Legislature(1997 - 1998)
04/07/1997 09:09 AM Senate HES
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* first hearing in first committee of referral
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+ teleconferenced
= bill was previously heard/scheduled
SB 96 REGULATION OF HOSPICE CARE
Number 530
CHAIRMAN WILKEN announced that SB 96 would be the next order of
business before the committee. Chairman Wilken noted that the K
version of the bill was before the committee.
BEN BROWN , Staff to Senator Kelly, discussed the changes that
version K includes. On page 8, line 21 after "which" the word
"including" was deleted and "may include" was inserted. That
language was inserted because sometimes a volunteer hospice would
not include all the items listed for bereavement services. Page 9,
line 14 the reference to 24 hour, seven days a week was deleted
because in a volunteer context that would not occur. That language
is on page 5 under the definition of nursing services as provided
by nonvolunteer hospice programs.
CHAIRMAN WILKEN asked Ms. Sonner to provide her testimony and noted
that the packet included her letter.
RITCHIE SONNER , Hospice & Home Care of Juneau, supported SB 96 as
written. With the changes to SB 96, Ms. Sonner did not believe it
to be burdensome administratively or financially. Hospice & Home
Care of Juneau is a small volunteer hospice with few funds. SB 96
is written to protect the consumer. Ms. Sonner noted that she was
not a supporter of regulation, but in this situation she
recommended the passage of SB 96.
SENATOR LEMAN asked Ms. Sonner if her notion that SB 96 was not
burdensome was the general consensus among volunteer hospices.
RITCHIE SONNER believed so, but noted there were folks on line who
could speak to that. SENATOR LEMAN did not want to burden such
organizations unnecessarily.
CHARLES QUARRE , President of the Central Peninsula Hospice, stated
that he maintained his previous testimony regarding concerns of the
administrative and financial burdens of SB 96. Mr. Quarre noted
that many industries are regulated by market forces. The volunteer
hospices adhere to the guidelines of the National Hospice
Organization which are almost identical to those specified in the
bill. Mr. Quarre suggested reviewing the advisability of incurring
additional expense and regulations in this area. Mr. Quarre
questioned if there are current statutes that address abuses in
this system. In response to Chairman Wilken, Mr. Quarre agreed
that he was speaking in opposition to SB 96. Mr. Quarre requested
that the volunteer hospice may be noted in the bill, but be
excluded from the provisions if not entirely.
CHAIRMAN WILKEN asked Mr. Quarre if he had any suggestions
regarding how to accomplish that within SB 96. CHARLES QUARRE
suggested that if the bill is to pass, the volunteer hospice could
be recognized but excluded from the provisions of the bill.
Number 427
BEN BROWN explained that if hospices are to be regulated, there
must be a standard that applies to any organization using the term
hospice. In the Commonwealth of Virginia, a bill excluding the
volunteer hospices was passed which resulted in volunteer hospices
being unable to use the term hospice in their name. Mr. Brown
acknowledged that language could be used to avoid that problem.
However, that would result in regulating only a portion of the
industry providing hospice services. Mr. Brown recognized that the
volunteer hospices in Alaska are exceeding the standards specified
in the bill, but that may not continue as time passes. Eliminating
the reference to the volunteer programs in SB 96 would not
accomplish the primary goal and the remainder of the hospice
community may not want that to go forward.
RITCHIE SONNER noted that there are shams, although not in Alaska
currently. Thirty-eight states have had to regulate hospices in
even a more restrictive manner. SB 96 is a proactive bill to
protect consumers who are in a vulnerable state. Ms. Sonner feared
the possibility of an opportunist. Ms. Sonner pointed out that
eliminating the reference to volunteer hospices would allow anyone
to refer to themselves as a hospice. SB 96 should be passed as is
or not at all.
SENATOR WARD inquired as to the number of cases of abuse in Alaska
this year. BEN BROWN did not believe there was a situation of
abuse in Alaska currently. SENATOR WARD suggested that regulation
could harm the process that is currently working. BEN BROWN
referred to Article 2 when saying that the Administrator of Health
Facilities Licensing & Certification will be reviewing mainly
nonvolunteer hospices a couple days a year. The volunteer programs
have a lower standard to adhere and the department has no intention
of charging volunteer hospices. Mr. Brown reiterated that the
volunteer hospices are already exceeding the standards in SB 96.
Mr. Brown noted that nurses and doctors have associations that
regulate them, only attorneys regulate themselves. Mr. Brown did
not know what more could be done to lighten the burden without
making the legislation meaningless.
Number 366
SENATOR WARD agreed that there was no middle ground. Senator Ward
inquired as to the public safety reasons for SB 96 within Alaska.
BEN BROWN could not give an example within the hospice community.
There was a problem in an assisted living home which lead to
changes in law. Mr. Brown noted that an assisted living home was
a comparable field.
BARBARA RICH , Hospice of the Tanana Valley, said that she was
speaking for the Board of Directors. Ms. Rich noted that all of
the concerns regarding the bill initially speaking only to
volunteer hospices when relevant were addressed. Ms. Rich noted
that she was concerned with the administrative and financial costs
of SB 96. Mr. Shelby of the Department of Health & Social Services
assured Ms. Rich that it would be very minimal: a yearly on-site
inspection would occur with a report following. The standards in
the bill are minimal. SB 96 would protect vulnerable patients and
families. Ms. Rich said that there has never been a problem in
this area and the impetus is to continue that record.
In response to Senator Ward, Ms. Rich said that the Hospice of the
Tanana Valley has not experienced any problems. Ms. Rich was
concerned that others may not do so. With regard to the expansion
of the regulations, Ms. Rich did not believe there could be
expansion. Ms. Rich said that she had heard of others who have
lower standards as well as problems with this in other states.
SENATOR WARD was not sure that regulation was necessary for a
problem that does not exist. BARBARA RICH believed that the
certified hospices would be regulated due to the presence of
nursing staff and such.
JOY JANSSEN , representing the forming Petersburg Hospice, informed
the committee that Petersburg was in the process of forming a
hospice beginning with neighbor to neighbor care. Ms. Janssen
asked if neighbor to neighbor care was given without using the name
hospice, would the organization still be regulated under this bill.
BEN BROWN replied no. SB 96 applies only to groups representing
themselves as hospices. Mr. Brown said that it would be a
judgement call for the Department of Law upon the request of the
Department of Health & Social Services. Mr. Brown pointed out the
definition of "hospice services" when noting that providing only
one service at home or not meeting all the needs listed could
possibly eliminate Ms. Janssen's concerns. Identifying an
organization as a hospice is the triggering mechanism and the
secondary definition is providing hospice services.
Number 251
MAXINE WORHATCH , testifying from Petersburg, asked if insurance,
personal or group, would be necessary if a group fell under this
bill as a volunteer. BEN BROWN said that was not covered by SB 96.
Mr. Brown believed that most volunteer hospices carried insurance.
SB 96 does not mandate liability insurance. Mr. Brown referred Ms.
Worhatch to Ms. Sonner or Ms. Rich. MAXINE WORHATCH commented that
it does not seem necessary to regulate volunteer hospices. Why
would someone volunteer and then take advantage of a patient?
ERICA WORHATCH asked if a hospice became licensed would the hospice
be liable if a neighbor who was not a hospice volunteer wanted to
help. BEN BROWN said that if a person wanted to help a dying
neighbor, of course that can be done. As long as that neighbor did
not say he/she was affiliated with a particular hospice, that
hospice would not be liable for his/her actions.
CHAIRMAN WILKEN suggested that those in Petersburg could consult
the many successful volunteer hospices such as those represented by
Ms. Sonner and Ms. Rich.
SHELBERT LARSEN , Administrator of Health Facilities Licensing &
Certification for DHSS, said that his agency would probably develop
and enforce the regulations if this statute were to pass. Mr.
Larsen believed that SB 96 was a good bill, providing minimum
standards for hospice programs. Mr. Larsen did not believe SB 96
would be burdensome for either the for profit or volunteer
hospices.
CHAIRMAN WILKEN referred to Article 2, page 7, line 18 when asking
if other volunteer organizations were required to show proof of
auto insurance and valid drivers license. BEN BROWN said that he
had asked Terri Lauterbach about that matter. Ms. Lauterbach was
unaware of other volunteer organizations requiring such. That
requirement was included because it was in the main statute and
seemed appropriate to put in SB 96. This has not been a concern
for anyone. Mr. Brown said that it would not be appropriate for an
individual to be driving around a terminally ill patient without
auto insurance and a valid drivers license. This is one reason for
a hospice to have liability insurance. Liability would be
increased if the two requirements were not met.
SENATOR GREEN informed everyone that her husband was employed by
the Auto Insurance Provider. Senator Green recalled that when she
drove for Scouts or her church, she was required to have proof of
insurance. Senator Green did not believe that those requirements
were unique to hospices.
SENATOR WARD requested that SB 96 be held until Kenai could provide
an amendment to eliminate the volunteers from the bill. Senator
Ward did not know when the amendment would be ready. Senator Ward
said that he did not want to move SB 96 out of committee; people
should not be regulated for a problem that does not exist.
CHAIRMAN WILKEN said that he would prefer not to hold SB 96 beyond
Wednesday. There being no further business before the committee,
the meeting was adjourned at 10:35 a.m.
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