00 SENATE BILL NO. 72 01 "An Act relating to caregivers of patients after release or departure from a hospital; and 02 providing for an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04  * Section 1. AS 18.20 is amended by adding new sections to read: 05 Article 5. Caregivers of Hospital Patients after Discharge.  06 Sec. 18.20.500. Naming a caregiver. (a) Except as otherwise provided in this 07 section, a hospital shall provide a patient or the patient's legal guardian with the 08 opportunity to name a caregiver to provide aftercare to the patient in the patient's 09 home after discharge from the hospital. The hospital shall provide the opportunity as 10 soon as possible after the patient's admission to the hospital or after the patient 11 recovers consciousness or capacity if the patient is unconscious or otherwise 12 incapacitated at the time of the patient's admission to the hospital. 13 (b) If a hospital discharges a patient before 24 hours have elapsed under (a) of 14 this section, the hospital shall provide the opportunity before discharge to name a 01 caregiver. 02 (c) To name an individual to be a caregiver under (a) or (b) of this section, a 03 patient or the patient's legal guardian shall provide the hospital with the name, 04 telephone number, and address of the individual. 05 (d) A patient or the patient's legal guardian may change the patient's named 06 caregiver at any time before discharge. 07 (e) A patient or the patient's legal guardian is not required to name a caregiver. 08 (f) A named caregiver may be a relative, partner, friend, neighbor, or another 09 individual who has a significant relationship with the patient. 10 (g) If a patient or the patient's legal guardian declines to name a caregiver 11 under this section, the hospital does not have any further obligations under 12 AS 18.20.500 - 18.20.590, except to perform the documentation required by 13 AS 18.20.560(b). 14 (h) The hospital shall make a good faith effort to contact and confirm the 15 name, telephone number, and address of the named caregiver within a reasonable time 16 after the patient or the patient's legal guardian names the caregiver under this section. 17 Sec. 18.20.510. Release of medical information. (a) If a patient names a 18 caregiver under AS 18.20.500(c), the hospital shall promptly ask the patient or the 19 patient's legal guardian to consent to the release of the patient's medical information 20 by the hospital to the named caregiver. If the patient or the patient's legal guardian 21 consents to the release, the hospital shall release the information to the named 22 caregiver. The hospital shall comply with federal and state law on the release of 23 medical information and follow the hospital's established procedures for releasing 24 medical information. 25 (b) If a patient or the patient's legal guardian does not consent to the release of 26 the patient's medical information under (a) of this section, the hospital is not required 27 to contact the named caregiver under AS 18.20.500(h), to provide notice to the named 28 caregiver under AS 18.20.520, or to provide information in the patient's discharge plan 29 to the named caregiver under AS 18.20.540 or 18.20.550. 30 Sec. 18.20.520. Notice to named caregiver. A hospital shall notify a patient's 31 named caregiver of the date and time when the hospital will discharge the patient or 01 transfer the patient to another hospital or facility as soon as possible after the hospital 02 determines the anticipated date and time of the discharge or transfer. 03 Sec. 18.20.530. Caregiver not obligated. Even if a patient or the patient's 04 legal guardian names an individual to be the patient's caregiver under 05 AS 18.20.500(c), the named individual is not required to provide aftercare to the 06 patient after the hospital discharges the patient. 07 Sec. 18.20.540. Discharge plan. (a) As soon as possible after the hospital 08 determines the anticipated date and time of a patient's discharge, the hospital shall 09 meet with the patient's named caregiver and the patient or the patient's legal guardian 10 to prepare a discharge plan and to assess the named caregiver's ability to provide 11 aftercare for the patient. 12 (b) A discharge plan must include, at a minimum, 13 (1) the name and contact information of the named caregiver; 14 (2) a description of the aftercare needed to maintain the patient's ability 15 to live at home; the description must consider the capabilities and limitations of the 16 named caregiver; 17 (3) contact information for health care, medical resources, community 18 resources, long-term services, and support services that are available and necessary to 19 carry out the discharge plan successfully; and 20 (4) contact information for a hospital or the instruction contractor 21 representative who is able to respond to questions from the named caregiver about the 22 discharge plan and the instruction provided under AS 18.20.550. 23 Sec. 18.20.550. Caregiver instruction. (a) A hospital shall instruct a named 24 caregiver on how to perform each of the tasks to be performed by the named caregiver 25 under the discharge plan. 26 (b) The hospital may provide the instruction required by this section by using 27 a person with whom the hospital has contracted to provide the instruction, if the 28 instruction contractor or the instruction contractor's employees have the necessary 29 education, competence, and licensing to provide the instruction. If the hospital 30 provides the instruction through an instruction contractor, the hospital shall provide 31 the named caregiver with the instruction contractor's name and contact information. 01 (c) At a minimum, the instruction provided under (a) of this section must 02 (1) include a live or prerecorded visual demonstration of each task by 03 an individual who is licensed or otherwise authorized to perform the task; if the 04 hospital or the instruction contractor is not able to provide a live or prerecorded visual 05 demonstration under this paragraph because of the situation of the patient or the 06 named caregiver, the hospital or the instruction contractor may provide the 07 information contained in the demonstration by electronic means or by telephone; and 08 (2) allow the named caregiver and the patient or the patient's legal 09 guardian to ask questions about each task and the discharge plan. 10 (d) A hospital or the instruction contractor shall, as necessary, 11 (1) provide the instruction under (a) of this section in a manner that 12 demonstrates an understanding of, communication with, and effective interaction with 13 individuals of different cultures, including, notwithstanding a provision of 14 AS 44.12.300 - 44.12.390 to the contrary, translation or other language access 15 services; and 16 (2) comply with applicable federal law, including 25 U.S.C. 2901 - 17 2906 (Native American Languages Act). 18 (e) A hospital or the instruction contractor shall provide the instruction 19 required by this section before the patient is discharged from the hospital unless the 20 instruction would delay the discharge. If the instruction would delay the discharge, the 21 hospital or the instruction contractor shall provide the instruction as soon as possible 22 after the discharge. 23 Sec. 18.20.560. Recording obligations. (a) A hospital shall promptly record in 24 a patient's medical record 25 (1) the naming of a caregiver, the relationship of the named caregiver 26 to the patient, and the name, telephone number, and address of the named caregiver; 27 (2) a summary of the instruction given under AS 18.20.550, including, 28 at a minimum, the date, time, and contents of the instruction; 29 (3) a change of the named caregiver to another individual, the 30 relationship of the new named caregiver to the patient, and the name, telephone 31 number, and address of the new named caregiver; and 01 (4) the hospital's efforts to contact the patient's named caregiver under 02 AS 18.20.500(h). 03 (b) If a patient or the patient's legal guardian declines to name a caregiver 04 under this section, the hospital shall promptly document that fact in the patient's 05 medical record. 06 Sec. 18.20.565. No delay of discharge or transfer. Compliance with the 07 provisions in AS 18.20.500 - 18.20.590 is not required if compliance would delay the 08 discharge of a patient or the transfer of a patient from a hospital to another hospital or 09 facility. 10 Sec. 18.20.570. Construction of provisions. The provisions of AS 18.20.500 - 11 18.20.590 may not be construed to 12 (1) create a right of action against a hospital, a hospital employee, or a 13 contractor of the hospital, including an instruction contractor, based on an action 14 performed or not performed under AS 18.20.500 - 18.20.590; or 15 (2) replace, change, or otherwise to affect rights or remedies that are 16 provided under another provision of law, including common law. 17 Sec. 18.20.580. Coordination with other authority. AS 18.20.500 - 18 18.20.590 may not be interpreted to interfere with the powers or duties of 19 (1) an agent operating under a valid advance health care directive 20 under AS 13.52; or 21 (2) a legal guardian of the individual. 22 Sec. 18.20.585. Regulations. The Department of Health and Social Services 23 may adopt regulations under AS 44.62 (Administrative Procedure Act) to implement 24 AS 18.20.500 - 18.20.590. 25 Sec. 18.20.590. Definitions. In AS 18.20.500 - 18.20.590, 26 (1) "admission" means accepted by a hospital for medical care on an 27 inpatient basis; 28 (2) "aftercare" means the assistance provided by a named caregiver to 29 an individual under a discharge plan; 30 (3) "caregiver" means an individual who provides, without pay, 31 aftercare to an individual; 01 (4) "discharge" means, after a patient's admission to a hospital, the 02 patient's departure or release from the hospital to the patient's home; 03 (5) "discharge plan" means the discharge plan a hospital issues under 04 AS 18.20.540; 05 (6) "home" means a dwelling that the patient considers to be the 06 patient's home; in this paragraph, "dwelling" does not mean a rehabilitation facility, 07 hospital, nursing home, assisted living facility, or group home; 08 (7) "hospital" has the meaning given in AS 18.20.130, but does not 09 include a hospital that is limited to the treatment of mental disorders; 10 (8) "instruction contractor" means the person with whom the hospital 11 has contracted under AS 18.20.550(b); 12 (9) "legal guardian" means 13 (A) if the patient is under 18 years of age, 14 (i) a parent of the patient; 15 (ii) an individual who acts as a guardian of the patient 16 by testamentary or court appointment under AS 13.26.030 - 13.26.085; 17 or 18 (iii) if the patient is committed to the custody of the 19 Department of Health and Social Services under AS 47.10 or AS 47.12, 20 a person who is under a duty to exercise general supervision over the 21 patient; 22 (B) an individual who acts as a guardian of the patient by 23 testamentary or court appointment under AS 13.26.090 - 13.26.150; 24 (10) "named caregiver" means an individual named as a caregiver 25 under AS 18.20.500(c). 26  * Sec. 2. The uncodified law of the State of Alaska is amended by adding a new section to 27 read: 28 TRANSITION: REGULATIONS. The Department of Health and Social Services may 29 adopt regulations necessary to implement AS 18.20.500 - 18.20.590, enacted by sec. 1 of this 30 Act. The regulations take effect under AS 44.62 (Administrative Procedure Act), but not 31 before January 1, 2016. 01  * Sec. 3. Section 2 of this Act takes effect immediately under AS 01.10.070(c). 02  * Sec. 4. Except as provided in sec. 3 of this Act, this Act takes effect January 1, 2016.