April 13, 2005, Introduced by Reps. Adamini and Gaffney and referred to the Committee on Health Policy.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending section 20201 (MCL 333.20201), as amended by 2001 PA
240.
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
responsibilities of patients or residents admitted to the health
facility or agency. Except for a licensed health maintenance
organization which shall comply with chapter 35 of the insurance
code of 1956, 1956 PA 218, MCL 500.3501 to 500.3580, the policy
shall be posted at a public place in the health facility or agency
and shall be provided to each member of the health facility or
agency staff. Patients or residents shall be treated in accordance
with the policy.
(2) The policy describing the rights and responsibilities of
patients or residents required under subsection (1) shall include,
as a minimum, all of the following:
(a) A patient or resident shall 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 medical record upon request. A Except as otherwise
permitted 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, or
as required by law or third party payment contract, or as permitted
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 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
medical condition, proposed course of treatment, and prospects for
recovery, in terms that the patient or resident can understand,
unless medically contraindicated as documented by the attending
physician in the medical record.
(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
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 or others to the health
facility or agency staff, to governmental officials, or to another
person of his or her 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 care and has the right to refuse to participate in the
experimental procedure without jeopardizing his or her continuing
care.
(i) A patient or resident is entitled to receive and examine
an explanation of his or her 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 direct care, is
entitled to receive information concerning his or her continuing
health needs and alternatives for meeting those needs, and to be
involved in his or her discharge planning, if appropriate.
(k) A patient or resident is entitled to associate and have
private communications and consultations with his or her physician,
attorney, or any other person of his or her 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 by the attending physician in the medical record. 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 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 discretion, unless medically
contraindicated as documented by the attending physician in the
medical record.
(l) A patient or resident is entitled to be free from mental
and physical abuse and from physical and chemical restraints,
except those restraints authorized in writing by the attending
physician 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 shall
promptly report the action to the attending physician. In case of a
chemical restraint, a physician shall be consulted within 24 hours
after the commencement of the chemical restraint.
(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.
(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.
(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 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 be provided to each nursing home patient
or home for the aged resident upon admission, and the staff of the
facility shall 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 choice. Reasonable, regular
visiting hours, which shall be not less than 8 hours per day, and
which shall take into consideration the special circumstances of
each visitor, shall 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 be
afforded for visitation of a patient who shares a room with another
patient. Each patient shall 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 spouse in a room that
assures privacy. If both spouses are residents in the same
facility, they are entitled to share a room unless medically
contraindicated and documented by the attending physician in the
medical record.
(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 by the attending physician in the medical record. Each
nursing home patient or home for the aged resident shall be
provided with reasonable space. At the request of a patient, a
nursing home shall provide for the safekeeping of personal effects,
funds, and other property of a patient in accordance with section
21767, except that a nursing home is not required to provide for
the 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 medical treatment. A nursing home patient shall be fully
informed by the attending physician of the patient's medical
condition unless medically contraindicated as documented by a
physician in the medical record. Each nursing home patient shall be
afforded the opportunity to discharge himself or herself from the
nursing home.
(e) A home for the aged resident may be transferred or
discharged only for medical reasons, for his or her welfare or that
of other residents, or for nonpayment of his or her 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 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 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 own financial affairs, or to have at
least a quarterly accounting of personal financial transactions
undertaken in his or her 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 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 be made available
unless it is medically contraindicated, and the medical
contraindication is justified in the patient's medical record by
the attending physician.
(j) A nursing home patient has the right to have his or her
parents, if a minor, or his or her 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.
(k) Each nursing home patient shall 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 fully informed, as evidenced by the patient's or
resident's written acknowledgment, before or at the time of
admission and during stay, of the policy required by this section.
The policy shall provide that if a patient or resident is
adjudicated incompetent and not restored to legal capacity, the
rights and responsibilities set forth in this section shall be
exercised by a person designated by the patient or resident. The
health facility or agency shall provide proper forms for the
patient or resident to provide for the designation of this person
at the time of admission.
(7) This section does not prohibit a health facility or agency
from establishing and recognizing additional patients' rights.
(8) As used in this section:
(a) "Patient's representative" means that term as defined in
section 21703.
(b) "Title XVIII" means title XVIII of the social security
act,
chapter 531, 49 Stat. 620, 42 U.S.C. 1395 to 1395b, 1395b-2,
1395b-6
to 1395b-7, 1395c to 1395i, 1395i-2 to 1395i-5, 1395j to
1395t,
1395u to 1395w, 1395w-2 to 1395w-4, 1395w-21 to 1395w-28,
1395x
to 1395yy, and 1395bbb to 1395ggg 42 USC 1395 to 1395hhh.
(c)
"Title XIX" means title XIX of the social security act,
chapter
531, 49 Stat. 620, 42 U.S.C. 1396 to 1396f, 1396g-1 to
1396r-6,
and 1396r-8 42 USC 1396 to 1396v.