Final
STAFF SUMMARY OF MEETING

HOSPICE AND PALLIATIVE CARE

Date:10/20/2009
ATTENDANCE
Time:09:01 AM to 10:21 AM
Balmer
X
Cadman
E
Place:HCR 0107
Kester
A
Newell
X
This Meeting was called to order by
Roberts
*
Representative Riesberg
Soper
X
Tochtrop
X
This Report was prepared by
Tyler
X
Kelly Stapleton
Williams
*
Riesberg
X
X = Present, E = Excused, A = Absent, * = Present after roll call
Bills Addressed: Action Taken:
Introduction
Draft Legislation
-
-


09:02 AM -- Introduction

Representative Riesberg convened the meeting and provided introductory remarks on the committee. He explained that the committee may adopt eight bills for consideration by of Legislative Council. He stated that the committee would be considering seven bills. He stated that the committee would review each bill in order, vote on the bill, and then indicate sponsorship of the bill.

09:05 AM -- Draft Legislation

Senator Tochtrop stated that she was withdrawing Draft Bill #1 - Concerning a Waiver of Patient Screening Requirements for Hospice Patients on Pschotropic Drugs. She explained that the issue will be addressed by the Attorney General's office. Senator Tochtrop stated she was also withdrawing Draft Bill #2 - Allow Registered Nurses to Pronounce Death. She indicated that the Department of Health Care Policy and Financing may be able to address the issue through rule instead of statutory language.



09:08 AM

Representative Roberts withdrew Draft Bill #3 - Medical Orders Scope of Treatment (Attachment A). She explained to the committee that the consortium of stakeholders working on the bill were not ready to move forward with the current language and need more time to work on the it. She indicated that there are about 50 members of the consortium, including the Colorado Center for Hospice and Palliative Care, the Denver Hospice, the Department of Public Health and Environment, the Colorado Bar Association, and the Colorado Medical Society. Several members indicated they would like to support the bill in its final form.

09Hospice1020AttachA.pdf

09:13 AM

Representative Riesberg explained that Draft Bill #4 - Limit Ability of Advanced Practice Nurse - removes the statutory authorization for an advanced practice nurse to declare a person terminally ill (Attachment B). Representative Roberts asked if the short title of the bill could be changed from Limit Ability of Advance Practice Nurse to Advance Practice Nurse and Terminal Illness.

09Hospice1020AttachB.pdf


BILL:Draft Legislation
TIME: 09:17:38 AM
MOVED:Roberts
MOTION:Moved to change the short title of Draft Bill #4 from "Limit Ability of Advanced Practice Nurse" to "Advance Practice Nurse and Terminal Illness." There was discussion regarding changing the short title of the bill. Representative Roberts amended the motion to change the short title from "Limit Ability of Advanced Practice Nurse" to "Declaring Patients Terminally Ill." The motion passed without objection.
SECONDED:
VOTE
Balmer
Cadman
Excused
Kester
Absent
Newell
Roberts
Soper
Tochtrop
Tyler
Williams
Riesberg
Not Final YES: 0 NO: 0 EXC: 1 ABS: 1 FINAL ACTION: Pass Without Objection


BILL:Draft Legislation
TIME: 09:30:19 AM
MOVED:Roberts
MOTION:Moved to remove the striken "advanced practice nurse" from line 10 on page 2. The motion passed without objection.
SECONDED:
VOTE
Balmer
Cadman
Excused
Kester
Absent
Newell
Roberts
Soper
Tochtrop
Tyler
Williams
Riesberg
Not Final YES: 0 NO: 0 EXC: 1 ABS: 1 FINAL ACTION: Pass Without Objection


BILL:Draft Legislation
TIME: 09:32:41 AM
MOVED:Roberts
MOTION:Include Draft Bill #4 - Declaring Patients Terminally Ill - as one of the eight bills recommended by the Interim Committee to Study Hospice and Palliative Care to Legislative Council. The motion passed on a 8-0 roll call vote.
SECONDED:
VOTE
Balmer
Yes
Cadman
Excused
Kester
Absent
Newell
Yes
Roberts
Yes
Soper
Yes
Tochtrop
Yes
Tyler
Yes
Williams
Yes
Riesberg
Yes
Final YES: 8 NO: 0 EXC: 1 ABS: 1 FINAL ACTION: PASS


The committee discussed sponsorship of the Draft Bill #4. The committee determined that the bill will be introduced as a House bill with Representatives Riesberg and Balmer as co-prime sponsors and Senator Williams as the Senate sponsor. Co-sponsors include Representatives Roberts, Soper, and Tyler, and Senator Newell.


09:35 AM

Representative Tyler explained Draft Bill #5 - On-line Registry Medical Directive Form - which establishes an on-line registry for medical directives (Attachment C). Representative Tyler spoke to some of the security measures that would need to be taken in order to make the on-line registry secure. There was some discussion regarding the funding of the on-line registry.

09Hospice1020AttachC.pdf


09:48 AM --
Jesi Dobosz, Legislative Liaison, Department of Public Health and Environment, came to the table and informed the committee that the bill has not been vetted by the department. She indicated that there may be financial barriers to implementing the bill.

BILL:Draft Legislation
TIME: 09:50:32 AM
MOVED:Roberts
MOTION:Moved to amend the bill to authorize the department to accept gifts, grants, and donations to pay for the on-line registry. The motion passed without objection.
SECONDED:
VOTE
Balmer
Cadman
Excused
Kester
Absent
Newell
Roberts
Soper
Tochtrop
Tyler
Williams
Riesberg
Not Final YES: 0 NO: 0 EXC: 1 ABS: 1 FINAL ACTION: Pass Without Objection


BILL:Draft Legislation
TIME: 09:55:07 AM
MOVED:Tyler
MOTION:Include Draft Bill #5 - On-line Registry Medical Directives Form - as amended, as one of the eight bills recommended by the Interim Committee to Study Hospice and Palliative Care to Legislative Council. The committee discussed how the bill will be funded. The motion passed on a 7-1 roll call vote.
SECONDED:
VOTE
Balmer
No
Cadman
Excused
Kester
Absent
Newell
Yes
Roberts
Yes
Soper
Yes
Tochtrop
Yes
Tyler
Yes
Williams
Yes
Riesberg
Yes
Final YES: 7 NO: 1 EXC: 1 ABS: 1 FINAL ACTION: PASS



09:57 AM

The committee discussed sponsorship of the bill. The committee determined that the bill will be introduced as a House bill with Representative Tyler and Senator Tochtrop as sponsors. Co-sponsors include Representatives Riesberg and Soper and Senator Williams.

09:59 AM

Representative Roberts explained Draft Bill #6 - Medicaid Hospice Life Expectancy - which extends the period of eligibility of Medicaid clients for hospice from six months to nine months, pending federal approval (Attachment D).

09Hospice1020AttachD.pdf

BILL:Draft Legislation
TIME: 09:59:37 AM
MOVED:Roberts
MOTION:Include Draft Bill #6 - Medicaid Hospice Life Expectancy - as one of the eight bills recommended by the Interim Committee to Study Hospice and Palliative Care to Legislative Council. The motion passed on a 8-0 roll call vote.
SECONDED:
VOTE
Balmer
Yes
Cadman
Excused
Kester
Absent
Newell
Yes
Roberts
Yes
Soper
Yes
Tochtrop
Yes
Tyler
Yes
Williams
Yes
Riesberg
Yes
Final YES: 8 NO: 0 EXC: 1 ABS: 1 FINAL ACTION: PASS


Committee members discussed sponsorship of the bill and determined that the bill will be introduced as a House bill with Representatives Roberts and Tyler as co-prime sponsors. Senator Williams volunteered to be the Senate sponsor. Co-sponsors include Representative Soper and Senators Tochtrop and Newell.

10:02 AM

Representative Roberts explained Draft Bill #7 - Colorado Medical Treatment Act Updates (Attachment E).

09Hospice1020AttachE.pdf

BILL:Draft Legislation
TIME: 10:03:45 AM
MOVED:Roberts
MOTION:Moved to strike lines 1 through 17 on page 14 of the draft bill. The motion was withdrawn.
SECONDED:
VOTE
Balmer
Cadman
Excused
Kester
Absent
Newell
Roberts
Soper
Tochtrop
Tyler
Williams
Riesberg
Not Final YES: 0 NO: 0 EXC: 1 ABS: 1 FINAL ACTION: Withdrawn



10:05 AM

Representative Roberts spoke to some changes to the bill that she would be seeking after the bill is introduced. She stated that amendments concern structural changes rather than substantive amendments.
BILL:Draft Legislation
TIME: 10:10:05 AM
MOVED:Roberts
MOTION:Include Draft Bill #7 - Colorado Medical Treatment Act Updates - as one of the eight bills recommended by the Interim Committee to Study Hospice and Palliative Care to Legislative Council. The motion passed on a 8-0 roll call.
SECONDED:
VOTE
Balmer
Yes
Cadman
Excused
Kester
Absent
Newell
Yes
Roberts
Yes
Soper
Yes
Tochtrop
Yes
Tyler
Yes
Williams
Yes
Riesberg
Yes
Final YES: 8 NO: 0 EXC: 1 ABS: 1 FINAL ACTION: PASS


The committee determined that Draft Bill #7 will be introduced as a House bill with Representative Roberts and Senator Newell as sponsors. Co-sponsors include Representatives Riesberg, Soper, and Tyler. Co-sponsors in the Senate include Senators Tochtrop and Williams.

10:11 AM

Senator Tochtrop explained Draft Bill #8 - Medicaid Hospice Room and Board Changes - which directs the Department of Health Care Policy and Financing to pay nursing facilities directly for inpatient services provided to a Medicaid recipient for hospice care rather than paying the hospice provider who then pays the nursing facility (Attachment F).

09Hospice1020AttachF.pdf
BILL:Draft Legislation
TIME: 10:12:24 AM
MOVED:Tochtrop
MOTION:Include Draft Bill #8 - Medicaid Hospice Room and Board Changes - as one of the eight bills recommended by the Interim Committee to Study Hospice and Palliative Care to Legislative Council. The motion passed on a 8-0 roll call vote.
SECONDED:
VOTE
Balmer
Yes
Cadman
Excused
Kester
Absent
Newell
Yes
Roberts
Yes
Soper
Yes
Tochtrop
Yes
Tyler
Yes
Williams
Yes
Riesberg
Yes
Final YES: 8 NO: 0 EXC: 1 ABS: 1 FINAL ACTION: PASS



10:13 AM

The committee determined that Draft Bill #8 will be introduced as a Senate bill. Senator Tochtrop and Representative Riesberg volunteered to be the sponsors of the legislation. Co-sponsors include Representatives Roberts and Tyler and Senators Newell and Williams.

10:14 AM

Draft Bill #9 - Advance Practice Nurses Physical Force - was withdrawn (Attachment G). Representative Riesberg stated that the bill was outside the charge of the committee.

09Hospice1020AttachG.pdf
BILL:Draft Legislation
TIME: 10:17:50 AM
MOVED:Soper
MOTION:Moved to allow the Office of Legislative Legal Services to make any necessary technical changes to the draft bills. The motion passed without objection.
SECONDED:
VOTE
Balmer
Cadman
Excused
Kester
Absent
Newell
Roberts
Soper
Tochtrop
Tyler
Williams
Riesberg
Not Final YES: 0 NO: 0 EXC: 1 ABS: 1 FINAL ACTION: Pass Without Objection



10:18 AM

Representative Riesberg provided concluding remarks to the committee. Representative Riesberg thanked the advocates and caregivers in the community. The committee adjourned.