BILL NUMBER: AB 1946 CHAPTERED 09/15/02 CHAPTER 550 FILED WITH SECRETARY OF STATE SEPTEMBER 15, 2002 APPROVED BY GOVERNOR SEPTEMBER 14, 2002 PASSED THE ASSEMBLY AUGUST 22, 2002 PASSED THE SENATE AUGUST 20, 2002 AMENDED IN SENATE AUGUST 7, 2002 AMENDED IN SENATE JUNE 12, 2002 AMENDED IN ASSEMBLY MAY 1, 2002 AMENDED IN ASSEMBLY APRIL 3, 2002 INTRODUCED BY Assembly Member Corbett FEBRUARY 14, 2002 An act to amend Section 1599.74 of, and to add Chapter 4 (commencing with Section 123222.1) to Part 1 of Division 106 of, the Health and Safety Code, relating to public health. LEGISLATIVE COUNSEL'S DIGEST AB 1946, Corbett. Written materials for patients. (1) Existing law requires every contract of admission for a skilled nursing or intermediate care facility to contain a complete copy of specified patients' rights provisions, in legible print of no less than 10-point type. This bill would instead require these provisions to be in legible print of no less than 12-point type. (2) Existing law contains various provisions relating to personal health care and patient rights. This bill would require specified printed materials that are provided to a patient by a general acute care hospital, skilled nursing, intermediate care, or nursing facility, or residential care facility for the elderly, to be printed in at least a 12-point font that is clear and legible. The bill would further require that, upon admission of a patient to a skilled nursing, intermediate care, or nursing facility, or to a general acute care hospital, the facility shall ask if the patient wishes specified patients' rights information to be provided to the patient's next of kin or agent under a durable power of attorney for health care, and to provide that information if the patient so directs. The bill would authorize the facility or hospital to provide materials regarding its expectations of patients and patients' responsibilities, as specified. This bill would also require a representative of the facility or hospital to explain these materials to the next of kin or agent under the durable power of attorney for health care, upon request. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 1599.74 of the Health and Safety Code is amended to read: 1599.74. (a) The department shall translate both the statutory Patients' Bill of Rights, as provided in Chapter 3.9 (commencing with Section 1599), the regulatory Patients' Bill of Rights for Skilled Nursing Facilities (commencing with Section 72527 of Title 22 of the California Administrative Code), and, if appropriate, the regulatory Patients' Bill of Rights for Intermediate Care Facilities (commencing with Section 73523 of Title 22 of the California Administrative Code), into Spanish and Chinese, and into other languages as needed for ethnic groups representing 1 percent or more of the nursing home population in the state. The department shall also translate the Patients' Bill of Rights into Braille or have it recorded for the use of blind patients, or both. These translations shall be sent to all long-term health care facilities in the state. (b) Every contract of admission shall contain a complete copy of both the statutory and regulatory Patients' Bill of Rights. Notwithstanding any other provision of law, the text of the Patients' Bill of Rights shall be in legible print of no less than 12-point type. If a translation has been provided by the department, the text given to non-English-speaking residents shall be in their language. (c) The contract shall also contain a separate written acknowledgement that the resident has been informed of the Patients' Bill of Rights. Written acknowledgement by the resident or the resident's representative must be made either on a separate document or in the agreement itself next to the clause informing the resident of these regulatory rights. Written acknowledgement by use of the signature on the agreement as a whole does not meet this requirement. SEC. 2. Chapter 4 (commencing with Section 123222.1) is added to Part 1 of Division 106 of the Health and Safety Code, to read: CHAPTER 4. WRITTEN MATERIALS FOR PATIENTS 123222.1. (a) Notwithstanding any other provision of law, any printed materials specified in subdivision (b), that are provided to a patient by an employee or authorized agent on behalf of a general acute care hospital, as defined in subdivision (a) of, a skilled nursing facility, as defined in subdivision (c) of, an intermediate care facility as defined in subdivision (d) of, a nursing facility, as defined in subdivision (k) of, Section 1250, or a residential care facility for the elderly, as defined in subdivision (l) of Section 1569.2, shall be printed in at least a 12-point font that is clear and legible. (b) The section shall apply only to the following: (1) Admission and discharge papers and forms from general acute care hospitals, skilled nursing facilities, intermediate care facilities, and nursing facilities. (2) Medical and therapeutic instructions prepared by the facility specifically for an individual upon his or her discharge from a general acute care hospital, a skilled nursing facility, an intermediate care facility, or a nursing facility. (3) Any contract for consent for hospitalization, or agreement to assume financial responsibility between a patient and any of the facilities specified in paragraph (1). (4) Instructions and forms for advance health care directives, as defined in Section 4605 of the Probate Code. (5) Information produced by the hospital or facility regarding the rights and responsibilities of patients or residents while receiving care at the hospital or facility, and regarding grievances and appeals, including forms and instructions. (6) Correspondence written, printed, or produced by any of the facilities specified in paragraph (1), or a residential care facility for the elderly. (c) Any entity described in paragraph (1) of subdivision (b), and any residential care facility for the elderly, may continue to use its supply of materials that exists on January 1, 2003, until that supply is exhausted or until January 1, 2006, whichever occurs first, and thereafter shall comply with the requirements of this section. (d) The hospital's or facility's policies and procedures are specifically excluded from the requirements of this section. 123222.2. (a) (1) Upon admission of a patient to a skilled nursing facility, as defined in subdivision (c) of, an intermediate care facility, as defined in subdivision (d) of, or a nursing facility, as defined in subdivision (k) of, Section 1250, the facility shall ask the patient if he or she would like the facility to provide the patient's next of kin or agent under a durable power of attorney for health care with materials regarding patients' rights and responsibilities. If the patient states that he or she would like these materials to be provided, the facility shall do so, in accordance with paragraph (2). (2) (A) The materials provided by the facility pursuant to this subdivision shall include a comprehensive Patients' Bill of Rights, as described in subdivision (d) of Section 1599.61. Until subdivision (d) of Section 1599.61 is fully implemented by the State Department of Health Services, the Patients' Bill of Rights provided pursuant to this subdivision shall include all of the following: (i) The rights contained in Chapter 3.9 (commencing with Section 1599) of Division 2. (ii) The resident rights applicable to skilled nursing facilities, contained in Section 72527 of Title 22 of the California Code of Regulations. (iii) The resident rights applicable to intermediate care facilities, contained in Section 73523 of Title 22 of the California Code of Regulations. (iv) The resident rights applicable to long-term care facilities under Sections 483.10 to 483.25, inclusive, of Title 42 of the Code of Federal Regulations. (B) The facility may also provide written materials regarding the facility's expectations of patients and patients' responsibilities while the patient is receiving care at the facility. This paragraph shall not be construed to require the facility to create any additional written materials regarding the facility's expectations of patients and patients' responsibilities. (b) (1) Upon admission of a patient to a general acute care hospital, as defined in subdivision (a) of Section 1250, the hospital shall ask the patient if he or she would like the hospital to provide the patient's next of kin or agent under a durable power of attorney for health care with materials regarding patients' rights and responsibilities. If the patient states that he or she would like these materials to be provided, the hospital shall do so, in accordance with paragraph (2). (2) (A) The materials provided by the hospital pursuant to this subdivision shall include a comprehensive Patients' Bill of Rights, including the regulatory patients' rights for general acute care hospitals contained in Section 70707 of Title 22 of the California Code of Regulations, and the rights afforded to patients under Section 482.13 of Title 42 of the Code of Federal Regulations. (B) The hospital may also provide written materials regarding the hospital's expectations of patients and patients' responsibilities while the patient is receiving care at the hospital. This paragraph shall not be construed to require the hospital to create any additional written materials regarding the hospital's expectations of patients and patients' responsibilities. (c) Upon the request of the patient, or of the patient's next of kin or agent under a durable power of attorney for health care, a representative of any facility or hospital providing patients' rights information or other documentation described in this section shall explain the materials provided. (d) This section shall not be construed to require the disclosure of patient information that would otherwise be exempt from disclosure.