84R6200 MEW-D
By: Miller of Fort Bend H.B. No. 2157
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 the assistance provided by a
caregiver to a patient after the patient's discharge from a
hospital, including:
(A) assisting with basic activities of daily
living;
(B) assisting with instrumental activities of
daily living; and
(C) carrying out medical or nursing tasks,
including:
(i) wound care;
(ii) administering medications; and
(iii) operating medical equipment.
(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 in the
patient's or caregiver's residence.
(3) "Discharge" means a patient's release from a
hospital to the patient's or caregiver's residence 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) "Residence" means the dwelling where a person
primarily resides. The term does not include a rehabilitation
facility, hospital, nursing facility, assisted living facility, or
group home.
(6) "Surrogate decision-maker" has the meaning
assigned by Section 313.002.
Sec. 317.002. DESIGNATION OF CAREGIVER. (a) Not later than
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 at least one caregiver.
(b) If a patient, a patient's legal guardian, or a patient's
surrogate decision-maker designates a caregiver, a hospital shall
promptly:
(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. Except as
provided by Section 317.002(d), as soon as possible before a
patient's discharge or transfer to another facility, 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.
Sec. 317.004. DISCHARGE PLAN. (a) Except as provided by
Section 317.002(d), as soon as possible 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 at the patient's or
caregiver's residence.
(b) A discharge plan must include:
(1) the name and contact information of the designated
caregiver;
(2) a description of each aftercare task necessary to
maintain the patient's ability to reside at home or at the
caregiver's home, 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 successfully implement the patient's discharge plan.
Sec. 317.005. INSTRUCTION IN AFTERCARE TASKS. (a) The
hospital shall provide each designated caregiver instruction in
each aftercare task 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.
(b) The instruction under Subsection (a) must include:
(1) a live demonstration of each aftercare task that
is performed by a hospital employee or a person in a contractual
relationship with the hospital that is authorized by the hospital
to perform the task; and
(2) an opportunity for the designated caregiver and
patient to ask questions and receive satisfactory 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, time, and content of the instruction.
Sec. 317.006. RULES. The executive commissioner of the
Health and Human Services Commission shall adopt rules necessary to
implement this chapter, including requirements for the content and
scope of any instruction required to be provided by a hospital to a
designated caregiver.
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.
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.