by ANDY MARSO

Legislators expressed skepticism Tuesday about a bill that would require hospitals to provide discharge instructions to patients’ designated caregivers. Kansas AARP has made House Bill 2058 one of its priorities for the session, running ads for it on public television.

But the group has not come to an agreement with the state hospital association on the bill, and members of the House Children and Seniors Committee questioned whether it’s necessary. Rep. Melissa Rooker, a Republican from Fairway, said hospitals provided sufficient discharge instructions on complicated medical issues when she served as a caregiver for her mother and father. “I’m sympathetic to the need for this, but everything we got was both demonstrated, provided verbally and provided in writing to take home,” Rooker said.

Maren Turner, director of AARP Kansas, said some hospitals already provide the caregiver instructions that the bill requires, so for them it would be no change. But she said some hospitals do not, and her group does not believe it would be overly onerous to require them to do so. “With a law, we can guarantee that there will be more consistency,” Turner said. The bill would help the state’s 600,000 caregivers and possibly save the state money by keeping frail Kansans at home and preventing hospital readmissions, she said.

Rooker said there are other, non-legislative methods for improving discharge procedures. Rep. Erin Davis, a Republican from Olathe, said she was reluctant to put another mandate on Kansas hospitals given all that the federal Affordable Care Act requires them to do. She and Rooker both said current Medicare regulations already require the caregiver instruction AARP hopes to put into state law .

“While there might not be a Kansas statute that necessitates such, all these hospitals that are participating in Medicare are required (to do it),” Davis said. Legislators had other questions about what would be done for patients who had multiple caregivers or no caregivers and how the provisions of the bill would be enforced. Turner said there were no specific penalties for noncompliance in the bill.

Those penalties, and how to enforce them, would have to be decided by state agencies through the rules and regulations process. She said AARP Kansas did not intend to increase liabilities on hospitals and was willing to change the text of the bill to make that more clear.

Tuesday’s hearing was an informational briefing, not a hearing on the bill itself. But AARP brought several retired health care workers who also were caregivers to testify for the measure.

Steve Miller, a doctor who took care of his wife when she had multiple sclerosis, said patients are now sent home “quicker and sicker” than when he started practice. That means their at-home caregivers need to be more involved in the discharge, especially when the patient is going home on narcotic painkillers. “They may be goofy, under the influence, not able to drive a car, not able to understand their discharge instructions,” Miller said.

Judy Davis-Cole, a retired home care nurse who also served as a family caregiver, said that based on the results of an AARP survey of caregivers, well-intentioned hospital workers are failing to give many caregivers the instruction they need to care for their loved ones at home. “

There’s a disconnect between what the hospital officials believe — they honestly believe they are doing this — versus what the caregivers and patients honestly believe,” Davis-Cole said.

Chad Austin, the Kansas Hospital Association’s senior vice president for government relations, said after the hearing that his organization is open to finding common ground on the issue, but it would prefer to do so outside the legislative process. “We’re happy to continue our conversation with representatives from AARP to see how we can better educate our hospitals on the importance of discharge procedures and including individuals providing care,” Austin said.

Andy Marso is a reporter for Heartland Health Monitor, a news collaboration focusing on health issues and their impact in Missouri and Kansas.