BILL NUMBER: SB 675	CHAPTERED
	BILL TEXT

	CHAPTER  494
	FILED WITH SECRETARY OF STATE  OCTOBER 4, 2015
	APPROVED BY GOVERNOR  OCTOBER 4, 2015
	PASSED THE SENATE  SEPTEMBER 1, 2015
	PASSED THE ASSEMBLY  AUGUST 27, 2015
	AMENDED IN ASSEMBLY  JULY 16, 2015
	AMENDED IN ASSEMBLY  JUNE 23, 2015
	AMENDED IN SENATE  APRIL 21, 2015

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, 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.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 1262.5 of the Health and Safety Code is amended
to read:
   1262.5.  (a) Each hospital shall have a written discharge planning
policy and process.
   (b) The policy required by subdivision (a) shall require that
appropriate arrangements for posthospital care, including, but not
limited to, care at home, in a skilled nursing or intermediate care
facility, or from a hospice, are made prior to discharge for those
patients who are likely to suffer adverse health consequences upon
discharge if there is no adequate discharge planning. If the hospital
determines that the patient and family members or interested persons
need to be counseled to prepare them for posthospital care, the
hospital shall provide for that counseling.
   (c) As part of the discharge planning process, the hospital shall
provide each patient who has been admitted to the hospital as an
inpatient with an opportunity to identify one family caregiver who
may assist in posthospital care, and shall record this information in
the patient's medical chart.
   (A) In the event that the patient is unconscious or otherwise
incapacitated upon admittance to the hospital, the hospital shall
provide the patient or patient's legal guardian with an opportunity
to designate a caregiver within a specified time period, at the
discretion of the attending physician, following the patient's
recovery of consciousness or capacity. The hospital shall promptly
document the attempt in the patient's medical record.
   (B) In the event that the patient or legal guardian declines to
designate a caregiver pursuant to this section, the hospital shall
promptly document this declination in the patient's medical record,
when appropriate.
   (d) The policy required by subdivision (a) shall require that the
patient's designated family caregiver be notified of the patient's
discharge or transfer to another facility as soon as possible 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 attempted notification in the patient's medical
record.
   (e) The process required by subdivision (a) shall require that the
patient and family caregiver be informed of the continuing health
care requirements following discharge from the hospital. The right to
information regarding continuing health care requirements following
discharge shall also apply to the person who has legal responsibility
to make decisions regarding medical care on behalf of the patient,
if the patient is unable to make those decisions for himself or
herself. The hospital shall provide an opportunity for the patient
and his or her designated family caregiver to engage in the discharge
planning process, which shall include providing information and,
when appropriate, instruction regarding the posthospital care needs
of the patient. This information shall include, but is not limited
to, education and counseling about the patient's medications,
including dosing and proper use of medication delivery devices, when
applicable. The information shall be provided in a culturally
competent manner and in a language that is comprehensible to the
patient and caregiver, consistent with the requirements of state and
federal law, and shall include an opportunity for the caregiver to
ask questions about the posthospital care needs of the patient.
   (f) (1) A transfer summary shall accompany the patient upon
transfer to a skilled nursing or intermediate care facility or to the
distinct part-skilled nursing or intermediate care service unit of
the hospital. The transfer summary shall include essential
information relative to the patient's diagnosis, hospital course,
pain treatment and management, medications, treatments, dietary
requirement, rehabilitation potential, known allergies, and treatment
plan, and shall be signed by the physician.
   (2) A copy of the transfer summary shall be given to the patient
and the patient's legal representative, if any, prior to transfer to
a skilled nursing or intermediate care facility.
   (g) A hospital shall establish and implement a written policy to
ensure that each patient receives, at the time of discharge,
information regarding each medication dispensed, pursuant to Section
4074 of the Business and Professions Code.
   (h) A hospital shall provide every patient anticipated to be in
need of long-term care at the time of discharge with contact
information for at least one public or nonprofit agency or
organization dedicated to providing information or referral services
relating to community-based long-term care options in the patient's
county of residence and appropriate to the needs and characteristics
of the patient. At a minimum, this information shall include contact
information for the area agency on aging serving the patient's county
of residence, local independent living centers, or other information
appropriate to the needs and characteristics of the patient.
   (i) A contract between a general acute care hospital and a health
care service plan that is issued, amended, renewed, or delivered on
or after January 1, 2002, may not contain a provision that prohibits
or restricts any health care facility's compliance with the
requirements of this section.
   (j) Discharge planning policies adopted by a hospital in
accordance with this section shall ensure that planning is
appropriate to the condition of the patient being discharged from the
hospital and to the discharge destination and meets the needs and
acuity of patients.
   (k) This section does not require a hospital to do either of the
following:
   (1) Adopt a policy that would delay discharge or transfer of a
patient.
   (2) Disclose information if the patient has not provided consent
that meets the standards required by state and federal laws governing
the privacy and security of protected health information.
   (l) This section does not supersede or modify any privacy and
information security requirements and protections in federal and
state law regarding protected health information or personally
identifiable information, including, but not limited to, the federal
Health Insurance Portability and Accountability Act of 1996 (42
U.S.C. Sec. 300gg).
   (m) For the purposes of this section, "family caregiver" means a
relative, friend, or neighbor who provides assistance related to an
underlying physical or mental disability but who is unpaid for those
services.
  SEC. 2.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.