MODEL BILLS

End-of-Life Palliative Care Act

Summary: The End-of-Life Palliative Care Act requires that health care practitioners provide appropriate information and palliative care options to the terminally ill.

Based on New York Chapter 59 (2011)

SECTION 1. SHORT TITLE

This Act may be cited as the “Palliative Care Act.”

SECTION 2. PURPOSE

Too often, terminally ill people are not provided adequate information about their physical condition or counseling about palliative care and end-of-life options. This legislation is intended to ease anxiety and pain for the terminally ill.

SECTION 3. PALLIATIVE CARE

After section XXX, the following new section XXX shall be inserted:

(A) DEFINITIONS – In this section:

1. “Appropriate” means consistent with applicable legal, health and professional standards; the patient’s clinical and other circumstances; and the patient’s reasonably known wishes and beliefs.

2. “Attending health care practitioner” means a physician or nurse practitioner who has primary responsibility for the care and treatment of the patient. Where more than one physician or nurse practitioner share that responsibility, each of them has responsibility under this section, unless they agree to assign that responsibility to one of them.

3. “Palliative care” means health care treatment, including interdisciplinary end-of-life care, and consultation with patients and family members, to prevent or relieve pain and suffering and to enhance the patient’s quality of life, including hospice care under article forty of this chapter.

4. “Terminal illness or condition” means an illness or condition which can reasonably be expected to cause death within six months, whether or not treatment is provided.

(B) RIGHT TO KNOW

1. If a patient is diagnosed with a terminal illness or condition, the patient’s attending health care practitioner shall offer to provide the patient with information and counseling regarding palliative care and end-of-life options appropriate to the patient, including but not limited to: the range of options appropriate to the patient; the prognosis, risks and benefits of the various options; and the patient’s legal rights to comprehensive pain and symptom management at the end of life.

2. The information and counseling may be provided orally or in writing. Where the patient lacks capacity to reasonably understand and make informed choices relating to palliative care, the attending health care practitioner shall provide information and counseling under this section to a person with authority to make health care decisions for the patient. The attending health care practitioner may arrange for information and counseling under this section to be provided by another professionally qualified individual.

3. Where the attending health care practitioner is not willing to provide the patient with information and counseling under this section, he or she shall arrange for another physician or nurse practitioner to do so, or shall refer or transfer the patient to another physician or nurse practitioner willing to do so.

(C) HEALTH CARE INSTITUTIONS

1. General hospitals, nursing homes, and other health care institutions licensed or certified under [cite state law] shall establish policies and procedures to provide patients with advanced life limiting conditions and illnesses who might benefit from palliative care, including associated pain management, services with access to information and counseling regarding such options appropriate to the patient.

2. Policies must include provision for patients who lack capacity to make medical decisions, so that access to such information and counseling shall be provided to the persons who are legally authorized to make medical decisions on behalf of such patients.

3. Those policies shall facilitate access to appropriate palliative care consultations and services, including associated pain management consultations and services, including but not limited to referrals consistent with patient needs and preferences. The healthcare institution may take into account access and proximity of palliative care services, including the availability of hospice and palliative care board certified practitioners and other related workforce staff, geographic factors, and facility size that may impact development of palliative care services.

(D) EDUCATION

1. Every health care professional practicing in the state shall, every four years complete course work or training regarding pain management and palliative care, appropriate to the professional’s practice, approved by the department in accordance with standards promulgated by the [appropriate state agency] in consultation with the [Secretary of Education] and so document completion to the department. The [state agency] shall, by regulation, designate areas of practice or specialty within a profession that are exempt from this education requirement. The [agency] shall provide an exemption from this requirement to anyone who requests such an exemption and:

(a) for whom there would be no need to complete such course work or training because of the nature, area, or specialty of his or her practice, or

(b) has completed course work or training deemed by the department to be equivalent to the standards for course work or training approved by the department under this section.

2. Existing curricula, including curricula developed by a nationally-recognized health care professional, specialty, or provider association, or nationally-recognized pain management association, may be considered in implementing this section. Curricula shall include but not be limited to: palliative medicine; pain; neuropsychologic and other symptoms; preventing, identifying, and responding to abuse of and addiction to prescription drugs; ethics and the law; patient and family perspectives on end-of-life care; acupuncture treatment; advanced care planning and clinical communication skills. The commissioner shall consult with organizations representative of health care practitioners, institutions and those with expertise in pain management, including expertise in the acupuncture field, and palliative care with respect to the standards and regulations promulgated under this section.

SECTION 4. EFFECTIVE DATE

This Act shall take effect on July 1, 20XX.