This week’s article will focus on one bill, since I am sure it will be of interest to many. HB 1279, the AARP “CARE” Act, came to the House Human services committee in late January with the intent to provide greater supports for caregivers.
The bill, as submitted, would require hospitals to act as an official portal for information, training, and recording of designated patient caregivers following a discharge from the hospital. On the face of it, this is a good thing – and I know of no one who isn’t in favor of providing greater supports for patients and caregivers, including myself.
We had a number of individuals provide testimony on their experiences and the need for comprehensive supports and resources. As a caregiver, arriving at home with a loved one is a tremendous responsibility. There is often a lack of assistance or services available in the home environment to help caregivers and patients transition to the recovery and rehabilitation stages of the patient’s care.
Testimony submitted by health care professionals and hospital representatives spoke of the shared interests of the after-patient care. There is an inherent and vested interest by the hospitals and providers to do all they can to ensure their patients are not readmitted prematurely, and current systems are in place to ensure patients receive the necessary details and instructions for restorative and rehabilitative healing. There are also practical interests as reimbursement schedules and penalties are directly tied to readmissions through the federal Affordable Care Act.
Ultimately the requirements within the original bill proved to be problematic as it looked to create additional systems; created concerns of liabilities by the hospital, or caregiver – or both; questions of accountability in the quality of care as a result of training; pragmatic issues of staffing with an unfunded mandate; and most importantly, the question of whether the bill would actually produce the outcomes expected for the continuum of healthcare that would be the goal.
It’s not uncommon for committee members to carefully weigh out the benefits versus costs on any given bill – and in this case we could find no way to reconcile the potential issues. I place great value in the professional opinions of our District 20 healthcare providers and administrators, and after gaining insights from their perspectives, realized it would be tragic if the bill’s concept didn’t receive due diligence.
With this in mind, I proposed an amendment to move HB 1279 into a legislative study that would consider not only the recovery and rehabilitation piece from a hospital release, but also the more comprehensive nature of Home and Community Based Services (HCBS). By studying the full spectrum of HCBS – and by bringing all partners to the table (public and private sectors, associations, hospitals, advocacy groups, social services, caregiver representatives, etc.) – it’s reasonable to expect real and substantial progress toward the objective of helping people to remain at home in a safe and healthy manner – to address not only after-care, but also preventive care. The amended version of HB 1279 passed through the House with 83 yeas and 10 nays.
I wanted to write about this in detail because I felt it important to relay that while the bill is not in its original form, the intent to arrive at a comprehensive continuum of care remains true. I – and others in the House – will continue to work to ensure this study is moved into the interim committee for a full and proper examination for pragmatic and viable solutions for all involved.
This week brings us to crossover – the time when all bills must either pass or fail in their originating chamber. When we return next week, we’ll begin taking up bills passed over from the Senate in the second stage of bill vetting.
Our next community forum is scheduled for Our Town Bakery in Hillsboro at 1 p.m. March 14. We hope to see you there – until then, hope you’re enjoying some North Dakota sunshine!
Representative Gail Mooney