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SB516,1,3 1An Act to amend 146.82 (4) (b) 2. a.; and to create 50.379 and 146.82 (4) (c) of
2the statutes; relating to: requiring hospitals to allow designation of a
3caregiver.
Analysis by the Legislative Reference Bureau
This bill requires hospitals to provide a patient or, if applicable, a patient's legal
guardian with an opportunity to designate a caregiver who will receive, before the
patient is discharged from the hospital, instruction regarding assistance with the
patient's care after discharge.
Under the bill, a hospital must, no later than 24 hours following a patient's
admission to a hospital and before the patient is discharged or transferred, provide
at least one opportunity for a patient or, if applicable, a patient's legal guardian to
designate at least one caregiver. If a patient is unconscious or otherwise
incapacitated when admitted, the hospital shall provide an opportunity for caregiver
designation within 24 hours after the patient regains consciousness or capacity. If
a patient or legal guardian designates a caregiver, a hospital must promptly record
the name and contact information of the caregiver. If a patient or legal guardian
declines to designate a caregiver, the hospital must also promptly document that
information. Patients are not required to designate a caregiver under this bill and,
further, the designation of a caregiver does not obligate any individual to provide
aftercare for the patient. A patient may elect to change the designated caregiver at
any time, and the hospital must record the change within 24 hours.
The bill requires that if a patient designates a caregiver, the hospital must
promptly request written consent to release medical information to the patient's

caregiver. If the patient or the patient's legal guardian declines to provide consent,
the hospital is relieved of its notification and consultation obligations.
Under current law, patient medical records are kept confidential except in
certain limited circumstances, including if a patient or a person authorized by the
patient gives consent to the disclosure. Even without agreement, a health care
provider may, in certain circumstances such as patient incapacitation, release a
limited amount of information necessary to identify, locate, or provide notification of
the patient's location, condition, or death. Beyond that, current law allows a health
care provider to provide more information only to certain listed individuals.
Specifically, a health care provider may provide to the patient's immediate family,
another relative, a close personal friend of the patient, or an individual identified by
the patient, that portion of information from the health care record directly relevant
to that individual's involvement in the patient's care. This bill adds designated
caregivers to the list of individuals permitted access to information directly relevant
to that individual's involvement in the patient's care.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB516,1 1Section 1. 50.379 of the statutes is created to read:
SB516,2,2 250.379 Designated caregivers. (1) Definitions. In this section:
SB516,2,83 (a) “Aftercare assistance” means any assistance provided by a caregiver to a
4patient under this section after the patient's discharge and related to the patient's
5condition at the time of discharge, including assisting with basic activities of daily
6living or instrumental activities of daily living, or carrying out medical or nursing
7tasks, such as managing wound care, assisting in administering medications, or
8operating medical equipment.
SB516,2,129 (b) “Caregiver” means any individual, including a relative, partner, friend,
10neighbor, or other person who has a significant relationship with a patient, who is
11designated as a caregiver under this section to provide aftercare assistance to that
12patient.
SB516,2,1413 (c) “Discharge" means a patient's exit or release from a hospital to the patient's
14residence following an inpatient admission.
SB516,3,1
1(d) “Hospital" has the meaning given in s. 50.33 (2).
SB516,3,22 (e) “Incapacitated" has the meaning given in s. 50.94 (1) (b).
SB516,3,53 (f) “Residence” means a dwelling that the patient considers to be his or her
4home. “Residence” does not include any rehabilitation facility, hospital, nursing
5home, assisted living facility, or group home licensed by the department.
SB516,3,10 6(2) Caregiver designation. (a) A hospital shall provide a patient or, if
7applicable, a patient's legal guardian at least one opportunity to designate at least
8one caregiver no later than 24 hours following the patient's admission to a hospital
9and before the patient's discharge or transfer to another hospital or facility licensed
10by the department.
SB516,3,1411 (b) If a patient is unconscious or otherwise incapacitated upon admission to the
12hospital, the hospital shall provide the patient or, if applicable, the patient's legal
13guardian with an opportunity to designate a caregiver within 24 hours following the
14patient's recovery of his or her consciousness or capacity.
SB516,3,1715 (c) If a patient or a patient's legal guardian declines to designate a caregiver
16under this section, the hospital shall promptly document that information in the
17patient's medical record.
SB516,3,2118 (d) If a patient or the patient's legal guardian designates a caregiver under this
19section, the hospital shall promptly record the designation of the caregiver, the
20relationship of the caregiver to the patient, and the name, telephone number, and
21address of the caregiver in the patient's medical record.
SB516,3,2322 (e) Nothing in this section requires a patient or a patient's legal guardian to
23designate a caregiver.
SB516,4,3
1(f) A patient may elect to change a designated caregiver at any time. The
2hospital shall, within 24 hours, record in the patient's medical record any
3designation change and any new information required under par. (d).
SB516,4,54 (g) Designation of a caregiver under the provisions of this section does not
5obligate any individual to perform aftercare assistance for the patient.
SB516,4,11 6(3) Release of medical information. (a) If a patient or a patient's legal
7guardian designates an individual as a caregiver under this section, the hospital
8shall promptly request the written consent of the patient or the patient's legal
9guardian to release medical information to the patient's designated caregiver
10following the hospital's established procedures for releasing personal health
11information and in accordance with applicable federal and state law.
SB516,4,1512 (b) If a patient or the patient's legal guardian declines to consent to the release
13of medical information to the patient's designated caregiver, the hospital is not
14required to provide notice to the caregiver or provide information contained in the
15patient's discharge plan as required under subs. (4) and (5).
SB516,4,18 16(4) Notification and instruction to designated caregiver. Subject to sub. (3),
17if a patient or a patient's legal guardian designates a caregiver under this section,
18a hospital shall do all of the following:
SB516,4,2319 (a) Notify the patient's designated caregiver of the patient's discharge or
20transfer to another hospital or facility licensed by the department as soon as possible,
21which may be after the patient's physician issues a discharge order, but not less than
224 hours before the patient's actual discharge or transfer to the other hospital or
23facility.
SB516,5,224 (b) No less than 24 hours before a patient's discharge from a hospital, consult
25with the designated caregiver along with the patient regarding the caregiver's

1capabilities and limitations and issue a written discharge plan that describes a
2patient's aftercare assistance needs at the patient's residence.
SB516,5,4 3(5) Discharge plan. (a) For purposes of this section, a hospital shall include
4in a discharge plan at least all of the following:
SB516,5,65 1. The name and contact information of the caregiver designated under this
6section.
SB516,5,97 2. A description of all aftercare assistance tasks necessary to maintain the
8patient's ability to reside at home, taking into account the capabilities of the
9caregiver.
SB516,5,1210 3. Contact information for any health care, community resources, and
11long-term services and supports necessary to successfully carry out the patient's
12discharge plan.
SB516,5,1513 (b) A hospital issuing a discharge plan under this section shall provide
14caregivers with instruction in all aftercare assistance tasks described in the
15discharge plan, and must include at least all of the following:
SB516,5,2016 1. A live demonstration of the tasks performed by a hospital employee or
17individual with whom the hospital has a contractual relationship authorized to
18perform the aftercare assistance task, provided in a culturally competent manner
19and in accordance with the hospital's requirements to provide language access
20services under state and federal law.
SB516,5,2221 2. An opportunity for the caregiver and patient to ask questions about the
22aftercare assistance tasks.
SB516,5,2523 3. Answers to the caregiver's and patient's questions provided in a culturally
24competent manner and in accordance with the hospital's requirements to provide
25language access services under state and federal law.
SB516,6,3
1(6) No interference with authorized decision making. Nothing in this section
2shall be construed to interfere with the rights of a person authorized by law to make
3health care decisions on behalf of a patient.
SB516,6,6 4(7) No right of action. Nothing in this section shall be construed to create a
5private right of action against a hospital, a hospital employee, or any authorized
6agent of the hospital, or to otherwise supercede or replace existing rights or remedies.
SB516,2 7Section 2. 146.82 (4) (b) 2. a. of the statutes is amended to read:
SB516,6,128 146.82 (4) (b) 2. a. A member of the patient's immediate family, another relative
9of the patient, a close personal friend of the patient, a caregiver designated under s.
1050.379,
or an individual identified by the patient, that portion that is directly
11relevant to the involvement by the member, relative, friend, or individual in the
12patient's care.
SB516,3 13Section 3 . 146.82 (4) (c) of the statutes is created to read:
SB516,6,1714 146.82 (4) (c) Notwithstanding subs. (1) and (4) (b), a health care provider may
15provide a caregiver who is designated under s. 50.379 and who is otherwise
16permitted access to a portion of a patient health care record under this subsection,
17with a copy of any written discharge plan issued under s. 50.379 (4) and (5).
SB516,6,1818 (End)
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