2002 -- S 2359 AS AMENDED

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LC01755

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2002

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A N A C T

RELATING TO HEALTH AND SAFETY -- PAIN ASSESSMENT ACT OF 2002

     Introduced By: Senators Graziano, Polisena, McDonald, Igliozzi, and Tassoni

     Date Introduced: January 30, 2002

     Referred To: Senate Corporations

It is enacted by the General Assembly as follows:

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     SECTION 1. Title 5 of the General Laws entitled "Businesses and Professions" is hereby

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amended by adding thereto the following chapter:

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     CHAPTER 37.5

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PAIN ASSESSMENT

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     5-37.5-1. Short title. – This chapter shall be known and may be cited as the “Pain

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Assessment Act of 2002.”

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      5-37.5-2. Findings. – The general assembly finds and declares that:

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     (1) Pain affects quality of life, job performance and security;

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     (2) Nearly thirty percent (30%) of nursing home residents with daily pain were receiving

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no pain medication of any form;

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     (3) Pain untreated or under-treated adversely impacts the quality of life for patients;

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     (4) Up to ninety-five percent (95%) of terminally ill patients’ pain can be relieved with

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adequate pain management; and

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     (5) Too many Rhode Islanders are suffering and dying in needless pain.

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     5-37.5-3. Definitions. – As used in this chapter, the following terms shall have the

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following meanings:

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     (1) “Assessment of pain” means the act of assessing an unpleasant sensation occurring in

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varying degrees of severity as a consequence of injury, disease, or emotional disorder.

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     (2) “Director” means the director of the department of health.

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     (3) “Health care facilities” shall be defined in the same manner as in section 23-17-2(5).

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     (4) “Person” means any individual, trust or estate, partnership, limited liability

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corporation, corporation (including associations, joint stock companies, and insurance

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companies), state, or political subdivision or instrumentality of a stat.

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     (5) “Regular Basis” mean a procedure done on a customary, usual, normal, orderly, even,

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or symmetrical schedule.

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     5-37.5-4. Pain assessment. – (a) Health care facilities and health care provides shall

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conduct an assessment of pain experienced by a patient on a regular basis.

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     (b) The assessment of pain shall be noted in the patient’s chart in a manner consistent

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with vital signs.

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     5-37.5-5. Regulations. – (a) Promulgation by department. The director of the department

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shall promulgate regulation relating to the assessment of pain requirements of this chapter.

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     (b) Educational materials. The department shall make available educational and

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informational materials concerning the assessment of pain to health care facilities and health care

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providers.

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     5-37.5-6. Enforcement. – The director of the department of health shall have the power

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to enforce the provisions of this chapter.

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     5-37.5-7. Penalty. – (a) Every person who shall willfully and continually violate the

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provisions of this section will be subject to a fine up to one hundred dollars ($100) for first

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violation.

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     (b) Every person who shall continuously violate this section will be subject to a fine up to

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five hundred dollars ($500) for each subsequent violation and any other remedy provided for in

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the Rhode Island law.

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     5-37.5-8. Severability. -- If any provision of this chapter or of any rule or regulation

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made under this chapter, or the application of any provision of this chapter to any person or

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circumstance shall be held invalid by any court of competent jurisdiction, the remainder of the

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chapter, rule or regulation and the application of such provision to other persons or circumstances

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shall not be affected thereby. The invalidity of any section or sections or parts of any section of

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this chapter shall not affect the validity of the remainder of this chapter and to this end the

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provisions of the chapter are declared to be severable.

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     SECTION 2. Section 23-17-19.1 of the General Laws in Chapter 23-17 entitled

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"Licensing of Health Care Facilities" is hereby amended to read as follows:

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     23-17-19.1. Rights of patients. -- Every health care facility licensed under this chapter

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shall observe the following standards and any other standards that may be prescribed in rules and

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regulations promulgated by the licensing agency with respect to each patient who utilizes the

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facility:

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      (1) The patient shall be afforded considerate and respectful care.

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      (2) Upon request, the patient shall be furnished with the name of the physician

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responsible for coordinating his or her care.

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      (3) Upon request, the patient shall be furnished with the name of the physician or other

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person responsible for conducting any specific test or other medical procedure performed by the

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health care facility in connection with the patient's treatment.

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      (4) The patient shall have the right to refuse any treatment by the health care facility to

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the extent permitted by law.

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      (5) The patient's right to privacy shall be respected to the extent consistent with

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providing adequate medical care to the patient and with the efficient administration of the health

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care facility. Nothing in this section shall be construed to preclude discreet discussion of a

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patient's case or examination of appropriate medical personnel.

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      (6) The patient's right to privacy and confidentiality shall extend to all records pertaining

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to the patient's treatment except as otherwise provided by law.

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      (7) The health care facility shall respond in a reasonable manner to the request of a

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patient's physician and/or certified nurse practitioner for medical services to the patient. The

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health care facility shall also respond in a reasonable manner to the patient's request for other

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services customarily rendered by the health care facility to the extent the services do not require

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the approval of the patient's physician and/or certified nurse practitioner or are not inconsistent

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with the patient's treatment.

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      (8) Before transferring a patient to another facility, the health care facility must first

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inform the patient of the need for and alternatives to a transfer.

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      (9) Upon request, the patient shall be furnished with the identities of all other health care

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and educational institutions that the health care facility has authorized to participate in the

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patient's treatment and the nature of the relationship between the institutions and the health care

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facility.

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      (10) If the health care facility proposes to use the patient in any human experimentation

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project, it shall first thoroughly inform the patient of the proposal and offer the patient the right to

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refuse to participate in the project.

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      (11) Upon request, the patient shall be allowed to examine and shall be given an

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explanation of the bill rendered by the health care facility irrespective of the source of payment of

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the bill.

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      (12) Upon request, the patient shall be permitted to examine any pertinent health care

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facility rules and regulations that specifically govern the patient's treatment.

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      (13) The patient shall be offered treatment without discrimination as to race, color,

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religion, national origin, or source of payment.

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      (14) Patients shall be provided with a summarized medical bill within thirty (30) days of

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discharge from a health care facility. Upon request, the patient shall be furnished with an itemized

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copy of his or her bill. When patients are residents of state-operated institutions and facilities, the

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provisions of this subsection shall not apply.

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      (15) Upon request, the patient shall be allowed the use of a personal television set

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provided that the television complies with underwriters' laboratory standards and O.S.H.A.

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standards, and so long as the television set is classified as a portable television.

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      (16) No charge shall be made for furnishing a health record or part of a health record to a

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patient, his or her attorney or authorized representative if the record or part of the record is

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necessary for the purpose of supporting an appeal under any provision of the Social Security Act,

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42 U.S.C. section 301 et seq., and the request is accompanied by documentation of the appeal or a

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claim under the provisions of the Workers' Compensation Act, chapters 29 -- 38 of title 28. A

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provider shall furnish a health record requested pursuant to this section within thirty (30) days of

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the request. Further, for patients of school based health centers, the director is authorized to

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specify by regulation an alternative list of age appropriate rights commensurate with this section.

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     (17) The patient shall have the right to have his or her pain assessed on a regular basis.

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     SECTION 3. Chapter 23-17.5 of the General Laws entitled "Rights of Nursing Home

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Patients" is hereby amended by adding thereto the following section:

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     23-17.5-28. Pain assessment. – The patient shall have the right to have his or her pain

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assessed on a regular basis.

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     SECTION 4. This act shall take effect upon passage.

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LC01755

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO HEALTH AND SAFETY -- PAIN ASSESSMENT ACT OF 2002

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     This act would create the “Pain Assessment Act of 2002” which would require that health

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care providers and facilities conduct an assessment of pain experienced by a patient on a regular

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basis.

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     This act would take effect upon passage.

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LC01755

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