This bill requires hospitals to provide a patient with an opportunity to
designate a lay caregiver who will receive instruction regarding patient aftercare
prior to the patient's discharge. If the patient is a minor, a parent or legal guardian
may designate a lay caregiver on the patient's behalf. If the patient is incapacitated
at the time of admission, a person authorized by the patient may make a designation
for the patient. Hospitals must promptly record the name and contact information
of a lay caregiver, if designated, after a patient is admitted into a hospital. If a patient
other than a minor is incapacitated at admission, but later regains capacity, the
hospital must notify the patient of the option to designate a lay caregiver or change
any designation made by a person authorized by the patient. Patients are not
required to designate a lay caregiver under this bill and, further, the designation of
a lay caregiver does not obligate any individual to provide aftercare for the patient.
Under this bill, if a patient designates a lay caregiver, the hospital is required
to attempt to notify the designated lay caregiver of the patient's discharge to another
facility or to a residence. The hospital must also attempt to consult with the lay
caregiver to prepare him or her for aftercare assistance tasks that he or she may
perform in caring for the patient, including, if applicable, wound care, injections,
medication management, and patient movement (for example, transferring a patient

in and out of bed or from a house to a car). The hospital must also issue a discharge
plan. However, if the patient or person authorized by the patient declines to provide
either informed consent or approval of the release of a portion of the patient's health
care record, the hospital is relieved of its notification and consultation obligations.
Further, under this bill, if the hospital is unsuccessful in attempting to contact the
lay caregiver, the lack of contact may not interfere with, delay, or otherwise affect the
medical care provided to the patient, or an appropriate discharge of the patient.
Under current law, patient medical records are kept confidential except in
certain limited circumstances, including if a patient or person authorized by the
patient gives informed consent to disclosure. Absent informed consent, a health care
provider may release a portion, but not a copy, of a patient health care record, to
certain individuals under certain limited circumstances. A health care provider may
also release a portion of a patient health care record to anyone if a patient or person
authorized by the patient agrees to the disclosure. Even without agreement, a health
care provider may, in certain circumstances such as patient incapacitation, release
to anyone the 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 person's involvement in the patient's care. This bill
adds designated lay caregivers to the list of individuals permitted access to
information directly relevant to that person's involvement in the patient's care.
Finally, this bill creates a limited exception to allow a hospital to provide a designated
lay caregiver a copy of any written discharge plan issued.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB19,1 1Section 1. 146.82 (4) (b) 2. a. of the statutes is amended to read:
SB19,2,62 146.82 (4) (b) 2. a. A member of the patient's immediate family, another relative
3of the patient, a close personal friend of the patient, a lay caregiver designated under
4s. 146.827,
or an individual identified by the patient, that portion that is directly
5relevant to the involvement by the member, relative, friend, or individual in the
6patient's care.
SB19,2 7Section 2. 146.82 (4) (c) of the statutes is created to read:
SB19,3,5
1146.82 (4) (c) Notwithstanding subs. (1) and (4) (b) (intro.), a health care
2provider may provide a lay caregiver who is designated under s. 146.827 and who is
3otherwise permitted access to a portion of a patient health care record under this
4subsection, with a copy of any written discharge plan issued under s. 146.827 (4) (a)
53.
SB19,3 6Section 3. 146.827 of the statutes is created to read:
SB19,3,7 7146.827 Designated caregivers. (1) Definitions. In this section:
SB19,3,118 (a) "Aftercare assistance" means any assistance provided by a lay caregiver to
9a patient under this section after the patient's discharge and related to the patient's
10condition at the time of discharge, including, if applicable, wound care, injections,
11medication management, and patient movement.
SB19,3,1312 (b) "Discharge" means a patient's exit or release from a hospital following any
13inpatient admission.
SB19,3,1414 (c) "Hospital" has the meaning given in s. 50.33 (2).
SB19,3,1515 (d) "Incapacitated" has the meaning given in s. 50.94 (1) (b).
SB19,3,1716 (e) "Lay caregiver" means any individual designated as a lay caregiver under
17this section to provide aftercare assistance to a patient.
SB19,3,24 18(2) Lay caregiver designation. (a) A hospital shall provide a patient, or a
19parent or legal guardian if the patient is a minor, or a person authorized by the
20patient if the patient is incapacitated, with an opportunity to designate a lay
21caregiver as soon as practicable after the patient's admission into the hospital and
22before the patient's discharge. An individual making a designation under this
23section may designate any person, including a family member, that is 18 years of age
24or older.
SB19,4,4
1(b) If a patient who is not a minor was incapacitated upon admission to the
2hospital, no lay caregiver was designated upon admission, and the patient is no
3longer incapacitated, the hospital shall inform the patient of the option to designate
4a lay caregiver under this section.
SB19,4,95 (c) If a patient was incapacitated upon admission to the hospital and a person
6authorized by the patient designated a lay caregiver under par. (a) and if the patient
7is no longer incapacitated, the hospital shall notify the patient of the existing lay
8caregiver designation and inform the patient of the option under par. (g) to change
9the designation at any time.
SB19,4,1410 (d) If a patient, parent, legal guardian, or person authorized by the patient
11designates a lay caregiver under this section, the hospital shall promptly record the
12designation of the lay caregiver, the relationship of the lay caregiver to the patient,
13and the name, telephone number, and address of the lay caregiver in the patient's
14medical record.
SB19,4,1715 (e) If a patient, parent, legal guardian, or person authorized by the patient,
16declines to designate a lay caregiver under this section, the hospital shall promptly
17document that information in the patient's medical record.
SB19,4,2118 (f) Nothing in this section requires a patient, parent, legal guardian, or person
19authorized by the patient to designate a lay caregiver. The designation or lack of
20designation under this section may not interfere with, delay, or otherwise affect the
21medical care provided to the patient.
SB19,5,222 (g) A patient, or, if applicable, a parent, legal guardian, or person authorized
23by the patient, may elect to designate a lay caregiver, withdraw a designation, or
24change the designated lay caregiver at any time. The hospital shall promptly record
25in the patient's medical record any designation modification, and, if an individual

1designates a new lay caregiver under this section, the information required under
2par. (d).
SB19,5,43 (h) Designation of a lay caregiver pursuant to the provisions of this section does
4not obligate any individual to perform aftercare assistance for the patient.
SB19,5,9 5(3) Release of medical information. (a) If a patient, parent, legal guardian,
6or person authorized by the patient designates an individual as a lay caregiver under
7this section, the hospital shall promptly request the informed consent of the patient
8or of a person authorized by the patient to release patient health care records under
9s. 146.82 (1).
SB19,5,1310 (b) Notwithstanding par. (a), the hospital may, to the extent allowed under s.
11146.82 (4) (b) and (c), release a portion of a patient's medical records to complete the
12requirements of sub. (4), unless a patient or person authorized by a patient expressly
13refuses to grant informed consent.
SB19,5,1814 (c) If a patient or person authorized by the patient declines to provide informed
15consent under s. 146.82 (1) and declines to release a portion of the patient's medical
16record under s. 146.82 (4) (b) 1. to allow necessary communication with a designated
17lay caregiver, the hospital is not required to complete the notification, consultation,
18and discharge plan requirements under sub. (4).
SB19,5,22 19(4) Notification, aftercare consultation, and discharge plan. (a) Subject to
20sub. (3), if a patient, parent, legal guardian, or person authorized by a patient
21designates a lay caregiver, the hospital shall, as soon as practicable, do all of the
22following:
SB19,5,2423 1. Attempt to notify the patient's designated lay caregiver of the patient's
24discharge or transfer to another facility.
SB19,6,2
12. Attempt to consult with the designated lay caregiver to prepare him or her
2for aftercare assistance.
SB19,6,43 3. Issue a discharge plan describing a patient's aftercare assistance needs with
4respect to the patient's condition at the time of discharge.
SB19,6,75 (b) In the event the hospital is unable to contact the designated lay caregiver,
6the lack of contact shall not interfere with, delay, or otherwise affect the medical care
7provided to the patient, or an appropriate discharge of the patient.
SB19,6,10 8(5) No interference with other law. Nothing in this section shall be construed
9to interfere with the rights of a person legally authorized to make health care
10decisions on behalf of a patient under this chapter or chs. 154 and 155.
SB19,6,14 11(6) No private right of action. Nothing in this section shall be construed to
12create a private right of action against a hospital, a hospital employee, or any
13authorized agent of the hospital, or to otherwise supercede or replace existing rights
14or remedies.
SB19,4 15Section 4. Effective date.
SB19,6,1716 (1) This act takes effect on the first day of the 7th month beginning after
17publication.
SB19,6,1818 (End)
Loading...
Loading...