On May 12, 2015, the Caregiver Advise, Record, Enable (CARE) Act went into effect, 180 days after it was signed into law on November 13, 2014, making New Jersey the second state in the country to support family caregivers with legal mandates for identification, notification, and instruction given to caregivers on how to adequately care for loved ones who have been released from hospital care. The CARE Act enables hospitals to work cooperatively with a patient’s preferred caregiver to ensure every patient gets the level of care needed from that person with whom he or she feels most comfortable. Pursuant to the CARE Act, hospitals are now required to:
1. Provide every patient with the opportunity to identify a designated family caregiver upon admission;
2. Notify the designated caregiver once a discharge or transfer plan is in place; and
3. Provide the designated caregiver, prior to the patient’s discharge, with adequate in-person instruction
and/or training for the care of the patient following the patient’s discharge from the hospital.
Notably, and in recognition of New Jersey’s public policy favoring patient rights, the CARE Act requires hospitals to provide every admitted patient with the opportunity to identify a caregiver, but does not require a patient to designate one. Moreover, patients are permitted to withdraw their designation of caregiver at any time. Compliance with the CARE Act will benefit patients as well as hospitals since readmissions should be reduced as a result of a caregiver’s proper instruction and/or training.
Because approximately 1.7 million New Jersey residents currently care for loved ones at home, the law’s potential impact on hospitals is immense, particularly because compliance with the CARE Act implicates other areas of the law. Most notably, the requirement that hospitals provide designated caregivers with adequate instruction for the care of a patient following discharge from the hospital implicates privacy laws and HIPAA, as compliance with the CARE Act can involve the release of protected health information to the designated caregiver.
Effective Compliance with the CARE Act Includes Consideration of Caregiver Needs
Because the CARE Act was signed into law on November 13, 2014, but did not go into effect until now, hospitals should have already put into place policies and procedures to educate their staff on the law, to notify patients, to capture the necessary information, and to ensure that identified caregivers are properly trained. These processes can be responsive to data captured in various patient surveys, as well as other concerns including those identified in a research study conducted by the Rutgers Center for State Health Policy. This recent study entitled “Supporting Family Caregivers in New Jersey,” identifies specific areas in which caregivers would like additional assistance in carrying out their roles as caregivers. These areas include:
1. Additional information on available services and resources for the patient;
2. Education on the patient’s disease or ailment;
3. Mechanisms for coping with stress;
4. Improved communication with health care professionals.
Though the CARE Act does not explicitly require hospitals to provide any of the additional assistance identified by the Rutgers survey, hospitals are encouraged to consider the types of assistance identified by caregivers in reviewing and revising their policies to guarantee the hospital not only complies with the basic requirements of the Act, but also produces the most effective results which, in time, will reduce hospital readmissions and benefit the patient.
Review of Existing Hospital Policies and Consent Forms Necessary to Comply with CARE Act
As part of their regulatory compliance and due diligence processes, New Jersey hospitals must ensure that they understand what does and does not comply with the CARE Act and take appropriate steps to satisfy the law’s requirements, if they have not already done so. Hospitals are advised to take a proactive approach to assessing the effectiveness of policies and procedures already put into place. This may include the review and revision of all relevant hospital policies and forms, including admissions forms and general consent forms to ensure that they adequately reflect both the CARE Act’s requirements and caregivers’ needs. As part of a general overhaul of outdated hospital policies and forms, or as part of a targeted review in connection with the CARE Act, it can often be a simple task to bring relevant hospital policies and forms into current compliance with the CARE Act.
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