2013 -- S 0279

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LC00782

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2013

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A N A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT - PALLIATIVE CARE AND

QUALITY OF LIFE - SERVICES AND EDUCATION

     Introduced By: Senators Lynch, Goodwin, Ottiano, Miller, and Gallo

     Date Introduced: February 12, 2013

     Referred To: Senate Health & Human Services

It is enacted by the General Assembly as follows:

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     SECTION 1. Title 42 of the General Laws entitled "STATE AFFAIRS AND

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GOVERNMENT" is hereby amended by adding thereto the following chapter:

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     CHAPTER 155

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RHODE ISLAND PALLIATIVE CARE

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     42-155-1. Purpose. – The purpose of this chapter is to improve the quality and delivery

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of patient centered and family focused care in Rhode Island by establishing a state advisory

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council on palliative care and quality of life, a palliative care consumer and professional

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information and education program, and a palliative care access initiative in Rhode Island.

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     42-155-2. State palliative care and quality of life interdisciplinary advisory council. –

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(a) Advisory council established. Not later than 90 days after the enactment of this section, the

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department of health shall establish a “State Palliative Care and Quality of Life Interdisciplinary

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Advisory Council” within the department of health.

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     (b) Membership terms.

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     (1) Council membership shall be appointed by the secretary of the executive office of

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health and human services, and shall include interdisciplinary palliative care medical, nursing,

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social work, pharmacy, and spiritual professional expertise; patient and family caregiver advocate

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representation; and any relevant appointees from the department of health or state committees or

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councils that the secretary determines appropriate. Membership shall specifically include health

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professionals having palliative care work experience and/or expertise in palliative care delivery

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models in a variety of inpatient, outpatient, and community settings (e.g., acute-care, long-term

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care, and hospice) and with a variety of populations, including pediatric, youth and adults. At

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least two (2) council members shall be board-certified hospice and palliative medicine physicians

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and/or nurses.

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     (2) Council members shall serve for a period of three (3) years.

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     (3) Advisory council members shall serve at the pleasure of the department of health and

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their respective appointing authorities. The members shall elect a chair and vice chair whose

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duties shall be established by the advisory council. The department of health shall fix a time and

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place for regular meetings of the advisory council, which shall meet at least twice yearly.

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     (c) General provisions. Council members shall receive no compensation for their

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services, but shall be allowed actual and necessary expenses in the performance of their duties.

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     (d) Duties. The palliative care and quality of life interdisciplinary advisory council shall

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consult with and advise the department of health on matters related to the establishment,

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maintenance, operation, and outcomes evaluation of palliative care initiatives in the state.

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     42-155-3. Palliative care consumer and professional information and education

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program. – (a) Information and education program established. There is created a statewide

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“Palliative Care Consumer and Professional Information and Education Program” in the

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department of health.

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     (b) Purpose and activities.

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     (1) The purpose of the palliative care consumer and professional information and

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education program is to maximize the effectiveness of palliative care initiatives in the state by

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ensuring that comprehensive and accurate information and education about palliative care is

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available to the public, health care providers, and health care facilities.

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     (2) The department of health shall publish on its website information and resources,

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including links to external resources, about palliative care for the public, health care providers,

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and health care facilities. This shall include, but not be limited to, continuing educational

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opportunities for health care providers; information about palliative care delivery in the home,

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primary, secondary, and tertiary environments; best practices for palliative care delivery; and

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consumer educational materials and referral information for palliative care, including hospice.

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     (3) The department of health may develop and implement any other initiatives regarding

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palliative care services and education that the department of health determines would further the

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purposes of this section.

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     (c) Implementation. The department of health shall consult with the palliative care and

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quality of life interdisciplinary advisory council in implementing this section.

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     42-155-4. Palliative care access. – (a) Definitions. For the purposes of this section, the

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following terms shall have the following meanings:

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     (1) "Appropriate" means consistent with applicable legal, health and professional

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standards; the patient's clinical and other circumstances; and the patient's reasonably known

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wishes and beliefs.

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     (2) “Medical care” means services provided, requested, or supervised by a physician or

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advanced practice nurse.

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     (3) “Palliative care” means patient- and family-centered medical care that optimizes

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quality of life by anticipating, preventing, and treating suffering caused by serious illness.

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Palliative care throughout the continuum of illness involves addressing physical, emotional,

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social, and spiritual needs and facilitating patient autonomy, access to information, and choice.

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Palliative care includes, but is not limited to, discussions of the patient’s goals for treatment;

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discussion of treatment options appropriate to the patient, including, where appropriate, hospice

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care; and comprehensive pain and symptom management.

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     (4) “Serious illness” means any medical illness or physical injury or condition that

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substantially impacts quality of life for more than a short period of time. Serious illness includes,

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but is not limited to, cancer; heart, renal or liver failure; lung disease; and Alzheimer's disease

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and related dementias.

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     (b) Palliative care access in Rhode Island health facilities.

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     (1) On or before January 1, 2015, all organizations which require a license to operate

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shall:

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     (i) Establish a system for identifying patients or residents who could benefit from

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palliative care.

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     (ii) Provide information about and facilitate access to appropriate palliative care services

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for patients or residents with serious illness.

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     (c) Implementation and enforcement.

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     (1) The department of health shall carry out this section with the consultation of the

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palliative care and quality of life interdisciplinary advisory council.

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     (2) In carrying out this section, the department of health shall take into account factors

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that may impact the development of such a system and its ability to facilitate access to palliative

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care, including the size of the organization, access and proximity to palliative care services,

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including the availability of hospice and palliative care board-certified practitioners and related

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workforce staff; and geographic factors.

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     (3) Enforcement. If an organization fails to carry out the provisions of this section, the

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secretary shall require the organization to provide a plan of action to bring the organization into

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compliance and may impose a civil monetary penalty.

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     SECTION 2. This act shall take effect 90 days after the date of passage.

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LC00782

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT - PALLIATIVE CARE AND

QUALITY OF LIFE - SERVICES AND EDUCATION

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     This act would establish a state advisory council on palliative care and quality of life, a

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palliative care consumer and professional information and education program and a palliative

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care access initiative in Rhode Island.

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     This act would take effect 90 days after the date of passage.

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LC00782

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