BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SCR 117|
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THIRD READING
Bill No: SCR 117
Author: Pan (D)
Introduced:3/7/16
Vote: 21
SENATE HEALTH COMMITTEE: 9-0, 4/13/16
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,
Pan, Roth, Wolk
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
SUBJECT: Palliative care
SOURCE: American Cancer Society Cancer Action Network
DIGEST: This resolution encourages the state to study the
status and importance of coordinated palliative care and to
develop solutions, tools, and best practices for providing
better patient-centered care and information to individuals with
chronic disease in California.
ANALYSIS:
Existing law:
1)Establishes the Department of Public Health (DPH) to protect
and improve the health of communities through education,
promotion of healthy lifestyles, and, research for disease and
injury prevention; and provides DPH with the authority to
perform activities that protect, preserve, and advance public
health, including studies and dissemination of information.
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2)Defines "palliative care" as a medical treatment,
interdisciplinary care, or consultation provided to a patient
or family members, or both, that has as its primary purpose
the prevention of, or relief from, suffering and the
enhancement of the quality of life, rather than treatment
aimed at investigation and intervention for the purpose of
cure or prolongation of life as described. In some cases,
disease-targeted treatment may be used in palliative care.
3)Defines "hospice care" as a specialized form of
interdisciplinary health care that is designed to provide
palliative care, alleviate the physical, emotional, social,
and spiritual discomforts of an individual who is experiencing
the last phases of life due to the existence of a terminal
disease, and provide supportive care to the primary caregiver
and the family of the hospice patient, and that meets
specified criteria.
4)Requires the Department of Health Care Services (DHCS), in
consultation with interested stakeholders, to establish
standards and provide technical assistance for Medi-Cal
managed care plans to ensure delivery of palliative care
services.
This resolution states:
1)All patients who are experiencing complex, chronic health
issues that affect their quality of life should be offered
palliative care.
2)When palliative care programs are provided, a larger
percentage of hospice patients are identified earlier in their
eligibility window, which enables them to take advantage of
these valuable services for a longer period of time.
3)The California Health and Human Services Agency's Let's Get
Healthy California Task Force identified palliative care as
one of its top priorities and indicators for all Californians
to enjoy optimal health in its 2012 report.
4)The formation of a state palliative care and quality of life
interdisciplinary advisory council and palliative care
information and education program within DPH would maximize
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the effectiveness of palliative care initiatives in the state.
5)The Legislature encourages the state to study the status and
importance of coordinated palliative care as a patient quality
of life issue, as a way to improve the quality and delivery of
health care services, and as a way to more effectively spend
limited health care dollars.
6)The Legislature encourages the state to develop solutions,
tools, and best practices for providing better
patient-centered care and information to individuals with
chronic diseases in California.
Comments
1)Author's statement. According to the author, palliative care
provides us an opportunity to defragment our health care
system and improve the lives of those who suffer from serious
illness, such as cancer, and the lives of those who care for
them. It is important that we study the status and importance
of coordinated palliative care to develop solutions and best
practices for providing better patient-centered care and
information to individuals with chronic disease.
2)Medi-Cal and palliative care. According to DHCS' Web site,
under SB 1004 (Hernandez, Chapter 574, Statutes of 2014) DHCS
must establish standards and provide technical assistance for
Medi-Cal managed care plans to ensure delivery of palliative
care services. DHCS held four meetings in 2015 and released a
draft policy paper and performance measures. In the draft
paper, DHCS indicates that its policy for implementing SB 1004
will be guided by the Centers for Medicare and Medicaid
Services definition of palliative care, which is: "patient and
family-centered care that optimizes quality of life by
anticipating, preventing, and treating suffering. Palliative
care throughout the continuum of illness involves addressing
physical, intellectual, emotional, social, and spiritual needs
and to facilitate patient autonomy, access to information, and
choice." However, DHCS will use more specific definitions of
eligible conditions, services, and providers.
3)Dying in California. According to a December 2015 report
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titled Dying in California. A Status Report on
End-of-Life-Care, overall California has made significant
strides in creating a supportive framework for end-of-life
care but significant challenges remain. Growing demand far
outpaces the capacity of services. Palliative care
specialists are in short supply, and certification programs
are limited. Reliable funding streams do not yet exist.
While knowledge is growing about best practices and quality
standards, they have not yet been broadly implemented. People
with serious advanced illness and their families could benefit
from all clinicians having a basic level of competence in
addressing palliative care needs. Some patients may also
require the involvement of interdisciplinary teams of
professionals trained in palliative care. However, specialty
palliative care is currently unavailable in many geographic
areas and in many care settings.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
SUPPORT: (Verified 5/3/16)
American Cancer Society Cancer Action Network (source)
Alliance of Catholic Health Care
California Catholic Conference
California Medical Association
California State Retirees
Providence Health & Services
OPPOSITION: (Verified5/3/16)
None received
ARGUMENTS IN SUPPORT: The California Catholic Conference writes
that access to palliative and hospice care in our state is both
limited and costly. Significant changes in current law are
needed in order to address the needs of patients with chronic
disease and/or nearing the end of life and raise their standard
of care. A comprehensive approach is needed and should include,
for example, expanding instruction in palliative care at medical
schools and other institutions providing health care
instruction, and ensuring increased access to palliative care
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for patients, and providing safe and appropriate levels of
staffing and salary scales in care facilities serving elderly
persons and persons with life-threatening chronic illnesses.
The Alliance of Catholic Health Care writes Catholic hospitals
are leaders in the provision of palliative care. Over 95% of
our Catholic and affiliated community hospitals operate
palliative care programs, compared to a little more than 50% of
California hospitals as a whole. Palliative care improves the
quality of life for patients and their families facing chronic
and life-threatening illness by preventing and relieving
suffering.
Prepared by: Teri Boughton / HEALTH /
5/4/16 14:58:07
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