Alert: 1418.8 (Epple) Decision-Making July 2021

ALERT: Requirement for Patient Representative is delayed 12 more months for 1418.8 (Epple) decision-making.

CALTCM members and supporters will be pleased to learn that the Alameda County Superior Court recently issued a modified judgment in the CANHR v. Angell case, which was posted on July 26, 2021.  This order grants another 12-month extension for the requirement for nursing homes to include a non-facility-affiliated patient representative on the interdisciplinary teams (IDTs) that are making medical decisions that require informed consent for incapacitated unrepresented residents, until July 2022.  So basically, the current process can be continued, with or without a patient representative, until then.  In the meantime, the California Department of Aging will be creating an Office of the Long-Term Care Patient Representative that will supply public patient representatives to serve on these committees statewide, in a fashion similar to the way the ombudsman used to serve in this capacity on Epple IDTs.  The decision reiterates that IDTs can make decisions about all psychotropic medications, POLST orders, and hospice election.  A recent trailer bill clarifies other Epple IDT issues, including that the IDT should reach consensus and if they do not, the proposed plan of action should not be implemented.  CALTCM looks forward to having patient representatives available for these IDT meetings, and since our members have participated in and led these types of meetings for many years, is also hoping to work with CDA on education, training and implementation for this new workforce position.

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