Legislature(1997 - 1998)
04/16/1997 08:20 AM FIN
* first hearing in first committee of referral
= bill was previously heard/scheduled
= 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.