Date: 03/11/2010
Final
BILL SUMMARY for HB10-1283
HOUSE COMMITTEE ON JUDICIARY
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03:50 PM -- House Bill 10-1283
Representative Levy announced that the committee would hear witness testimony on House Bill 10-1283, but the bill would laid over to Thursday, March 18, 2010, for action.
03:51 PM
Representative Riesberg, prime sponsor, presented the bill, which concerns increasing patient safety outside of the litigation process, requiring physicians to engage in ongoing professional development, and facilitating information sharing about health care workers. The bill, as amended by the House Health and Human Services Committee, requires the State Board of Medical Examiners in the Department of Regulatory Agencies (DORA) to adopt rules for and implement a professional development program for physicians and physician assistants. The board must develop the program in conjunction with statewide professional associations, and must be in place no later than the 2013 license renewal cycle.
The bill creates the Patient Safety Act to require that health care providers make reasonable efforts to verify the employment history and references of all applicants for any job that involves access to patients. Health care providers and other employers must share known information regarding a health care employee's:
- work performance affected by drug or alcohol use;
- known drug tampering or diversion;
- patient abuse; or
- violent crimes.
The act permits protected communications with patients and other interested persons as part of a health care assessment and allows information to be shared among health care providers without waiving the confidentiality or privilege of the information.
Finally, the Health and Human Services Committees of the General Assembly are required to request that one or more health care provider associations prepare a report on demonstration projects that explore alternatives to the existing medical liability litigation system. The report is due January 31, 2012.
Representative Riesberg distributed a New York Times article entitled "Learning to Keep Patients Safe in a Culture of Fear" (Attachment I).
04:01 PM -- Dr. Timothy B. McDonald, representing himself, spoke in support of the bill. Dr. McDonald discussed his educational and professional background. He spoke about comprehensive responses to patient harm. He talked about a process developed at the University of Illinois at Chicago that facilitates communication between medical staff and the families of patients who have been harmed. Dr. McDonald responded to questions from the committee about privileged conversations related to mistakes made in a medical situation.
04:47 PM -- Natalie Brown, Colorado Trial Lawyers' Association, spoke in opposition to the bill. Ms. Brown discussed judicial evidentiary rulings and how those pertain to what is true and not true in a case of a medical mistake. She expressed her desire to provide constructive criticism about the bill. She stated that her desire is to protect patients in instances where physicians are not truthful. She spoke to provisions of the bill that address objective reasonableness. She suggested a reexamination of the "corporate practice of medicine" doctrine. Ms. Brown responded to questions from the committee about the broadness of the bill. The committee discussed litigation in the area of medical malpractice.
05:08 PM -- John Stoffel, Colorado Senior Lobby, spoke in opposition to the bill. Mr. Stoffel expressed his opinion that the bill prohibits a patient from sharing with his or her attorney a conversation with a physician about a negative medical outcome. He stated that a lot of litigation would not happen if patients were told the truth by doctors in the beginning. He indicated that he does support many other portions of the bill.
05:15 PM -- Dr. Mark Laitos and Kari Hershey, Colorado Medical Society, spoke in support of the bill. Dr. Laitos stated that improving patient safety lowers health care costs and makes the system work better. Medical malpractice litigation is not particularly useful in holding medical providers accountable for their actions. The Colorado Medical Society seeks to make it simpler to share information among health care facilities about medical professionals who commit bad acts. He spoke to the adversarial process that goes into effect when a patient is harmed or dies through the actions of a medical professional. He indicated that doctors would prefer to be able to share information with patients without the threat of having those conversations used against them at trial. Dr. Laitos discussed the final sections of the bill, which provide new ways for physicians and health care facilities to improve patient safety and patient redress options that are alternatives to litigation.
05:24 PM
Ms. Hershey discussed efforts to amend the bill that will be addressed on Thursday, March 18. She spoke to concerns the committee raised earlier in the hearing about the discovery or admissibility of evidence. She also addressed comments about the issue of truthfulness. She explained the "objectively reasonable" standard and how it relates to the peer review process. She responded to questions from the committee regarding whether the bill prohibits patients from disclosing information obtained through interactions with their doctors. The committee discussed the "fruit of the poisonous tree" doctrine, which describes evidence gathered with the aid of information obtained illegally. The committee continued to discuss the confidentiality of conversations between doctors and patients.
05:56 PM -- Barbara Thompson, Mountain States Employers' Council, testified about the bill. Ms. Thompson discussed an employer's obligation to disclose certain information upon request.
05:59 PM -- Patty Skolnik, Citizens for Patient Safety, spoke in support of the bill. Ms. Skolnik distributed pictures of her son, who died after brain surgery (Attachment J). She related details of her experience with a medical malpractice lawsuit. She talked about her activism on behalf of patients and families who want to know what happened in the course of care. She expressed her opinion that her physician lied to her throughout the process.
06:04 PM
Representative Levy reiterated that the bill would be laid over. She discussed her concerns with the bill. Members of the committee commented about their positions on the bill. Representative Riesberg addressed many of the comments and questions made during the hearing. He provided closing comments.