Maine Code § 22-1711-G

Designated lay caregivers
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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. [PL 2015, c. 370, §6 (NEW).]
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. [PL 2015, c. 370, §6
(NEW).]
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. [PL 2015, c. 370, §6 (NEW).]
[PL 2015, c. 370, §6 (NEW).]
2. Designation of lay caregiver. In accordance with this subsection, a hospital 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 decisions, as described in Title 18-C, Article 5,
Part 8, the hospital shall provide the patient with at least one opportunity to designate a lay caregiver
following the patient's admission to the hospital, or observation at the hospital for a period that
includes midnight of at least one calendar day, and prior to the patient's discharge. [PL 2017, c.
402, Pt. C, §45 (AMD); PL 2019, c. 417, Pt. B, §14 (AFF).]
B. For a patient without capacity to make health care decisions, as described in Title 18-C, Article
5, Part 8, the hospital shall provide the patient's legal guardian, agent or surrogate who is reasonably
available and acting pursuant to Title 18-C, Article 5, Part 8 with at least one opportunity to
designate a lay caregiver following the patient's admission to the hospital, or observation at the
hospital for a period that includes midnight of at least one calendar day, and prior to the patient's
discharge. [PL 2017, c. 402, Pt. C, §45 (AMD); PL 2019, c. 417, Pt. B, §14 (AFF).]
C. The hospital shall document the designation of a lay caregiver under this subsection in the
patient's medical record, including the lay caregiver's name, relationship to the patient, telephone
number, address and any other contact information as provided. If the patient or the patient's legal
guardian, agent or surrogate who is reasonably available and acting pursuant to Title 18-C, Article
5, Part 8 declines to designate a lay caregiver, the hospital shall document that decision in the
patient's medical record and that documentation constitutes compliance by the hospital with the
requirements of this section. A designated lay caregiver may be removed or changed by the patient
or the patient's legal guardian, agent or surrogate at any time, so long as the change or removal is
documented by the hospital in the patient's medical record. [PL 2017, c. 402, Pt. C, §45 (AMD);
PL 2019, c. 417, Pt. B, §14 (AFF).]
D. Designation of a lay caregiver under this subsection by the patient or the patient's legal guardian,
agent or surrogate who is reasonably available and acting pursuant to Title 18-C, Article 5, Part 8
is optional. A designated lay caregiver is not obligated under this section to perform any aftercare
tasks for the patient. [PL 2017, c. 402, Pt. C, §45 (AMD); PL 2019, c. 417, Pt. B, §14 (AFF).]
[PL 2017, c. 402, Pt. C, §45 (AMD); PL 2019, c. 417, Pt. B, §14 (AFF).]
3. Written consent. If a lay caregiver is designated under subsection 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-C, Article 5, 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 purposes of this
section. Written consent under this subsection must be provided pursuant to the hospital's established
procedures for releasing personal health information and in compliance with state and federal law.

[PL 2017, c. 402, Pt. C, §45 (AMD); PL 2019, c. 417, Pt. B, §14 (AFF).]
4. Notice to designated lay caregiver. For a patient unable to effectively communicate with a lay
caregiver designated under subsection 2, and for whom 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 the patient's medical
record its attempt to notify the designated lay caregiver under this subsection.
[PL 2015, c. 370, §6 (NEW).]
5. Discharge plan. If written consent is received under subsection 3, a hospital shall make
reasonable efforts to communicate with a lay caregiver designated under subsection 2 regarding the
development of a patient's discharge plan to help prepare the designated lay caregiver for the patient's
aftercare needs at the patient's residence in accordance with the hospital's discharge policy.
[PL 2015, c. 370, §6 (NEW).]
6. Instruction to designated lay caregiver. If written consent is received under subsection 3,
prior to a patient's discharge, the hospital shall make reasonable efforts to instruct the patient's lay
caregiver designated under subsection 2, in a culturally competent manner, on how to meet the patient's
aftercare needs and shall provide a meaningful opportunity for the designated lay caregiver to ask
questions about the patient's discharge plan.
[PL 2015, c. 370, §6 (NEW).]
7. Noninterference with health care directives. The provisions of this section may not be
construed to interfere with the rights of an agent of a patient operating under a valid health care directive
under Title 18-C, Article 5, Part 8.
[PL 2017, c. 402, Pt. C, §45 (AMD); PL 2019, c. 417, Pt. B, §14 (AFF).]
8. Rules. The department may adopt rules to carry out the purposes of this section, including
defining the content and scope of any instruction given under subsection 5 or 6. In the development of
any rules pursuant to this subsection, the department shall consult with representatives of hospitals,
consumers and organizations that represent seniors. Rules adopted pursuant to this subsection are
routine technical rules pursuant to Title 5, chapter 375, subchapter 2-A.
[PL 2015, c. 370, §6 (NEW).]

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