An Act To Allow a Patient To Designate a Caregiver in the Patient's Medical Record
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 22 MRSA §1711-B, sub-§3, ¶C, as amended by PL 1997, c. 793, Pt. A, §5 and affected by §10, is further amended to read:
C. The designee of a durable health care power of attorney executed by the person who is the subject of the record, at such time as the power of attorney is in effect; or
Sec. 2. 22 MRSA §1711-B, sub-§3, ¶D, as enacted by PL 1997, c. 793, Pt. A, §6 and affected by §10, is amended to read:
D. The agent, guardian or surrogate pursuant to the Uniform Health-care Decisions Act . ; or
Sec. 3. 22 MRSA §1711-B, sub-§3, ¶E is enacted to read:
E. The caregiver designated pursuant to section 1711-G by the person who is the subject of the record.
Sec. 4. 22 MRSA §1711-C, sub-§6, ¶¶R and S, as enacted by PL 1999, c. 512, Pt. A, §5 and affected by §7 and c. 790, Pt. A, §§58 and 60, are amended to read:
R. To a member of the media who asks a health care facility about an individual by name, of brief confirmation of general health status unless expressly prohibited by the individual or a person acting pursuant to subsection 3-B; and
S. To a member of the public who asks a health care facility about an individual by name, of the room number of the individual and brief confirmation of general health status unless expressly prohibited by the individual or a person acting pursuant to subsection 3-B . ; and
Sec. 5. 22 MRSA §1711-C, sub-§6, ¶T is enacted to read:
T. To a caregiver designated by an individual pursuant to section 1711-G.
Sec. 6. 22 MRSA §1711-G is enacted to read:
§ 1711-G. Designated caregivers
1. Definitions. As used in this section, unless the context indicates otherwise, the following terms have the following meanings.
A. "Aftercare" means any assistance provided by a caregiver designated pursuant to subsection 2 to a patient after the patient's discharge from a hospital, including assistance with basic or instrumental activities of daily living, performance of medical and nursing tasks, assistance in administering medication and operation of medical equipment.
B. "Discharge" means a patient's exit or release from a hospital to the patient's residence following any medical care, treatment or observation.
C. "Entry" means a patient's entrance into a hospital for the purpose of medical care, treatment or observation.
D. "Residence" means a dwelling that the patient considers to be the patient's home. "Residence" does not include a rehabilitation facility, hospital, nursing home, assisted living facility, group home or any other health care facility licensed by the State.
2. Designation of caregiver. A hospital licensed under chapter 405 shall provide a patient or patient's legal guardian with at least one opportunity to designate a caregiver no later than 24 hours following the patient's entry into the hospital and prior to the patient's discharge or transfer to another facility. If the patient is unconscious or otherwise incapacitated upon entry into the hospital, the hospital shall provide the patient or patient's legal guardian with an opportunity to designate a caregiver within 24 hours following the patient's recovery of consciousness or capacity. The hospital shall promptly document the designation of the caregiver in the patient's medical record, including the caregiver's name, relationship to the patient, telephone number, address and any other contact information. If the patient or patient's legal guardian declines to designate a caregiver, the hospital shall promptly document in the patient's medical record that the patient or patient's legal guardian declined to designate a caregiver. A designation of a caregiver under this subsection does not obligate the person designated as caregiver to perform any aftercare tasks for a patient. The designation of a caregiver under this subsection is optional for a patient or patient's legal guardian, and a patient or patient's legal guardian may change or remove a designated caregiver at any time, which must be recorded in the patient's medical record by the hospital within 24 hours of notification of the change or removal.
3. Written consent. If a caregiver is designated under subsection 2, the hospital shall promptly request that the patient or patient's legal guardian provide written consent to release medical information to the patient's designated caregiver, which must be provided pursuant to the hospital's established procedures for releasing personal health information and in compliance with state and federal law.
4. Notice to designated caregiver. If written consent is received under subsection 3, a hospital shall notify the designated caregiver under subsection 2 of the patient's discharge or transfer to another facility licensed under chapter 405 as soon as possible and no later than 4 hours before the patient's actual discharge or transfer.
5. Discharge plan. If written consent is received under subsection 3, as soon as possible and no later than 24 hours before a patient's discharge from a hospital, the hospital shall consult with the patient's designated caregiver under subsection 2 regarding the caregiver's capabilities and limitations and issue a discharge plan that describes the patient's aftercare needs at the patient's residence. The discharge plan must include:
A. The name and contact information of the caregiver;
B. A description of all aftercare tasks necessary to maintain the patient's ability to remain at the patient's residence; and
C. Contact information for any health care services, community resources and long-term services and support necessary to successfully implement the discharge plan.
6. Instruction to designated caregiver. If written consent is received under subsection 3, the hospital issuing a discharge plan under subsection 5 shall provide the designated caregiver with instruction in all aftercare tasks described in the discharge plan. Any instruction given under this subsection must be documented in the patient's medical record, including the contents of the instruction and the date and time at which the instruction was given. Instruction to a caregiver under this subsection must include:
A. A live demonstration by a hospital employee authorized to perform an aftercare task of the aftercare tasks described in the discharge plan. A demonstration under this paragraph must be performed in a culturally competent manner and in accordance with the hospital's requirement to provide language access services under state and federal law;
B. An opportunity for the caregiver to ask questions about the discharge plan; and
C. Answers to the caregiver's questions provided in a culturally competent manner and in accordance with the hospital's requirement to provide language access services under state and federal law.
7. Noninterference with health care directives. The provisions of this section may not be construed to interfere with the rights of an agent of a patient operating under a valid health care directive under Title 18-A, Article 5, Part 8.
8. Rules. The department may adopt rules to carry out the purposes of this section, including defining the content and scope of any instruction given under subsection 5 or 6. Rules adopted pursuant to this subsection are routine technical rules pursuant to Title 5, chapter 375, subchapter 2-A.
SUMMARY
This bill allows a patient admitted to a hospital to designate a caregiver, who may provide aftercare for the patient and whose identifying information must be entered into the patient's medical records at the hospital. If the patient or patient's legal guardian provides written consent to release medical information to the designated caregiver, the hospital is required to notify the caregiver prior to the patient's being discharged or transferred, consult with the caregiver as to the patient's discharge plan and provide the caregiver any necessary instruction in providing aftercare to the patient if the patient is discharged to the patient's residence.