Office Of The Long-term Care Patient Representative - - CA Welfare And Institutions

Section § 9260

This law sets up the Long-Term Care Patient Representative Program within the California Department of Aging. It aims to provide representatives for residents in nursing homes when family or friends can't participate. The department will manage the representatives and make sure they're trained and certified. It can work with local agencies to offer these services, bypassing some standard contract rules. Nursing homes will get contact info for these services, and there will be ongoing data collection about the program's effectiveness.

(a)

(1) The Long-Term Care Patient Representative Program is established within the California Department of Aging to provide public patient representatives for residents of skilled nursing or intermediate care facilities to participate in interdisciplinary team reviews held pursuant to Section 1418.8 of the Health and Safety Code in the event that a family member, friend, or other person authorized by state or federal law cannot be located, or is otherwise unavailable, unwilling, or unable to participate as a patient representative.

(2) The Office of the Long-Term Care Patient Representative is established within the California Department of Aging to coordinate and oversee the statewide provision of public patient representative services and to train and certify individuals who serve as public patient representatives in the Long-Term Care Patient Representative Program.

(b) The department may enter into agreements with area agencies on aging, government agencies, or nonprofit organizations to provide patient representative services as local long-term care patient representative programs (“local program”). Contracts between the department and local programs shall be exempt from Chapter 2 (commencing with Section 10290) of Part 2 of Division 2 of the Public Contract Code.

(c) The department shall provide every skilled nursing facility and intermediate care facility, and update as needed, contact information for local programs to be used for required notices.

(d) The department shall collect, analyze, and report data related to the program, including the number of residents represented and the number of interdisciplinary team meetings attended.

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(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)

Section § 9265

This law section outlines the requirements for public patient representatives in California. These representatives must meet specific eligibility, training, certification, and continuing education standards set by the department. Before they can start working in skilled nursing or intermediate care facilities, they must pass a criminal background check. Additionally, the certification process ensures that they comply with certain legal prohibitions specified in another health and safety regulation.

(a) The department shall establish appropriate eligibility, training, certification, and continuing education requirements for public patient representatives. An individual shall not serve as a public patient representative until and unless the individual obtains and maintains certification pursuant to this section.

(b) Each public patient representative shall obtain a criminal offender record clearance prior to entry into any skilled nursing facility or intermediate care facility.

(c) The certification process shall ensure that each public patient representative is not prohibited from serving as a patient representative by Section 1418.8 of the Health and Safety Code.

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(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)

Section § 9270

A public patient representative isn't allowed to be part of a team review if the decision leads directly to death. But, they can join discussions to create or change medical orders like life-sustaining treatments, do not resuscitate (DNR), and hospice care. The representative needs to check if these decisions align with the patient's healthcare wishes or are in the patient's best interest if their wishes aren't fully known.

(a) A public patient representative shall not participate in an interdisciplinary team review of a decision that would directly and inexorably lead to death.

(b) Notwithstanding subdivision (a), a public patient representative may participate in an interdisciplinary team review to create or revise Physician Orders for Life Sustaining Treatment, as specified in Part 4 (commencing with Section 4780) of Division 4.7 of the Probate Code, Do Not Resuscitate, comfort care orders, and elections of hospice care. The public patient representative shall ascertain whether that care is consistent with the resident’s individual health care instructions, if any, and other expressed wishes, to the extent known, or otherwise whether the proposed intervention appears consistent with the best interest of the resident.

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(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)

Section § 9275

A public patient representative is responsible for ensuring all requirements are met for their involvement in a resident's care review team. They must check that a meeting is necessary and that no one else can make decisions for the resident. The representative must meet the resident, review their medical records, and understand facility policies.

They participate in team discussions about medical treatments, always considering what aligns best with the resident's wishes or interests. They express the resident's preferences, report any signs of abuse or neglect, and guide residents to legal services if they want a court to review their situation.

A public patient representative assigned by the program to an interdisciplinary team review shall do all of the following:

(a) Conduct a review to confirm that all criteria are met for an interdisciplinary team to convene for a resident and for the assignment of a patient representative by the program, as required by Section 1418.8 of the Health and Safety Code, including reviewing a copy of all written notices from the facility to the resident regarding the physician’s determination that the resident lacks the ability to provide informed consent, and the facility’s determination that there is no surrogate decisionmaker.

(b) Meet and, if possible, interview the resident prior to an interdisciplinary team meeting for initial review of a proposed treatment intervention or quarterly review of that intervention, or upon a change of condition in the resident necessitating a change in the proposed intervention.

(d) Review relevant policies and procedures of the facility.

(e) Participate in the interdisciplinary team review of the proposed intervention, considering the factors required by Section 1418.8 of the Health and Safety Code, including the risks and benefits of the proposed intervention, and any alternatives, and consider whether the proposed intervention is either consistent with the resident’s preferences or best approximation of preferences, if known, or otherwise whether the proposed intervention appears consistent with the best interests of the resident.

(f) Articulate the resident’s preferences, if known, or best approximation of preferences.

(g) Identify and report any concerns regarding abuse and neglect of the resident to the Office of the Long-Term Care Ombudsman, the State Department of Public Health, and other appropriate organizations or agencies.

(h) Refer a resident who seeks judicial review pursuant to Section 1418.8 of the Health and Safety Code to appropriate legal services identified by the program. Public patient representatives and the program shall not provide legal representation or advice to residents.

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(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)

Section § 9280

This law states that if needed, the Attorney General will provide legal representation in court for a department or local programs. However, if the Attorney General is already representing another state agency that is involved, then the department or program must hire a different lawyer.

Upon request of the department, the Attorney General shall represent the department, local programs, and the program’s representatives in litigation concerning affairs of the program, unless the Attorney General represents another state agency, in which case the agency or the department shall employ other counsel.

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(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)

Section § 9285

This law allows the department to put parts of this chapter or another specific health and safety section into effect using a program memo or similar guidance, without following the usual detailed rulemaking process required by the Administrative Procedure Act.

Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement this chapter or Section 1418.8 of the Health and Safety Code, in whole or in part, by means of a program memo or other similar instruction.

Administrative Procedure Act program memo implementation rulemaking process Health and Safety Code Section 1418.8 department discretion regulatory guidance non-standard rulemaking government code instruction issuance

(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)

Section § 9290

This section protects the State of California, its Department of Aging, and local aging programs, including their employees and representatives, from being held legally responsible for any harm, injury, or death as long as they are acting in good faith while performing their official duties. Additionally, communications made by these parties, when related to their duties and conducted in good faith, are protected from legal claims of defamation, such as libel or slander.

(a) The State of California, the California Department of Aging, local programs, and any employee or representative of the program shall not be held liable for civil damages on the account of any harm, injury, or death resulting from any act or omission by the state, department, program, or its employees or representatives in good faith performance of the duties and responsibilities under this chapter.

(b) All communications by employees or representatives of the State of California, the California Department of Aging, and local programs, if reasonably related to the duties and responsibilities under this chapter and done in good faith, shall be privileged, and that privilege shall serve as a defense to any action in libel or slander.

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(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)

Section § 9295

This law states that the department doesn't have to start offering public patient representatives until July 1, 2022, or until the Director of the California Department of Aging confirms and announces that the Long-Term Care Patient Representative Program is ready to go, whichever comes first.

Notwithstanding any other provision of this chapter, the department is not required to begin providing public patient representatives pursuant to this chapter until July 1, 2022, or the date that the Director of the California Department of Aging certifies to the State Public Health Officer and provides public notice that the Long-Term Care Patient Representative Program is operational, whichever is earlier.

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(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)