85R7542 JCG-D
By: Price H.B. No. 2425
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 assistance provided by a
designated caregiver to a person after that person's discharge from
a hospital, as described by this chapter. The term includes
assistance with tasks that are related to the person's condition at
the time of that person's discharge from a hospital but does not
include those tasks required to be performed by a licensed health
care professional.
(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.
(3) "Discharge" means a patient's release from a
hospital 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) "Surrogate decision-maker" has the meaning
assigned by Section 313.002.
Sec. 317.002. DESIGNATION OF CAREGIVER. (a) On admission
to a hospital or at 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 a caregiver.
(b) If a patient, a patient's legal guardian, or a patient's
surrogate decision-maker designates a caregiver, a hospital shall:
(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. (a) Except
as provided by Section 317.002(d), as soon as possible before a
patient's discharge or transfer to another facility but not later
than the time the patient's attending physician issues a discharge
order, 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.
(b) If the hospital is unable to contact the designated
caregiver, the hospital shall promptly record in the patient's
medical record that the hospital attempted to contact the
designated caregiver.
Sec. 317.004. DISCHARGE PLAN. (a) Except as provided by
Section 317.002(d), as soon as possible, but not later than 24 hours
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.
(b) A discharge plan must include:
(1) the name and contact information of the designated
caregiver;
(2) a description of the aftercare tasks included in
the discharge plan, 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 implement the patient's discharge plan.
Sec. 317.005. INSTRUCTION IN AFTERCARE TASKS. (a) The
hospital shall provide the designated caregiver instruction in the
aftercare tasks 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.
The instruction may be provided in person or by video or other
technology-based method. If a hospital offers instruction using a
method other than in-person instruction, the designated caregiver
may choose the method by which the designated caregiver receives
the instruction.
(b) Training and instruction provided to a designated
caregiver under Subsection (a) must:
(1) to the extent practicable, be provided using
clear, nontechnical language; and
(2) include:
(A) a demonstration of each aftercare task that
is performed by a hospital employee or a person in a contractual
relationship with the hospital who is authorized by the hospital to
perform the task; and
(B) an opportunity for the designated caregiver
and patient to ask questions and receive 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 and time the instruction was given to the patient and
designated caregiver.
Sec. 317.006. RULES. The executive commissioner of the
Health and Human Services Commission shall adopt rules necessary to
implement this chapter.
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.
(c) A hospital, a hospital employee, or a person in a
contractual relationship with a hospital may not be held liable in
any way for services rendered or not rendered by a patient's
designated caregiver to the patient.
(d) A designated caregiver may not be reimbursed by a
government or commercial payer for aftercare assistance provided
under this chapter.
(e) Nothing in this chapter may be construed:
(1) to alter the obligation of an insurance company,
health service corporation, hospital service corporation, medical
service corporation, health maintenance organization, or other
entity issuing health benefit plans to provide coverage required
under a health benefit plan;
(2) to affect, impede, or otherwise disrupt or reduce
the reimbursement obligations of an insurance company, health
service corporation, hospital service corporation, medical service
corporation, health maintenance organization, or other entity
issuing health benefit plans; or
(3) to affect the time at which a patient may be
discharged or transferred from a hospital to another facility.
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, 2017.