Bill Summary – FastDemocracy

HOUSE BILL NO. 5948
     September 25, 2024, Introduced by Rep. Rheingans and referred to the Committee on Health
        Policy.
          A bill to amend 1978 PA 368, entitled
    "Public health code,"
    by amending sections 20201 and 21734 (MCL 333.20201 and 333.21734),
    section 20201 as amended by 2016 PA 499 and section 21734 as
    amended by 2022 PA 187.
                     THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
       Sec. 20201. (1) A health facility or agency that provides
 services directly to patients or residents and is licensed under
 this article shall adopt a policy describing the rights and
    EMR                                                                             06339'24
                                       2
 responsibilities of patients or residents admitted to the health
 facility or agency. Except for a licensed health maintenance
 organization that is subject to chapter 35 of the insurance code of
 1956, 1956 PA 218, MCL 500.3501 to 500.3573, the health facility or
 agency shall post the policy at a public place in the health
 facility or agency and shall provide the policy to each member of
 the health facility or agency staff. Patients or residents shall
 must be treated in accordance with the policy.
       (2) The policy describing the rights and responsibilities of
 patients or residents required under subsection (1) shall must
 include, as a minimum, all of the following:
       (a) A patient or resident shall must not be denied appropriate
 care on the basis of race, religion, color, national origin, sex,
 age, disability, marital status, sexual preference, or source of
 payment.
       (b) An individual who is or has been a patient or resident is
 entitled to inspect, or receive for a reasonable fee, a copy of his
 or her the individual's medical record upon request in accordance
 with the medical records access act, 2004 PA 47, MCL 333.26261 to
 333.26271. Except as otherwise permitted or required under the
 health insurance portability and accountability act of 1996, Public
 Law 104-191, or regulations promulgated under that act, 45 CFR
 parts 160 and 164, a third party shall not be given a copy of the
 patient's or resident's medical record without prior authorization
 of the patient or resident.
       (c) A patient or resident is entitled to confidential
 treatment of personal and medical records, and may refuse their
 release to a person outside the health facility or agency except as
 required because of a transfer to another health care facility, as
     EMR                                                           06339'24
                                       3
 required by law or third party payment contract, or as permitted or
 required under the health insurance portability and accountability
 act of 1996, Public Law 104-191, or regulations promulgated under
 that act, 45 CFR parts 160 and 164.
       (d) A patient or resident is entitled to privacy, to the
 extent feasible, in treatment and in caring for personal needs with
 consideration, respect, and full recognition of his or her the
 patient's or resident's dignity and individuality.
       (e) A patient or resident is entitled to receive adequate and
 appropriate care, and to receive, from the appropriate individual
 within the health facility or agency, information about his or her
 the patient's or resident's medical condition, proposed course of
 treatment, and prospects for recovery, in terms that the patient or
 resident can understand, unless medically contraindicated as
 documented in the medical record by the attending physician, a
 physician's assistant with whom the physician has a practice
 agreement, or an advanced practice registered nurse.
       (f) A patient or resident is entitled to refuse treatment to
 the extent provided by law and to be informed of the consequences
 of that refusal. If a refusal of treatment prevents a health
 facility or agency or its staff from providing appropriate care
 according to ethical and professional standards, the relationship
 with the patient or resident may be terminated upon reasonable
 notice.
       (g) A patient or resident is entitled to exercise his or her
 the patient's or resident's rights as a patient or resident and as
 a citizen, and to this end may present grievances or recommend
 changes in policies and services on behalf of himself or herself
 the patient or resident or others to the health facility or agency
     EMR                                                         06339'24
                                       4
 staff, to governmental officials, or to another person of his or
 her the patient's or resident's choice within or outside the health
 facility or agency, free from restraint, interference, coercion,
 discrimination, or reprisal. A patient or resident is entitled to
 information about the health facility's or agency's policies and
 procedures for initiation, review, and resolution of patient or
 resident complaints.
       (h) A patient or resident is entitled to information
 concerning an experimental procedure proposed as a part of his or
 her the patient's or resident's care and has the right to refuse to
 participate in the experimental procedure without jeopardizing his
 or her the patient's or resident's continuing care.
       (i) A patient or resident is entitled to receive and examine
 an explanation of his or her the patient's or resident's bill
 regardless of the source of payment and to receive, upon request,
 information relating to financial assistance available through the
 health facility or agency.
       (j) A patient or resident is entitled to know who is
 responsible for and who is providing his or her the patient's or
 resident's direct care, to receive information concerning his or
 her the patient's or resident's continuing health needs and
 alternatives for meeting those needs, and to be involved in his or
 her the patient's or resident's discharge planning, if appropriate.
       (k) A patient or resident is entitled to associate and have
 private communications and consultations with his or her the
 patient's or resident's physician or a physician's assistant with
 whom the physician has a practice agreement, with his or her the
 patient's or resident's advanced practice registered nurse, with
 his or her the patient's or resident's attorney, or with any other
     EMR                                                           06339'24
                                       5
 individual of his or her the patient's or resident's choice and to
 send and receive personal mail unopened on the same day it is
 received at the health facility or agency, unless medically
 contraindicated as documented in the medical record by the
 attending physician, a physician's assistant with whom the
 physician has a practice agreement, or an advanced practice
 registered nurse. A patient's or resident's civil and religious
 liberties, including the right to independent personal decisions
 and the right to knowledge of available choices, shall must not be
 infringed and the health facility or agency shall encourage and
 assist in the fullest possible exercise of these rights. A patient
 or resident may meet with, and participate in, the activities of
 social, religious, and community groups at his or her the patient's
 or resident's discretion, unless medically contraindicated as
 documented in the medical record by the attending physician, a
 physician's assistant with whom the physician has a practice
 agreement, or an advanced practice registered nurse.
       (l) A patient or resident is entitled to be free from mental
 and physical abuse. and
       (m) Except as otherwise provided in this subdivision, a
 patient or resident is entitled to be free from physical and
 chemical restraints, except those restraints authorized in writing
 by the attending physician, by a physician's assistant with whom
 the physician has a practice agreement, or by an advanced practice
 registered nurse, for a specified and limited time or as are
 necessitated by an emergency to protect the patient or resident
 from injury to self or others, in which case the restraint may only
 be applied by a qualified professional who shall set forth in
 writing the circumstances requiring the use of restraints and who
     EMR                                                           06339'24
                                        6
 shall promptly report the action to the attending physician,
 physician's assistant, or advanced practice registered nurse who
 authorized the restraint. In case of a chemical restraint, the
 physician, or the advanced practice registered nurse who authorized
 the restraint, shall must be consulted within 24 hours after the
 commencement of the chemical restraint. Subject to subsection (7),
 if the health facility or agency is a hospital, the patient is
 entitled to be free from restraint or seclusion, except that a
 hospital may use restraint or seclusion as authorized under 42 CFR
 482.13.
        (n) (m) A patient or resident is entitled to be free from
 performing services for the health facility or agency that are not
 included for therapeutic purposes in the plan of care.
        (o) (n) A patient or resident is entitled to information about
 the health facility or agency rules and regulations affecting
 patient or resident care and conduct.
        (p) (o) A patient or resident is entitled to adequate and
 appropriate pain and symptom management as a basic and essential
 element of his or her the patient's or resident's medical
 treatment.
        (3) The following additional requirements for the policy
 described in subsection (2) apply to licensees under parts 213 and
 217:
        (a) The policy shall must be provided to each nursing home
 patient or home for the aged resident upon admission, and the staff
 of the facility shall must be trained and involved in the
 implementation of the policy.
        (b) Each nursing home patient may associate and communicate
 privately with persons of his or her the patient's choice.
     EMR                                                          06339'24
                                       7
 Reasonable, regular visiting hours, which shall must be not less
 than 8 hours per day, and which shall must take into consideration
 the special circumstances of each visitor, shall must be
 established for patients to receive visitors. A patient may be
 visited by the patient's attorney or by representatives of the
 departments named in section 20156, during other than established
 visiting hours. Reasonable privacy shall must be afforded for
 visitation of a patient who shares a room with another patient.
 Each patient shall must have reasonable access to a telephone. A
 married nursing home patient or home for the aged resident is
 entitled to meet privately with his or her the patient's spouse in
 a room that ensures privacy. If both spouses are residents in the
 same facility, they are entitled to share a room unless medically
 contraindicated and documented in the medical record by the
 attending physician, a physician's assistant with whom the
 physician has a practice agreement, or an advanced practice
 registered nurse.
       (c) A nursing home patient or home for the aged resident is
 entitled to retain and use personal clothing and possessions as
 space permits, unless to do so would infringe upon the rights of
 other patients or residents, or unless medically contraindicated as
 documented in the medical record by the attending physician, a
 physician's assistant with whom the physician has a practice
 agreement, or an advanced practice registered nurse. Each nursing
 home patient or home for the aged resident shall must be provided
 with reasonable space. At the request of a patient, a nursing home
 shall provide for the safekeeping of personal effects, money, and
 other property of a patient in accordance with section 21767,
 except that a nursing home is not required to provide for the
     EMR                                                           06339'24
                                       8
 safekeeping of a property that would impose an unreasonable burden
 on the nursing home.
       (d) A nursing home patient or home for the aged resident is
 entitled to the opportunity to participate in the planning of his
 or her the patient's or resident's medical treatment. The attending
 physician, a physician's assistant with whom the physician has a
 practice agreement, or an advanced practice registered nurse, shall
 fully inform the nursing home patient of the patient's medical
 condition unless medically contraindicated as documented in the
 medical record by a physician, a physician's assistant with whom
 the physician has a practice agreement, or an advanced practice
 registered nurse. Each nursing home patient shall must be afforded
 the opportunity to discharge himself or herself the patient from
 the nursing home.
       (e) A home for the aged resident may be transferred or
 discharged only for medical reasons, for his or her the resident's
 welfare or that of other residents, or for nonpayment of his or her
 the resident's stay, except as provided by title XVIII or title
 XIX. A nursing home patient may be transferred or discharged only
 as provided in sections 21773 to 21777. A nursing home patient or
 home for the aged resident is entitled to be given reasonable
 advance notice to ensure orderly transfer or discharge. Those
 actions shall must be documented in the medical record.
       (f) A nursing home patient or home for the aged resident is
 entitled to be fully informed before or at the time of admission
 and during stay of services available in the facility, and of the
 related charges including any charges for services not covered
 under title XVIII, or not covered by the facility's basic per diem
 rate. The statement of services provided by the facility shall must
     EMR                                                            06339'24
                                       9
 be in writing and shall include those required to be offered on an
 as-needed basis.
       (g) A nursing home patient or home for the aged resident is
 entitled to manage his or her the patient's or resident's own
 financial affairs, or to have at least a quarterly accounting of
 personal financial transactions undertaken in his or her the
 patient's or resident's behalf by the facility during a period of
 time the patient or resident has delegated those responsibilities
 to the facility. In addition, a patient or resident is entitled to
 receive each month from the facility an itemized statement setting
 forth the services paid for by or on behalf of the patient and the
 services rendered by the facility. The admission of a patient to a
 nursing home does not confer on the nursing home or its owner,
 administrator, employees, or representatives the authority to
 manage, use, or dispose of a patient's property.
       (h) A nursing home patient or a person authorized by the
 patient in writing may inspect and copy the patient's personal and
 medical records. The records shall must be made available for
 inspection and copying by the nursing home within a reasonable
 time, not exceeding 1 week, after the receipt of a written request.
       (i) If a nursing home patient desires treatment by a licensed
 member of the healing arts, the treatment shall must be made
 available unless it is medically contraindicated, and the medical
 contraindication is justified in the patient's medical record by
 the attending physician, a physician's assistant with whom the
 physician has a practice agreement, or an advanced practice
 registered nurse.
       (j) A nursing home patient has the right to have his or her
 the patient's parents, if a minor, or his or her the patient's
     EMR                                                           06339'24
                                      10
 spouse, next of kin, or patient's representative, if an adult, stay
 at the facility 24 hours a day if the patient is considered
 terminally ill by the physician responsible for the patient's care,
 a physician's assistant with whom the physician has a practice
 agreement, or an advanced practice registered nurse.
       (k) Each nursing home patient shall must be provided with
 meals that meet the recommended dietary allowances for that
 patient's age and sex and that may be modified according to special
 dietary needs or ability to chew.
       (l) Each nursing home patient has the right to receive
 representatives of approved organizations as provided in section
 21763.
       (4) A nursing home, its owner, administrator, employee, or
 representative shall not discharge, harass, or retaliate or
 discriminate against a patient because the patient has exercised a
 right protected under this section.
       (5) In the case of a nursing home patient, the rights
 enumerated in subsection (2)(c), (g), and (k) and subsection
 (3)(d), (g), and (h) may be exercised by the patient's
 representative.
       (6) A nursing home patient or home for the aged resident is
 entitled to be fu