Bill Text: IA HF533 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act providing for the designation of a lay caregiver relating to a patient's inpatient stay at a hospital. (Formerly HF 340.)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2019-03-28 - Withdrawn. H.J. 688. [HF533 Detail]
Download: Iowa-2019-HF533-Introduced.html
House
File
533
-
Introduced
HOUSE
FILE
533
BY
COMMITTEE
ON
HUMAN
RESOURCES
(SUCCESSOR
TO
HF
340)
(COMPANION
TO
SF
84
BY
SEGEBART)
A
BILL
FOR
An
Act
providing
for
the
designation
of
a
lay
caregiver
1
relating
to
a
patient’s
inpatient
stay
at
a
hospital.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
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Section
1.
NEW
SECTION
.
144F.1
Definitions.
1
As
used
in
this
chapter,
unless
the
context
otherwise
2
requires:
3
1.
“Aftercare
assistance”
means
any
assistance
provided
4
by
a
lay
caregiver
to
a
patient
following
discharge
of
the
5
patient
that
are
tasks
directly
related
to
the
patient’s
6
condition
at
the
time
of
discharge,
do
not
require
a
licensed
7
professional,
and
are
determined
to
be
appropriate
by
the
8
patient’s
discharging
physician
or
other
licensed
health
care
9
professional.
10
2.
“Discharge”
means
the
exit
or
release
of
a
patient
from
11
inpatient
care
in
a
hospital
to
the
residence
of
the
patient.
12
3.
“Facility”
means
a
health
care
facility
as
defined
in
13
section
135C.1,
an
elder
group
home
as
defined
in
section
14
231B.1,
or
an
assisted
living
program
as
defined
in
section
15
231C.2.
16
4.
“Hospital”
means
a
licensed
hospital
as
defined
in
17
section
135B.1.
18
5.
“Lay
caregiver”
means
an
individual,
eighteen
years
of
19
age
or
older,
who
is
designated
as
a
lay
caregiver
under
this
20
chapter
by
a
patient
or
the
patient’s
legal
representative,
and
21
who
is
willing
and
able
to
perform
aftercare
assistance
for
the
22
patient
at
the
patient’s
residence
following
discharge.
23
6.
“Legal
representative”
means,
in
order
of
priority,
24
an
attorney
in
fact
under
a
durable
power
of
attorney
for
25
health
care
pursuant
to
chapter
144B
or,
if
no
durable
power
26
of
attorney
for
health
care
has
been
executed
pursuant
to
27
chapter
144B
or
if
the
attorney
in
fact
is
unavailable,
a
legal
28
guardian
appointed
pursuant
to
chapter
633.
29
7.
“Patient”
means
an
individual
who
is
receiving
or
who
has
30
received
inpatient
medical
care
in
a
hospital.
31
8.
“Residence”
means
the
dwelling
that
a
patient
considers
32
to
be
the
patient’s
home.
“Residence”
does
not
include
any
33
rehabilitation
facility,
hospital,
or
facility.
34
Sec.
2.
NEW
SECTION
.
144F.2
Discharge
policies
——
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opportunity
to
designate
lay
caregiver.
1
1.
a.
A
hospital
shall
adopt
and
maintain
evidence-based
2
discharge
policies
and
procedures.
At
a
minimum,
the
policies
3
and
procedures
shall
provide
for
an
assessment
of
the
patient’s
4
ability
for
self-care
after
discharge
and,
as
part
of
the
5
assessment,
shall
provide
a
patient,
or
if
applicable
the
6
patient’s
legal
representative,
with
an
opportunity
to
7
designate
one
lay
caregiver
prior
to
discharge
of
the
patient.
8
b.
A
legal
representative
who
is
an
agent
under
a
durable
9
power
of
attorney
for
health
care
pursuant
to
chapter
144B
10
shall
be
given
the
opportunity
to
designate
a
lay
caregiver
11
in
lieu
of
the
patient’s
designation
of
a
lay
caregiver
only
12
if,
consistent
with
chapter
144B,
in
the
judgment
of
the
13
attending
physician,
the
patient
is
unable
to
make
the
health
14
care
decision.
A
legal
representative
who
is
a
guardian
shall
15
be
given
the
opportunity
to
designate
a
lay
caregiver
in
lieu
16
of
the
patient’s
designation
of
a
lay
caregiver
to
the
extent
17
consistent
with
the
powers
and
duties
granted
the
guardian
18
pursuant
to
section
633.635.
19
2.
If
a
patient
or
the
patient’s
legal
representative
20
declines
to
designate
a
lay
caregiver,
the
hospital
shall
21
document
the
declination
in
the
patient’s
medical
record
and
22
the
hospital
shall
be
deemed
to
be
in
compliance
with
this
23
section.
24
3.
If
a
patient
or
the
patient’s
legal
representative
25
designates
a
lay
caregiver,
the
hospital
shall
do
all
of
the
26
following:
27
a.
Record
in
the
patient’s
medical
record
the
designation
of
28
the
lay
caregiver,
in
accordance
with
the
hospital’s
policies
29
and
procedures,
which
may
include
information
such
as
the
30
relationship
of
the
lay
caregiver
to
the
patient,
and
the
name,
31
telephone
number,
and
address
of
the
lay
caregiver.
32
b.
(1)
Request
written
consent
from
the
patient
or
the
33
patient’s
legal
representative
to
release
medical
information
34
to
the
lay
caregiver
in
accordance
with
the
hospital’s
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established
procedures
for
releasing
a
patient’s
personal
1
health
information
and
in
compliance
with
all
applicable
state
2
and
federal
laws.
3
(2)
If
a
patient
or
the
patient’s
legal
representative
4
declines
to
consent
to
the
release
of
medical
information
to
5
the
lay
caregiver,
the
hospital
is
not
required
to
provide
6
notice
to
the
lay
caregiver
under
section
144F.3
or
to
consult
7
with
or
provide
information
contained
in
the
patient’s
8
discharge
plan
to
the
lay
caregiver
under
section
144F.4.
9
4.
A
patient
or
the
patient’s
legal
representative
may
10
change
the
designation
of
a
lay
caregiver
if
the
lay
caregiver
11
becomes
incapacitated.
12
5.
The
designation
of
an
individual
as
a
lay
caregiver
under
13
this
section
does
not
obligate
the
individual
to
perform
any
14
aftercare
assistance
for
the
patient.
15
6.
This
section
shall
not
be
construed
to
require
a
patient
16
or
the
patient’s
legal
representative
to
designate
a
lay
17
caregiver.
18
Sec.
3.
NEW
SECTION
.
144F.3
Notification
of
lay
caregiver
19
of
discharge.
20
If
a
lay
caregiver
is
designated
under
section
144F.2,
the
21
hospital
shall,
in
accordance
with
the
hospital’s
established
22
policies
and
procedures,
attempt
to
notify
the
lay
caregiver
of
23
the
discharge
of
the
patient
as
soon
as
practicable.
24
Sec.
4.
NEW
SECTION
.
144F.4
Aftercare
assistance
25
instructions
to
lay
caregiver.
26
1.
If
a
lay
caregiver
is
designated
under
section
144F.2,
as
27
soon
as
practicable
prior
to
discharge
of
a
patient,
a
hospital
28
shall
attempt
to
do
all
of
the
following:
29
a.
Consult
with
the
patient’s
lay
caregiver
to
prepare
the
30
lay
caregiver
for
the
aftercare
assistance
the
lay
caregiver
31
may
provide.
32
b.
Issue
a
discharge
plan
that
describes
the
aftercare
33
assistance
needs
of
the
patient
and
offer
to
provide
the
lay
34
caregiver
with
instructions
for
the
aftercare
assistance
tasks
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described
in
the
discharge
plan
and
the
opportunity
for
the
lay
1
caregiver
to
ask
questions
regarding
such
tasks.
2
2.
The
inability
of
a
hospital
to
consult
with
a
patient’s
3
lay
caregiver
shall
not
interfere
with,
delay,
or
otherwise
4
affect
the
medical
care
provided
to
the
patient
or
the
5
patient’s
discharge.
6
Sec.
5.
NEW
SECTION
.
144F.5
Hospital
discharge
process
——
7
evidence-based
practices.
8
A
hospital’s
discharge
process
may
incorporate
established
9
evidence-based
practices,
including
but
not
limited
to
any
of
10
the
following:
11
1.
The
standards
for
accreditation
adopted
by
the
joint
12
commission
on
the
accreditation
of
health
care
organizations
13
or
any
other
nationally
recognized
hospital
accreditation
14
organization.
15
2.
The
conditions
of
participation
for
hospitals
adopted
by
16
the
centers
for
Medicare
and
Medicaid
services
of
the
United
17
States
department
of
health
and
human
services.
18
Sec.
6.
NEW
SECTION
.
144F.6
Construction
of
chapter
19
relative
to
other
health
care
directives.
20
Nothing
in
this
chapter
shall
be
construed
to
interfere
with
21
the
authority
or
responsibilities
of
an
agent
operating
under
22
a
valid
durable
power
of
attorney
for
health
care
pursuant
to
23
chapter
144B
or
of
the
powers
and
duties
granted
to
a
guardian
24
pursuant
to
section
633.635.
25
Sec.
7.
NEW
SECTION
.
144F.7
Limitations.
26
1.
Nothing
in
this
chapter
shall
be
construed
to
create
27
a
private
right
of
action
against
a
hospital,
a
hospital
28
employee,
or
any
consultant
or
contractor
with
whom
a
hospital
29
has
a
contractual
relationship,
or
to
limit
or
otherwise
30
supersede
or
replace
existing
rights
or
remedies
under
any
31
other
provision
of
law.
32
2.
Nothing
in
this
chapter
shall
delay
the
appropriate
33
discharge
or
transfer
of
a
patient.
34
3.
Nothing
in
this
chapter
shall
be
construed
to
interfere
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with
or
supersede
a
health
care
provider’s
instructions
1
regarding
a
Medicare-certified
home
health
agency
or
any
other
2
post-acute
care
provider.
3
4.
Nothing
in
this
chapter
shall
be
construed
to
grant
4
decision-making
authority
to
a
lay
caregiver
to
determine
the
5
type
of
provider
or
provider
of
the
patient’s
post-hospital
6
care
as
specified
in
the
patient’s
discharge
plan.
7
EXPLANATION
8
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
9
the
explanation’s
substance
by
the
members
of
the
general
assembly.
10
This
bill
relates
to
the
designation
of
a
lay
caregiver
11
relative
to
an
inpatient
stay
of
a
patient
in
a
hospital
to
12
provide
aftercare
assistance
to
the
patient
upon
discharge
of
13
the
patient
to
the
patient’s
residence.
The
bill
provides
14
definitions
used
in
new
Code
chapter
144F.
15
The
bill
requires
a
hospital
to
adopt
and
maintain
16
evidence-based
discharge
policies
and
procedures
that
provide
17
for
an
assessment
of
the
patient’s
ability
for
self-care
18
after
discharge
and
provide
the
patient
or,
if
applicable,
19
the
patient’s
legal
representative,
with
an
opportunity
to
20
designate
one
lay
caregiver
prior
to
the
patient’s
discharge
21
from
the
hospital.
The
bill
provides
for
the
priority
order
22
in
determining
who
may
designate
a
lay
caregiver
between
23
the
patient,
an
agent
under
a
durable
power
of
attorney
for
24
health
care,
or
a
guardian
and
provides
that
if
a
patient
or
25
legal
representative
declines
to
designate
a
lay
caregiver
26
the
hospital
is
required
to
document
the
declination
in
the
27
patient’s
medical
record
and
the
hospital
is
then
deemed
in
28
compliance
with
the
designation
provision.
29
If
a
patient
or
the
patient’s
legal
representative
30
designates
a
lay
caregiver,
the
hospital
is
required
to
31
record
the
designation
in
the
patient’s
medical
record,
and
to
32
request
the
written
consent
of
the
patient
or
the
patient’s
33
legal
representative
to
release
medical
information
to
the
34
lay
caregiver
in
accordance
with
the
hospital’s
established
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procedures
and
in
compliance
with
all
federal
and
state
laws.
1
If
the
patient
or
the
patient’s
legal
representative
declines
2
to
consent
to
release
medical
information
to
the
lay
caregiver,
3
the
hospital
is
not
required
to
provide
notice
to
the
lay
4
caregiver
of
the
patient’s
discharge
or
to
provide
information
5
contained
in
the
patient’s
discharge
plan
to
the
lay
caregiver.
6
The
bill
allows
for
a
change
in
the
designation
of
a
lay
7
caregiver
by
the
patient
or
the
patient’s
legal
representative
8
if
the
lay
caregiver
becomes
incapacitated.
Under
the
bill,
9
the
designation
of
a
lay
caregiver
does
not
obligate
the
10
designated
individual
to
perform
any
aftercare
assistance
for
11
the
patient
and
the
bill
is
not
to
be
construed
to
require
a
12
patient
or
a
patient’s
legal
representative
to
designate
a
lay
13
caregiver.
14
Under
the
bill,
a
hospital
is
required
to
notify
the
15
designated
lay
caregiver
of
the
patient’s
discharge
as
soon
as
16
practicable.
If
a
lay
caregiver
is
designated,
the
hospital
17
is
required
as
soon
as
practicable
prior
to
the
patient’s
18
discharge
from
a
hospital,
to
attempt
to
consult
with
the
19
lay
caregiver
to
prepare
the
lay
caregiver
for
the
aftercare
20
assistance
that
may
be
provided
by
the
lay
caregiver;
and
21
to
issue
a
discharge
plan
and
offer
to
provide
the
lay
22
caregiver
with
instructions
for
the
aftercare
assistance
tasks
23
described
in
the
discharge
plan
and
the
opportunity
to
ask
24
questions.
The
inability
of
a
hospital
to
consult
with
a
lay
25
caregiver
shall
not
interfere
with,
delay,
or
otherwise
affect
26
the
medical
care
provided
to
the
patient
or
the
patient’s
27
discharge.
28
A
hospital’s
discharge
process
adopted
and
maintained
under
29
the
bill
may
incorporate
established
evidence-based
practices
30
including
those
specified
in
the
bill.
The
bill
is
not
to
be
31
construed
to
interfere
with
the
authority
or
responsibilities
32
of
an
agent
operating
under
a
valid
durable
power
of
attorney
33
for
health
care
or
with
the
power
and
duties
granted
a
34
guardian;
or
to
create
a
private
right
of
action
against
a
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hospital,
a
hospital
employee,
or
any
consultant
or
contractor
1
with
whom
a
hospital
has
a
contractual
relationship
or
to
limit
2
or
otherwise
supersede
or
replace
existing
rights
or
remedies
3
under
other
provisions
of
law.
Additionally,
the
bill
shall
4
not
delay
the
appropriate
discharge
or
transfer
of
a
patient;
5
shall
not
be
construed
to
interfere
with
or
supersede
a
health
6
care
provider’s
instructions
regarding
a
Medicare-certified
7
home
health
agency
or
any
other
post-acute
care
provider;
and
8
shall
not
be
construed
to
grant
decision-making
authority
to
a
9
lay
caregiver
to
determine
the
type
of
provider
or
provider
of
10
the
patient’s
post-hospital
care
as
specified
in
the
patient’s
11
discharge
plan.
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