SB-0352, As Passed House, March 24, 2016

HOUSE SUBSTITUTE FOR

SENATE BILL NO. 352

A bill to allow for designation of a caregiver; to prescribe

the duties of a designated caregiver; to enable a hospital to

assist in designating a caregiver; and to prescribe the duties of

state departments and agencies.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

Sec. 1. This act shall be known and may be cited as the

"designated caregiver act".

Sec. 3. As used in this act:

(a) "After-care assistance" means assistance provided by a lay

caregiver to a patient following the patient's discharge from a

hospital that is related to the patient's condition at the time of

discharge. After-care assistance includes, but is not limited to, 1

or more of the following:

Senate Bill No. 352 as amended March 24, 2016

(i) Assisting with basic activities of daily living.

(ii) Assisting with instrumental activities of daily living.

(iii) Assisting with medical or nursing tasks, including

managing wound care, assisting in administering medications, or

operating medical equipment.

(b) "Attending physician" means that term as defined in

section 20102 of the public health code, 1978 PA 368, MCL

333.20102.

means an individual 18 years of age or older designated as a

caregiver by a patient under this act who[ voluntarily

] provides after-care assistance to a patient in the

patient's residence. Caregiver, designated caregiver, or lay

caregiver includes, but is not limited to, a relative, spouse,

partner, friend, or neighbor who has a significant relationship

with the patient.

(d) "Discharge" means a patient's exit or release from a

hospital to the patient's residence following any medical care or

treatment rendered to the patient following an inpatient admission.

(e) "Entry" means a patient's admission into a hospital for

the purposes of receiving inpatient medical care.

(f) "Health care professional" means an individual licensed or

otherwise authorized to practice medicine under article 15 of the

public health code, 1978 PA 368, MCL 333.16101 to 333.18838.

(g) "Hospital" means that term as defined in section 20106 of

the public health code, 1978 PA 368, MCL 333.20106.

(h) "Patient advocate" means that term as described and used

in section 5506 of the estates and protected individuals code, 1998

PA 386, MCL 700.5506.

(i) "Residence" means the dwelling that the patient considers

to be his or her home. Residence does not include a rehabilitation

facility, hospital, or nursing home.

Sec. 5. (1) As soon as practicable following a patient's

admission to a hospital as an inpatient and before the patient's

discharge from the hospital to the patient's residence, the

hospital shall provide each patient or, if applicable, the

patient's legal guardian or patient advocate with an opportunity to

designate a lay caregiver.

(2) If the patient is unconscious or otherwise incapacitated

upon entry into the hospital, the hospital shall provide the

patient, the patient's legal guardian, or the patient advocate with

an opportunity to designate a lay caregiver within a given time

frame, at the discretion of the attending physician, following the

patient's recovery of consciousness or capacity.

(3) If the patient, the patient's legal guardian, or the

patient advocate declines to designate a caregiver under this act,

the hospital shall document that decline in the patient's medical

record. Upon the documentation in the patient's medical record

described in this subsection, the hospital has complied with the

requirements of this act.

(4) If the patient, the patient's legal guardian, or the

patient advocate designates an individual as a caregiver under this

act, the hospital shall record the patient's designation of

caregiver, the relationship of the designated caregiver to the

patient, and the name, telephone number, and other appropriate

contact information of the patient's designated caregiver in the

patient's medical record.

(5) A patient, the patient's legal guardian, or the patient

advocate may elect to change the patient's designated caregiver at

any time, and the hospital must record the change in the patient's

medical record before the patient's discharge.

(6) This does not require a patient or a patient's legal

guardian to designate an individual as a caregiver.

(7) A designation of a caregiver by a patient, a patient's

legal guardian, or a patient advocate does not obligate the

designated individual to perform any after-care assistance for the

patient.

(8) If the patient is a minor child and the parents of the

patient are divorced, the custodial parent has the authority to

designate a caregiver. If the parents have joint custody of the

patient, the parents shall jointly designate the caregiver.

Sec. 7. A hospital shall notify the patient's designated

caregiver of the patient's discharge or transfer to another

facility as soon as practicable and, in any event, upon issuance of

a discharge order by the patient's attending physician. If the

hospital is unable to contact the designated caregiver, the lack of

contact shall not interfere with, delay, or otherwise affect the

medical care provided to the patient, or an appropriate discharge

of the patient. The hospital shall promptly document the attempt in

the patient's medical record.

Sec. 9. (1) As soon as practicable before the patient's

discharge from a hospital to the patient's residence, the hospital

shall attempt to consult with the designated caregiver to prepare

the designated caregiver for the patient's after-care assistance

needs and issue a discharge plan that describes the patient's

after-care assistance needs, if any, at the patient's residence.

The discharge plan may include contact information for health care,

community resources, and long-term services and supports necessary

to successfully carry out the discharge plan. To the extent

possible, training or instructions provided to a designated

caregiver shall be provided in nontechnical language, in a

culturally competent manner, and in accordance with the hospital's

requirements to provide language access services under state and

federal law.

(2) As part of the consultation under subsection (1), the

hospital shall attempt to provide the designated caregiver the

opportunity to ask questions and receive answers about the after-

care assistance needs of the patient. If the hospital personnel who

consult with the designated caregiver determine, in the exercise of

their professional judgment, that a live or recorded demonstration

is necessary in order to appropriately prepare the designated

caregiver for the patient's after-care needs, the hospital may

provide to a designated caregiver a live or recorded demonstration

of the aftercare described in the patient's discharge plan and

contact information for a hospital employee who can respond to

questions about the discharge plan after the instruction provided.

If the hospital is unable to contact the designated caregiver, the

lack of contact shall not interfere with, delay, or otherwise

affect the medical care provided to the patient, or an appropriate

discharge of the patient.

(3) Instruction required under this act shall be documented in

the patient's medical record, including, at a minimum, the date,

time, and contents of the instruction.

Sec. 11. (1) This act does not interfere with the rights of an

agent operating under a valid advance directive.

(2) A patient may designate a caregiver in an advance

directive.

Sec. 13. (1) This act does not create a private right of

action against a hospital, a hospital employee, or a consultant or

contractor with whom a hospital has a contractual relationship.

(2) A hospital, a hospital employee, or a consultant or

contractor with whom a hospital has a contractual relationship

shall not be held liable, in any way, for the services rendered or

not rendered by the caregiver to the patient at the patient's

residence.

(3) This act does not obviate the obligation of an insurance

company, health service corporation, hospital service corporation,

medical service corporation, health maintenance organization, or

any other entity issuing health benefits plans to provide coverage

required under a health benefits plan.

(4) This act does not impact, impede, or otherwise disrupt or

reduce the reimbursement obligations of an insurance company,

including an insurance company providing any form of no-fault

automobile personal protection insurance as required under chapter

31 of the insurance code of 1956, 1956 PA 218, MCL 500.3101 to

500.3119, an insurance company providing any form of worker's

compensation benefits under the worker's disability compensation

act of 1969, 1969 PA 317, MCL 418.101 to 418.941, a health service

corporation, hospital service corporation, medical service

corporation, health maintenance organization, or any other entity

responsible to pay any of a patient's medical expenses or issuing

other health benefits plans to provide coverage under those health

benefits plans.

Sec. 15. This act does not delay the discharge of a patient or

the transfer of a patient from a hospital to another facility.

Enacting section 1. This act takes effect 90 days after the

date it is enacted into law.