HB 7158, An Act Concerning Safety Plans And Discharge Plans For Minor Patients

TESTIMONY OF THE CONNECTICUT HOSPITAL ASSOCIATION
SUBMITTED TO THE PUBLIC HEALTH COMMITTEE

Monday, March 10, 2025

The Connecticut Hospital Association (CHA) appreciates this opportunity to submit testimony concerning HB 7158, An Act Concerning Safety Plans And Discharge Plans For Minor Patients. CHA appreciates the intent of the bill and looks forward to working with the committee and the bill’s proponent on improving the care of minor patients, but we must oppose the bill as written.

Connecticut hospitals and health systems care for patients, strengthen the state’s economy, and support vulnerable communities across the state. Every day, they work to improve healthcare access, affordability, and health equity. Even as they face ongoing challenges, hospitals provide world-class care to everyone who walks through their doors, regardless of their ability to pay. Hospitals also support an exemplary workforce as the largest collective employer in the state, contribute significantly to the state’s economy, and invest in their communities addressing social drivers of health.

HB 7158 seeks to require healthcare providers to undertake specific discharge planning and patient safety planning for minor patients. But the mandates of the bill are unworkable as written and would result in unintended consequences, which we believe is contrary to the goals of the bill

The goal of the bill appears to be to ensure educators have access to and input in patient safety care plans for when students who have had hospitalizations return to class. Better said: The bill seeks to bridge the gap between medical care and school oversight and intervention for certain vulnerable patients. CHA supports that goal.

However, the bill, as drafted, does not achieve this goal. For example, HB 7158:

  • Requires a clinical care plan one week in advance of discharge, which is unachievable in most cases due to the rapidly changing care picture coupled with the impact of deciding the next setting of care for when the immediate crisis resolves
  • Does not provide the necessary communication corridor between providers and schools for success
  • Places the sole burden on the clinical team to make premature determinations about next steps for good care, including if a competent safety plan would be better developed in the next setting of care (i.e., not during stabilizing or crisis care)
  • Will delay discharge planning, which is an unacceptable risk to take. There is a well-known crisis now in moving patients needing follow-up mental or behavioral healthcare. Patients are often stuck for days or longer due to red tape and too few outpatient providers. That crisis will only be exacerbated by having to coordinate meetings or input with school personnel, who might not be the right individuals to advise on medical discharge planning

In addition, a different set of rules applies to privacy and consent for educational and student records than medical care and medical records. This is not recognized in the bill. It is not feasible, legally or realistically, to include school personnel in every hospital discharge plan for this patient population. HB 7158 does not take into account that there are various parts of Connecticut medical consent and privacy laws that give control to the minor child (the actual patient) for decision-making, and corresponding privacy controls for care records, many times to the exclusion of that person’s parent. Those situations do not appear to be considered in the bill, yet they implicate various healthcare-related privacy laws, both state and federal. Examples include reproductive health, testing and care for HIV and other STDs, and mental health and substance use disorder treatment.

Finally, there are several technical but critical issues in the bill that would cause confusion in the field. For example, at lines 7 and 8, the bill indicates an appointed healthcare representative would be included as a “legally authorized representative” of a minor patient. But Connecticut law does not permit a person under 18 to appoint a healthcare representative. (See 19a-576(a), which states a person 18 or older may appoint a healthcare representative.)

CHA and its member hospitals would like the opportunity to work with the committee, the proponent of the bill and other interested stakeholders to find solutions that can best help foster communication between providers and schools. We believe that with all the right stakeholders working together, we can find solutions that can achieve the goals of this bill.

Thank you for your consideration of our position. For additional information, contact CHA Government Relations at (203) 294-7301.