Proposed Draft Legislation
HOSPICE AND PALLIATIVE CARE
|Votes: View--> ||Action Taken: |
11:11 AM -- Proposed Draft Legislation
Representative Roberts suggested that a bill be drafted that would update the living will statute (Recommendation number three from the Colorado Center for Hospice and Palliative Care. See Attachment C for a list of all the recommendations from the Colorado Center for Hospice and Palliative Care).
Representative Tyler suggested that a bill be drafted using the Statewide Internet Portal Authority (SIPA) to establish a central registry for living wills and other advance care directives. He spoke to the funding mechanism of SIPA. There was committee discussion regarding any bills that drive a fiscal note.
Dr. Kassner returned to the table to speak to recommendation number four from the Colorado Center for Hospice and Palliative Care which goes to adopting the recommendation from the Colorado Advance Directive Consortium regarding the MOST form. Representative Roberts spoke to the need for statutory recognition of the MOST form, especially in legal settings. Carl Bladstein, attorney in Denver practicing elder law, commented on the issues that were brought forth with House Bill 09-1232 concerning advanced care directives. He spoke to the difference between 'what a patient wants' versus a medical order signed by a physician. He emphasized that the MOST form is a medical order that can be portable across various medical providers. He stated that it is important to acknowledge the patient's wishes.
Representative Roberts suggested a bill be drafted that would increase the time frame for Medicaid eligibility for hospice care from six months to nine months. Dr. Kassner spoke to the eligibility renewal period for hospice care. He stated that eligibility can be extended six months at a time after the initial approval. He stated that the bill is focused on the initial eligibility prognosis. He stated that this recommendation will be a cost saver.
Senator Tochtrop suggested that a bill be drafted that would improve efficiencies in hospice care. She spoke to the recommendation from the Colorado Center for Hospice and Palliative Care describing eliminating the 'pass through' and allowing long-term facilities to be reimbursed directly for room and board costs rather than paying the hospice which then in turn pays the long-term facility. See Recommendations 1a and 1c from the Colorado Center for Hospice and Palliative Care (Attachment C). There was discussion regarding whether this would need to be two bills. Christy Chase, Office of Legislative Legal Services, stated she did not know at this time.
Senator Tochtrop also suggested that a bill be drafted that would address the pre-admssion screening and resident review (PASRR) issue that was discussed in committee at the July 9, 2009, meeting. She stated she would like to seek a waiver for the current requirement that patients must first recieve a PASARR prior to be admitted to a hospital.
Representative Riesberg asked that a bill be drafted that would address the Colorado Medical Society's concern with House Bill 08-1061. The bill would amend current statute to state that physicians only, rather than physicians and advance practice nurses, may certify terminal illnesses.
Senator Tochtrop suggested that a bill be drafted that would allow advanced practice nurses the authority to pronounce death.
The committee discussed various issues raised throughout the committee meetings.
Christy Chase, Office of Legislative Legal Services, recapped the bill draft requests.
The committee adjourned.