Connecticut 2023 Regular Session

Connecticut Senate Bill SB00956 Compare Versions

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Version 2 (New)

Old	New		Differences
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4		-	Senate Bill No. 956
	7	+	General Assembly Raised Bill No. 956
	8	+	January Session, 2023
	9	+	LCO No. 3486
5	10
6		-	Public Act No. 23-39
	11	+
	12	+	Referred to Committee on PUBLIC HEALTH
	13	+
	14	+
	15	+	Introduced by:
	16	+	(PH)
	17	+
7	18
8	19
9	20		AN ACT REQUIRING DISCHARGE STANDARDS REGARDING
10	21		FOLLOW-UP APPOINTMENTS AND PRESCRIPTION MEDICATIONS
11	22		FOR PATIENTS BEING DISCHARGED FROM A HOSPITAL OR
12	23		NURSING HOME FACILITY.
13	24		Be it enacted by the Senate and House of Representatives in General
14	25		Assembly convened:
15	26
16		-	Section 1. Section 19a-504c of the general statutes is repealed and the
17		-	following is substituted in lieu thereof (Effective October 1, 2023):
18		-	(a) For purposes of this section and section 19a-504e:
19		-	(1) "Caregiver" means any individual who a patient designates as a
20		-	caregiver to provide post-discharge assistance to the patient in the
21		-	patient's home in the community. The term "caregiver" includes, but is
22		-	not limited to, a relative, spouse, partner, friend or neighbor who has a
23		-	significant relationship with the patient. For the purposes of this section
24		-	and section 19a-504e, the term caregiver shall not include any individual
25		-	who receives compensation for providing post-discharge assistance to
26		-	the patient.
27		-	(2) "Home" means the dwelling that the patient considers to be the
28		-	patient's home in the community. The term "home" shall not include,
29		-	and the provisions of this section and section 19a-504e shall not apply
30		-	to, a discharge to any rehabilitation facility, hospital, nursing home, Senate Bill No. 956
	27	+	Section 1. Section 19a-504c of the general statutes is repealed and the 1
	28	+	following is substituted in lieu thereof (Effective October 1, 2023): 2
	29	+	(a) For purposes of this section and section 19a-504e: 3
	30	+	(1) "Caregiver" means any individual who a patient designates as a 4
	31	+	caregiver to provide post-discharge assistance to the patient in the 5
	32	+	patient's home in the community. The term "caregiver" includes, but is 6
	33	+	not limited to, a relative, spouse, partner, friend or neighbor who has a 7
	34	+	significant relationship with the patient. For the purposes of this 8
	35	+	section and section 19a-504e, the term caregiver shall not include any 9
	36	+	individual who receives compensation for providing post-discharge 10
	37	+	assistance to the patient. 11
	38	+	(2) "Home" means the dwelling that the patient considers to be the 12
	39	+	patient's home in the community. The term "home" shall not include, 13 Bill No. 956
31	40
32		-	Public Act No. 23-39 2 of 7
33	41
34		-	assisted living facility, group home or any other setting that was not the
35		-	patient's home in the community immediately preceding the patient's
36		-	inpatient admission.
37		-	(3) "Hospital" has the same meaning as provided in section 19a-490.
38		-	(4) "Post-discharge assistance" means nonprofessional care provided
39		-	by a designated caregiver to a patient following the patient's discharge
40		-	from an inpatient admission to a hospital in accordance with the written
41		-	discharge plan of care signed by the patient or the patient's
42		-	representative, including, but not limited to, assisting with basic
43		-	activities of daily living, instrumental activities of daily living and
44		-	carrying out support tasks, such as assisting with wound care,
45		-	administration of medications and use of medical equipment.
46		-	(b) The Department of Public Health shall adopt regulations, in
47		-	accordance with the provisions of chapter 54, to set minimum standards
48		-	for hospital discharge planning services. Such standards shall include,
49		-	but [not necessarily] need not be limited to, requirements for (1) a
50		-	written discharge plan prepared in consultation with the patient, or the
51		-	patient's family or representative, and the patient's physician, including,
52		-	but not limited to, the date and location of each follow-up medical
53		-	appointment scheduled prior to the patient's discharge and, to the
54		-	extent known to the hospital, a list of all medications the patient is
55		-	currently taking and will continue to take after the patient's discharge,
56		-	and (2) a procedure for advance notice to the patient of the patient's
57		-	discharge and provision of a copy of the discharge plan to the patient
58		-	prior to discharge.
59		-	(c) Whenever a hospital refers a patient's name to a nursing home as
60		-	part of the hospital's discharge planning process, or when a hospital
61		-	patient requests such a referral, the hospital shall make a copy of the
62		-	patient's hospital record available to the nursing home and shall allow
63		-	the nursing home access to the patient for purposes of care planning and Senate Bill No. 956
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64	45
65		-	Public Act No. 23-39 3 of 7
	46	+	and the provisions of this section and section 19a-504e shall not apply 14
	47	+	to, a discharge to any rehabilitation facility, hospital, nursing home, 15
	48	+	assisted living facility, group home or any other setting that was not 16
	49	+	the patient's home in the community immediately preceding the 17
	50	+	patient's inpatient admission. 18
	51	+	(3) "Hospital" has the same meaning as provided in section 19a-490. 19
	52	+	(4) "Post-discharge assistance" means nonprofessional care provided 20
	53	+	by a designated caregiver to a patient following the patient's discharge 21
	54	+	from an inpatient admission to a hospital in accordance with the 22
	55	+	written discharge plan of care signed by the patient or the patient's 23
	56	+	representative, including, but not limited to, assisting with basic 24
	57	+	activities of daily living, instrumental activities of daily living and 25
	58	+	carrying out support tasks, such as assisting with wound care, 26
	59	+	administration of medications and use of medical equipment. 27
	60	+	(b) The Department of Public Health shall adopt regulations, in 28
	61	+	accordance with the provisions of chapter 54, to set minimum 29
	62	+	standards for hospital discharge planning services. Such standards 30
	63	+	shall include, but [not necessarily] need not be limited to, requirements 31
	64	+	for (1) a written discharge plan prepared in consultation with the 32
	65	+	patient, or the patient's family or representative, and the patient's 33
	66	+	physician, including, but not limited to, the date and location of each 34
	67	+	follow-up medical appointment scheduled prior to the patient's 35
	68	+	discharge and a list of all medications the patient is currently taking 36
	69	+	and will continue to take after the patient's discharge, and (2) a 37
	70	+	procedure for advance notice to the patient of the patient's discharge 38
	71	+	and provision of a copy of the discharge plan to the patient prior to 39
	72	+	discharge. 40
	73	+	(c) Whenever a hospital refers a patient's name to a nursing home as 41
	74	+	part of the hospital's discharge planning process, or when a hospital 42
	75	+	patient requests such a referral, the hospital shall make a copy of the 43
	76	+	patient's hospital record available to the nursing home and shall allow 44
	77	+	the nursing home access to the patient for purposes of care planning 45 Bill No. 956
66	78
67		-	consultation.
68		-	(d) Whenever a hospital's discharge planning indicates that an
69		-	inpatient will be discharged to the patient's home, the hospital shall (1)
70		-	allow the patient to designate a caregiver at, or prior to, the time that a
71		-	written copy of the discharge plan is provided to the patient, and (2)
72		-	transmit in an electronic manner to the patient's pharmacy each
73		-	prescription ordered by a hospital employee for the patient prior to
74		-	discharge that the patient will need after discharge. A patient is not
75		-	required to designate any individual as a caregiver and any individual
76		-	designated as a caregiver under this section is not obligated to perform
77		-	any post-discharge assistance for the patient.
78		-	(e) If an inpatient designates a caregiver pursuant to subsection (d) of
79		-	this section prior to receiving written discharge instructions, the
80		-	hospital shall:
81		-	(1) Record the patient's designation of caregiver, the relationship of
82		-	the designated caregiver to the patient, and the name, telephone number
83		-	and address of the patient's designated caregiver in the discharge plan.
84		-	(2) Make reasonable attempts to notify the patient's designated
85		-	caregiver of the patient's discharge to the patient's home as soon as
86		-	practicable. In the event the hospital is unable to contact the designated
87		-	caregiver, the lack of contact shall not interfere with, delay, or otherwise
88		-	affect the medical care provided to the patient or an appropriate
89		-	discharge of the patient.
90		-	(3) Prior to discharge, provide caregivers with instructions in all post-
91		-	discharge assistance tasks described in the discharge plan. Training and
92		-	instructions for caregivers may be conducted in person or through video
93		-	technology, as determined by the hospital to effectively provide the
94		-	necessary instruction. Any training or instructions provided to a
95		-	caregiver shall be provided in nontechnical language, to the extent Senate Bill No. 956
96	79
97		-	Public Act No. 23-39 4 of 7
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98	83
99		-	possible. At a minimum, this instruction shall include: (A) A live or
100		-	recorded demonstration of the tasks performed by an individual
101		-	designated by the hospital who is authorized to perform the post-
102		-	discharge assistance task and is able to perform the demonstration in a
103		-	culturally competent manner and in accordance with the hospital's
104		-	requirements to provide language access services under state and
105		-	federal law; (B) an opportunity for the caregiver to ask questions about
106		-	the post-discharge assistance tasks; and (C) answers to the caregiver's
107		-	questions provided in a culturally competent manner and in accordance
108		-	with the hospital's requirements to provide language access services
109		-	under state and federal law.
110		-	(4) Document in the patient's medical record any training for initial
111		-	implementation of the discharge plan provided to the patient, the
112		-	patient's representative or the designated caregiver. Any instruction
113		-	required under subdivision (3) of this subsection shall be documented
114		-	in the patient's medical record, including, at a minimum, the date, time
115		-	and contents of the instruction.
116		-	(f) If the patient agrees, the written discharge materials referenced in
117		-	this section may include electronic-only versions, and acknowledgment
118		-	of any such written discharge materials may be documented through
119		-	electronic means.
120		-	Sec. 2. Section 19a-535c of the general statutes is repealed and the
121		-	following is substituted in lieu thereof (Effective October 1, 2023):
122		-	(a) For purposes of this section and section 19a-535d:
123		-	(1) "Caregiver" means any individual who a resident designates to
124		-	provide post-discharge assistance to the resident in the resident's home
125		-	in the community. The term "caregiver" includes, but is not limited to, a
126		-	relative, spouse, partner, friend or neighbor who has a significant
127		-	relationship with the resident. For the purposes of this section and Senate Bill No. 956
	84	+	and consultation. 46
	85	+	(d) Whenever a hospital's discharge planning indicates that an 47
	86	+	inpatient will be discharged to the patient's home, the hospital shall (1) 48
	87	+	allow the patient to designate a caregiver at, or prior to, the time that a 49
	88	+	written copy of the discharge plan is provided to the patient, and (2) 50
	89	+	transmit in an oral, written or electronic manner to the patient's 51
	90	+	pharmacy each prescription ordered for the patient prior to discharge 52
	91	+	that the patient will need after discharge. A patient is not required to 53
	92	+	designate any individual as a caregiver and any individual designated 54
	93	+	as a caregiver under this section is not obligated to perform any post-55
	94	+	discharge assistance for the patient. 56
	95	+	(e) If an inpatient designates a caregiver pursuant to subsection (d) 57
	96	+	of this section prior to receiving written discharge instructions, the 58
	97	+	hospital shall: 59
	98	+	(1) Record the patient's designation of caregiver, the relationship of 60
	99	+	the designated caregiver to the patient, and the name, telephone 61
	100	+	number and address of the patient's designated caregiver in the 62
	101	+	discharge plan. 63
	102	+	(2) Make reasonable attempts to notify the patient's designated 64
	103	+	caregiver of the patient's discharge to the patient's home as soon as 65
	104	+	practicable. In the event the hospital is unable to contact the 66
	105	+	designated caregiver, the lack of contact shall not interfere with, delay, 67
	106	+	or otherwise affect the medical care provided to the patient or an 68
	107	+	appropriate discharge of the patient. 69
	108	+	(3) Prior to discharge, provide caregivers with instructions in all 70
	109	+	post-discharge assistance tasks described in the discharge plan. 71
	110	+	Training and instructions for caregivers may be conducted in person or 72
	111	+	through video technology, as determined by the hospital to effectively 73
	112	+	provide the necessary instruction. Any training or instructions 74
	113	+	provided to a caregiver shall be provided in nontechnical language, to 75
	114	+	the extent possible. At a minimum, this instruction shall include: (A) A 76 Bill No. 956
128	115
129		-	Public Act No. 23-39 5 of 7
130	116
131		-	section 19a-535d, the term "caregiver" shall not include any individual
132		-	who receives compensation for providing post-discharge assistance to
133		-	the resident.
134		-	(2) "Home" means the dwelling that the resident considers to be the
135		-	resident's home in the community. The term "home" shall not include,
136		-	and the provisions of this section and section 19a-535d, shall not apply
137		-	to, a discharge to any rehabilitation facility, hospital, assisted living
138		-	facility, group home or any other setting that was not the resident's
139		-	home in the community immediately preceding the resident's
140		-	admission.
141		-	(3) "Resident" means a resident of a nursing home facility or the
142		-	resident's representative.
143		-	(4) "Nursing home facility" has the same meaning as provided in
144		-	section 19a-521.
145		-	(5) "Post-discharge assistance" means nonprofessional tasks provided
146		-	by a designated caregiver to a resident following the resident's
147		-	discharge from a nursing home facility in accordance with the written
148		-	discharge plan of care signed by the resident or the resident's
149		-	representative, which involves assisting with basic activities of daily
150		-	living, instrumental activities of daily living and carrying out support
151		-	tasks, such as assisting with wound care, administration of medications
152		-	and use of medical equipment.
153		-	(b) The Department of Public Health may adopt regulations, in
154		-	accordance with the provisions of chapter 54, to set minimum standards
155		-	for nursing home facility discharge planning services. Any such
156		-	standards shall include, but need not be limited to, requirements for (1)
157		-	a written discharge plan prepared in consultation with the resident, or
158		-	the resident's family or representative, and the resident's physician,
159		-	including, but not limited to, the date and location of each follow-up Senate Bill No. 956
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160	120
161		-	Public Act No. 23-39 6 of 7
	121	+	live or recorded demonstration of the tasks performed by an 77
	122	+	individual designated by the hospital who is authorized to perform the 78
	123	+	post-discharge assistance task and is able to perform the 79
	124	+	demonstration in a culturally competent manner and in accordance 80
	125	+	with the hospital's requirements to provide language access services 81
	126	+	under state and federal law; (B) an opportunity for the caregiver to ask 82
	127	+	questions about the post-discharge assistance tasks; and (C) answers to 83
	128	+	the caregiver's questions provided in a culturally competent manner 84
	129	+	and in accordance with the hospital's requirements to provide 85
	130	+	language access services under state and federal law. 86
	131	+	(4) Document in the patient's medical record any training for initial 87
	132	+	implementation of the discharge plan provided to the patient, the 88
	133	+	patient's representative or the designated caregiver. Any instruction 89
	134	+	required under subdivision (3) of this subsection shall be documented 90
	135	+	in the patient's medical record, including, at a minimum, the date, time 91
	136	+	and contents of the instruction. 92
	137	+	(f) If the patient agrees, the written discharge materials referenced in 93
	138	+	this section may include electronic -only versions, and 94
	139	+	acknowledgment of any such written discharge materials may be 95
	140	+	documented through electronic means. 96
	141	+	Sec. 2. Section 19a-535c of the general statutes is repealed and the 97
	142	+	following is substituted in lieu thereof (Effective October 1, 2023): 98
	143	+	(a) For purposes of this section and section 19a-535d: 99
	144	+	(1) "Caregiver" means any individual who a resident designates to 100
	145	+	provide post-discharge assistance to the resident in the resident's home 101
	146	+	in the community. The term "caregiver" includes, but is not limited to, 102
	147	+	a relative, spouse, partner, friend or neighbor who has a significant 103
	148	+	relationship with the resident. For the purposes of this section and 104
	149	+	section 19a-535d, the term "caregiver" shall not include any individual 105
	150	+	who receives compensation for providing post-discharge assistance to 106
	151	+	the resident. 107 Bill No. 956
162	152
163		-	medical appointment scheduled prior to the resident's discharge and a
164		-	list of all medications the resident is currently taking and, to the extent
165		-	known to the nursing home facility, will continue to take after the
166		-	resident's discharge, and (2) a procedure for advance notice to the
167		-	resident of the resident's discharge and provision of a copy of the
168		-	discharge plan to the resident prior to discharge.
169		-	(c) Whenever a discharge plan from a nursing home facility indicates
170		-	that a resident shall be discharged to the resident's home, the nursing
171		-	home facility shall (1) allow the resident to designate a caregiver at, or
172		-	prior to, the time that a written copy of the discharge plan is provided
173		-	to the resident, and (2) transmit in an electronic manner to the resident's
174		-	pharmacy each prescription ordered by a nursing home facility
175		-	employee for the resident prior to discharge that the resident will need
176		-	after discharge. A resident is not required to designate any individual
177		-	as a caregiver and any individual designated as a caregiver under this
178		-	section is not obligated to perform any post-discharge assistance for the
179		-	resident or agree to receive any instruction required under this section.
180		-	(d) If a resident designates a caregiver pursuant to subsection (c) of
181		-	this section prior to receiving written discharge instructions, the nursing
182		-	home facility shall:
183		-	(1) Record the resident's designation of caregiver, the relationship of
184		-	the designated caregiver to the resident and, if known, the name,
185		-	telephone number and address of the resident's designated caregiver in
186		-	the discharge plan.
187		-	(2) Make more than one reasonable attempt to notify the resident's
188		-	designated caregiver of the resident's discharge to the resident's home
189		-	as soon as practicable. In the event the nursing home facility is unable
190		-	to contact the designated caregiver, the lack of contact shall not interfere
191		-	with, delay, or otherwise affect the medical care provided to the resident
192		-	or an appropriate discharge of the resident. Senate Bill No. 956
193	153
194		-	Public Act No. 23-39 7 of 7
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195	157
196		-	(3) Prior to discharge, provide caregivers with instructions in all post-
197		-	discharge assistance tasks described in the discharge plan. Training and
198		-	instructions for caregivers may be provided in writing or conducted in
199		-	person or through video technology, as determined by the nursing
200		-	home facility to effectively provide the necessary instruction. Any
201		-	training or instructions provided to a caregiver shall be provided in
202		-	nontechnical language, to the extent possible. At a minimum, this
203		-	instruction shall include: (A) A written, live or recorded demonstration
204		-	of the tasks performed by an individual designated by the nursing home
205		-	facility who is authorized to perform the post-discharge assistance task
206		-	and is able to perform the demonstration in a culturally competent
207		-	manner and in accordance with the requirements of the nursing home
208		-	facility to provide language access services under state and federal law;
209		-	(B) an opportunity for the caregiver to ask questions about the post-
210		-	discharge assistance tasks; and (C) answers to the caregiver's questions
211		-	provided in a culturally competent manner and in accordance with the
212		-	requirements of the nursing home facility to provide language access
213		-	services under state and federal law.
214		-	(4) Document in the resident's medical record any training for initial
215		-	implementation of the discharge plan provided to the resident, the
216		-	resident's representative or the designated caregiver. Any instruction
217		-	required under subdivision (3) of this subsection shall be documented
218		-	in the resident's medical record, including, at a minimum, the date, time
219		-	and subject of the instruction.
	158	+	(2) "Home" means the dwelling that the resident considers to be the 108
	159	+	resident's home in the community. The term "home" shall not include, 109
	160	+	and the provisions of this section and section 19a-535d, shall not apply 110
	161	+	to, a discharge to any rehabilitation facility, hospital, assisted living 111
	162	+	facility, group home or any other setting that was not the resident's 112
	163	+	home in the community immediately preceding the resident's 113
	164	+	admission. 114
	165	+	(3) "Resident" means a resident of a nursing home facility or the 115
	166	+	resident's representative. 116
	167	+	(4) "Nursing home facility" has the same meaning as provided in 117
	168	+	section 19a-521. 118
	169	+	(5) "Post-discharge assistance" means nonprofessional tasks 119
	170	+	provided by a designated caregiver to a resident following the 120
	171	+	resident's discharge from a nursing home facility in accordance with 121
	172	+	the written discharge plan of care signed by the resident or the 122
	173	+	resident's representative, which involves assisting with basic activities 123
	174	+	of daily living, instrumental activities of daily living and carrying out 124
	175	+	support tasks, such as assisting with wound care, administration of 125
	176	+	medications and use of medical equipment. 126
	177	+	(b) The Department of Public Health may adopt regulations, in 127
	178	+	accordance with the provisions of chapter 54, to set minimum 128
	179	+	standards for nursing home facility discharge planning services. Any 129
	180	+	such standards shall include, but need not be limited to, requirements 130
	181	+	for (1) a written discharge plan prepared in consultation with the 131
	182	+	resident, or the resident's family or representative, and the resident's 132
	183	+	physician, including, but not limited to, the date and location of each 133
	184	+	follow-up medical appointment scheduled prior to the resident's 134
	185	+	discharge and a list of all medications the resident is currently taking 135
	186	+	and will continue to take after the resident's discharge, and (2) a 136
	187	+	procedure for advance notice to the resident of the resident's discharge 137
	188	+	and provision of a copy of the discharge plan to the resident prior to 138
	189	+	discharge. 139 Bill No. 956
	190	+
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	195	+
	196	+	(c) Whenever a discharge plan from a nursing home facility 140
	197	+	indicates that a resident shall be discharged to the resident's home, the 141
	198	+	nursing home facility shall (1) allow the resident to designate a 142
	199	+	caregiver at, or prior to, the time that a written copy of the discharge 143
	200	+	plan is provided to the resident, and (2) transmit in an oral, written or 144
	201	+	electronic manner to the resident's pharmacy each prescription 145
	202	+	ordered for the resident prior to discharge that the resident will need 146
	203	+	after discharge. A resident is not required to designate any individual 147
	204	+	as a caregiver and any individual designated as a caregiver under this 148
	205	+	section is not obligated to perform any post-discharge assistance for 149
	206	+	the resident or agree to receive any instruction required under this 150
	207	+	section. 151
	208	+	(d) If a resident designates a caregiver pursuant to subsection (c) of 152
	209	+	this section prior to receiving written discharge instructions, the 153
	210	+	nursing home facility shall: 154
	211	+	(1) Record the resident's designation of caregiver, the relationship of 155
	212	+	the designated caregiver to the resident and, if known, the name, 156
	213	+	telephone number and address of the resident's designated caregiver 157
	214	+	in the discharge plan. 158
	215	+	(2) Make more than one reasonable attempt to notify the resident's 159
	216	+	designated caregiver of the resident's discharge to the resident's home 160
	217	+	as soon as practicable. In the event the nursing home facility is unable 161
	218	+	to contact the designated caregiver, the lack of contact shall not 162
	219	+	interfere with, delay, or otherwise affect the medical care provided to 163
	220	+	the resident or an appropriate discharge of the resident. 164
	221	+	(3) Prior to discharge, provide caregivers with instructions in all 165
	222	+	post-discharge assistance tasks described in the discharge plan. 166
	223	+	Training and instructions for caregivers may be provided in writing or 167
	224	+	conducted in person or through video technology, as determined by 168
	225	+	the nursing home facility to effectively provide the necessary 169
	226	+	instruction. Any training or instructions provided to a caregiver shall 170
	227	+	be provided in nontechnical language, to the extent possible. At a 171 Bill No. 956
	228	+
	229	+
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	233	+
	234	+	minimum, this instruction shall include: (A) A written, live or recorded 172
	235	+	demonstration of the tasks performed by an individual designated by 173
	236	+	the nursing home facility who is authorized to perform the post-174
	237	+	discharge assistance task and is able to perform the demonstration in a 175
	238	+	culturally competent manner and in accordance with the requirements 176
	239	+	of the nursing home facility to provide language access services under 177
	240	+	state and federal law; (B) an opportunity for the caregiver to ask 178
	241	+	questions about the post-discharge assistance tasks; and (C) answers to 179
	242	+	the caregiver's questions provided in a culturally competent manner 180
	243	+	and in accordance with the requirements of the nursing home facility 181
	244	+	to provide language access services under state and federal law. 182
	245	+	(4) Document in the resident's medical record any training for initial 183
	246	+	implementation of the discharge plan provided to the resident, the 184
	247	+	resident's representative or the designated caregiver. Any instruction 185
	248	+	required under subdivision (3) of this subsection shall be documented 186
	249	+	in the resident's medical record, including, at a minimum, the date, 187
	250	+	time and subject of the instruction. 188
	251	+	This act shall take effect as follows and shall amend the following
	252	+	sections:
	253	+
	254	+	Section 1 October 1, 2023 19a-504c
	255	+	Sec. 2 October 1, 2023 19a-535c
	256	+
	257	+	PH Joint Favorable
220	258