Ten Things Health Care Administrators Need to Know as New Virginia Laws Take Effect July 1, 2016
Legislation approved by the 2016 Virginia General Assembly, and signed into law by the Governor, has resulted in a number of changes to state laws affecting hospitals and health systems that become effective July 1, 2016. Health care administrators and their teams should be aware of the 10 bills listed below.
Advance Directives for Involuntary Admissions at Psychiatric Facilities — HB 616 requires that for any involuntary admission for mental illness or involuntary admission accompanied by an authorization for mandatory outpatient treatment, the treating physician or his or her designee must, prior to discharge, give to the patient a written explanation of the procedures for executing an advance directive and an advance directive form, if the person has not already executed an advance directive. When discharged from a licensed hospital, the person in charge of the licensed hospital or his or her designee is responsible for providing the patient with the written explanation. (Va. Code §§ 37.2-817, 37.2-837, 37.2-838)
Family Notice of Mental Health Treatment of Minors — HB 1110 requires any health care provider furnishing services to a minor pursuant to an involuntary commitment or similar proceeding to make a reasonable attempt to notify the minor’s parent (or under certain circumstances, the minor’s personal representative, including an agent named in an advance directive) of information that is directly relevant to the parent’s involvement with the minor’s health care, which may include the minor’s location and general knowledge. The requirement does, however, provide exceptions for circumstances where the provider has actual knowledge that the parent is currently prohibited by court order from contacting the minor or the provider has actual knowledge that such notice has already been provided. Previously, the law gave the provider the authority to provide such notification, whereas now, a reasonable attempt is required. (Va. Code §§ 16.1-337, 37.2-804.2, 37.2-809)
Definition of Neurologic Death — HB 652 changes the definition of neurologic death from “the absence of brain stem reflexes, spontaneous brain functions and spontaneous respiratory functions” to “irreversible cessation of all functions of the entire brain, including the brain stem.” This change was designed to update the definition of neurologic death to conform with the Uniform Declaration of Death Act, which is applied in a majority of states. (Va. Code § 54.1-2972)
Dead Body Storage — SB 595 requires a hospital or other institution having initial custody of a dead body (such as a nursing home) where the body is being stored for more than 48 hours to store the body in refrigeration at a temperature of no more than forty degrees Fahrenheit (40o F). Alternatively, if the hospital or other institution is unable to accommodate storage in refrigeration, it can make arrangements with a local funeral establishment to do so. (Va. Code § 32.1-309.5)
Patient Fee Estimates — HB 905 includes in the hospital licensure code a requirement for every hospital to provide to a patient, upon a request made by the patient or his or her legally authorized representative no less than three days in advance of any scheduled elective procedure, test, or service to be performed by the hospital, an estimate of the payment amount for such elective procedure, test, or service. VHHA is seeking further guidance from the state on the implementation of this new law. (Va. Code § 32.1-137.05)
Statute of Limitations for Benign Schwannomas — HB 637 includes in the current exception to the two-year statute of limitations applicable to medical malpractice actions that applies to a failure to diagnose a malignant tumor or cancer, intracranial, intraspinal, or spinal schwannomas (nerve sheath tumors). Under these circumstances, the statute of limitations runs for a period of one year from the date that the diagnosis of the intracranial, intraspinal, or spinal schwannoma is made. (Va. Code § 8.01-243)
Consent for Minor Victims of Sexual Assault — SB 248 allows a minor who is believed to be the victim of sexual assault to consent to a physical evidence recovery examination if the parent or guardian of a minor refuses to do so. (Va. Code § 54.1-2970.1)
Nurse Practitioner Transition of Patient Care Team Physician — Under circumstances where a nurse practitioner’s patient care team physician dies, becomes disabled, retires, relocates, or has his or her license surrendered, suspended, or revoked, HB 581 allows the nurse practitioner to continue to practice under an existing practice agreement (including prescriptive authority) with that physician for a period of 60 days where the nurse practitioner is unable to enter into a new practice agreement with another physician. The nurse practitioner must have access to appropriate physician input in complex clinical cases and patient emergencies and for referrals during this time period. The period can be extended for an additional 60 days where the nurse practitioner provides evidence of efforts made to secure another patient care team physician. (Va. Code § 54.1-2957)
Certified Nurse Midwife Scope of Practice — SB 463 allows a certified nurse midwife to practice outside of the traditional patient care team for nurse practitioners in consultation with a licensed physician under a practice agreement with a physician that addresses the availability of the physician for routine and urgent consultation. (Va. Code §§ 54.1-2901, 54.1-2914, 54.1-2957, 54.1-2957.01, 54.1-2957.03, 54.1-2957.9, and 54.1-3401)
Medical School Rotations in Underserved Areas — SB 452 requires medical schools to support at least one clinical rotation in a hospital or clinic located in a medically underserved area of the state, in an area of the state that has an unemployment rate one and one-half times the statewide average, or in a locality with a population of 50,000 or less. (Va. Code § 23-9.2:3.11)
Hospitals and health systems should take steps now to prepare for implementation of any of these new laws as of the July 1, 2016 effective date. Regulatory action on these new laws may be forthcoming.
Please note that this is only a summary of the legislation identified. It is not a complete description of all requirements of the laws and does not represent a compendium of all legislation affecting hospitals and health systems. Further, it does not constitute legal advice or interpretation. If you have questions about interpretation or implementation of these laws in your organization, you should contact your legal counsel for further guidance.
