2013 -- S 0279 SUBSTITUTE A AS AMENDED

=======

LC00782/SUB A

=======

STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2013

____________

A N A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT - PALLIATIVE CARE AND

QUALITY OF LIFE - SERVICES AND EDUCATION

     Introduced By: Senators Lynch, Goodwin, Ottiano, Miller, and Gallo

     Date Introduced: February 12, 2013

     Referred To: Senate Health & Human Services

It is enacted by the General Assembly as follows:

1-1

     SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby

1-2

amended by adding thereto the following chapter:

1-3

     CHAPTER 89

1-4

THE RHODE ISLAND PALLIATIVE CARE AND QUALITY OF LIFE ACT

1-5

     23-89-1. Establishment of advisory council - Purposes. -- (a) There is hereby

1-6

authorized, created and established a nine (9) member advisory council to be known as "The

1-7

Rhode Island Palliative Care and Quality of Life Interdisciplinary Advisory Council" within the

1-8

department of health with the powers and duties set forth in this chapter.

1-9

     (b) The director of the department of health shall appoint nine (9) members to the council

1-10

who shall have expertise in various aspects of palliative care including, but not limited to,

1-11

medical, nursing, social work, pharmacy and spiritual; and patient and family caregivers.

1-12

Membership shall specifically include experience in palliative care in a variety of inpatient,

1-13

outpatient and community settings such as acute care, long-term care and hospice and with a

1-14

variety of populations including pediatric, youth and adult care. One (1) council member shall be

1-15

a designee of the Rhode Island American Cancer Society and two (2) member's shall be a chief

1-16

executive of a licensed homecare agency or their designee. At least two (2) council members shall

1-17

be board-certified hospice and palliative medicine physicians and/or nurses. Members shall serve

1-18

for a term of three (3) years. Members shall receive no compensation for their services.

2-19

     (c) The Rhode Island palliative care and quality of life interdisciplinary advisory council

2-20

shall consult with and advise the department of health on matters related to the establishment,

2-21

maintenance, operation, and outcomes evaluation of palliative care initiatives in the state.

2-22

     23-89-2. Establishment of palliative care consumer and professional information

2-23

and education program. -- (a) There is hereby created and established a statewide "Palliative

2-24

Care Consumer and Professional Information and Education Program" within the department of

2-25

health.

2-26

     (b) The purpose of the palliative care consumer and professional information and

2-27

education program shall be to maximize the effectiveness of palliative care initiatives in the state

2-28

by ensuring that comprehensive and accurate information and education about palliative care is

2-29

available to the public, healthcare providers, and healthcare facilities.

2-30

     (c) The department of health shall publish on its website information and resources,

2-31

including links to external resources, about palliative care delivery for the public, healthcare

2-32

providers, and healthcare facilities. This shall include, but not limited to, continuing educational

2-33

opportunities for healthcare providers; information about palliative care delivery in the home,

2-34

primary, secondary, and tertiary environments; best practices for palliative care delivery; and

2-35

consumer educational materials and referral information for palliative care, including hospice.

2-36

     (d) The department of health may develop and implement any other initiatives regarding

2-37

palliative care services and education that the director determines would further the purposes of

2-38

this subsection.

2-39

     (e) The department shall consult with the palliative care and quality of life

2-40

interdisciplinary advisory council in implementing this section.

2-41

     23-89-3. Access to palliative care. -- (a) As used in this section, the following terms

2-42

shall have the following meanings:

2-43

     (1) "Appropriate" means consistent with applicable legal, health and professional

2-44

standards, the patient's clinical and other circumstances, and the patient's reasonably known

2-45

wishes and beliefs.

2-46

     (2) "Medical care" means services provided, requested, or supervised by a physician or

2-47

advanced practice nurse.

2-48

     (3) "Palliative care" means patient and family centered medical care that optimizes

2-49

quality of life by anticipating, preventing, and treating suffering caused by serious illness.

2-50

Palliative care throughout the continuum of illness involves addressing physical, emotional,

2-51

social, and spiritual needs and facilitating patient autonomy, access to information, and choice.

2-52

Palliative care includes, but is not limited to, discussions of the patient's goals for treatment;

2-53

discussion of treatment options appropriate to the patient, including, where appropriate, hospice

3-1

care; and comprehensive pain and symptom management.

3-2

     (4) "Serious illness" means any medical illness or physical injury or condition that

3-3

substantially impacts quality of life for more than a short period of time. Serious illness includes,

3-4

but is not limited to, cancer; heart, renal or liver failure; lung disease; and Alzheimer's disease

3-5

and related dementias.

3-6

     (b) On or before January 1, 2015, all healthcare organizations which required a license to

3-7

operate shall:

3-8

     (1) Consult with the organization’s physicians to educate them on how to provide

3-9

information about appropriate palliative care services for those patients or residents with serious

3-10

illnesses, who, in their professional medical opinion, would benefit from them.

3-11

      (c) The department shall carry out this section with the consultation of the palliative care

3-12

and quality of life interdisciplinary advisory council.

3-13

     (d) In carrying out this section, the department shall take into account factors that may

3-14

impact the development of such a system and its ability to facilitate access to palliative care,

3-15

including the size of the healthcare organization; access and proximity to palliative care services,

3-16

including the availability of hospice and palliative care board-certified practitioners and related

3-17

workforce staff; and geographic factors.

3-18

     SECTION 2. This act shall take effect upon passage.

=======

LC00782/SUB A

========

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT - PALLIATIVE CARE AND

QUALITY OF LIFE - SERVICES AND EDUCATION

***

4-1

     This act would establish the "Rhode Island Palliative Care and Quality of Life

4-2

Interdisciplinary Advisory Council" within the department of health and would require healthcare

4-3

organizations to provide information about palliative care to appropriate patients.

4-4

     This act would take effect upon passage.

=======

LC00782/SUB A

=======