S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                        1323--A
                              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, ROBERTS, GALEF,
         STIRPE, DINOWITZ, SKOUFIS, GUNTHER, BRAUNSTEIN, JAFFEE, RAIA, LINARES,
         FAHY, BRINDISI, BRONSON, WOERNER, McDONALD, LAVINE,  STECK  --  Multi-
         Sponsored  by -- M. of A. RA, WALTER, WRIGHT -- read once and referred
         to the Committee on Health  --  committee  discharged,  bill  amended,
         ordered reprinted as amended and recommitted to said committee
       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 "GENERAL HOSPITAL" AS DEFINED IN  SECTION
   16  TWENTY-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 HOSPITAL
   19  THAT  IS  RELATED  TO  THE PATIENT'S CONDITION AT THE TIME OF DISCHARGE.
   20  SUCH ASSISTANCE SHALL INCLUDE, BUT IS NOT  LIMITED  TO,  ASSISTING  WITH
   21  BASIC  ACTIVITIES  OF  DAILY  LIVING  (ADLS), INSTRUMENTAL ACTIVITIES OF
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD03921-04-5
       A. 1323--A                          2
    1  DAILY LIVING (IADLS), AND OTHER TASKS AS DETERMINED TO BE APPROPRIATE BY
    2  THE DISCHARGING PHYSICIAN.
    3    3. "CAREGIVER" SHALL MEAN ANY INDIVIDUAL DULY IDENTIFIED AS A CAREGIV-
    4  ER BY A PATIENT UNDER THIS ARTICLE WHO PROVIDES AFTER-CARE ASSISTANCE TO
    5  A  PATIENT LIVING IN HIS OR HER RESIDENCE. AN IDENTIFIED CAREGIVER SHALL
    6  INCLUDE, BUT IS NOT LIMITED TO, A RELATIVE, PARTNER, FRIEND OR  NEIGHBOR
    7  WHO HAS A SIGNIFICANT RELATIONSHIP WITH THE PATIENT.
    8    4.  "DISCHARGE" SHALL MEAN A PATIENT'S EXIT OR RELEASE FROM A HOSPITAL
    9  TO THE PATIENT'S RESIDENCE FOLLOWING AN INPATIENT ADMISSION.
   10    5. "ENTRY" SHALL MEAN A PATIENT'S ADMISSION INTO A  HOSPITAL  FOR  THE
   11  PURPOSES OF RECEIVING INPATIENT CARE.
   12    6. "PATIENT" SHALL MEAN A PATIENT EIGHTEEN YEARS OF AGE OR OLDER.
   13    7.  "RESIDENCE" SHALL MEAN A DWELLING THAT THE PATIENT CONSIDERS TO BE
   14  HIS  OR  HER  HOME. A "RESIDENCE" FOR THE PURPOSES OF THIS ARTICLE SHALL
   15  NOT  INCLUDE  ANY  REHABILITATION  FACILITY,  HOSPITAL,  NURSING   HOME,
   16  ASSISTED  LIVING  FACILITY,  GROUP HOME OR OTHER RESIDENTIAL HEALTH CARE
   17  FACILITY AS DEFINED IN SECTION TWENTY-EIGHT HUNDRED ONE OF THIS  CHAPTER
   18  OR ANY INPATIENT FACILITY REGULATED BY THE OFFICE OF MENTAL HEALTH.
   19    S  2994-JJ.  CAREGIVER;  OPPORTUNITY  TO IDENTIFY. 1. A HOSPITAL SHALL
   20  PROVIDE EACH PATIENT OR, IF APPLICABLE,  THE  PATIENT'S  LEGAL  GUARDIAN
   21  WITH  AT  LEAST ONE OPPORTUNITY TO IDENTIFY AT LEAST ONE CAREGIVER UNDER
   22  THIS ARTICLE FOLLOWING THE PATIENT'S ENTRY INTO A HOSPITAL AND PRIOR  TO
   23  THE  PATIENT'S  DISCHARGE  OR TRANSFER TO ANOTHER FACILITY. THE HOSPITAL
   24  SHALL INFORM THE PATIENT THAT THE PURPOSE OF PROVIDING  THE  CAREGIVER'S
   25  IDENTITY  IS TO INCLUDE THAT CAREGIVER IN DISCHARGE PLANNING AND SHARING
   26  OF POST-DISCHARGE CARE INFORMATION OR INSTRUCTION.
   27    (A) IN THE EVENT THAT THE PATIENT IS UNCONSCIOUS OR OTHERWISE INCAPAC-
   28  ITATED UPON HIS OR HER ENTRY INTO A HOSPITAL, THE HOSPITAL SHALL PROVIDE
   29  SUCH PATIENT OR HIS/HER LEGAL GUARDIAN WITH AN OPPORTUNITY TO IDENTIFY A
   30  CAREGIVER FOLLOWING THE PATIENT'S RECOVERY OF HIS OR  HER  CONSCIOUSNESS
   31  OR CAPACITY.
   32    (B)  IN  THE  EVENT  THAT  THE PATIENT OR THE PATIENT'S LEGAL GUARDIAN
   33  DECLINES TO IDENTIFY A CAREGIVER UNDER THIS ARTICLE, THE HOSPITAL  SHALL
   34  PROMPTLY DOCUMENT THIS IN THE PATIENT'S MEDICAL RECORD.
   35    (C)  THE HOSPITAL SHALL RECORD THE PATIENT'S IDENTIFICATION OF A CARE-
   36  GIVER IF GIVEN BY THE PATIENT OR LEGAL GUARDIAN, THE RELATIONSHIP OF THE
   37  IDENTIFIED CAREGIVER TO THE PATIENT, AND THE NAME, TELEPHONE NUMBER, AND
   38  ADDRESS OF THE PATIENT'S IDENTIFIED CAREGIVER IN THE  PATIENT'S  MEDICAL
   39  RECORD.
   40    (D)  A  PATIENT MAY ELECT TO CHANGE HIS OR HER IDENTIFIED CAREGIVER AT
   41  ANY TIME, AND THE HOSPITAL MUST RECORD  THIS  CHANGE  IN  THE  PATIENT'S
   42  MEDICAL RECORD.
   43    (E) (I) THE HOSPITAL SHALL PROMPTLY REQUEST THE WRITTEN CONSENT OF THE
   44  PATIENT  OR  THE PATIENT'S LEGAL GUARDIAN TO RELEASE MEDICAL INFORMATION
   45  TO THE PATIENT'S DESIGNATED CAREGIVER FOLLOWING  THE  HOSPITAL'S  ESTAB-
   46  LISHED  PROCEDURE  FOR  RELEASING  PERSONAL  HEALTH  INFORMATION  AND IN
   47  COMPLIANCE WITH ALL STATE AND FEDERAL LAWS, INCLUDING THE FEDERAL HEALTH
   48  INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF  1996  AS  AMENDED,  AND
   49  RELATED REGULATIONS.
   50    (II)  IF  THE  PATIENT  OR  THE  PATIENT'S  LEGAL GUARDIAN DECLINES TO
   51  CONSENT TO RELEASE MEDICAL INFORMATION TO THE PATIENT'S DESIGNATED CARE-
   52  GIVER, THE HOSPITAL SHALL NOT BE REQUIRED TO PROVIDE NOTICE TO THE CARE-
   53  GIVER UNDER SECTION TWENTY-NINE HUNDRED NINETY-FOUR-KK OF  THIS  ARTICLE
   54  OR  PROVIDE  INFORMATION CONTAINED IN THE PATIENT'S DISCHARGE PLAN UNDER
   55  SECTION TWENTY-NINE HUNDRED NINETY-FOUR-LL OF THIS ARTICLE.
       A. 1323--A                          3
    1    2. AN IDENTIFICATION OF A CAREGIVER BY A PATIENT OR A PATIENT'S  LEGAL
    2  GUARDIAN  UNDER THIS SECTION DOES NOT OBLIGATE ANY INDIVIDUAL TO PERFORM
    3  ANY AFTER-CARE TASKS FOR ANY PATIENT.
    4    3.  THIS  SECTION  SHALL  NOT  BE  CONSTRUED TO REQUIRE A PATIENT OR A
    5  PATIENT'S LEGAL GUARDIAN TO IDENTIFY ANY INDIVIDUAL AS  A  CAREGIVER  AS
    6  DEFINED BY THIS ARTICLE.
    7    S 2994-KK. NOTICE TO IDENTIFIED CAREGIVER. A HOSPITAL SHALL NOTIFY THE
    8  PATIENT'S IDENTIFIED CAREGIVER OF THE PATIENT'S DISCHARGE OR TRANSFER TO
    9  ANOTHER HOSPITAL OR FACILITY LICENSED BY THE DEPARTMENT OR THE OFFICE OF
   10  MENTAL  HEALTH AS SOON AS THE DATE AND TIME OF DISCHARGE OR TRANSFER CAN
   11  BE ANTICIPATED PRIOR TO THE PATIENT'S ACTUAL DISCHARGE  OR  TRANSFER  TO
   12  SUCH  FACILITY.    IN  THE  EVENT  THE HOSPITAL IS UNABLE TO CONTACT THE
   13  DESIGNATED CAREGIVER, THE LACK OF  CONTACT  SHALL  NOT  INTERFERE  WITH,
   14  DELAY,  OR  OTHERWISE AFFECT THE MEDICAL CARE PROVIDED TO THE PATIENT OR
   15  AN APPROPRIATE DISCHARGE OF THE PATIENT.  THE  HOSPITAL  SHALL  PROMPTLY
   16  DOCUMENT THE ATTEMPT IN THE PATIENT'S MEDICAL RECORD.
   17    S  2994-LL. INSTRUCTION TO IDENTIFIED CAREGIVER.  1. AS SOON AS POSSI-
   18  BLE AND NOT LATER THAN TWENTY-FOUR HOURS PRIOR TO A PATIENT'S  DISCHARGE
   19  FROM A HOSPITAL, THE HOSPITAL SHALL CONSULT WITH THE IDENTIFIED CAREGIV-
   20  ER  ALONG  WITH  THE  PATIENT REGARDING THE CAREGIVER'S CAPABILITIES AND
   21  LIMITATIONS AND ISSUE  A  DISCHARGE  PLAN  THAT  DESCRIBES  A  PATIENT'S
   22  AFTER-CARE  NEEDS AT HIS OR HER RESIDENCE.  IN THE EVENT THE HOSPITAL IS
   23  UNABLE TO CONTACT THE DESIGNATED CAREGIVER, THE LACK  OF  CONTACT  SHALL
   24  NOT INTERFERE WITH, DELAY, OR OTHERWISE AFFECT THE MEDICAL CARE PROVIDED
   25  TO  THE PATIENT OR AN APPROPRIATE DISCHARGE OF THE PATIENT. THE HOSPITAL
   26  SHALL PROMPTLY DOCUMENT THE ATTEMPT IN THE PATIENT'S MEDICAL RECORD.  AT
   27  MINIMUM, A DISCHARGE PLAN SHALL INCLUDE:
   28    (A) THE NAME AND CONTACT INFORMATION OF THE CAREGIVER IDENTIFIED UNDER
   29  THIS ARTICLE;
   30    (B) A DESCRIPTION OF ALL AFTER-CARE TASKS RECOMMENDED BY THE DISCHARG-
   31  ING PHYSICIAN, TAKING INTO ACCOUNT THE CAPABILITIES AND  LIMITATIONS  OF
   32  THE CAREGIVER; AND
   33    (C)  CONTACT  INFORMATION  FOR  HEALTH  CARE, COMMUNITY RESOURCES, AND
   34  LONG-TERM SERVICES AND SUPPORTS NECESSARY TO SUCCESSFULLY CARRY OUT  THE
   35  PATIENT'S DISCHARGE PLAN.
   36    2.  THE HOSPITAL ISSUING THE DISCHARGE PLAN MUST OFFER CAREGIVERS WITH
   37  INSTRUCTION IN ALL AFTER-CARE TASKS DESCRIBED IN THE DISCHARGE PLAN.
   38    (A) AT MINIMUM, SUCH INSTRUCTION SHALL INCLUDE:
   39    (I) A LIVE OR RECORDED DEMONSTRATION  OF  THE  TASKS  PERFORMED  BY  A
   40  HOSPITAL EMPLOYEE AUTHORIZED TO PERFORM THE AFTER-CARE TASK, PROVIDED IN
   41  A  CULTURALLY  COMPETENT  MANNER  AND  IN ACCORDANCE WITH THE HOSPITAL'S
   42  REQUIREMENTS TO PROVIDE LANGUAGE ACCESS SERVICES UNDER STATE AND FEDERAL
   43  LAW;
   44    (II) AN OPPORTUNITY FOR THE CAREGIVER AND  PATIENT  TO  ASK  QUESTIONS
   45  ABOUT THE AFTER-CARE TASKS; AND
   46    (III) ANSWERS TO THE CAREGIVER'S AND PATIENT'S QUESTIONS PROVIDED IN A
   47  CULTURALLY  COMPETENT  MANNER  AND  IN  ACCORDANCE  WITH  THE HOSPITAL'S
   48  REQUIREMENTS TO PROVIDE LANGUAGE ACCESS SERVICES UNDER STATE AND FEDERAL
   49  LAW.
   50    (B) ANY INSTRUCTIONS REQUIRED UNDER THIS ARTICLE SHALL  BE  DOCUMENTED
   51  IN  THE PATIENT'S MEDICAL RECORD, INCLUDING, AT MINIMUM, THE DATE, TIME,
   52  AND CONTENTS OF THE INSTRUCTION.
   53    3. THE DEPARTMENT IS AUTHORIZED TO PROMULGATE REGULATIONS TO IMPLEMENT
   54  THE PROVISIONS OF THIS ARTICLE, INCLUDING  BUT  NOT  LIMITED  TO,  REGU-
   55  LATIONS  TO  FURTHER  DEFINE  THE  CONTENT  AND SCOPE OF ANY INSTRUCTION
   56  PROVIDED TO CAREGIVERS UNDER THIS ARTICLE.
       A. 1323--A                          4
    1    S 2994-MM. EFFECT ON OTHER RIGHTS. 1. NOTHING IN THIS ARTICLE SHALL BE
    2  CONSTRUED TO INTERFERE WITH THE RIGHTS OF AN  AGENT  OPERATING  UNDER  A
    3  VALID  HEALTH  CARE  DIRECTIVE CREATED UNDER SECTION TWENTY-NINE HUNDRED
    4  EIGHTY-TWO OF THIS CHAPTER.
    5    2.  NOTHING  IN  THIS  ARTICLE  SHALL BE CONSTRUED TO CREATE A PRIVATE
    6  RIGHT OF ACTION AGAINST A HOSPITAL OR ANY OF  ITS  DIRECTORS,  TRUSTEES,
    7  OFFICERS,  EMPLOYEES  OR AGENTS, OR ANY CONTRACTORS WITH WHOM A HOSPITAL
    8  HAS A CONTRACTUAL RELATIONSHIP.
    9    3. A HOSPITAL, ANY OF ITS DIRECTORS, TRUSTEES, OFFICERS, EMPLOYEES  OR
   10  AGENTS,  OR  ANY  CONTRACTORS  WITH  WHOM  A  HOSPITAL HAS A CONTRACTUAL
   11  RELATIONSHIP SHALL NOT BE HELD LIABLE, IN  ANY  WAY,  FOR  THE  SERVICES
   12  RENDERED  OR  NOT  RENDERED  BY  THE  CAREGIVER  TO  THE  PATIENT AT THE
   13  PATIENT'S RESIDENCE.
   14    S 2. This act shall take effect on the one hundred eightieth day after
   15  it shall have become a law.