BILL ANALYSIS                                                                                                                                                                                                    �




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          Date of Hearing:  May 6, 2014

                            ASSEMBLY COMMITTEE ON HEALTH
                                 Richard Pan, Chair
                    AB 2139 (Eggman) - As Amended:  April 2, 2014
           
          SUBJECT :  End-of-life care: patient notification.

           SUMMARY  :  Requires health care providers, when they make a  
          diagnosis that a patient has a terminal illness, to notify the  
          patient of his or her right under current law to comprehensive  
          information and counseling regarding legal end-of-life options.   
          Specifically,  this bill  :  

          1)Requires a health care provider, when he or she makes a  
            terminal diagnosis, to notify the patient of his or her right  
            to, or when applicable, the agent of the patient's right to,  
            comprehensive information and counseling regarding legal  
            end-of-life options.

          2)Expands current law that gives patients the right to receive  
            comprehensive information and counseling to also allow the  
            patient's agent to receive this information and counseling.  
            Specifies that an agent, for these purposes, is an individual  
            designated in a power of attorney for health care, as  
            specified, to make a health care decision for the patient who  
            has been diagnosed with a terminal illness, regardless of  
            whether the person is known as an agent or attorney in fact,  
            or by some other term.

          3)Specifies that a terminal illness, for the purposes of this  
            bill and current law about end-of-life counseling, is a  
            medical condition resulting in a prognosis of a life  
            expectancy of one year or less, if the disease follows its  
            normal course.

           EXISTING LAW  :  

             1)   Requires a health care provider, when he or she makes a  
               diagnosis that a patient has a terminal illness, to provide  
               the patient comprehensive information and counseling  
               regarding legal end-of-life options, upon request.   
               Requires the provider, if he or she does not wish to comply  
               with a patient's request, to refer the patient to another  
               provider who will.  Defines "health care provider," for  









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               these purposes, as an attending physician and surgeon or a  
               nurse practitioner or physician assistant, as specified.

             2)   Requires comprehensive information about end-of-life  
               options to include: a) hospice care at home or in a health  
               care setting; b) a prognosis with and without the  
               continuation of disease-targeted treatment; c) the  
               patient's right to refusal of or withdrawal from  
               life-sustaining treatment; d) the patient's right to  
               continue to pursue disease-targeted treatment, with or  
               without concurrent palliative care; e) the patient's right  
               to comprehensive pain and symptom management at the end of  
               life; and f) the patient's right to give individual health  
               care instructions under current law, including advance  
               health care directives.

             3)   Allows for the referral of a patient in a health  
               facility to a hospice provider, a private or public agency,  
               or a community-based organization that specializes in  
               end-of-life care case management and consultation for  
               comprehensive information and counseling.  

             4)   Defines advanced health care directive or advance  
               directive to mean either an individual health care  
               instruction or a power of attorney for health care.   
               Establishes a process and form for an individual to give  
               instructions about health care decision making and  
               designating an agent to make decisions on his or her  
               behalf.

             5)   Establishes the Physician Orders for Life Sustaining  
               Treatment (POLST) form, which directs a health care  
               provider regarding resuscitative and life-sustaining  
               measures, and requires that it be explained by a health  
               care provider.  Also requires a health care provider to  
               treat an individual in accordance with a POLST form.

             6)   Requires all physicians to complete a mandatory  
               continuing education course in the subjects of pain  
               management and the treatment of terminally ill and dying  
               patients.  

             7)   For the purpose of various provisions of law, defines  
               "terminal disease" and "terminal illness" in various ways:










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             a)   For the purpose of law governing residential care  
               facilities for persons with chronic life-threatening  
               illness, defines "terminal disease" or "terminal illness"  
               to mean a medical condition resulting from a prognosis of a  
               life expectancy of one year or less, if the disease follows  
               its normal course.

             b)   For the purpose of law governing hospice licensure,  
               defines "terminal disease" or "terminal illness" to mean a  
               medical condition resulting in a prognosis of life of one  
               year or less, if the disease follows its natural course.

             c)   For the purpose of coverage of continuity of care by  
               health insurance, defines "terminal illness" as an  
               incurable or irreversible condition that has a high  
               probability of causing death within one year or less.

             d)   For the purpose of law governing licensing of congregate  
               living health facilities, defines terminal illness to apply  
               if an individual has a life expectancy of six months or  
               less as stated in writing by his or her attending physician  
               and surgeon.

           FISCAL EFFECT  :  None

           COMMENTS  :

           1)PURPOSE OF THIS BILL  .  The author states that the need for  
            this bill arises from the discrepancy between the care that  
            most Californians prefer at the end of life and that which  
            they are receiving.  The author cites three reports from 2012  
            and 2013 prepared by the California HealthCare Foundation  
            (CHCF) that raise serious concerns with the care Californians  
            receive at the end of life.  One report provides evidence that  
            most Californians would prefer to die at home, avoid pain, and  
            be comfortable as they approach the end of life.  However, an  
            additional study finds great disparity in end-of-life care in  
            California across regions and institutions, with California,  
            compared to the nation as a whole, trending toward providing  
            more inpatient care and more intensive care in the last six  
            months of life.  Similarly, in a third study specific to  
            cancer care, CHCF finds that, compared to the country as a  
            whole, California's patients with advanced cancer are more  
            likely to die in the hospital, spend time in an intensive care  
            unit (or ICU), and receive aggressive life-saving measures in  









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            the final weeks of life.  Finally, while 80% of Californians  
            indicate they would definitely or probably would like to talk  
            with a doctor about end-of-life care, only about 7% have had  
            these important conversations.  

          The author writes that these concerns have persisted despite the  
            passage of AB 2747 (Berg), Chapter 683, Statutes of 2008,  
            which gives patients with a terminal diagnosis the right to be  
            informed, upon request, about their legal end-of-life care  
            options.  The author indicates this bill would ensure that  
            patients with a terminal illness are notified about this  
            right.

           2)BACKGROUND  .  A 2008 study found that end-of-life discussions  
            are associated with less aggressive medical care near death  
            and earlier hospice referrals, and that aggressive care is  
            associated with worse patient quality of life and worse  
            bereavement adjustment for family members.<1>  A 2013 report  
            by CHCF notes that although the use of palliative and hospice  
            care has increased over the past 25 years, problems remain in  
            making sure end-of-life treatment is aligned with patient  
            wishes.  The report finds that there are still barriers to  
            conversations about end-of-life care between clinicians,  
            patients, and families, including lack of training for  
            physicians and other caregivers and lack of payment for  
            physicians to spend time in such discussions.  

           3)HOSPICE AND PALLIATIVE CARE  .  Palliative care is medical care  
            that focuses on providing comfort to patients and their loved  
            ones without respect to disease or prognosis.  Palliative care  
            is not restricted to those who are dying or enrolled in  
            hospice programs, and can be provided concurrently with  
            curative therapy and other medical treatments.  Palliative  
            care can be provided across inpatient and outpatient settings,  
            including homes, hospitals, and nursing homes.

            Hospice care is 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  
            --------------------------
          <1> Wright, Alexi A., Baohui Zhang, Alaka Ray, Jennifer W. Mack,  
          Elizabeth Trice, Tracy Balboni, Susan L. Mitchell et al.  
          "Associations between end-of-life discussions, patient mental  
          health, medical care near death, and caregiver bereavement  
          adjustment." JAMA 300, no. 14 (2008): 1665-1673.








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            to the existence of a terminal illness, and provide supportive  
            care to the primary caregiver as well as to the family of the  
            hospice patient.  

           4)MEDICARE REIMBURSEMENT  .  Medicare fee-for-service reimburses  
            for an Initial Preventive Physical Examination (IPPE, also  
            known as a Welcome to Medicare Visit) provided during an  
            individual's first 12 months of Medicare Part B coverage.  The  
            IPPE is required to include various services.  Since 2009,  
            these services have included end-of-life planning, upon  
            agreement with the individual.  End-of-life planning means  
            verbal or written information about the ability to prepare an  
            advance directive and whether the physician is willing to  
            follow the individual's advance directive wishes.  

          Medicare only covers end-of-life planning in the IPPE, not in  
            annual wellness visits.  Federal regulations briefly added  
            end-of-life planning to the annual wellness visit in 2010 in  
            response to the requests of health care providers and others,  
            based upon a number of recent research studies and the  
            inclusion in the IPPE benefit.  However, Centers for Medicare  
            and Medicaid Services rescinded this coverage in January 2011,  
            indicating that it had not had the opportunity to consider  
            prior to the issuance of the final rule the wide range of  
            views on this subject held by a broad range of stakeholders  
            (including members of Congress and those who were involved  
            with this provision during the debate on the Patient  
            Protection and Affordable Care Act).  

            Medicare also covers hospice benefits if an individual's  
            attending physician and the hospice's medical director certify  
            that the individual is terminally ill and has six months or  
            less to live if the illness runs its normal course.  To  
            receive hospice care, a beneficiary must sign a statement  
            choosing hospice care instead of other Medicare-covered  
            benefits to treat the terminal illness.  

           5)SUPPORT  .  California Advocates for Nursing Home Reform  
            (CANHR), in support, writes that people with terminal  
            illnesses are often unprepared for end-of-life decision making  
            and consequently receive treatment that is not consistent with  
            their wishes.  CANHR writes that this bill will ensure that  
            patients are offered an opportunity for patients to have a  
            conversation with their physicians about the course of a  
            terminal disease and the full range of expected treatment  









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            options.  The California Commission on Aging writes that while  
            current law does nothing to prevent a terminally ill patient  
            from obtaining important information on end-of-life care,  
            newly diagnosed patients may not know what to ask for, or even  
            that such care options exist.  By offering to provide the  
            information, the physician opens the door for an important  
            conversation that can help the patient make a wise decision at  
            such a crucial time.  Also in support, the Alzheimer's  
            Foundation of America writes that, in the case of individuals  
            with dementia, it is imperative that such choices are  
            presented as early as possible after diagnosis to ensure that  
            the individual has input into end-of-life choices before the  
            disease robs them of their ability to make decisions.   
            Compassion and Choices, in support, writes that this bill will  
            help patients who might not know end-of-life information is  
            available upon request, and that providing notification at 12  
            months will provide a greater amount of time for patients to  
            receive and consider the comprehensive information.
           
           6)OPPOSITION  .  The California Medical Association (CMA), in  
            opposition, asserts that end-of-life issues should definitely  
            be discussed, but they should be discussed upon the patient's  
            request, as required by current law, or when the physician  
            deems it appropriate.  CMA writes that, by requiring the  
            physician to give a patient information about end-of-life  
            options upon diagnosis, this bill could disrupt the  
            physician-patient relationship.  CMA further argues that this  
            bill's definitions of the terms "terminal diagnosis" and  
            "agent" are problematic and could serve to limit when and with  
            whom a physician can have end-of-life-discussions.  The  
            Medical Oncology Association of Southern California (MOASC),  
            in opposition, writes that oncologists generally oppose  
            mandates and similar efforts to legislate the specifics of the  
            physician-patient relationship because state law cannot  
            address the complexity and nuance of that relationship,  
            especially during the end-of-life period.  MOASC argues that  
            interactions with patient should be guided by the physician's  
            relationship with the patient and the physician's professional  
            judgment, and should not be subject to external forces that  
            might interfere with the relationship.  MOASC also writes that  
            this bill undoes the carefully negotiated agreement in AB 2747  
            of 2008.  MOASC writes that the compromise in that bill, which  
            required counseling upon the patient's request, allows the  
            physician and patient flexibility to work together to address  
            the patient's end-of-life needs.  Also in opposition, the  









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            California Right to Life Committee writes that this bill will  
            not create a more informed and supportive environment but will  
            make a vulnerable patient more anxious.

           7)RELATED LEGISLATION  .  AB 2452 (Pan) requires the Secretary of  
            State to establish and maintain a secure website that provides  
            an electronic reproduction of an advance health care directive  
            and other specified documents submitted to the registry  
            system.

           8)PREVIOUS LEGISLATION  .  

             a)   AB 2747 requires a health care provider, when he or she  
               makes a diagnosis that a patient has a terminal illness, to  
               provide the patient comprehensive information and  
               counseling regarding legal end-of-life options, upon  
               request.

             b)   AB 3000 (Wolk), Chapter 266, Statutes of 2008, created  
               POLST in California, which is a standardized form to  
               reflect a broader vision of resuscitative or life  
               sustaining requests and to encourage the use of POLST  
               orders to better handle resuscitative or life sustaining  
               treatment consistent with a patient's wishes.

             c)   AB 891 (Alquist), Chapter 658, Statutes of 2000,  
               established the Health Care Decisions Law which also  
               governs advance health care directives.

           9)POLICY COMMENTS  .  
           
              a)   There is broad evidence and agreement that conversations  
               about end-of-life care are beneficial for patients.   
               However, there is little evidence about what the best point  
               in time is to notify patients they have a right to have  
               this discussion.  By requiring the notification to happen  
               upon the diagnosis of a terminal illness, this bill may  
               create a statutory requirement for a clinical practice that  
               conflicts with evidence that emerges later.
              
              b)   This bill requires notification when a health care  
               provider diagnoses an individual with a terminal illness.   
               This could result in repeated notifications, each time a  
               patient with a terminal illness comes into contact with a  
               different attending physician.  If this occurs, it could  









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               divert time and resources away from providing a patient  
               with the curative and/or palliative care they need.
              
              c)   This bill defines terminal illness as a medical  
               condition resulting in a prognosis of a life expectancy of  
               one year or less, if the disease follows its normal course.  
                However, prognosis is a matter a clinical judgment; it is  
               a subjective probability determined by the provider.   
               Studies have shown that physicians are often not able to  
               provide an accurate prognosis,<2> and that accuracy  
               diminishes as the length of time judged increases, a  
               problem known as the horizon effect.  Specifically, the  
               ability to discriminate between patients who would survive  
               for one year and those who would not has been found to be  
               very poor.<3>  This bill, by requiring notification for  
               patients who are judged to have less than one year to live,  
               may require physicians to notify patients based on a  
               judgment that has a high probability of being inaccurate,  
               especially as the prognosis approaches a year.  
              
          REGISTERED SUPPORT / OPPOSITION  :  

           Support 
           
          Alzheimer's Foundation of America
          American Cancer Society Cancer Action Network
          California Advocates for Nursing Home Reform
          California Commission on Aging
          California Hospice and Palliative Care Association
          Compassion and Choices Northern California
          National Association of Social Workers, California Chapter

           Opposition 
           
          Association of Northern California Oncologists
          California Medical Association
          California Right to Life Committee
          Medical Oncology Association of Southern California
          ---------------------------
          <2> Glare, Paul, Kiran Virik, Mark Jones, Malcolm Hudson,  
          Steffen Eychmuller, John Simes, and Nicholas Christakis. "A  
          systematic review of physicians' survival predictions in  
          terminally ill cancer patients." BMJ 327, no. 7408 (2003): 195.
          <3> Mackillop, William J., and Carol F. Quirt. "Measuring the  
          accuracy of prognostic judgments in oncology." Journal of  
          clinical epidemiology 50, no. 1 (1997): 21-29.








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          Analysis Prepared by  :    Ben Russell / HEALTH / (916) 319-2097