S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         1323
                              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 -- 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    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 "HOSPITAL" AS DEFINED IN SECTION TWENTY-
   16  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  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
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD03921-02-5
       A. 1323                             2
    1  A PATIENT LIVING IN HIS OR HER RESIDENCE. AN IDENTIFIED CAREGIVER  SHALL
    2  INCLUDE,  BUT IS NOT LIMITED TO, A RELATIVE, PARTNER, FRIEND OR NEIGHBOR
    3  WHO HAS A SIGNIFICANT RELATIONSHIP WITH THE PATIENT.
    4    4.  "DISCHARGE" SHALL MEAN A PATIENT'S EXIT OR RELEASE FROM A HOSPITAL
    5  TO THE PATIENT'S RESIDENCE FOLLOWING  ANY  MEDICAL  CARE,  TREATMENT  OR
    6  OBSERVATION.
    7    5.  "ENTRY"  SHALL  MEAN A PATIENT'S ADMISSION INTO A HOSPITAL FOR THE
    8  PURPOSES OF MEDICAL CARE.
    9    6. "RESIDENCE" SHALL MEAN A DWELLING THAT THE PATIENT CONSIDERS TO  BE
   10  HIS  OR  HER  HOME. A "RESIDENCE" FOR THE PURPOSES OF THIS ARTICLE SHALL
   11  NOT  INCLUDE  ANY  REHABILITATION  FACILITY,  HOSPITAL,  NURSING   HOME,
   12  ASSISTED  LIVING  FACILITY,  GROUP HOME OR OTHER RESIDENTIAL HEALTH CARE
   13  FACILITY AS DEFINED IN SECTION TWENTY-EIGHT HUNDRED ONE OF THIS  CHAPTER
   14  OR ANY INPATIENT FACILITY REGULATED BY THE OFFICE OF MENTAL HEALTH.
   15    S  2994-JJ.  CAREGIVER;  OPPORTUNITY  TO IDENTIFY. 1. A HOSPITAL SHALL
   16  PROVIDE EACH PATIENT OR, IF APPLICABLE,  THE  PATIENT'S  LEGAL  GUARDIAN
   17  WITH  AT  LEAST ONE OPPORTUNITY TO IDENTIFY AT LEAST ONE CAREGIVER UNDER
   18  THIS ARTICLE NO LATER THAN TWENTY-FOUR  HOURS  FOLLOWING  THE  PATIENT'S
   19  ENTRY  INTO A HOSPITAL AND PRIOR TO THE PATIENT'S  ENTRY INTO A HOSPITAL
   20  AND PRIOR TO THE PATIENT'S DISCHARGE OR TRANSFER  TO  ANOTHER  FACILITY.
   21  THE  HOSPITAL SHALL INFORM THE PATIENT THAT THE PURPOSE OF PROVIDING THE
   22  CAREGIVER'S IDENTITY IS TO INCLUDE THAT CAREGIVER IN DISCHARGE  PLANNING
   23  AND SHARING OF POST-DISCHARGE CARE INFORMATION OR INSTRUCTION.
   24    (A) IN THE EVENT THAT THE PATIENT IS UNCONSCIOUS OR OTHERWISE INCAPAC-
   25  ITATED UPON HIS OR HER ENTRY INTO A HOSPITAL, THE HOSPITAL SHALL PROVIDE
   26  SUCH PATIENT OR HIS/HER LEGAL GUARDIAN WITH AN OPPORTUNITY TO IDENTIFY A
   27  CAREGIVER  WITHIN  TWENTY-FOUR HOURS FOLLOWING THE PATIENT'S RECOVERY OF
   28  HIS OR HER CONSCIOUSNESS OR CAPACITY.
   29    (B) IN THE EVENT THAT THE PATIENT  OR  THE  PATIENT'S  LEGAL  GUARDIAN
   30  DECLINES  TO IDENTIFY A CAREGIVER UNDER THIS ARTICLE, THE HOSPITAL SHALL
   31  PROMPTLY DOCUMENT THIS IN THE PATIENT'S MEDICAL RECORD.
   32    (C) THE HOSPITAL SHALL RECORD THE PATIENT'S IDENTIFICATION OF A  CARE-
   33  GIVER,  THE RELATIONSHIP OF THE IDENTIFIED CAREGIVER TO THE PATIENT, AND
   34  THE NAME, TELEPHONE NUMBER, AND  ADDRESS  OF  THE  PATIENT'S  IDENTIFIED
   35  CAREGIVER IN THE PATIENT'S MEDICAL RECORD.
   36    (D)  A  PATIENT MAY ELECT TO CHANGE HIS OR HER IDENTIFIED CAREGIVER AT
   37  ANY TIME, AND THE HOSPITAL MUST RECORD  THIS  CHANGE  IN  THE  PATIENT'S
   38  MEDICAL RECORD WITHIN TWENTY-FOUR HOURS.
   39    (E)  PRIOR  TO  NOTIFYING  THE  PATIENT'S  CAREGIVER  OF THE PATIENT'S
   40  DISCHARGE OR TRANSFER TO ANOTHER HOSPITAL OR FACILITY AS REQUIRED  UNDER
   41  SECTION TWENTY-NINE HUNDRED NINETY-FOUR-KK OF THIS ARTICLE, THE HOSPITAL
   42  SHALL  ASK  THE  PATIENT  TO  VERIFY  THE PATIENT'S CAREGIVER CHOICE AND
   43  PROVIDE THE PATIENT THE OPPORTUNITY TO  CHANGE  HIS  OR  HER  IDENTIFIED
   44  CAREGIVER.
   45    2.  AN IDENTIFICATION OF A CAREGIVER BY A PATIENT OR A PATIENT'S LEGAL
   46  GUARDIAN UNDER THIS SECTION DOES NOT OBLIGATE ANY INDIVIDUAL TO  PERFORM
   47  ANY AFTER-CARE TASKS FOR ANY PATIENT.
   48    3.  THIS  SECTION  SHALL  NOT  BE  CONSTRUED TO REQUIRE A PATIENT OR A
   49  PATIENT'S LEGAL GUARDIAN TO IDENTIFY ANY INDIVIDUAL AS  A  CAREGIVER  AS
   50  DEFINED BY THIS ARTICLE.
   51    S 2994-KK. NOTICE TO IDENTIFIED CAREGIVER. A HOSPITAL SHALL NOTIFY THE
   52  PATIENT'S IDENTIFIED CAREGIVER OF THE PATIENT'S DISCHARGE OR TRANSFER TO
   53  ANOTHER HOSPITAL OR FACILITY LICENSED BY THE DEPARTMENT OR THE OFFICE OF
   54  MENTAL  HEALTH AS SOON AS THE DATE AND TIME OF DISCHARGE OR TRANSFER CAN
   55  BE ANTICIPATED PRIOR TO THE PATIENT'S ACTUAL DISCHARGE  OR  TRANSFER  TO
   56  SUCH FACILITY.
       A. 1323                             3
    1    S  2994-LL. INSTRUCTION TO IDENTIFIED CAREGIVER.  1. AS SOON AS POSSI-
    2  BLE AND NOT LATER THAN TWENTY-FOUR HOURS PRIOR TO A PATIENT'S  DISCHARGE
    3  FROM A HOSPITAL, THE HOSPITAL SHALL CONSULT WITH THE IDENTIFIED CAREGIV-
    4  ER  ALONG  WITH  THE  PATIENT REGARDING THE CAREGIVER'S CAPABILITIES AND
    5  LIMITATIONS  AND  ISSUE  A  DISCHARGE  PLAN  THAT  DESCRIBES A PATIENT'S
    6  AFTER-CARE NEEDS AT HIS OR HER RESIDENCE.  AT MINIMUM, A DISCHARGE  PLAN
    7  SHALL INCLUDE:
    8    (A) THE NAME AND CONTACT INFORMATION OF THE CAREGIVER IDENTIFIED UNDER
    9  THIS ARTICLE;
   10    (B)  A  DESCRIPTION  OF ALL AFTER-CARE TASKS NECESSARY TO MAINTAIN THE
   11  PATIENT'S ABILITY TO RESIDE AT HOME, TAKING INTO ACCOUNT  THE  CAPABILI-
   12  TIES AND LIMITATIONS OF THE CAREGIVER; AND
   13    (C)  CONTACT INFORMATION FOR ANY HEALTH CARE, COMMUNITY RESOURCES, AND
   14  LONG-TERM SERVICES AND SUPPORTS NECESSARY TO SUCCESSFULLY CARRY OUT  THE
   15  PATIENT'S DISCHARGE PLAN.
   16    2.  THE HOSPITAL ISSUING THE DISCHARGE PLAN MUST OFFER CAREGIVERS WITH
   17  INSTRUCTION IN ALL AFTER-CARE TASKS DESCRIBED IN THE DISCHARGE PLAN.
   18    (A) AT MINIMUM, SUCH INSTRUCTION SHALL INCLUDE:
   19    (I) A LIVE DEMONSTRATION OF THE TASKS PERFORMED BY A HOSPITAL EMPLOYEE
   20  AUTHORIZED TO PERFORM THE AFTER-CARE  TASK,  PROVIDED  IN  A  CULTURALLY
   21  COMPETENT  MANNER  AND IN ACCORDANCE WITH THE HOSPITAL'S REQUIREMENTS TO
   22  PROVIDE LANGUAGE ACCESS SERVICES UNDER STATE AND FEDERAL LAW;
   23    (II) AN OPPORTUNITY FOR THE CAREGIVER AND  PATIENT  TO  ASK  QUESTIONS
   24  ABOUT THE AFTER-CARE TASKS; AND
   25    (III) ANSWERS TO THE CAREGIVER'S AND PATIENT'S QUESTIONS PROVIDED IN A
   26  CULTURALLY  COMPETENT  MANNER  AND  IN  ACCORDANCE  WITH  THE HOSPITAL'S
   27  REQUIREMENTS TO PROVIDE LANGUAGE ACCESS SERVICES UNDER STATE AND FEDERAL
   28  LAW.
   29    (B) ANY INSTRUCTIONS REQUIRED UNDER THIS ARTICLE SHALL  BE  DOCUMENTED
   30  IN  THE PATIENT'S MEDICAL RECORD, INCLUDING, AT MINIMUM, THE DATE, TIME,
   31  AND CONTENTS OF THE INSTRUCTION.
   32    3. THE DEPARTMENT IS AUTHORIZED TO PROMULGATE REGULATIONS TO IMPLEMENT
   33  THE PROVISIONS OF THIS ARTICLE, INCLUDING  BUT  NOT  LIMITED  TO,  REGU-
   34  LATIONS  TO  FURTHER  DEFINE  THE  CONTENT  AND SCOPE OF ANY INSTRUCTION
   35  PROVIDED TO CAREGIVERS UNDER THIS ARTICLE.
   36    S 2994-MM. EFFECT ON OTHER RIGHTS. NOTHING IN THIS  ARTICLE  SHALL  BE
   37  CONSTRUED  TO  INTERFERE  WITH  THE RIGHTS OF AN AGENT OPERATING UNDER A
   38  VALID HEALTH CARE DIRECTIVE CREATED UNDER  SECTION  TWENTY-NINE  HUNDRED
   39  EIGHTY-TWO OF THIS CHAPTER.
   40    S 2. This act shall take effect immediately.