardian, or a patient's |
|
surrogate decision-maker designates a caregiver, a hospital shall: |
|
(1) document in the patient's medical record: |
|
(A) the name, telephone number, and address of |
|
the patient's designated caregiver; and |
|
(B) the relationship of the designated caregiver |
|
to the patient; and |
|
(2) request written authorization from the patient, |
|
the patient's legal guardian, or the patient's surrogate |
|
decision-maker to disclose health care information to the patient's |
|
designated caregiver. |
|
(c) If a patient, a patient's legal guardian, or a patient's |
|
surrogate decision-maker declines to designate a caregiver, the |
|
hospital shall promptly record in the patient's medical record that |
|
the patient, the patient's legal guardian, or the patient's |
|
surrogate decision-maker did not wish to designate a caregiver. |
|
(d) If a patient, a patient's legal guardian, or a patient's |
|
surrogate decision-maker declines to give authorization to a |
|
hospital to disclose health care information to the designated |
|
caregiver, a hospital is not required to comply with Sections |
|
317.003 and 317.004. |
|
(e) A patient, a patient's legal guardian, or a patient's |
|
surrogate decision-maker may change the patient's designated |
|
caregiver at any time, and the hospital must document the change in |
|
the patient's medical record. |
|
(f) The designation of a person as the patient's caregiver |
|
does not obligate the person to serve as the patient's designated |
|
caregiver or to provide aftercare to the patient. |
|
Sec. 317.003. NOTICE TO DESIGNATED CAREGIVER. (a) Except |
|
as provided by Section 317.002(d), as soon as possible before a |
|
patient's discharge or transfer to another facility but not later |
|
than the time the patient's attending physician issues a discharge |
|
order, a hospital shall notify the designated caregiver of the |
|
patient's discharge or transfer. The inability of the hospital to |
|
contact the designated caregiver may not interfere with, delay, or |
|
otherwise affect any medical care provided to the patient or the |
|
discharge of the patient. |
|
(b) If the hospital is unable to contact the designated |
|
caregiver, the hospital shall promptly record in the patient's |
|
medical record that the hospital attempted to contact the |
|
designated caregiver. |
|
Sec. 317.004. DISCHARGE PLAN. (a) Except as provided by |
|
Section 317.002(d), as soon as possible, but not later than 24 hours |
|
before a patient's discharge from a hospital, the hospital shall |
|
consult with the designated caregiver and the patient regarding the |
|
designated caregiver's capabilities and limitations and issue a |
|
discharge plan that describes the patient's aftercare needs. |
|
(b) A discharge plan must include: |
|
(1) the name and contact information of the designated |
|
caregiver; |
|
(2) a description of the aftercare tasks included in |
|
the discharge plan, taking into account the capabilities and |
|
limitations of the caregiver; and |
|
(3) the contact information for any health care |
|
services, community resources, and long-term services and supports |
|
necessary to implement the patient's discharge plan. |
|
Sec. 317.005. INSTRUCTION IN AFTERCARE TASKS. (a) The |
|
hospital shall provide the designated caregiver instruction in the |
|
aftercare tasks described in the discharge plan under Section |
|
317.004 in a manner that is culturally competent and in accordance |
|
with applicable requirements to provide language access services. |
|
The instruction may be provided in person or by video or other |
|
technology-based method. If a hospital offers instruction using a |
|
method other than in-person instruction, the designated caregiver |
|
may choose the method by which the designated caregiver receives |
|
the instruction. |
|
(b) Training and instruction provided to a designated |
|
caregiver under Subsection (a) must: |
|
(1) to the extent practicable, be provided using |
|
clear, nontechnical language; and |
|
(2) include: |
|
(A) a demonstration of each aftercare task that |
|
is performed by a hospital employee or a person in a contractual |
|
relationship with the hospital who is authorized by the hospital to |
|
perform the task; and |
|
(B) an opportunity for the designated caregiver |
|
and patient to ask questions and receive answers regarding the |
|
aftercare tasks. |
|
(c) The hospital shall document in the patient's medical |
|
record the instruction given under Subsection (a), including the |
|
date and time the instruction was given to the patient and |
|
designated caregiver. |
|
Sec. 317.006. RULES. The executive commissioner of the |
|
Health and Human Services Commission shall adopt rules necessary to |
|
implement this chapter. |
|
Sec. 317.007. RIGHTS AND REMEDIES. (a) This chapter may |
|
not be construed to: |
|
(1) interfere with the rights of an agent operating |
|
under a valid advance directive in accordance with Chapter 166; or |
|
(2) alter, amend, or revoke any existing right or |
|
remedy granted under any other provision of law. |
|
(b) This chapter does not create a private right of action |
|
against a hospital, a hospital employee, or a person in a |
|
contractual relationship with a hospital. |
|
(c) A hospital, a hospital employee, or a person in a |
|
contractual relationship with a hospital may not be held liable in |
|
any way for services rendered or not rendered by a patient's |
|
designated caregiver to the patient. |
|
(d) A designated caregiver may not be reimbursed by a |
|
government or commercial payer for aftercare assistance provided |
|
under this chapter. |
|
(e) Nothing in this chapter may be construed: |
|
(1) to alter the obligation of an insurance company, |
|
health service corporation, hospital service corporation, medical |
|
service corporation, health maintenance organization, or other |
|
entity issuing health benefit plans to provide coverage required |
|
under a health benefit plan; |
|
(2) to affect, impede, or otherwise disrupt or reduce |
|
the reimbursement obligations of an insurance company, health |
|
service corporation, hospital service corporation, medical service |
|
corporation, health maintenance organization, or other entity |
|
issuing health benefit plans; or |
|
(3) to affect the time at which a patient may be |
|
discharged or transferred from a hospital to another facility. |
|
SECTION 2. This Act takes effect immediately if it receives |
|
a vote of two-thirds of all the members elected to each house, as |
|
provided by Section 39, Article III, Texas Constitution. If this |
|
Act does not receive the vote necessary for immediate effect, this |
|
Act takes effect September 1, 2015. |