State of Illinois
2015 and 2016


Introduced 2/18/2015, by Sen. Ira I. Silverstein


New Act

    Creates the Caregiver Advise, Record, and Enable Act. Provides that before a patient is discharged from a hospital and no later than 24 hours after a patient enters a hospital, the hospital shall provide the patient or the patient's legal guardian with the opportunity to designate a caregiver. Provides that the hospital shall document the patient's designation of a caregiver and shall provide instruction regarding after-care tasks to the caregiver. Requires the hospital to notify the patient's caregiver at least 4 hours before the patient is discharged. Authorizes the Department of Public Health to adopt rules relating to the implementation of the Act. Contains other provisions. Effective immediately.

LRB099 10037 RPS 30259 b





SB1305LRB099 10037 RPS 30259 b

1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 1. Short title. This Act may be cited as the
5Caregiver Advise, Record, and Enable Act.
6    Section 5. Definitions. As used in this Act, the following
7terms have the meaning given in this Section.
8    "After-care" means any assistance provided by a caregiver
9to a patient after the patient's discharge from a hospital.
10After-care may include, but is not limited to, assisting with
11basic activities of daily living (ADLs), assisting with
12instrumental activities of daily living (IADLs), or carrying
13out medical or nursing tasks, such as managing wound care,
14assisting in administering medications, and operating medical
16    "Caregiver" means any individual who provides after-care
17to a patient living in his or her residence and is duly
18designated as a caregiver by a patient. A designated caregiver
19may include, but is not limited to, a relative, partner,
20friend, or neighbor who has a significant relationship with the
22    "Discharge" means a patient's exit or release from a
23hospital to the patient's residence following any medical care,



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1treatment, or observation.
2    "Entry into a hospital" means a patient's entrance into a
3hospital for the purposes of medical care, treatment, or
4observation. For purposes of this Act, "entry into a hospital"
5does not require that a patient be formally admitted to a
7    "Hospital" means a facility licensed under the Hospital
8Licensing Act.
9    "Residence" means a dwelling that the patient considers to
10be his or her home. A "residence" does not include any
11rehabilitation facility, hospital, nursing home, assisted
12living establishment, or group home licensed by the Department
13of Public Health.
14    Section 10. Opportunity to designate caregiver.
15    (a) Before any patient is discharged or transferred to
16another facility, but no later than 24 hours after a patient's
17entry into a hospital, the hospital shall provide the patient
18or the patient's legal guardian with at least one opportunity
19to designate one or more caregivers under this Act.
20        (1) If a patient is unconscious or otherwise
21    incapacitated upon his or her entry into a hospital, the
22    hospital shall provide the patient or the patient's legal
23    guardian with an opportunity to designate a caregiver
24    within 24 hours following the patient's recovery of his or
25    her consciousness or capacity.



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1        (2) If a patient or the patient's legal guardian
2    declines to designate a caregiver under this Act, the
3    hospital shall promptly document in the patient's medical
4    record that the patient or the patient's legal guardian
5    declined to designate a caregiver.
6        (3) If a patient or the patient's legal guardian
7    designates an individual as a caregiver under this Act:
8            (A) the hospital shall promptly request the
9        written consent of the patient or the patient's legal
10        guardian to release medical information to the
11        patient's designated caregiver following the
12        hospital's established procedures for releasing
13        personal health information and in compliance with all
14        State and federal laws; and
15            (B) the hospital shall record the patient's
16        designation of caregiver, the relationship of the
17        designated caregiver to the patient, and the name,
18        telephone number, and address of the patient's
19        designated caregiver in the patient's medical record.
20        (4) If a patient or the patient's legal guardian
21    declines to consent to the release of medical information
22    to the patient's designated caregiver, then the hospital is
23    not required to provide notice to the caregiver under
24    Section 15 of this Act or provide information contained in
25    the patient's discharge plan under Section 20 of this Act.
26        (5) A patient may elect to change his or her designated



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1    caregiver at any time, and the hospital must record this
2    change in the patient's medical record within 24 hours of
3    the change.
4    (b) A designation of a caregiver by the patient or the
5patient's legal guardian under this Section does not obligate
6any individual to provide any after-care for the patient.
7    (c) This Section shall not be construed to require a
8patient or a patient's legal guardian to designate any
9individual as a caregiver under this Act.
10    Section 15. Notice to designated caregiver. A hospital
11shall notify a patient's designated caregiver of the patient's
12discharge or transfer to another hospital or facility licensed
13by the Department of Public Health as soon as possible, but no
14later than 4 hours prior to the patient's actual discharge or
15transfer to that facility.
16    Section 20. Instruction to designated caregiver.
17    (a) As soon as possible but no later than 24 hours prior to
18a patient's discharge from a hospital, the hospital shall
19consult with the designated caregiver regarding the
20caregiver's capabilities and limitations and shall issue a
21discharge plan that describes the patient's after-care needs at
22his or her residence.
23    At minimum, a discharge plan shall include:
24        (1) the name and contact information of the caregiver



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1    designated under this Act;
2        (2) a description of all after-care necessary to
3    maintain the patient's ability to reside at home, taking
4    into account the capabilities and limitations of the
5    caregiver; and
6        (3) contact information for any health care providers,
7    community resources, and long-term services and supports
8    necessary to successfully carry out the patient's
9    discharge plan.
10    (b) The hospital that issues the discharge plan must
11provide caregivers with instruction in all after-care
12described in the discharge plan.
13        (1) At minimum, the instruction shall include:
14            (A) a live demonstration of the after-care tasks
15        performed by a hospital employee authorized to perform
16        each after-care task, provided in a culturally
17        competent manner and in accordance with the hospital's
18        requirements to provide language access services under
19        State and federal law;
20            (B) an opportunity for the caregiver to ask
21        questions about the after-care; and
22            (C) answers to the caregiver's questions provided
23        in a culturally competent manner and in accordance with
24        the hospital's requirements to provide language access
25        services under State and federal law.
26        (2) Any instruction provided under this Act shall be



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1    documented in the patient's medical record, including, but
2    not limited to, documentation of the date, time, and
3    contents of the instruction.
4    (c) The Department of Public Health is authorized to adopt
5rules to implement the provisions of this Act, including, but
6not limited to, rules to further define the content and scope
7of any instruction provided to caregivers under this Act.
8    Section 25. Non-interference with powers of existing
9health care directives. Nothing in this Act shall be construed
10to interfere with the rights of an agent operating under a
11valid health care directive that was in existence prior to a
12patient's entry into a hospital.
13    Section 99. Effective date. This Act takes effect upon
14becoming law.