Bill Text: IA SF33 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act providing for the designation of a caregiver relating to a patient's inpatient stay at a hospital.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2019-01-17 - Subcommittee: Segebart, Carlin, and Ragan. S.J. 125. [SF33 Detail]
Download: Iowa-2019-SF33-Introduced.html
Senate
File
33
-
Introduced
SENATE
FILE
33
BY
SEGEBART
A
BILL
FOR
An
Act
providing
for
the
designation
of
a
caregiver
relating
to
1
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.
“After-care
assistance”
means
any
assistance
provided
4
by
a
caregiver
to
a
patient
following
the
patient’s
discharge
5
from
a
hospital
that
is
related
to
the
patient’s
condition
6
at
the
time
of
discharge,
including
but
not
limited
to
7
assisting
with
basic
activities
of
daily
living,
assisting
8
with
instrumental
activities
of
daily
living,
and
performing
9
other
tasks
including
but
not
limited
to
managing
wound
care,
10
assisting
in
the
administering
of
medications,
and
operating
11
medical
equipment,
as
determined
to
be
appropriate
by
the
12
patient’s
discharging
physician
or
other
licensed
health
care
13
professional.
14
2.
“Caregiver”
means
any
individual
designated
as
a
15
caregiver
by
a
patient
who
provides
after-care
assistance
to
a
16
patient
in
the
patient’s
residence.
“Caregiver”
includes
but
is
17
not
limited
to
a
relative,
spouse,
partner,
friend,
or
neighbor
18
who
has
a
significant
relationship
with
the
patient.
19
3.
“Discharge”
means
a
patient’s
exit
or
release
from
a
20
hospital
to
the
patient’s
residence
following
an
inpatient
21
admission.
22
4.
“Entry”
means
a
patient’s
admission
into
a
hospital
for
23
the
purposes
of
receiving
inpatient
medical
care.
24
5.
“Facility”
means
a
health
care
facility
as
defined
in
25
section
135C.1,
an
elder
group
home
as
defined
in
section
26
231B.1,
or
an
assisted
living
program
as
defined
in
section
27
231C.2.
28
6.
“Hospital”
means
a
licensed
hospital
as
defined
in
29
section
135B.1.
30
7.
“Residence”
means
the
dwelling
that
the
patient
considers
31
to
be
the
patient’s
home.
“Residence”
does
not
include
any
32
rehabilitation
facility,
hospital,
nursing
home,
assisted
33
living
facility,
or
group
home
licensed
by
the
department
of
34
inspections
and
appeals.
35
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33
Sec.
2.
NEW
SECTION
.
144F.2
Caregiver
——
opportunity
to
1
designate.
2
1.
a.
A
hospital
shall
provide
each
patient
or,
if
3
applicable,
the
patient’s
legal
guardian
with
an
opportunity
4
to
designate
at
least
one
caregiver
within
twenty-four
hours
5
following
the
patient’s
entry
into
a
hospital,
and
prior
to
6
the
patient’s
discharge
or
transfer
to
another
hospital
or
7
facility.
8
b.
If
the
patient
is
unconscious
or
otherwise
incapacitated
9
upon
entry
into
the
hospital,
the
hospital
shall
provide
the
10
patient
or
the
patient’s
legal
guardian
with
an
opportunity
to
11
designate
a
caregiver
within
twenty-four
hours
following
the
12
patient’s
recovery
of
consciousness
or
capacity.
13
c.
If
the
patient
or
legal
guardian
declines
to
designate
14
a
caregiver,
the
hospital
shall
promptly
document
this
15
declination
in
the
patient’s
medical
record.
16
d.
If
the
patient
or
the
patient’s
legal
guardian
designates
17
an
individual
as
a
caregiver,
all
of
the
following
shall
apply:
18
(1)
The
hospital
shall
promptly
request
the
written
consent
19
of
the
patient
or
the
patient’s
legal
guardian
to
release
20
medical
information
to
the
patient’s
caregiver
following
the
21
hospital’s
established
procedures
for
releasing
personal
health
22
information
and
in
compliance
with
all
federal
and
state
23
laws.
If
the
patient
or
the
patient’s
legal
guardian
declines
24
to
consent
to
release
medical
information
to
the
patient’s
25
caregiver,
the
hospital
shall
not
be
required
to
provide
notice
26
to
the
caregiver
under
section
144F.3
or
to
provide
information
27
contained
in
the
patient’s
discharge
plan
to
the
caregiver
28
under
section
144F.4.
29
(2)
The
hospital
shall
record
the
patient’s
designation
of
30
caregiver,
the
relationship
of
the
caregiver
to
the
patient,
31
and
the
name,
telephone
number,
and
address
of
the
patient’s
32
caregiver
in
the
patient’s
medical
record.
33
e.
A
patient
or
the
patient’s
legal
guardian
may
elect
to
34
change
the
designation
of
the
patient’s
caregiver
at
any
time,
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and
the
hospital
shall
record
such
change
in
the
patient’s
1
medical
record
prior
to
the
patient’s
discharge.
2
2.
The
designation
of
a
caregiver
by
a
patient
or
a
3
patient’s
legal
guardian
does
not
obligate
the
designated
4
individual
to
perform
any
after-care
assistance
for
the
5
patient.
6
3.
This
section
shall
not
be
construed
to
require
a
patient
7
or
a
patient’s
legal
guardian
to
designate
any
individual
as
a
8
caregiver.
9
Sec.
3.
NEW
SECTION
.
144F.3
Notification
of
caregiver.
10
A
hospital
shall
notify
the
patient’s
caregiver
of
the
11
patient’s
discharge
or
transfer
to
another
hospital
or
facility
12
as
soon
as
possible
upon
issuance
of
a
discharge
or
transfer
13
order
by
the
patient’s
attending
physician
and
prior
to
the
14
patient’s
actual
discharge
or
transfer
to
another
hospital
or
15
facility.
If
the
hospital
is
unable
to
contact
the
caregiver,
16
the
lack
of
contact
shall
not
interfere
with,
delay,
or
17
otherwise
affect
the
medical
care
provided
to
the
patient,
or
18
an
appropriate
discharge
or
transfer
of
the
patient.
19
Sec.
4.
NEW
SECTION
.
144F.4
Instructions
to
caregiver.
20
1.
a.
As
soon
as
possible
and
prior
to
a
patient’s
21
discharge
from
a
hospital,
the
hospital
shall
consult
with
the
22
caregiver
along
with
the
patient
regarding
the
caregiver’s
23
capabilities
and
limitations
and
issue
a
discharge
plan
that
24
describes
the
patient’s
after-care
assistance
needs
at
the
25
patient’s
residence.
At
a
minimum,
the
discharge
plan
shall
26
include:
27
(1)
The
name
and
contact
information
of
the
caregiver.
28
(2)
A
description
of
all
after-care
assistance
tasks
29
necessary
to
maintain
the
patient’s
ability
to
reside
at
the
30
patient’s
residence.
31
(3)
Contact
information
for
any
health
care,
community
32
resource,
and
long-term
services
and
supports
necessary
to
33
successfully
carry
out
the
patient’s
discharge
plan.
34
b.
If
the
hospital
is
unable
to
contact
the
caregiver,
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the
lack
of
contact
shall
not
interfere
with,
delay,
or
1
otherwise
affect
the
medical
care
provided
to
the
patient,
or
2
an
appropriate
discharge
or
transfer
of
the
patient.
3
2.
The
hospital
issuing
the
discharge
plan
shall
offer
4
to
provide
a
caregiver
with
instructions
for
all
after-care
5
assistance
tasks
described
in
the
discharge
plan.
At
a
6
minimum,
this
instruction
shall
include:
7
a.
A
live
demonstration
or
video
instruction
of
the
8
after-care
tasks,
performed
by
a
hospital
employee
or
9
an
individual
with
whom
the
hospital
has
a
contractual
10
relationship,
who
has
the
appropriate
education
and
competency
11
in
the
task
to
be
performed
and
is
authorized
to
perform
the
12
task,
in
a
culturally-competent
manner
and
in
accordance
with
13
the
hospital’s
requirements
to
provide
language
access
services
14
under
state
and
federal
law.
15
b.
An
opportunity
for
the
caregiver
to
ask
questions
about
16
the
after-care
assistance
tasks.
17
c.
Answers
to
the
caregiver’s
questions
provided
in
18
a
culturally-competent
manner
and
in
accordance
with
the
19
hospital’s
requirements
to
provide
language
access
services
20
under
state
and
federal
law.
21
Sec.
5.
NEW
SECTION
.
144F.5
Adoption
of
rules.
22
The
department
of
inspections
and
appeals,
in
consultation
23
with
the
department
of
public
health,
may
adopt
rules
pursuant
24
to
chapter
17A
to
administer
this
chapter
including
but
not
25
limited
to
rules
to
further
define
the
content
and
scope
of
any
26
instructions
provided
to
caregivers
under
this
chapter.
27
Sec.
6.
NEW
SECTION
.
144F.6
Construction
of
chapter
28
relative
to
other
health
care
directive.
29
Nothing
in
this
chapter
shall
be
construed
to
interfere
with
30
the
rights
of
an
agent
operating
under
a
valid
durable
power
of
31
attorney
for
health
care
pursuant
to
chapter
144B.
32
Sec.
7.
NEW
SECTION
.
144F.7
Limitations.
33
1.
Nothing
in
this
chapter
shall
be
construed
to
create
34
a
private
right
of
action
against
a
hospital,
a
hospital
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employee,
or
any
consultant
or
contractor
with
whom
a
hospital
1
has
a
contractual
relationship,
or
to
limit
or
otherwise
2
supersede
or
replace
existing
rights
or
remedies
under
any
3
other
provision
of
law.
4
2.
Nothing
in
this
chapter
shall
delay
the
appropriate
5
discharge
or
transfer
of
a
patient.
6
3.
Nothing
in
this
chapter
shall
be
construed
to
interfere
7
with
or
supersede
a
health
care
provider’s
instructions
8
regarding
a
Medicare-certified
home
health
agency
or
any
other
9
postacute
care
provider.
10
4.
Nothing
in
this
chapter
shall
be
construed
to
grant
11
decision-making
authority
to
a
caregiver
to
determine
the
type
12
of
provider
or
provider
of
the
patient’s
posthospital
care
as
13
specified
in
the
patient’s
discharge
plan.
14
EXPLANATION
15
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
16
the
explanation’s
substance
by
the
members
of
the
general
assembly.
17
This
bill
relates
to
the
designation
of
a
caregiver
relative
18
to
an
inpatient
admission
of
a
patient
to
a
hospital
to
19
provide
after-care
assistance
to
the
patient
upon
discharge
20
of
the
patient
to
the
patient’s
residence.
The
bill
provides
21
definitions
used
in
the
new
Code
chapter
144F,
including
22
“after-care
assistance”,
“caregiver”,
“discharge”,
“entry”,
23
“facility”,
“hospital”,
and
“residence”.
24
The
bill
requires
a
hospital
to
provide
each
patient
or,
if
25
applicable,
the
patient’s
legal
guardian,
with
an
opportunity
26
to
designate
at
least
one
caregiver
following
the
patient’s
27
entry
into
a
hospital,
and
prior
to
the
patient’s
discharge
28
or
transfer
to
another
hospital
or
facility,
and
provides
for
29
situations
in
which
the
patient
is
unconscious
or
otherwise
30
incapacitated
or
if
the
patient
or
patient’s
legal
guardian
31
declines
to
designate
a
caregiver.
If
a
patient
or
patient’s
32
legal
guardian
designates
a
caregiver,
the
hospital
is
required
33
to
promptly
request
the
written
consent
of
the
patient
or
the
34
patient’s
legal
guardian
to
release
medical
information
to
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the
patient’s
caregiver
following
the
hospital’s
established
1
procedures
and
in
compliance
with
all
federal
and
state
2
laws.
If
the
patient
or
the
patient’s
legal
guardian
declines
3
to
consent
to
release
medical
information
to
the
patient’s
4
caregiver,
the
hospital
is
not
required
to
provide
notification
5
to
the
caregiver
or
to
provide
information
contained
in
the
6
patient’s
discharge
plan
to
the
caregiver.
The
hospital
is
7
required
to
record
the
patient’s
designation
of
caregiver,
the
8
relationship
of
the
caregiver
to
the
patient,
and
the
name,
9
telephone
number,
and
address
of
the
patient’s
caregiver
in
10
the
patient’s
medical
record.
The
bill
allows
for
a
change
in
11
the
caregiver
designation
by
a
patient
or
the
patient’s
legal
12
guardian
at
any
time.
The
bill
provides
that
the
designation
13
of
a
caregiver
by
a
patient
or
a
patient’s
legal
guardian
14
does
not
obligate
the
designated
individual
to
perform
any
15
after-care
assistance
for
the
patient
and
that
the
provisions
16
of
the
bill
are
not
to
be
construed
to
require
a
patient
or
17
a
patient’s
legal
guardian
to
designate
any
individual
as
a
18
caregiver.
19
Under
the
bill,
a
hospital
is
required
to
notify
the
20
patient’s
caregiver
of
the
patient’s
discharge
or
transfer
to
21
another
hospital
or
facility
as
soon
as
possible
upon
issuance
22
of
a
discharge
or
transfer
order
by
the
patient’s
attending
23
physician
and
prior
to
the
patient’s
actual
discharge
or
24
transfer
to
another
hospital
or
facility.
If
the
hospital
is
25
unable
to
contact
the
caregiver,
the
lack
of
contact
shall
not
26
interfere
with,
delay,
or
otherwise
affect
the
medical
care
27
provided
to
the
patient,
or
an
appropriate
discharge
of
the
28
patient.
29
Under
the
bill,
as
soon
as
possible
and
prior
to
a
patient’s
30
discharge
from
a
hospital,
the
hospital
is
required
to
consult
31
with
the
caregiver
along
with
the
patient
regarding
the
32
caregiver’s
capabilities
and
limitations
and
issue
a
discharge
33
plan
that
describes
the
patient’s
after-care
assistance
needs
34
at
the
patient’s
residence.
The
bill
also
requires
specified
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minimum
instructions
to
be
provided
to
the
caregiver.
1
The
bill
directs
the
department
of
inspections
and
appeals
2
to
adopt
rules,
in
cooperation
with
the
department
of
public
3
health,
to
administer
the
bill.
The
bill
is
not
to
be
4
construed
to
interfere
with
the
rights
of
an
agent
operating
5
under
a
valid
durable
power
of
attorney
for
health
care;
6
is
not
to
be
construed
to
create
a
private
right
of
action
7
against
a
hospital,
a
hospital
employee,
or
any
consultant
or
8
contractor
with
whom
a
hospital
has
a
contractual
relationship,
9
or
to
otherwise
supersede
or
replace
existing
rights
or
10
remedies
under
any
other
provision
of
law;
shall
not
delay
11
the
appropriate
discharge
or
transfer
of
a
patient;
is
not
12
to
be
construed
to
interfere
with
or
supersede
a
health
care
13
provider’s
instructions
regarding
a
Medicare-certified
home
14
health
agency
or
any
other
postacute
care
provider;
and
is
15
not
to
be
construed
to
grant
decision-making
authority
to
a
16
caregiver
to
determine
the
type
of
provider
or
provider
of
17
the
patient’s
posthospital
care
as
specified
in
the
patient’s
18
discharge
plan.
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