Amended in Assembly July 16, 2015

Amended in Assembly June 23, 2015

Amended in Senate April 21, 2015

Senate BillNo. 675


Introduced by Senator Liu

(Coauthor: Senator Wolk)

February 27, 2015


An act to amend Section 1262.5 of the Health and Safety Code, relating to health facilities.

LEGISLATIVE COUNSEL’S DIGEST

SB 675, as amended, Liu. Hospitals: family caregivers.

Existing law requires the State Department of Public Health to license and regulate health facilities, defined to mean a facility, place, or building that is organized, maintained, and operated for the diagnosis, care, prevention, and treatment of human illness, as specified. Existing law requires hospitals, among other things, to have a written discharge planning policy and process that requires appropriate arrangements to be made for posthospital care. A violation of those provisions is a crime.

This bill would require a hospital to take specified actions relating to family caregivers, including, among others, notifying the family caregiver of the patient’s discharge or transfer to another facility and providing information and counseling regarding the posthospital care needs of the patient, if the patient has consented to the disclosure of this information. By expanding the scope of a crime, this bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

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SECTION 1.  

Section 1262.5 of the Health and Safety Code is
2amended to read:

3

1262.5.  

(a) Each hospital shall have a written discharge
4planning policy and process.

5(b) The policy required by subdivision (a) shall require that
6appropriate arrangements for posthospital care, including, but not
7limited to, care at home, in a skilled nursing or intermediate care
8facility, or from a hospice, are made prior to begin delete theend delete dischargebegin delete of each
9patient.end delete
begin insert for those patients who are likely to suffer adverse health
10 consequences upon discharge if there is no adequate discharge
11planning. If the hospital determines that the patient and family
12members or interested persons need to be counseled to prepare
13them for posthospital care, the hospital shall provide for that
14counseling.end insert

15(c) As part of the discharge planning process, the hospital shall
16provide each patient who has been admitted to the hospital as an
17inpatient with an opportunity to identify one family caregiver who
18may assist in posthospital care, and shall record this information
19in the patient’s medical chart.

20(A) In the event that the patient is unconscious or otherwise
21incapacitated upon admittance to the hospital, the hospital shall
22provide the patient or patient’s legal guardian with an opportunity
23to designate a caregiver within a specified time period, at the
24discretion of the attending physician, following the patient’s
25recovery of consciousness or capacity. The hospital shall promptly
26document the attempt in the patient’s medical record.

27(B) In the event that the patient or legal guardian declines to
28designate a caregiver pursuant to this section, the hospital shall
29promptly document this declination in the patient’s medical record,
30when appropriate.

P3    1(d) The policy required by subdivision (a) shall require that the
2patient’s designated family caregiver be notified of the patient’s
3discharge or transfer to another facility as soon as possible and, in
4any event, upon issuance of a discharge order by the patient’s
5attending physician. If the hospital is unable to contact the
6designated caregiver, the lack of contact shall not interfere with,
7delay, or otherwise affect the medical care provided to the patient
8or an appropriate discharge of the patient. The hospital shall
9promptly document the attempted notification in the patient’s
10medical record.

11(e) The process required by subdivision (a) shall require that
12the patient and family caregiver be informed of the continuing
13health care requirements following discharge from the hospital.
14The right to information regarding continuing health care
15requirements following discharge shall also apply to the person
16who has legal responsibility to make decisions regarding medical
17care on behalf of the patient, if the patient is unable to make those
18decisions for himself or herself. The hospital shall provide an
19opportunity for the patient and his or her designated family
20caregiver to engage in the discharge planning process, which shall
21include providing information and, when appropriate, instruction
22regarding the posthospital care needs of the patient. This
23information shall include, but is not limited to, education and
24counseling about the patient’s medications, including dosing and
25proper use of medication delivery devices, when applicable. The
26information shall be provided in a culturally competent manner
27and in a language that is comprehensible to the patient and
28caregiver, consistent with the requirements of state and federal
29law, and shall include an opportunity for the caregiver to ask
30questions about the posthospital care needs of the patient.

31(f) (1) A transfer summary shall accompany the patient upon
32transfer to a skilled nursing or intermediate care facility or to the
33distinct part-skilled nursing or intermediate care service unit of
34the hospital. The transfer summary shall include essential
35information relative to the patient’s diagnosis, hospital course,
36pain treatment and management, medications, treatments, dietary
37requirement, rehabilitation potential, known allergies, and treatment
38plan, and shall be signed by the physician.

P4    1(2) A copy of the transfer summary shall be given to the patient
2and the patient’s legal representative, if any, prior to transfer to a
3skilled nursing or intermediate care facility.

4(g) A hospital shall establish and implement a written policy to
5ensure that each patient receives, at the time of discharge,
6information regarding each medication dispensed, pursuant to
7Section 4074 of the Business and Professions Code.

8(h) A hospital shall provide every patient anticipated to be in
9need of long-term care at the time of discharge with contact
10information for at least one public or nonprofit agency or
11organization dedicated to providing information or referral services
12relating to community-based long-term care options in the patient’s
13county of residence and appropriate to the needs and characteristics
14of the patient. At a minimum, this information shall include contact
15information for the area agency on aging serving the patient’s
16county of residence, local independent living centers, or other
17information appropriate to the needs and characteristics of the
18patient.

19(i) A contract between a general acute care hospital and a health
20care service plan that is issued, amended, renewed, or delivered
21on or after January 1, 2002, may not contain a provision that
22prohibits or restricts any health care facility’s compliance with the
23requirements of this section.

24(j) Discharge planning policies adopted by a hospital in
25accordance with this section shall ensure that planning is
26appropriate to the condition of the patient being discharged from
27the hospital and to the discharge destination and meets the needs
28and acuity of patients.

29(k) This section does not require a hospital to do either of the
30following:

31(1) Adopt a policy that would delay discharge or transfer of a
32patient.

33(2) Disclose information if the patient has not provided consent
34that meets the standards required by state and federal laws
35governing the privacy and security of protected health information.

36(l) This section does not supersede or modify any privacy and
37information security requirements and protections in federal and
38state law regarding protected health information or personally
39identifiable information, including, but not limited to, the federal
P5    1Health Insurance Portability and Accountability Act of 1996 (42
2U.S.C. Sec. 300gg).

3(m) For the purposes of this section, “family caregiver” means
4a relative, friend, or neighbor who provides assistance related to
5an underlying physical or mental disability but who is unpaid for
6those services.

7

SEC. 2.  

No reimbursement is required by this act pursuant to
8Section 6 of Article XIII B of the California Constitution because
9the only costs that may be incurred by a local agency or school
10district will be incurred because this act creates a new crime or
11infraction, eliminates a crime or infraction, or changes the penalty
12for a crime or infraction, within the meaning of Section 17556 of
13the Government Code, or changes the definition of a crime within
14the meaning of Section 6 of Article XIII B of the California
15Constitution.



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