An Act To Allow lOa Patient To Designate a Caregiver in the Patient's Medical Record
Maine Legislature, Session 127, LD 0666
Committee Amendment CA_A_H432 (House)
Amends: 22 MRSA §1711-G

COMMITTEE AMENDMENT "A "to H.P. 447, L.D. 666, Bill, "An Act To Allow 
lOa Patient To Designate a Caregiver in the Patient's Medical Record" 
Amend the bill in section 3 in subsection 3 in paragraph E in the first line (page 1, 
line 11 in L.D.) by striking out the following: "The caregiver" and inserting the 
following: 'The lay caregiver' 
Amend the bill in section 5 in subsection 6 in paragraph T in the first line (page 1, 
line 23 in L.D.) by striking out the following: "a caregiver" and inserting the following: '.!! 
lay caregiver' 
Amend the bill by striking out all of section 6 and inserting the following: 
'Sec. 6. 22 MRSA §1711-G is enacted to read: 
§ t71t-G. Designated lay caregivers 
1. Definitions. As used in this section, unless the context indicates otherwise, the 
following terms have the following meanings. 
A. "Aftercare" means any assistance to a patient, after the patient's discharge, that is 
directly related to the content of the patient's hospital discharge plan and that is 
provided by a lay caregiver designated pursuant to subsection 2, including assistance 
with basic or instrumental activities of daily living, performance of medical and 
nursing tasks, assistance in administering medication and operation of medical 
equipment. 
B. "Discharge" means a patient's exit or release from a hospital to the patient's 
residence or another health care setting following any medical care or treatment at the 
hospital or observation at the hospital for a period that includes midnight of at least 
one calendar day. 
C. "Residence" means a dwelling that a person considers to be the person's home. 
"Residence" does not include a rehabilitation facility, hospital, nursing home, assisted 
living facility, group home or any other health care facility licensed by the State. 
COMMITTEE AMENDMENT 
ROFS 
CQMMITTEE AMENDMeNT "A " 
to H.P. 447, L.D. 666 
2. 
D~s\gn~tion of lax caregiver,. In acc~rdance with th,\S s),l;~sectio~, a h()spital 
licensed under chapter 405, but not a private mental hospital as described in chapter 404, 
shall allow for the designation of a lay caregiver to provide aftercare to a patient. 
. 
", 
. 
' .... '" 
" 
, 
. 
,-, 
... 
., 
' .. , 
'"., 
" 
A. For. a patient with capacity to make health-care d~cisions, as describeg in Title 
18-A" Article 5, Part 8, the ~ospital shall provi~e t~e. patient Viith at least one 
opportunity to designate a lay caregi"er following the .patient's admissiQn to the 
hQspital, Qr OQsel\Tation at the h.osQital for.a period that incl~des midnigh.t of at least 
one calendar day, and prior to the patient's discharge. 
B .. :For a patient without capacity to make health-care gecisions, as described in T~tle 
18:-A, Article 5 ,Part 8, the hospital shallprovide the patient's legal.gyardian., agent or 
surrog~te who is reasonably available and acting pursuant to Title 18:-A, Article 5, 
Part 8 with at least one opportunity to designate a lay caregiver following the patient's 
adn1ission to the hospital, or observation at the hospital for a period that includes 
midnight of at least one calendar day, and prior t9 th~ R~tient'sgischarge. 
. . .' 
C. 
The hospital shall document the designation Qf. a lay caregiver under this 
su!2section in the patient's medical record, including the lay caregiver'S name, 
relationship to the patient. teleRhone 
tlumb~~, addre~sand at?:y ()ther .. contact 
informat~on as Rrovided~ If the .Ratient 9r th~ p~~ient's l~g~l guar4i~n, ~gent ()r 
surrogate who is reasonably available and acting Rursuant to Title I8-A, Article 5, 
Part 8 de£lines to designate a l~y caregiver, the hospitai shallQ~~·~meJ1t that decision 
in the patient's medical record and that documentation constitutes· compliance by the 
hQspital with the requirements of this section. A designated lay caregiver may be 
removed or changed by the Rat,ientor the. pati~nt's l~gal gvardian, a~getlt .or surr()gate 
at any~ime" so long as the change or re~oval is doc'll:mented py the hospital in the 
patie~t~s medical record. 
Q. DesignatiQn of a lay caregiver under this subsection by the Ratient or the patient's 
legal guardian, agent or surrogat~ who is reas~mably avaiiabl~ anclacting pur~uant to 
Title 18-A, Article 5, Part 8 is oRtional. A designated lay caregiver is not obligated 
underthis sec'tiQn to,perform any aftercare tasks for ~he patient.· 
. ... 
, .. . 
3. Written consent. If a lay caregiver is designated under s,ubsectiQn 2, the hospital 
shall request that the patient or the patient's legal guardian, agent or surrogate who is 
reasonably available and acting pursuant to Title 18:-A, Article ?,Part 8 provide written 
consent to release medical information regarding the scope of care to the patient's 
designated lay caregiver to carrY out the putposes· of this sectiQtl .. Written consent under 
this subsection must be provided pursuant to the hospital's establi~hed· procedures for 
releasing Rersonal health information and in compliance with state and federal law. 
4. 
Notice to designated lax caregiver. 
For a patient unable to effectively 
communicate· with a hiy caregiver designated under subsection 2, and for ~hom written 
consent is received under subsection 3, a hospital shall make reasonable efforts to notify 
the designated lay caregiver prior to the patient's discharge or transfer to another hospital 
licensed under chapter 405. The hospital may not withhold, delay or otherwise fail to 
deliver medical care to the patient or an appropriate discharge or transfer of the patient 
because the hospital is unable to notify the designated lay caregiver in accordance with 
this subsection prior to the patient's discharge or transfer. A hospital shall document in 
COMMITTEE AMENDMENT 
ROFS 
COMMITIEE AMENl;:>MENT "A" to H.P. 447, L.V. 666 
the patient's megical record its attempt to notify the designated lay caregiver under this 
subsection. 
. 
. 
5. pi.scltarge plan. If written consent is received under sll.b~ecti,<>n i3, a hospital s~all 
make reasonable efforts to communicate with a lay caregiver designated under subsection 
regardillg the development of a patient's disch~rge 'plan to lielpprepare the 4esignated 
lay caregiver for the patient's aftercare needs at the patient's residence in accordance with 
the hospital's discha~ge policy. 
. 
'. 
,. . ... 
.,. , 
6. Instrucdon to desi.gnated lay caregi.ver. If written consent is received under 
subsection. 3" prior to 'a patient's discharge, the' hospital 'shall make ~eas~nable 'efforts to 
instruct the patient's lay caregiver designated ynder subsection 2, in a. culturally 
c~ni.petent mal1~er, Qn how to meet the"pa'd~nt's aftercare needs' and shall prOvide a 
meanil1.gful ()ppQrtunity for the designated lay caregiyer to ask questions about the 
Pf!tient'~ discharge plan. 
7. Noni.nterference wUh hea,lth care di.re~dves. The provisions of this section m~ 
not be construed to interfere with the rights of an agent of a patient operating under a 
valid' heaith care directive under Title I8-A, Article 5, Part 8.' .. 
... 
. 
~. Rules. The department may adopt rules to carrY out thr purposes of this section, 
including defining the content and scope of any instruction given under subsection 5 or 6. 
In' the develop~ent of any rules pursuant to this subs~ciion,' the dep~rtJnent' shallco~~,ult 
with representatives of hospitals, consumers and org~nizations that represent seniors. 
Rules adQpted t!ursuant to this subsection are rQutine technical rules pursuant to Title 5, 
chapter375,subchapter 2-A,' 
'.' . ..' 
..... . . 
SUMMARY 
This amendment makes the following changes to section 6 of the bill: 
1. It eliminates the definition of "entry"; 
2. It eliminates the requirement that the designation of a caregiver needs to be made 
within the first 24 hours; 
3. It changes the notice requirements to caregivers from a requirement to notify to a 
requirement to make reasonable efforts to notify; 
4. It eliminates what a discharge plan must include and defers to the hospital's 
established policy; and 
5. It eliminates the instruction requirements. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
i\pproved: 06/03/15 
~~ 
LD666 
LR 989(02) 
An Act To Allow a Patient To Designate a Caregiver in the Patient's Medical Record 
Fiscal Note for Bill as Amended by Committee Amendment flo( II, 'I :J ')., ) 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Fiscal Detail and Notes 
Any additional costs to the Department of Health and Human Services to adopt the changes in this bill are expected to 
be minor and can be absorbed within existing budgeted resources. 
LR0989(02) - Fiscal Note - Page 1 of 1