REPORT TITLE:
Hospice Services


DESCRIPTION:
Authorizes the department of health to license hospice service
agencies.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                            172         
HOUSE OF REPRESENTATIVES                H.B. NO.           
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO HOSPICE SERVICES.


BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  The legislature finds that death is often
 
 2 accompanied by pain that is severe enough to make living
 
 3 unbearable.  On the other hand, an interdisciplinary approach to
 
 4 the palliation of pain can in most instances bring relief,
 
 5 comfort, and dignity during one's final days.  Hospice care
 
 6 facilitates pain management.  Its goal is to make dying as
 
 7 comfortable as possible for the person dying, and for family and
 
 8 friends.
 
 9      Hospice is a service that can be delivered at home, in a
 
10 free-standing unit operated by the hospice, in nursing or care
 
11 homes, or even in beds set aside in acute care hospitals.  It is
 
12 a philosophy that accepts that an illness has progressed to a
 
13 terminal stage, and death cannot be avoided even with aggressive
 
14 medical treatment.
 
15      The legislature further finds that virtually every study of
 
16 hospice care has concluded that:
 
17      (1)  The primary benefit of hospice care is increased
 
18           patient satisfaction; and
 
19      (2)  Hospice care almost always costs less than either
 
20           hospital care or other forms of acute care at the end
 
21           of life.
 

 
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 1      If pain management is improved and hospice care increased,
 
 2 many of Hawaii's health care providers believe that few people
 
 3 would consider physician-assisted death or physician-assisted
 
 4 suicide, which may be viewed as "desirable" when pain is not
 
 5 controlled and when the patient foresees being in a sterile or
 
 6 strange hospital or other residential program.
 
 7      The governor's blue ribbon panel on living and dying with
 
 8 dignity unanimously recommended, among other things, that:
 
 9      (1)  Hospice care be made more available and offered more
 
10           expediently to the dying; and
 
11      (2)  Effective pain management programs be required in all
 
12           health care institutions.
 
13      In line with the blue ribbon panel's unanimous
 
14 recommendation, the legislature finds it necessary to ensure
 
15 consistent, high-quality hospice care is maintained.
 
16      The purpose of this Act is to authorize the department of
 
17 health to license hospice service agencies.
 
18      SECTION 2.  Chapter 321, Hawaii Revised Statutes, is amended
 
19 by adding a new section to be appropriately designated and to
 
20 read as follows:
 
21      "§321-    Hospice services.  (a)  The department of health
 
22 is authorized to license hospice service agencies.
 
23      (b)  For the purposes of this section:
 

 
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                                     H.B. NO.           
                                                        
                                                        

 
 1      "Hospice" means a hospice service agency or the provision of
 
 2 hospice services in an in-patient facility.
 
 3      "Hospice service" means a program of palliative and
 
 4 supportive care for terminally ill persons and their families or
 
 5 caregivers.
 
 6      "Hospice service agency" means an agency or organization, or
 
 7 a subdivision of that agency or organization, which is engaged in
 
 8 providing hospice services at the place of residence of its
 
 9 clients.
 
10      (c)  The director shall adopt rules regarding hospices in
 
11 accordance with chapter 91, which shall be designed to:
 
12      (1)  Establish criteria for licensure of hospices, including
 
13           inspections, registration, fees, qualifications of
 
14           operators and staff, and other factors necessary to
 
15           ensure the safe and appropriate operation of each
 
16           hospice;
 
17      (2)  Protect the health, safety, and civil rights of persons
 
18           residing in the hospices;
 
19      (3)  Establish penalties for the failure to comply with any
 
20           rule;
 
21      (4)  Establish criteria for training of operators and staff
 
22           of any hospice licensed under this section; and
 

 
 
 
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 1      (5)  Establish criteria for required training and continuing
 
 2           education programs in pain management of any hospice
 
 3           licensed under this section.
 
 4      (d)  Rules adopted under this section shall be enforced by
 
 5 the director.
 
 6      (e)  The department shall consider the use of pain
 
 7 management programs and services when reviewing records,
 
 8 observing patient and client care, and interviewing staff and
 
 9 clients to determine licensure.
 
10      (f)  The department shall maintain a registry of all
 
11 hospices licensed under this section."
 
12      SECTION 3.  New statutory material is underscored.
 
13      SECTION 4.  This Act shall take effect upon its approval.
 
14 
 
15                       INTRODUCED BY:  ___________________________
 
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18 ___________________________           ___________________________
 
19 ___________________________           ___________________________
 
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21 ___________________________           ___________________________
 

 
 
 
 
 
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