CHAPTER 373

FORMERLY

HOUSE BILL NO. 841

AS AMENDED BY

SENATE AMENDMENT NO. 1

AN ACT TO AMEND TITLE 16, AND TITLE 31, OF THE DELAWARE CODE RELATING TO THE RIGHTS OF PATIENTS IN SANITORIA, REST HOMES, NURSING HOMES, BOARDING HOMES AND RELATED STATE INSTITUTIONS.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend Chapter 11, Part 11, Title 16 of the Delaware Code by re-designating all of said Chapter as new Subchapter 1 of said Chapter, which new Subchapter shall be entitled:

"SUBCHAPTER I. LICENSING BY THE STATE"

Section 2. Amend Chapter 11, Part 11, Title 16 of the Delaware Code by adding thereto a new Subchapter, designated as Subchapter 11, which new Subchapter shall read as follows:

"SUBCHAPTER II. RIGHTS OF PATIENTS

§1121. Patient's Bill of Rights

It is the intent of the Delaware General Assembly, and the purpose of this section, to promote the interests and well-being of the patients and residents in sanitoria, rest homes, nursing homes, boarding homes and related institutions. It is declared to be the public policy of this State that the interests of the patient shall be protected by a declaration of a patient's bill of rights, and by requiring that all facilities treat their patients in accordance with the provisions of such bill of rights, which shall include but not be limited to the following:

(a) Every patient and resident shall be treated with consideration, respect, and full recognition of his or her dignity and individuality.

(b) Every patient and resident shall receive care, treatment and services which are adequate, appropriate, and in compliance with relevant Federal and State laws and regulations.

(c) Each patient or resident and the family of such patient or resident shall, prior to or at the time of admission and during stay, receive a written statement of the services provided by the facility including those required to be offered on an 'as-needed' basis; and a statement of related charges, including any charges for services

not covered by the facility's basic per diem rate. Upon receiving such statement, the patient and his representative shall sign a written receipt which must be retained by the facility in its files.

(d) Each patient shall receive from the attending physician or the resident physician of the facility complete and current information concerning the patient's diagnosis, treatment and prognosis in terms and language the patient can reasonably be expected to understand, unless medically inadvisable. The patient and resident shall participate in the planning of his or her medical treatment, may refuse medication or treatment, be informed of the medical consequences of all medication and treatment alternatives, and shall give prior informed consent to participation in any experimental research after a complete disclosure of the goals, possible effects on the patient, and whether or not the patient can expect any benefits or alleviation of his condition. In any instance of any type of experiment or administration of experimental medicine, there shall be written evidence of compliance with this subsection, including the signature of the patient and a member of the patient's family or his representative. A copy of the signed acknowledgements shall be forwarded to the family or representative, and a copy shall be retained by the facility.

(e) At the bedside of each patient and resident the facility shall place and maintain in good order the name, address and telephone number of the physician responsible for the patient's care.

(f) Each patient and resident shall receive respect and privacy in his medical care program. Case discussion, consultation, examination and treatment shall be confidential, and shall be conducted discretely. Persons not directly involved in the patient's care shall not be permitted to be present during such discussions, consultations, examinations or treatment. Personal and medical records shall be treated confidentially, and shall not be made public without the consent of the patient or resident, except such records as are needed for a patient's transfer to another health care institution as required by law or third-party payment contract. No personal or medical record shall be released to any person inside or outside the facility who has no demonstrable need for such records.

(g) Each patient and resident has the right to be free from mental and physical abuse and has the right to be free from chemical and physical restraints (except as authorized by a physican according to clear and indicated medical requirements).

(h) Every patient and resident shall receive from the Administrator or staff of the facility a courteous and reasonable response to his requests.

(i) Every patient and resident shall be provided with information as to any relationship of the facility to other health care and related institutions, insofar as the patient's care is concerned.

(j) Every patient and resident shall receive reasonable continuity of care which shall include, but not be limited to, what appointment times and physicians are available.

(k) Every patient and resident may associate and communicate privately and without restriction with persons and groups of his own choice on his own or their initiative at any reasonable hour; may send and shall receive mail promptly and unopened; shall have access at any reasonable hours to a telephone where the patient may speak privately; and shall have access to writing instruments, stationery, and postage.

(1) Each patient and resident has the right to manage his own financial affairs. If, by written request signed by the patient and a member of his family or representative, the facility manages the patient's financial affairs, it shall have available for inspection a monthly account, and shall furnish the patient and his family or representative with a quarterly statement of the patient's account. The patient and resident shall have unrestricted access to such account at reasonable hours.

(m) If married, every patient and resident shall enjoy privacy in visits by his or her spouse and, if both are in-patients of the facility, they shall be afforded the opportunity where feasible to share a room, unless medically contraindicated.

(n) Every patient and resident has the right of privacy in his or her room, and personnel of the facility shall respect thib right by knocking on the door before entering the patient's room.

(o) Every patient and resident has the right, personally or through other persons or in combination with others, to present grievances; to recommend changes in facility policies or services on behalf of himself or others; to present complaints or petitions to the facility's staff or Administrator, to the Division of Aging, or to other persons or groups without fear of reprisal, restraint, interference, coercion or discrimination.

(p) A patient or resident shall not be required to perform services for the facility.

(q) Each patient and resident shall have the right to retain and use his or her personal clothing and possessions where reasonable, and shall have the right to security in the storage and use of such clothing and possessions.

(r) No patient or resident shall be transferred or discharged out of a facility except for medical reasons; the patient's own welfare or the welfare of the other patients; or for non-payment of justified charges. If good cause for transferral is reasonably believed to exist, the patient or resident shall be given at least thirty days' advance notice of the proposed action, together with the reasons for the decision, and the patient shall have the opportunity for an impartial hearing to challenge such action if the patient so desires. In emergency situations such notice need not be given.

§1122. Devolving of Rights

Where consistent with the nature of each right in §1121, all of such rights, particularly as they pertain to a person adjudicated incompetent in accordance with State law, or a patient who is found medically incapable by his attending physician, or a patient who is unable to communicate with others, shall devolve to the patient's next of kinguardian, representative, sponsoring agency, or representative payee (except where the facility itself is the representative payee) selected pursuant to §205 (j) of the Social Security Act.

§1123. Notice to Patient

The provisions of §1121 shall be posted conspicuously in a public place in all sanitoria, rest homes, nursing homes, boarding homes and related institutions. Copies shall be furnished to the patient or resident upon admittance to the facility;all patients and residents currently residing in the facility; and the next of kin, guardian, representative, sponsoring agency, or representative payee of the patient and resident. Receipts for the statement signed by the aforesaid parties shall be retained in the facility's files.

§1124. Staff Training; Issuance of Regulations

Each facility shall provide appropriate staff training to implement the bill of rights set forth in §1121. Rules and regulations implementing the provisions of this Subchapter shall be developed by the Secretary of the Department of Health and Social Services and shall be promulgated within sixty days after this Chapter becomes effective.

§1125. Investigation of Grievances

The Secretary of the Department of Health and Social Services or his designee shall have the right and responsibility to independently investigate any grievance concerning sanitoria, rest homes, nursing homes, boarding homes and related institutions. Upon completion of an investigation, the Secretary of the Department of Health and Social Services or his designee shall report his findings to the complainants and to all other appropriate agencies of the State, county, or municipality as the case may be."

Section 3. Amend Subchapter IV, Chapter I, Part I, Title 16 of the Delaware Code by striking the Subchapter title and substituting in lieu thereof the following:

"SUBCHAPTER IV. EMILY P. BISSELL HOSPITAL"

Section 4. Amend Chapter I, Part I, Title 16 of the Delaware Code by adding thereto a new section, designated as 6157, which new section shall read as follows:

"6157. Rights of Patients

Each patient of the Hospital shall be entitled to all the patient rights set forth in Subchapter II, Chapter 11 of this Title, and all sections in said Subschapter II shall apply to the patients of the Emily P. Bissell Hospital."

Section 5. Amend Chapter 28, Part II, Title 31 of the Delaware Code by adding thereto a new section, designated as §2802, which new section shall read as follows:

§2802. Rights of Patients

Each patient of the Hospital shall be entitled to all the patient rights set forth in Subchapter II, Chapter 11 of Title 16, and all sections in said Subchapter II shall apply to the patients of the Delaware Hospital for the Chronically Ill."

Approved June 28, 1978.