Relating to care facility placement decisions for certain adults

This bill relates to care facility placement decisions for certain adults. The bill defines “authorized representative” as an agent, attorney in fact, conservator, or guardian. “Person authorized to consent” (authorized person) is defined as a member of any of the following groups of individuals, in order of priority, that is willing and able to consent, refuse to consent, or withdraw consent on a patient’s behalf: the patient’s spouse, the adult children, the parent or parents of a patient, or the adult siblings of the patient. “Care facility” is defined as a facility that provides a patient with health-related and personal care services, including a hospital, medical clinic, nursing facility, rehabilitation facility, or residential care facility. “Placement” is defined as the admission, discharge, or transfer of a patient. The bill provides that a physician licensed under the laws of this state may certify in a patient’s record that the patient is not able to consent, an authorized representative for the patient has not been located by the physician despite good-faith efforts, and that it is in the patient’s best interests to be discharged from the patient’s current care facility and transferred or admitted to a care facility recommended by the physician. “Patient” and “able to consent” are defined in the bill. The bill provides that an authorized person shall act in good faith and consider the patient’s rights, wishes, and best interests. The bill authorizes the authorized person, upon the physician’s certification, to make care facility placement decisions and assist the patient in applying for health insurance coverage through private insurance, or for a public assistance program, as necessary to facilitate placement. The bill allows the authorized person, as reasonably necessary to assist the patient in applying for health insurance coverage through a private insurer or a public assistance program and as permitted under state and federal law, to access a patient’s financial and banking records as well as disclose relevant health information to a third party. The bill provides that the authority of an authorized person expires when the placement decided by the authorized person is completed and notice of approval or denial of an application for health insurance coverage through a private insurer, or for a public assistance program, if applicable, is received by a qualified employee of the receiving care facility, or when an authorized representative or authorized person of higher priority is located. The bill requires a social worker, discharge planner, or other qualified employee as designated by the current care facility of the patient to inform an authorized person of the person’s powers and duties and to assist the person with identifying a receiving care facility for the patient that will provide the least restrictive and appropriate level of care for the patient as recommended by the certifying physician. If the receiving care facility as described in the bill is identified and consents, the patient shall be transferred to the receiving care facility. After a good-faith effort to locate an authorized representative or authorized person, the bill allows an attending physician or a care facility to petition a court of competent jurisdiction to order placement or that a patient’s attending physician or a social worker, intake worker, or other qualified employee of the receiving care facility assist the patient in applying for health insurance coverage through a private insurer or a public assistance program. The petition must include certain information about the patient, the petitioner, the current care facility, and the proposed receiving care facility, and be supported by affidavits from an attending physician, a social worker, intake coordinator, discharge planner, or other qualified employee from both the current and the proposed receiving care facility. The bill allows the court to grant the petition if it finds that the patient is not able to consent, no authorized representative for the patient or authorized person has been located by the attending physician and the patient’s current care facility despite good-faith efforts, placement in the receiving care facility recommended to the court by the patient’s attending physician is in the best interests of the patient, and will provide the least restrictive and most appropriate level of care for the patient. A social worker, intake coordinator, or other qualified employee of the proposed receiving care facility must consent to the admission of the patient. If a court order authorizes a patient’s transfer to the receiving care facility, the authority, if necessary, to apply for a public assistance program on the patient’s behalf shall transfer pursuant to court order to a qualified employee of the receiving care facility. The bill provides that the court’s order shall be effective until a date specified by the court not to exceed 30 calendar days from the date of the issuance of the order, the completion of any placement of the patient in the receiving care facility as ordered, or the date that a physician certifies that the patient is able to consent to the patient’s placement in a care facility. The bill provides that a court order authorizing a qualified employee of a receiving facility to apply for a public assistance program on a patient’s behalf shall be effective until a date specified by the court, the date notice of approval or denial of an application for health insurance coverage through a private insurer, or for a public assistance program is received by a qualified employee of the receiving facility, or the date that an attending physician certifies that the patient is able to consent to the application for a public assistance program. The bill provides immunity from civil or criminal liability to a person or care facility acting in good faith under the bill. Immunity from licensee discipline is also provided for licensees acting reasonably and in good faith. The bill is not to be construed to require a health care facility to accept the transfer or admission of a patient; to repeal, abrogate, or impair the operation of any other federal or state laws governing the transfer, admission, or discharge of a patient to or from a care facility; or to infringe upon the rights of patients under federal or state law relating to the involuntary transfer, admission, or discharge to or from a care facility. The bill authorizes the department of health and human services to adopt rules to administer the bill.