To amend Chapter 22 of Title 21 of the District of Columbia Official Code to require hospitals to allow a patient the opportunity to designate, upon inpatient admission, a lay caregiver in the patient's medical record, to require a hospital to notify and meet with the designated lay caregiver along with the patient to discuss the patient's plan of care before the patient's discharge, and to require a hospital to instruct the designated lay caregiver in certain after-care tasks upon a patient's discharge to the patient's current residence.
BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this act may be cited as the "Caregiver Advise, Record, and Enable Amendment Act of 2016".
Sec. 2. Chapter 22 of Title 21 of the District of Columbia Official Code is amended as follows:
(a) The table of contents is amended by adding a new Subchapter III to read as follows:
"Subchapter III. Hospital Discharge Planning.
"21-2231.02. Lay caregiver designation.
"21-2231.03. Hospital discharge plan.
(b) A new Subchapter III is added to read as follows:
"Subchapter III. Hospital Discharge Planning.
New § 21-2231.01
"Sec. 21-2231.01. Definitions.
"For the purposes of this subchapter, the term:
"(1) "After-care" means any type of assistance that is not regulated under Chapter 12 of Title 3, or similar law, and that is provided by a lay caregiver to a patient after the patient's discharge and is limited to the patient's condition at the time of discharge.
"(2) "Authorized representative" means a person who is authorized to make a health-care decision on behalf of an incapacitated individual or minor in accordance with §§ 21-2205 and 21-2210.
"(3) "Discharge" means a patient's exit and release from a hospital to the patient's residence following an inpatient admission.
"(4) "Hospital" shall have the same meaning as provided in § 44-501(a)(1).
"(5) "Lay caregiver" means an individual who is designated by the patient or authorized representative to provide after-care to the patient at the patient's residence and accepts the role as the patient's lay caregiver.
"(6) "Residence" means a dwelling that the patient considers to be the patient's home and does not include a rehabilitation facility, hospital, nursing home, assisted living facility, or group home licensed by the Department of Health.
"Sec. 21-2231.02. Lay caregiver designation.
"(a) A hospital shall provide each patient or authorized representative an opportunity to designate a lay caregiver as soon as practicable following the patient's inpatient admission into a hospital and before the patient's discharge.
"(b)(1) If the patient or authorized representative designates an individual as a lay caregiver, the hospital shall:
"(A) Provide notice to the lay caregiver as soon as practicable following the designation and before the patient's discharge;
"(B) Promptly request the written consent of the patient or authorized representative to release medical information to the patient's lay caregiver in accordance with the hospital's procedures for releasing personal health information and in compliance with all federal and District laws, including the Health Insurance Portability and Accountability Act of 1996, approved August 21, 1996 (Pub. L. No. 104-191; 110 Stat. 1936);
"(C) Record the patient's or authorized representative's designation of the lay caregiver, the relationship of the lay caregiver to the patient, and the name, telephone number, and address of the lay caregiver in the patient's medical record; and
"(D) Notify the lay caregiver of the patient's discharge to the patient's residence as soon as practicable; provided, that if the hospital is unable to contact the lay caregiver, the hospital shall document that in the patient's medical record as soon as practicable.
"(2) If a patient or authorized representative fails to authorize the release of medical information to the lay caregiver under paragraph (1)(B) of this subsection, the hospital is deemed to have met the requirements of the subchapter and no further action is needed.
"(3) A patient or authorized representative may elect to change the designation of a lay caregiver at any time before the patient's discharge; provided, that if a change is made, the hospital shall record that change in the patient's medical record as soon as practicable.
"(4) The designation of a lay caregiver by the patient or authorized representative does not obligate the lay caregiver to accept the designation or provide after-care.
"(5) A hospital is not obligated to determine the ability of a lay caregiver to understand or perform after-care tasks.
"Sec. 21-2231.03. Hospital discharge plan.
"(a) As soon as practicable before the patient's discharge, the hospital shall:
"(1) Consult with the lay caregiver and the patient or authorized representative regarding the lay caregiver's capabilities and limitations;
"(2) Provide a copy of the discharge plan to the lay caregiver;
"(3) Consult with, and provide instruction to, the lay caregiver regarding the patient's discharge plan; and
"(4) Provide contact information for any health care, community resources, and long-term care services and supports necessary to carry out the patient's discharge plan.
"(b) At a minimum, the discharge plan described in subsection (a) of this section shall include:
"(1) The name and contact information of the lay caregiver;
"(2) A description of all after-care tasks necessary to maintain the patient's ability to reside in the patient's residence; and
"(3) Contact information for any health care, community resources, and long-term care services and supports necessary to carry out the patient's discharge plan.
"(c)(1) At a minimum, the instruction to the lay caregiver described in subsection (a) of this section shall include:
"(A) An opportunity for a demonstration at the hospital of the after-care tasks; and
"(B) An opportunity for the lay caregiver and the patient to ask questions and receive answers to questions about the after-care tasks; and
"(2) The instruction provided shall be documented in the patient's medical record and shall include, at minimum, the date, time, and contents of the instruction.
"Sec. 21-2231.04. Construction.
"(a) Nothing in this subchapter shall be construed to delay the discharge of a patient or the transfer of a patient from a hospital to another facility, including the inability of the hospital to contact a designated lay caregiver;
"(b) Nothing in this subchapter shall be construed to create a private right of action not otherwise existing in the law for compliance or non-compliance with this subchapter.
"Sec. 21-2231.05. Rules.
"The Mayor, pursuant to subchapter 1 of Chapter 5 of Title 2, may issue rules to implement the provisions of this subchapter. ".
Sec. 3. Fiscal impact statement.
The Council adopts the fiscal impact statement in the committee report as the fiscal impact statement required by section 4a of the General Legislative Procedures Act of 1975, approved October 16, 2006 (120 Stat. 2038; D.C. Official Code § 1-301.47a).
Sec. 4. Effective date.
This act shall take effect following approval by the Mayor (or in the event of veto by the Mayor, action by the Council to override the veto), a 30-day period of congressional review as provided in section 602(c)(1) of the District of Columbia Home Rule Act, approved December 24, 1973 (87 Stat. 813; D.C. Official Code § 1-206.02(c)(1)), and publication in the District of Columbia Register.