CHAPTER 3.6. Office of the Long-Term Care Patient Representative [9260 - 9295]
( Chapter 3.6 added by Stats. 2021, Ch. 85, Sec. 21. )
(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.
(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)
(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.
(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)
(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.
(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)
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.
(c) Review the medical and clinical records of the resident.
(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.
(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)
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.
(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)
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.
(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)
(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.
(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)
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.
(Added by Stats. 2021, Ch. 85, Sec. 21. (AB 135) Effective July 16, 2021.)