S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                          676
                              2015-2016 Regular Sessions
                                   I N  S E N A T E
                                      (PREFILED)
                                    January 7, 2015
                                      ___________
       Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
         printed to be committed 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.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD03921-02-5
       S. 676                              2
    1    3. "CAREGIVER" SHALL MEAN ANY INDIVIDUAL DULY IDENTIFIED AS A CAREGIV-
    2  ER BY A PATIENT UNDER THIS ARTICLE WHO PROVIDES AFTER-CARE ASSISTANCE TO
    3  A PATIENT LIVING IN HIS OR HER RESIDENCE. AN IDENTIFIED CAREGIVER  SHALL
    4  INCLUDE,  BUT IS NOT LIMITED TO, A RELATIVE, PARTNER, FRIEND OR NEIGHBOR
    5  WHO HAS A SIGNIFICANT RELATIONSHIP WITH THE PATIENT.
    6    4.  "DISCHARGE" SHALL MEAN A PATIENT'S EXIT OR RELEASE FROM A HOSPITAL
    7  TO THE PATIENT'S RESIDENCE FOLLOWING  ANY  MEDICAL  CARE,  TREATMENT  OR
    8  OBSERVATION.
    9    5.  "ENTRY"  SHALL  MEAN A PATIENT'S ADMISSION INTO A HOSPITAL FOR THE
   10  PURPOSES OF MEDICAL CARE.
   11    6. "RESIDENCE" SHALL MEAN A DWELLING THAT THE PATIENT CONSIDERS TO  BE
   12  HIS  OR  HER  HOME. A "RESIDENCE" FOR THE PURPOSES OF THIS ARTICLE SHALL
   13  NOT  INCLUDE  ANY  REHABILITATION  FACILITY,  HOSPITAL,  NURSING   HOME,
   14  ASSISTED  LIVING  FACILITY,  GROUP HOME OR OTHER RESIDENTIAL HEALTH CARE
   15  FACILITY AS DEFINED IN SECTION TWENTY-EIGHT HUNDRED ONE OF THIS  CHAPTER
   16  OR ANY INPATIENT FACILITY REGULATED BY THE OFFICE OF MENTAL HEALTH.
   17    S  2994-JJ.  CAREGIVER;  OPPORTUNITY  TO IDENTIFY. 1. A HOSPITAL SHALL
   18  PROVIDE EACH PATIENT OR, IF APPLICABLE,  THE  PATIENT'S  LEGAL  GUARDIAN
   19  WITH  AT  LEAST ONE OPPORTUNITY TO IDENTIFY AT LEAST ONE CAREGIVER UNDER
   20  THIS ARTICLE NO LATER THAN TWENTY-FOUR  HOURS  FOLLOWING  THE  PATIENT'S
   21  ENTRY  INTO A HOSPITAL AND PRIOR TO THE PATIENT'S  ENTRY INTO A HOSPITAL
   22  AND PRIOR TO THE PATIENT'S DISCHARGE OR TRANSFER  TO  ANOTHER  FACILITY.
   23  THE  HOSPITAL SHALL INFORM THE PATIENT THAT THE PURPOSE OF PROVIDING THE
   24  CAREGIVER'S IDENTITY IS TO INCLUDE THAT CAREGIVER IN DISCHARGE  PLANNING
   25  AND SHARING OF POST-DISCHARGE CARE INFORMATION OR INSTRUCTION.
   26    (A) IN THE EVENT THAT THE PATIENT IS UNCONSCIOUS OR OTHERWISE INCAPAC-
   27  ITATED UPON HIS OR HER ENTRY INTO A HOSPITAL, THE HOSPITAL SHALL PROVIDE
   28  SUCH PATIENT OR HIS/HER LEGAL GUARDIAN WITH AN OPPORTUNITY TO IDENTIFY A
   29  CAREGIVER  WITHIN  TWENTY-FOUR HOURS FOLLOWING THE PATIENT'S RECOVERY OF
   30  HIS OR HER CONSCIOUSNESS OR CAPACITY.
   31    (B) IN THE EVENT THAT THE PATIENT  OR  THE  PATIENT'S  LEGAL  GUARDIAN
   32  DECLINES  TO IDENTIFY A CAREGIVER UNDER THIS ARTICLE, THE HOSPITAL SHALL
   33  PROMPTLY DOCUMENT THIS IN THE PATIENT'S MEDICAL RECORD.
   34    (C) THE HOSPITAL SHALL RECORD THE PATIENT'S IDENTIFICATION OF A  CARE-
   35  GIVER,  THE RELATIONSHIP OF THE IDENTIFIED CAREGIVER TO THE PATIENT, AND
   36  THE NAME, TELEPHONE NUMBER, AND  ADDRESS  OF  THE  PATIENT'S  IDENTIFIED
   37  CAREGIVER IN THE PATIENT'S MEDICAL RECORD.
   38    (D)  A  PATIENT MAY ELECT TO CHANGE HIS OR HER IDENTIFIED CAREGIVER AT
   39  ANY TIME, AND THE HOSPITAL MUST RECORD  THIS  CHANGE  IN  THE  PATIENT'S
   40  MEDICAL RECORD WITHIN TWENTY-FOUR HOURS.
   41    (E)  PRIOR  TO  NOTIFYING  THE  PATIENT'S  CAREGIVER  OF THE PATIENT'S
   42  DISCHARGE OR TRANSFER TO ANOTHER HOSPITAL OR FACILITY AS REQUIRED  UNDER
   43  SECTION TWENTY-NINE HUNDRED NINETY-FOUR-KK OF THIS ARTICLE, THE HOSPITAL
   44  SHALL  ASK  THE  PATIENT  TO  VERIFY  THE PATIENT'S CAREGIVER CHOICE AND
   45  PROVIDE THE PATIENT THE OPPORTUNITY TO  CHANGE  HIS  OR  HER  IDENTIFIED
   46  CAREGIVER.
   47    2.  AN IDENTIFICATION OF A CAREGIVER BY A PATIENT OR A PATIENT'S LEGAL
   48  GUARDIAN UNDER THIS SECTION DOES NOT OBLIGATE ANY INDIVIDUAL TO  PERFORM
   49  ANY AFTER-CARE TASKS FOR ANY PATIENT.
   50    3.  THIS  SECTION  SHALL  NOT  BE  CONSTRUED TO REQUIRE A PATIENT OR A
   51  PATIENT'S LEGAL GUARDIAN TO IDENTIFY ANY INDIVIDUAL AS  A  CAREGIVER  AS
   52  DEFINED BY THIS ARTICLE.
   53    S 2994-KK. NOTICE TO IDENTIFIED CAREGIVER. A HOSPITAL SHALL NOTIFY THE
   54  PATIENT'S IDENTIFIED CAREGIVER OF THE PATIENT'S DISCHARGE OR TRANSFER TO
   55  ANOTHER HOSPITAL OR FACILITY LICENSED BY THE DEPARTMENT OR THE OFFICE OF
   56  MENTAL  HEALTH AS SOON AS THE DATE AND TIME OF DISCHARGE OR TRANSFER CAN
       S. 676                              3
    1  BE ANTICIPATED PRIOR TO THE PATIENT'S ACTUAL DISCHARGE  OR  TRANSFER  TO
    2  SUCH FACILITY.
    3    S  2994-LL. INSTRUCTION TO IDENTIFIED CAREGIVER.  1. AS SOON AS POSSI-
    4  BLE AND NOT LATER THAN TWENTY-FOUR HOURS PRIOR TO A PATIENT'S  DISCHARGE
    5  FROM A HOSPITAL, THE HOSPITAL SHALL CONSULT WITH THE IDENTIFIED CAREGIV-
    6  ER  ALONG  WITH  THE  PATIENT REGARDING THE CAREGIVER'S CAPABILITIES AND
    7  LIMITATIONS AND ISSUE  A  DISCHARGE  PLAN  THAT  DESCRIBES  A  PATIENT'S
    8  AFTER-CARE  NEEDS AT HIS OR HER RESIDENCE.  AT MINIMUM, A DISCHARGE PLAN
    9  SHALL INCLUDE:
   10    (A) THE NAME AND CONTACT INFORMATION OF THE CAREGIVER IDENTIFIED UNDER
   11  THIS ARTICLE;
   12    (B) A DESCRIPTION OF ALL AFTER-CARE TASKS NECESSARY  TO  MAINTAIN  THE
   13  PATIENT'S  ABILITY  TO RESIDE AT HOME, TAKING INTO ACCOUNT THE CAPABILI-
   14  TIES AND LIMITATIONS OF THE CAREGIVER; AND
   15    (C) CONTACT INFORMATION FOR ANY HEALTH CARE, COMMUNITY RESOURCES,  AND
   16  LONG-TERM  SERVICES AND SUPPORTS NECESSARY TO SUCCESSFULLY CARRY OUT THE
   17  PATIENT'S DISCHARGE PLAN.
   18    2. THE HOSPITAL ISSUING THE DISCHARGE PLAN MUST OFFER CAREGIVERS  WITH
   19  INSTRUCTION IN ALL AFTER-CARE TASKS DESCRIBED IN THE DISCHARGE PLAN.
   20    (A) AT MINIMUM, SUCH INSTRUCTION SHALL INCLUDE:
   21    (I) A LIVE DEMONSTRATION OF THE TASKS PERFORMED BY A HOSPITAL EMPLOYEE
   22  AUTHORIZED  TO  PERFORM  THE  AFTER-CARE  TASK, PROVIDED IN A CULTURALLY
   23  COMPETENT MANNER AND IN ACCORDANCE WITH THE HOSPITAL'S  REQUIREMENTS  TO
   24  PROVIDE LANGUAGE ACCESS SERVICES UNDER STATE AND FEDERAL LAW;
   25    (II)  AN  OPPORTUNITY  FOR  THE CAREGIVER AND PATIENT TO ASK QUESTIONS
   26  ABOUT THE AFTER-CARE TASKS; AND
   27    (III) ANSWERS TO THE CAREGIVER'S AND PATIENT'S QUESTIONS PROVIDED IN A
   28  CULTURALLY COMPETENT  MANNER  AND  IN  ACCORDANCE  WITH  THE  HOSPITAL'S
   29  REQUIREMENTS TO PROVIDE LANGUAGE ACCESS SERVICES UNDER STATE AND FEDERAL
   30  LAW.
   31    (B)  ANY  INSTRUCTIONS REQUIRED UNDER THIS ARTICLE SHALL BE DOCUMENTED
   32  IN THE PATIENT'S MEDICAL RECORD, INCLUDING, AT MINIMUM, THE DATE,  TIME,
   33  AND CONTENTS OF THE INSTRUCTION.
   34    3. THE DEPARTMENT IS AUTHORIZED TO PROMULGATE REGULATIONS TO IMPLEMENT
   35  THE  PROVISIONS  OF  THIS  ARTICLE,  INCLUDING BUT NOT LIMITED TO, REGU-
   36  LATIONS TO FURTHER DEFINE THE  CONTENT  AND  SCOPE  OF  ANY  INSTRUCTION
   37  PROVIDED TO CAREGIVERS UNDER THIS ARTICLE.
   38    S  2994-MM.  EFFECT  ON OTHER RIGHTS. NOTHING IN THIS ARTICLE SHALL BE
   39  CONSTRUED TO INTERFERE WITH THE RIGHTS OF AN  AGENT  OPERATING  UNDER  A
   40  VALID  HEALTH  CARE  DIRECTIVE CREATED UNDER SECTION TWENTY-NINE HUNDRED
   41  EIGHTY-TWO OF THIS CHAPTER.
   42    S 2. This act shall take effect immediately.