Date: 07/09/2009
Final
Introductory Remarks
HOSPICE AND PALLIATIVE CARE
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09:03 AM -- Introductory Remarks
Representative Riesberg brought the meeting to order. He spoke to a handout provided by the Colorado Center for Hospice and Palliative Care regarding hospice cost savings (Attachment A).
09:06 AM -- Urban Hospice: Current Challenges and Potential Solutions
Cathy Wagner, Colorado Community Hospice, introduced herself and provided a handout to the committee (Attachment B). Ms. Wager provided information regarding the composition of the Colorado Community Hospice. She explained that some patients are not ready to discuss hospice and the implications of what it means. She stated that many physicians try to have conversations with their patients regarding end of life decisions, but many are hesitant to have those discussions. The committee discussed how to encourage more individuals to fill out some type of end of life directive. The committee discussed how to streamline end of life documents. Ms. Wagner stated that many people believe that filling out end of life directives is equivalent to acknowledging that they are dying. She stated that she would like to move the discussion towards having individuals understand that filling out advanced directive forms are helpful. Ms. Wagner spoke to patient's rights and advanced care directives.
09:33 AM
Ms. Wagner discussed the evolution of hospice care. She described the hospice approach to care. She spoke about long-term care providers and the need to coordinate care better between the two entities. Ms. Wagner spoke to the need for increasing surveys performed by the state. There was some discussion regarding the accreditation of hospice facilities. She stated that as of December 2008, new federal regulations for Medicare became effective. Ms. Wagner explained a scenario where a hospice patient may be in need of some type of general in-patient admittance. She explained that in order to admit the person to a hospital, a mental health diagnosis or a "PASR" or a pre-admission screening and resident review, must be ordered for the patient to be admitted. She explained that these patients are typically in crisis and are in need of a particular type of drug immediately. She stated that a PASR takes more time than is available due to the crisis situation. She stated that this regulation does not provide quality of care or take into consideration the safety of the patient.
09:59 AM
Ms. Wagner continued to respond to questions to the committee, with Representative Tyler inquiring about certification of hospice centers. Senator Tochtrop asked clarifying questions about what medications may be administered by hospice care employees.