Hos­pital dis­charge law con­cerns advoc­ates

by Sarah Volpen­hein

A bill passed by the Wis­con­sin Legis­lature will make it easier for hos­pit­als to dis­charge cer­tain patients deemed inca­pa­cit­ated to nurs­ing homes, free­ing up hos­pital beds that might oth­er­wise be tied up for weeks.

The bill, which Gov. Tony Evers signed into law on March 20, has the sup­port of hos­pital sys­tems that com­plain of long, costly delays in dis­char­ging patients who can no longer make med­ical decisions for them­selves and haven’t des­ig­nated someone to act on their behalf. At present, they remain in the hos­pital while await­ing court pro­ceed­ings to appoint a guard­ian.

“This legis­la­tion will help ensure patients can move more quickly to the most appro­pri­ate set­ting for their recov­ery, while also improv­ing hos­pital capa­city for those who need hos­pital care,” said Kyle O’Brien, pres­id­ent and chief exec­ut­ive of the Wis­con­sin Hos­pital Asso­ci­ation, a trade group rep­res­ent­ing hos­pit­als.

The legis­la­tion was opposed by dis­ab­il­ity and aging rights advoc­ates, who say it cir­cum­vents the guard­i­an­ship pro­cess, designed to pro­tect the rights of vul­ner­able indi­vidu­als, and could res­ult in patients becom­ing con­fined to insti­tu­tions against their will.

“The guard­i­an­ship pro­cess is com­plex for a reason,” Lisa Has­sen­stab, pub­lic policy man­ager at Dis­ab­il­ity Rights Wis­con­sin, said dur­ing a Novem­ber hear­ing on the bill. “That reason is due pro­cess.”

The Sen­ate voted 28-5 in favor of the legis­la­tion on March 17 dur­ing what could be the body’s last floor ses­sion for the year.

The bill passed the Assembly in Feb­ru­ary with bipar­tisan sup­port, fol­low­ing an amend­ment adding price trans­par­ency require­ments for hos­pit­als.

Health sys­tems engaged in heavy lob­by­ing for bill

The legis­la­tion received a major push from Wis­con­sin health sys­tems, hos­pit­als and industry trade groups, which col­lect­ively spent more than 400 hours lob­by­ing in favor of the bill, accord­ing to reports made to the Wis­con­sin Eth­ics Com­mis­sion.

Wis­con­sin hos­pit­als spend hun­dreds of mil­lions of dol­lars every year hous­ing patients who no longer need hos­pital care and are await­ing dis­charge or trans­fer to nurs­ing homes or other facil­it­ies. While the reas­ons behind

dis­charge delays are many, the bill addresses only the guard­i­an­ship issue.

It does not address other under­ly­ing causes, such as lim­ited bed avail­ab­il­ity at nurs­ing homes or the lack of med­ical facil­it­ies accept­ing com­plex patients.

Up until now, if phys­i­cians deemed a patient no longer able to make med­ical decisions for them­selves and they did not have a power of attor­ney, the hos­pital could not dis­charge the patient to a nurs­ing home until a guard­i­an­ship peti­tion was filed with a court, even when fam­ily mem­bers agreed to the trans­fer. Those pro­ceed­ings could take weeks or months, hos­pital offi­cials said.

The patient may be someone who had a stroke, suffered a trau­matic brain injury, or has demen­tia or another agere­lated dis­ease and lacks the abil­ity to man­age their own health care, whether tem­por­ar­ily or per­man­ently.

The new law removes the require­ment to file for guard­i­an­ship and allows a fam­ily mem­ber, called a patient rep­res­ent­at­ive, to agree to the patient’s admis­sion to a nurs­ing home, make health care decisions for them and approve health-related spend­ing.

Dis­ab­il­ity advoc­ates argue the legis­la­tion removes pro­tec­tions like court over­sight that come with the guard­i­an­ship pro­cess while also grant­ing a lot of the same author­ity as a guard­ian. They say the legis­la­tion does not require that the patient be noti­fied of the rep­res­ent­at­ive’s appoint­ment or of their rights to ask for a ree­valu­ation of their men­tal capa­city. Nor does it require the rep­res­ent­at­ive to con­sider the wishes of the patient, they say.

The legis­la­tion, they said, also lacks pro­tec­tions against an abuser or estranged rel­at­ive assum­ing the role.

“Often­times the per­son who is an abuser is the per­son who is really keep­ing an eye on the per­son in the hos­pital,” said Tami Jack­son, pub­lic policy ana­lyst and legis­lat­ive liaison with the Wis­conVon sin Board for People with Devel­op­mental Dis­ab­il­it­ies. “Some­body who gets picked under this bill ends up with a whole lot of author­ity.”

Under the new law, the patient or another fam­ily mem­ber may object to the nurs­ing home place­ment, if aware.

Any­one may ask a court to review the patient rep­res­ent­at­ive’s actions or may request a ree­valu­ation of the patient’s capa­city.

Exten­ded hos­pital stays can con­trib­ute to over­crowding

While pro­mot­ing the bill, health sys­tems argued that patients may miss out on cru­cial rehab­il­it­a­tion or other health care while wait­ing in the hos­pital for dis­charge. By remain­ing in the hos­pital, they also are at increased risk of hos­pital-acquired infec­tions or falls espe­cially dan­ger­ous for eld­erly patients.

From Janu­ary to Octo­ber 2025, Mayo Clinic Health Sys­tem coun­ted about 35 patients with exten­ded stays at its north­w­est Wis­con­sin hos­pit­als, Gina

Ruden, a Mayo senior nurse admin­is­trator, said at a Novem­ber hear­ing on the bill. At Mayo’s Eau Claire hos­pital, that added up to patients spend­ing a col­lect­ive 1,200 days in the hos­pital because of guard­i­an­ship delays, she said.

The exten­ded stays con­trib­ute to hos­pital over­crowding. Mayo Clinic has seen an influx of patients, Von Ruden said, ever since the abrupt clos­ure in 2024 of two area hos­pit­als by Hos­pital Sis­ters Health Sys­tem, a com­pet­ing health sys­tem.

When over­crowded, the Mayo hos­pital in Eau Claire has to board patients in the emer­gency depart­ment, Von Ruden said, where they may spend the rest of their hos­pital visit if no bed becomes avail­able on an inpa­tient floor.

“They might be in a hall­way in the emer­gency depart­ment or even in the ambu­lance bay when things get real tight,” Von Ruden said.

The bill has a three-year sun­set pro­vi­sion, which allows legis­lat­ors to check if the bill is work­ing as inten­ded before renew­ing it. 

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Hos­pital dis­charge law con­cerns advoc­ates 

Senate Unanimously Passes Bill to Protect Seniors with Alzheimer’s & Other Dementias from Elder Abuse

Bipartisan bill was introduced by Senators Collins, Menendez & Grassley

 

WASHINGTON – Approximately one in 10 seniors aged 60 and older have experienced some form of elder abuse. For people with Alzheimer’s and related dementias, the prevalence is much higher, with some estimates putting it at just over 50 percent. 

 

The U.S. Senate unanimously passed legislation authored by Senators Susan Collins (R-Maine), Bob Menendez (D-N.J.), and Chuck Grassley (R-Iowa) to protect seniors with dementia from harm and exploitation. The Promoting Alzheimer's Awareness to Prevent Elder Abuse Act would ensure that the Department of Justice’s elder abuse training materials take into account individuals with Alzheimer’s disease and related dementias.

 

“America’s seniors too often face abuse and exploitation. Preventing and responding to these crimes can be particularly challenging in cases involving Alzheimer’s and or other forms of dementia. I was honored to lead the recent effort to strengthen the Justice Department’s tools to combat elder abuse and I’m grateful that the Senate passed this important bill to equip law enforcement with critical training to better respond to cases involving Alzheimer’s and dementias,” Grassley said.

 

“As Chairman of the Senate Aging Committee, one of my top priorities is protecting our seniors against abuse. During the COVID-19 pandemic, there may be increased risk for elder abuse, including elder financial exploitation. Our bipartisan bill would help to ensure that the frontline professionals who are leading the charge against elder abuse have the training needed to respond to cases where the victim or a witness has Alzheimer’s disease or other forms of dementia,” said Collins, a founder and co-chair of the Congressional Task Force on Alzheimer's Disease. 

 

“I am thrilled that the Senate has unanimously passed our bill, fully recognizing that we must address the fact that as the number of Americans struggling with Alzheimer’s disease and dementia continues to grow, so does the potential for exploitation, physical or emotional abuse, and neglect. We must do more to provide the education caregivers, social service and health providers, law enforcement and others need to understand the unique symptoms people with AD/ADRD may have, as well as the training necessary to ensure they are safe from abuse and can live with dignity,” Menendez said.

 

The legislation is supported by the Alzheimer’s Association, Alzheimer’s Foundation of America, Alzheimer’s Impact Movement, Elder Justice Coalition, American Geriatrics Society, American Society on Aging, B’nai B’rith International, Gerontological Society of America, International Association for Indigenous Aging, Jewish Federations of North America, Justice in Aging, LEAD Coalition (Leaders Engaged on Alzheimer’s Disease), National Adult Protective Services Association, National Association of Area Agencies on Aging (N4A), National Association of Elder Law Attorneys, and SAGE: Advocacy and Services for LGBT Elders.

 

“On behalf of the more than 5 million Americans living with Alzheimer’s I want to thank Senators Collins, Menendez, and Grassley for their leadership on this critical bill,” said Robert Egge, Alzheimer's Association chief public policy officer and Alzheimer’s Impact Movement (AIM) executive director. “The bipartisan Promoting Alzheimer’s Awareness to Prevent Elder Abuse Act will help protect our nation’s most vulnerable from abuse and lead to better outcomes for all people living with dementia.”  

 

Specifically, the Promoting Alzheimer's Awareness to Prevent Elder Abuse Act would: 

• Require that the National Elder Justice Coordinator take into account people with Alzheimer’s disease and related dementias when creating or compiling elder abuse training materials;

 

• Instruct DOJ to consult with stakeholders, as appropriate, in developing these materials and to review and update existing materials; and

 

• Include information in DOJ’s annual report about where to access the publicly available training materials.

 

The bill builds on Grassley’s Elder Abuse Prevention and Prosecution Act, which became law in October 2017 and required DOJ to create training materials to help criminal justice, health care, and social services personnel assess and respond to elder abuse cases. It also aligns with the latest recommendations from the National Plan to Address Alzheimer’s Disease, which include disseminating information on abuse of those with dementia and educating law enforcement about interacting with these individuals.

 

 

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Senate Unanimously Passes Bill to Protect Seniors with Alzheimer’s & Other Dementias from Elder Abuse

Maine lawmakers pass bill allowing terminally ill patients to end their lives

The Maine state House has passed legislation that would allow physicians to prescribe lethal doses of medication to terminally ill patients who want to end their lives.

According to the Portland Press Herald, the state House passed the bill by a narrow vote of 72-68 on Tuesday with support and opposition cutting across party lines.

Under the bill, called the Maine Death with Dignity Act, patients at least 18 years old can request lethal prescriptions if a doctor has determined he or she to be suffering from a terminal disease and has less than six months to live.

However, the bill has a number of qualifications a patient would be required to meet before their request is granted.

Consulting physicians would need to assess the patient’s competency to determine if they “may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment.” If the patient is determined to be suffering from a disorder, the physician is required to refer the patient to counseling.

“Medication to end a patient's life in a humane and dignified manner may not be prescribed until the person performing the counseling determines that the patient is not suffering from a psychiatric or psychological disorder or depression causing impaired judgment,” the bill states.

After the adult is determined competent, he or she must “make a written request for medication that the adult may self-administer in accordance” with the bill.

A valid request must be “signed and dated by the patient and witnessed by at least 2 individuals who, in the presence of the patient, attest that to the best of their knowledge and belief the patient is competent, is acting voluntarily and is not being coerced to sign the request,” the bill states.

The bill says the terminal disease the patient is suffering from in such cases has to be “incurable and irreversible” as well as “medically confirmed and will, within reasonable medical judgment, produce death within 6 months.”

The bill now heads to the state senate for consideration.

It arrives on the heels of a similar piece of legislation that New Jersey Gov. Phil Murphy (D) said he would approve back in March that would allow terminally ill patients the right to end their lives.

If the legislation becomes law, Maine would become the eighth jurisdiction in the U.S. to have a "death with dignity" act.

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Maine lawmakers pass bill allowing terminally ill patients to end their lives

Senate Bills Passed, Aimed to Help End Elderly Abuse

A 2015 study done by the Department of Social Services found that by 2035, elders will make up around 30% of the population in cities like Sioux Falls and Rapid City. Two bills passed in the latest legislative session that are aimed to help protect this growing population.

In the last 5 years, the Department of Social Services has received 661 adult protective service calls and has made 92 charges in adult abuse in the last 10 years.

Now, in the latest legislative session two bills, senate bill 19 and 54, passed to help end elder abuse.

"People can use that weakness to kinda prey on them, if you will, and they don't always know where that's going to come from," said Jason Valder, owner of Home Instead Senior Care in Sioux Falls.
The abuse can range from physical and emotional to financial and even sexual.

And owner of Home Instead Senior Care Jason Valder says sometimes, the elderly don't know it's going on.

"There'll be contractors coming to the door, there'll be obviously people with phishing scams and emails," Valder explained. "We see folks getting duped by people over the phone, is where we see the most of it."

He noted that most people don't necessarily think of financial abuse when it comes to elder abuse.

But with the help of two senate bills, Senate Bill 19 and Senate Bill 54, he hopes to see that change.

Already a law, Senate Bill 19 made slight changes to Chapter 22-46-9 in the codified law which would require anyone who knows of abuse to report it within 24 hours or be guilty of a class 1 misdemeanor. The new changes specified who is required to report the abuse.

"We're bringing more effort and energy to the topic of elder abuse and that we're making it easier to prosecute the people, making the punishments harder," explained Jason Valder, owner of Home Instead Senior Care in Sioux Falls.

While Senate Bill 54 would adopt statutory recommendations made by the Elder Abuse Task Force.

The task force was created back in 2015 and the list of changes they made in a short amount of time isn't going unnoticed, especially by Jason Valder, "Certainly done their due diligence and gotten things accomplished. With the two bills passing, in such a short time, I commend them on their efforts."

Valder says the caretakers employed by Home Instead Senior Care go through background checks. A way, he says, to reduce the risk of elder abuse from his staff.

If you know of abuse or want to learn more about the signs of elderly abuse, the Department of Social Services offers many signs and resources. The Elderly Abuse Hotline is 605-773-3656.

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Senate Bills Passed, Aimed to Help End Elderly Abuse