Legislature(1997 - 1998)
04/16/1997 08:20 AM House FIN
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE BILL 152
"An Act regulating hospice care."
REPRESENTATIVE JOE RYAN stated that HB 152 would provide for
licensing of hospice care programs in Alaska, ensuring that
terminally ill persons receive comfort, support, and care
consistent with hospice philosophy and concepts through a
uniform level of services. There are no federal regulations
or licensing requirements for either certified or volunteer
hospice programs. As of the January, 1997, forty states
have regulated hospice programs. The licensing and
appropriate regulation of volunteer and certified hospice
programs in Alaska will assure consumers of consistent
standards in the delivery of hospice services.
Representative Ryan noted that hospice is a unique component
of a health care delivery system, one that has evolved over
the past twenty years in the United States. Hospice
provides care and support for people with terminal illness.
The goal of hospice care is to enable patients to live an
alert, pain-free life and to manage symptoms so that the
last weeks and months of life may be spent in dignity and
peace.
The annual growth in the hospice programs averaged about
eight percent in the early 1990's. In the last five years,
growth has averaged seventeen percent. Hospice services are
provided through a variety of means. Representative Ryan
continued, the rapid growth of hospice programs is due to
increased demand for home care services, the desire of
terminally ill persons to keep control over the remainder of
their lives, and a trend towards reimbursement for home-care
3
services.
Representative Ryan noted that passage of HB 152 would help
to standardize hospice care and guarantee the Alaskan public
the opportunity to access quality hospice care from both
volunteer and certified hospice programs.
Representative Ryan stated that the fiscal note would
provide for the travel costs associated with establishing
licensure of six new hospice facilities outside of
Anchorage.
Representative Mulder inquired if the licensure of the
volunteer program would make it difficult for the volunteers
to achieve the necessary requirements. Representative Ryan
replied that the volunteer programs in Alaska adhere to the
national hospice standard. The legislation would create an
uniformity of those care standards.
Representative Martin expressed his hesitation of government
becoming involved with a system that currently works well.
He asked if the legislation would increase the costs
associated with the program. Representative Ryan replied
that the legislation would provide oversight that the dying
person is not taken advantage of. A standard has already
been determined and the legislation would not create micro-
management.
Co-Chair Therriault referenced language in the bill
referring to a "temporary" license. He asked why would a
temporary license be given before an agency had met the
requirements. Representative Ryan replied that the
temporary license would be provided if a problem existed
which needed to be corrected during the time the program was
being brought up to meet the standard.
Co-Chair Therriault continued, Page 3, Lines 3-12, makes
reference to the Department "suspending" or "reducing" a
license. He asked if clients would be required to move from
the facility when the agency's license was suspended.
Representative Ryan stated that he would assume that if the
agency's license was revoked, the facility would no longer
be able to operate. To revoke a license, conditions listed
on Page 2 would need to exist. Representative Ryan stressed
the vulnerability of people needing hospice services.
Representative Kelly asked if the requirements listed on
Page 4, were different from the procedures currently used.
Representative Ryan stated they were not.
RITCHIE SONNER, EXECUTIVE DIRECTOR, HOSPICE AND HOME CARE OF
JUNEAU, noted that the proposed legislation was supported by
4
hospices throughout the State of Alaska. She stated that
the bill adequately differentiates between the certified
hospice and the volunteer hospice. The volunteer hospices
are required to fulfill a minimum set of standards. The
criteria listed on Pages 4, 5 & 6 of the bill would not be
required for a voluntary hospice. Page 7 establishes the
criteria that a voluntary hospice must fulfill. She
stressed that criteria recommended would not be financially
or administratively burdensome for a hospice to meet.
Ms. Sonner continued, the proposed legislation would
prohibit any agency from calling itself a hospice. Hospice
infers a set of a comprehensive services as well as the
ability to address the entire family's needs.
She added, in Alaska there is no specific hospice facility.
Most of the hospice care is done in the home or in a home-
like setting. To fit into the certified criteria, there
needs to be a facility available. All the hospices in the
State use only one or two beds designated in a hospital. At
this time, care is provided in the home and must fit
established criteria.
In response to Co-Chair Therriault's query regarding the
confidentiality statement, Ms. Sonner replied that the
confidentiality aspect would guarantee that a staff member
or volunteer that is involved in a patient's home,
understand the requirements of confidentiality regarding the
client and family's personal issues.
Representative Martin asked if current facilities in the
State would be grand-fathered in. Ms. Sonner replied that
every facility would be required to fulfill the criteria
when the regulations become effective. That criteria
guarantees anyone coming into the hospice fulfills the needs
of what the consumer expects and deserves in the business.
(Tape Change HFC 97-99, Side 2).
Ms. Sonner explained that most hospices in the State are
small and depend on community funding. She added, that with
the exception of one hospice, the rest are confident that
the regulations imposed through the legislation would not be
difficult to incorporate. This observation was based on
hospice testimony from previous committee hearings.
Representative G. Davis asked if there exists a hospice
international organization. Ms. Sonner explained that there
is a National Hospice Organization with voluntary
membership. They establish standards of excellence. It is
up to each individual hospice to choose whether or not they
fulfill those standards. All the hospices which have
5
testified in the past few weeks have stated that they meet
and exceed the criteria established by that organization.
Representative Martin warned that eventually a fee would be
charged by the Department for licensure; he stressed that
someone will be responsible to pay to inspect the
facilities. Ms. Sonner could not speak to that concern.
Representative G. Davis commented that the proposed
legislation would provide an immediate return to the State
by taking care of our sick and dying population.
Representative Foster MOVED to report CS HB 152 (HES) out of
Committee with individual recommendations and with the
accompanying fiscal note. There being NO OBJECTION, it was
so ordered.
CS HB 152 (HES) was reported out of Committee with "no
recommendation" and with a fiscal note by the Department of
Health and Social Services dated 4/2/97.
| Document Name | Date/Time | Subjects |
|---|