Amended IN Assembly September 07, 2017 Amended IN Senate May 26, 2017 Amended IN Senate March 27, 2017 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Senate Bill No. 294Introduced by Senator HernandezFebruary 09, 2017 An act to amend Sections 1746 and 1749 of add and repeal Section 1747.3 of the Health and Safety Code, relating to palliative care. hospice.LEGISLATIVE COUNSEL'S DIGESTSB 294, as amended, Hernandez. Hospices: palliative care. Hospice: services to seriously ill patients. The(1) The California Hospice Licensure Act of 1990 provides for the licensure and regulation by the State Department of Public Health of persons or agencies that provide hospice services, such as palliative care and skilled nursing services, to persons, and the families of persons, who are experiencing the last phases of life due to terminal disease. Existing law defines palliative care to mean patient and family-centered care that optimizes quality of life of a patient with a terminal illness by anticipating, preventing, and treating suffering, and defines skilled nursing services to mean nursing services provided by or under the supervision of a registered nurse, as specified, that pertain to the palliative, supportive services required by patients with a terminal illness. Existing law authorizes licensed hospices to provide, in addition to hospice services authorized under the act, specified preliminary services, including preliminary palliative care consultations, for any person in need of those services, as determined by the physician and surgeon, if any, in charge of the care of a patient. hospice, which is a type of interdisciplinary health care that includes palliative care to individuals experiencing the last phases of life due to the existence of a terminal disease and supportive care to the primary caregivers and family of the hospice patient. A violation of the act is a misdemeanor.This bill would, among other things, expand the definition of palliative care to mean patient and family centered care that optimizes quality of life of any patient. The bill would also expand the definition of skilled nursing services to include palliative, supportive services required by patients with a serious illness, and would define serious illness to mean a condition that may result in death, regardless of the estimated length of the individuals remaining period of life. The bill would further authorize a licensed hospice authorize, until January 1, 2022, a licensee under the act to provide any of the same authorized interdisciplinary hospice services services, including palliative care, to a patient who is not a hospice patient, but has a serious illness, as specified, and authorize the hospice to provide services to the patient even if the patient is continuing to receive curative treatment from other licensed health care professionals. has a serious illness. The bill would require a licensee that elects to provide palliative care pursuant to this temporary authorization to report additional specified information to the department, including the number of patients receiving palliative care. By modifying the scope of a crime for a violation of the act, this bill would impose a state-mandated local program. The bill would require the department, on or before June 1, 2021, to convene a stakeholder meeting to discuss the results of the information collected pursuant to these provisions.(2) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NOYES Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 1747.3 is added to the Health and Safety Code, to read:1747.3. (a) Notwithstanding any other law, beginning January 1, 2018, a licensee pursuant to this chapter may provide any interdisciplinary hospice services described in this chapter, including, but not limited to, palliative care, to a patient with a serious illness as determined by the physician and surgeon in charge of the care of the patient, including, among other kinds of patients, a patient who continues to receive curative treatment from other licensed health care professionals.(b) A licensee that elects to provide palliative care pursuant to this section shall provide the department with the date the licensee intends to begin providing the palliative care no less than 45 days before that date and all of the following:(1) The completed relevant portions of a form HS 200, or a successor form, as determined by the department.(2) A complete federal form CMS 417, or a successor form, as determined by the department.(c) (1) The department shall not require the documents submitted pursuant to subdivision (b) to be approved prior to the licensee providing palliative care pursuant to this section.(2) The department shall not charge an application fee to provide any care or services pursuant to this section.(d) On or before January 1, 2019, January 1, 2020, and January 1, 2021, a licensee shall provide the department with all of the following information for the period of time the licensee provided palliative care pursuant to this section on a form prescribed by the department:(1) The number of non-hospice patients who received palliative care pursuant to this section.(2) The number of patients enrolled in hospice.(3) The primary diagnoses of the patients for which the licensee provided palliative care pursuant to this section.(4) The numbers and types of providers hired during the previous 12 months.(5) The numbers and types of providers who left employment during the previous 12 months.(6) Complaints received by the licensee during the previous 12 months that related to all the following:(A) Events that caused or were likely to cause serious injury, harm, impairment, or death.(B) Events or incidents that negatively impacted a patients mental, physical, or psychosocial status and were of such consequence to the patients well-being that a rapid response was required.(C) Delays in patient care for hospice and non-hospice patients who received palliative care pursuant to this section.(D) Qualifications of staff.(e) During the period of time a licensee provides palliative care pursuant to this section, the licensee shall simultaneously submit to the department all information the licensee provides to the Office of Statewide Health Planning and Development.(f) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific the provisions of this section by means of all-facility letters, or similar instructions, without taking regulatory action.(g) If the licensee ceases to provide palliative care services pursuant to this section on or before January 1, 2022, the licensee shall submit to the department the same documents as required in subdivision (b).(h) The provisions of this section shall not be applicable to a hospice facility established pursuant to subdivision (n) of Section 1250, or Section 1339.30 or 1339.40.(i) This section shall not be deemed to modify the provision of hospice care required pursuant to Section 1368.2.(j) On or before June 1, 2021, the department shall convene a stakeholder meeting to discuss the results of the information collected pursuant to this section. The department may, at its discretion, use electronic means, such as a webinar, to convene the stakeholder meeting.(k) For purposes of this section, serious illness shall mean a condition that may result in death, regardless of the estimated length of the patients remaining period of life.(l) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.SEC. 2. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.SECTION 1.Section 1746 of the Health and Safety Code is amended to read:1746.For the purposes of this chapter, the following definitions apply:(a)Bereavement services means those services available to the surviving family members for a period of at least one year after the death of the patient, including an assessment of the needs of the bereaved family and the development of a care plan that meets these needs, both prior to and following the death of the patient.(b)Home health aide has the same meaning as that term is defined in subdivision (c) of Section 1727.(c)Home health aide services means those services described in subdivision (d) of Section 1727 that provide for the personal care of the seriously or terminally ill patient and the performance of related tasks in the patients home in accordance with the plan of care in order to increase the level of comfort and to maintain personal hygiene and a safe, healthy environment for the patient.(d)Hospice means 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 all of the following criteria:(1)Considers the patient and the patients family, in addition to the patient, as the unit of care.(2)Utilizes an interdisciplinary team to assess the physical, medical, psychological, social, and spiritual needs of the patient and the patients family.(3)Requires the interdisciplinary team to develop an overall plan of care and to provide coordinated care that emphasizes supportive services, including, but not limited to, home care, pain control, and limited inpatient services. Limited inpatient services are intended to ensure both continuity of care and appropriateness of services for those patients who cannot be managed at home because of acute complications or the temporary absence of a capable primary caregiver.(4)Provides for the palliative medical treatment of pain and other symptoms associated with a terminal disease, but does not provide for efforts to cure the disease.(5)Provides for bereavement services following death to assist the family in coping with social and emotional needs associated with the death of the patient.(6)Actively utilizes volunteers in the delivery of hospice services.(7)To the extent appropriate, based on the medical needs of the patient, provides services in the patients home or primary place of residence.(e)Hospice facility means a health facility as defined in subdivision (n) of Section 1250.(f)Inpatient care arrangements means arranging for those short inpatient stays that may become necessary to manage acute symptoms or because of the temporary absence, or need for respite, of a capable primary caregiver. The hospice shall arrange for these stays, ensuring both continuity of care and the appropriateness of services.(g)An interdisciplinary team means the hospice care team that includes, but is not limited to, the patient and patients family, a physician and surgeon, a registered nurse, a social worker, a volunteer, and a spiritual caregiver. The team shall be coordinated by a registered nurse and shall be under medical direction. The team shall meet regularly to develop and maintain an appropriate plan of care.(h)Medical direction means those services provided by a licensed physician and surgeon who is charged with the responsibility of acting as a consultant to the interdisciplinary team, a consultant to the patients attending physician and surgeon, as requested, with regard to pain and symptom management, and a liaison with physician and surgeons in the community.(i)Multiple location means a location or site from which a hospice makes available basic hospice services within the service area of the parent agency. A multiple location shares administration, supervision, policies and procedures, and services with the parent agency in a manner that renders it unnecessary for the site to independently meet the licensing requirements.(j)Palliative care means 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.(k)Parent agency means the part of the hospice that is licensed pursuant to this chapter and that develops and maintains administrative control of multiple locations. All services provided from each multiple location and parent agency are the responsibility of the parent agency.(l)Plan of care means a written plan developed by the attending physician and surgeon, the medical director or physician and surgeon designee, and the interdisciplinary team that addresses the needs of a patient and family admitted to the hospice organization. The hospice shall retain overall responsibility for the development and maintenance of the plan of care and quality of services delivered.(m)Preliminary services means those services authorized pursuant to subdivision (d) of Section 1749.(n)Skilled nursing services means nursing services provided by or under the supervision of a registered nurse under a plan of care developed by the interdisciplinary team and the patients physician and surgeon to a patient and his or her family that pertain to the palliative, supportive services required by patients with a serious or terminal illness. Skilled nursing services include, but are not limited to, patient assessment, evaluation and case management of the medical nursing needs of the patient, the performance of prescribed medical treatment for pain and symptom control, the provision of emotional support to both the patient and his or her family, and the instruction of caregivers in providing personal care to the patient. Skilled nursing services shall provide for the continuity of services for the patient and his or her family. Skilled nursing services shall be available on a 24-hour on-call basis.(o)Social services/counseling services means those counseling and spiritual care services that assist the patient and his or her family to minimize stresses and problems that arise from social, economic, psychological, or spiritual needs by utilizing appropriate community resources, and maximize positive aspects and opportunities for growth.(p)Terminal disease or terminal illness means a medical condition resulting in a prognosis of life of one year or less, if the disease follows its natural course.(q)Volunteer services means those services provided by trained hospice volunteers who have agreed to provide service under the direction of a hospice staff member who has been designated by the hospice to provide direction to hospice volunteers. Hospice volunteers may be used to provide support and companionship to the patient and his or her family during the remaining days of the patients life and to the surviving family following the patients death.(r)Serious illness means a condition that may result in death, regardless of the estimated length of the individuals remaining period of life.SEC. 2.Section 1749 of the Health and Safety Code is amended to read:1749.(a)To qualify for a license under this chapter, an applicant shall satisfy all of the following:(1)Be of good moral character. If the applicant is a franchise, franchisee, firm, association, organization, partnership, business trust, corporation, company, political subdivision of the state, or governmental agency, the person in charge of the hospice for which the application for a license is made shall be of good moral character.(2)Demonstrate the ability of the applicant to comply with this chapter and any rules and regulations promulgated under this chapter by the state department.(3)File a completed application with the state department that was prescribed and furnished pursuant to Section 1748.(b)In order for a person, political subdivision of the state, or other governmental agency to be licensed as a hospice it shall satisfy the definition of a hospice contained in Section 1746, and also provide, or make provision for, the following basic services:(1)Skilled nursing services.(2)Social services/counseling services.(3)Medical direction.(4)Bereavement services.(5)Volunteer services.(6)Inpatient care arrangements.(7)Home health aide services.(c)The services required to be provided pursuant to subdivision (b) shall be provided in compliance with the Standards for Quality Hospice Care, 2003, as available from the California Hospice and Palliative Care Association, until the state department adopts regulations establishing alternative standards pursuant to subdivision (e).(d)(1)Notwithstanding any other law, to meet the unique needs of the community, licensed hospices may provide, in addition to hospice services authorized in this chapter, any of the following preliminary services for any person in need of those services, as determined by the physician and surgeon, if any, in charge of the care of a patient, or at the request of the patient or family:(A)Preliminary palliative care consultations.(B)Preliminary counseling and care planning.(C)Preliminary grief and bereavement services.(2)Preliminary services authorized pursuant to this subdivision may be provided concurrently with curative treatment to a person who does not have a terminal prognosis or who has not elected to receive hospice services only by licensed and certified hospices. These services shall be subject to the schedule of benefits under the Medi-Cal program, pursuant to subdivision (w) of Section 14132 of the Welfare and Institutions Code.(e)(1)Notwithstanding any other law, a licensed hospice is further authorized to provide any of the same interdisciplinary hospice services, as defined in this chapter, to a patient with a serious illness, as determined by the physician and surgeon in charge of the care of the patient, including a patient who continues to receive curative treatment from other licensed health care professionals.(2)This subdivision is not intended to modify the provision of hospice care required under Section 1368.2.(f)The state department may adopt regulations establishing standards for any or all of the services required to be provided under subdivision (b). The regulations of the state department adopted pursuant to this subdivision shall supersede the standards referenced in subdivision (c) to the extent the regulations duplicate or replace those standards.
Amended IN Assembly September 07, 2017 Amended IN Senate May 26, 2017 Amended IN Senate March 27, 2017 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Senate Bill No. 294Introduced by Senator HernandezFebruary 09, 2017 An act to amend Sections 1746 and 1749 of add and repeal Section 1747.3 of the Health and Safety Code, relating to palliative care. hospice.LEGISLATIVE COUNSEL'S DIGESTSB 294, as amended, Hernandez. Hospices: palliative care. Hospice: services to seriously ill patients. The(1) The California Hospice Licensure Act of 1990 provides for the licensure and regulation by the State Department of Public Health of persons or agencies that provide hospice services, such as palliative care and skilled nursing services, to persons, and the families of persons, who are experiencing the last phases of life due to terminal disease. Existing law defines palliative care to mean patient and family-centered care that optimizes quality of life of a patient with a terminal illness by anticipating, preventing, and treating suffering, and defines skilled nursing services to mean nursing services provided by or under the supervision of a registered nurse, as specified, that pertain to the palliative, supportive services required by patients with a terminal illness. Existing law authorizes licensed hospices to provide, in addition to hospice services authorized under the act, specified preliminary services, including preliminary palliative care consultations, for any person in need of those services, as determined by the physician and surgeon, if any, in charge of the care of a patient. hospice, which is a type of interdisciplinary health care that includes palliative care to individuals experiencing the last phases of life due to the existence of a terminal disease and supportive care to the primary caregivers and family of the hospice patient. A violation of the act is a misdemeanor.This bill would, among other things, expand the definition of palliative care to mean patient and family centered care that optimizes quality of life of any patient. The bill would also expand the definition of skilled nursing services to include palliative, supportive services required by patients with a serious illness, and would define serious illness to mean a condition that may result in death, regardless of the estimated length of the individuals remaining period of life. The bill would further authorize a licensed hospice authorize, until January 1, 2022, a licensee under the act to provide any of the same authorized interdisciplinary hospice services services, including palliative care, to a patient who is not a hospice patient, but has a serious illness, as specified, and authorize the hospice to provide services to the patient even if the patient is continuing to receive curative treatment from other licensed health care professionals. has a serious illness. The bill would require a licensee that elects to provide palliative care pursuant to this temporary authorization to report additional specified information to the department, including the number of patients receiving palliative care. By modifying the scope of a crime for a violation of the act, this bill would impose a state-mandated local program. The bill would require the department, on or before June 1, 2021, to convene a stakeholder meeting to discuss the results of the information collected pursuant to these provisions.(2) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NOYES
Amended IN Assembly September 07, 2017 Amended IN Senate May 26, 2017 Amended IN Senate March 27, 2017
Amended IN Assembly September 07, 2017
Amended IN Senate May 26, 2017
Amended IN Senate March 27, 2017
CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION
Senate Bill No. 294
Introduced by Senator HernandezFebruary 09, 2017
Introduced by Senator Hernandez
February 09, 2017
An act to amend Sections 1746 and 1749 of add and repeal Section 1747.3 of the Health and Safety Code, relating to palliative care. hospice.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
SB 294, as amended, Hernandez. Hospices: palliative care. Hospice: services to seriously ill patients.
The(1) The California Hospice Licensure Act of 1990 provides for the licensure and regulation by the State Department of Public Health of persons or agencies that provide hospice services, such as palliative care and skilled nursing services, to persons, and the families of persons, who are experiencing the last phases of life due to terminal disease. Existing law defines palliative care to mean patient and family-centered care that optimizes quality of life of a patient with a terminal illness by anticipating, preventing, and treating suffering, and defines skilled nursing services to mean nursing services provided by or under the supervision of a registered nurse, as specified, that pertain to the palliative, supportive services required by patients with a terminal illness. Existing law authorizes licensed hospices to provide, in addition to hospice services authorized under the act, specified preliminary services, including preliminary palliative care consultations, for any person in need of those services, as determined by the physician and surgeon, if any, in charge of the care of a patient. hospice, which is a type of interdisciplinary health care that includes palliative care to individuals experiencing the last phases of life due to the existence of a terminal disease and supportive care to the primary caregivers and family of the hospice patient. A violation of the act is a misdemeanor.This bill would, among other things, expand the definition of palliative care to mean patient and family centered care that optimizes quality of life of any patient. The bill would also expand the definition of skilled nursing services to include palliative, supportive services required by patients with a serious illness, and would define serious illness to mean a condition that may result in death, regardless of the estimated length of the individuals remaining period of life. The bill would further authorize a licensed hospice authorize, until January 1, 2022, a licensee under the act to provide any of the same authorized interdisciplinary hospice services services, including palliative care, to a patient who is not a hospice patient, but has a serious illness, as specified, and authorize the hospice to provide services to the patient even if the patient is continuing to receive curative treatment from other licensed health care professionals. has a serious illness. The bill would require a licensee that elects to provide palliative care pursuant to this temporary authorization to report additional specified information to the department, including the number of patients receiving palliative care. By modifying the scope of a crime for a violation of the act, this bill would impose a state-mandated local program. The bill would require the department, on or before June 1, 2021, to convene a stakeholder meeting to discuss the results of the information collected pursuant to these provisions.(2) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.
The
(1) The California Hospice Licensure Act of 1990 provides for the licensure and regulation by the State Department of Public Health of persons or agencies that provide hospice services, such as palliative care and skilled nursing services, to persons, and the families of persons, who are experiencing the last phases of life due to terminal disease. Existing law defines palliative care to mean patient and family-centered care that optimizes quality of life of a patient with a terminal illness by anticipating, preventing, and treating suffering, and defines skilled nursing services to mean nursing services provided by or under the supervision of a registered nurse, as specified, that pertain to the palliative, supportive services required by patients with a terminal illness. Existing law authorizes licensed hospices to provide, in addition to hospice services authorized under the act, specified preliminary services, including preliminary palliative care consultations, for any person in need of those services, as determined by the physician and surgeon, if any, in charge of the care of a patient. hospice, which is a type of interdisciplinary health care that includes palliative care to individuals experiencing the last phases of life due to the existence of a terminal disease and supportive care to the primary caregivers and family of the hospice patient. A violation of the act is a misdemeanor.
This bill would, among other things, expand the definition of palliative care to mean patient and family centered care that optimizes quality of life of any patient. The bill would also expand the definition of skilled nursing services to include palliative, supportive services required by patients with a serious illness, and would define serious illness to mean a condition that may result in death, regardless of the estimated length of the individuals remaining period of life.
The bill would further authorize a licensed hospice authorize, until January 1, 2022, a licensee under the act to provide any of the same authorized interdisciplinary hospice services services, including palliative care, to a patient who is not a hospice patient, but has a serious illness, as specified, and authorize the hospice to provide services to the patient even if the patient is continuing to receive curative treatment from other licensed health care professionals. has a serious illness. The bill would require a licensee that elects to provide palliative care pursuant to this temporary authorization to report additional specified information to the department, including the number of patients receiving palliative care. By modifying the scope of a crime for a violation of the act, this bill would impose a state-mandated local program. The bill would require the department, on or before June 1, 2021, to convene a stakeholder meeting to discuss the results of the information collected pursuant to these provisions.
(2) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 1747.3 is added to the Health and Safety Code, to read:1747.3. (a) Notwithstanding any other law, beginning January 1, 2018, a licensee pursuant to this chapter may provide any interdisciplinary hospice services described in this chapter, including, but not limited to, palliative care, to a patient with a serious illness as determined by the physician and surgeon in charge of the care of the patient, including, among other kinds of patients, a patient who continues to receive curative treatment from other licensed health care professionals.(b) A licensee that elects to provide palliative care pursuant to this section shall provide the department with the date the licensee intends to begin providing the palliative care no less than 45 days before that date and all of the following:(1) The completed relevant portions of a form HS 200, or a successor form, as determined by the department.(2) A complete federal form CMS 417, or a successor form, as determined by the department.(c) (1) The department shall not require the documents submitted pursuant to subdivision (b) to be approved prior to the licensee providing palliative care pursuant to this section.(2) The department shall not charge an application fee to provide any care or services pursuant to this section.(d) On or before January 1, 2019, January 1, 2020, and January 1, 2021, a licensee shall provide the department with all of the following information for the period of time the licensee provided palliative care pursuant to this section on a form prescribed by the department:(1) The number of non-hospice patients who received palliative care pursuant to this section.(2) The number of patients enrolled in hospice.(3) The primary diagnoses of the patients for which the licensee provided palliative care pursuant to this section.(4) The numbers and types of providers hired during the previous 12 months.(5) The numbers and types of providers who left employment during the previous 12 months.(6) Complaints received by the licensee during the previous 12 months that related to all the following:(A) Events that caused or were likely to cause serious injury, harm, impairment, or death.(B) Events or incidents that negatively impacted a patients mental, physical, or psychosocial status and were of such consequence to the patients well-being that a rapid response was required.(C) Delays in patient care for hospice and non-hospice patients who received palliative care pursuant to this section.(D) Qualifications of staff.(e) During the period of time a licensee provides palliative care pursuant to this section, the licensee shall simultaneously submit to the department all information the licensee provides to the Office of Statewide Health Planning and Development.(f) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific the provisions of this section by means of all-facility letters, or similar instructions, without taking regulatory action.(g) If the licensee ceases to provide palliative care services pursuant to this section on or before January 1, 2022, the licensee shall submit to the department the same documents as required in subdivision (b).(h) The provisions of this section shall not be applicable to a hospice facility established pursuant to subdivision (n) of Section 1250, or Section 1339.30 or 1339.40.(i) This section shall not be deemed to modify the provision of hospice care required pursuant to Section 1368.2.(j) On or before June 1, 2021, the department shall convene a stakeholder meeting to discuss the results of the information collected pursuant to this section. The department may, at its discretion, use electronic means, such as a webinar, to convene the stakeholder meeting.(k) For purposes of this section, serious illness shall mean a condition that may result in death, regardless of the estimated length of the patients remaining period of life.(l) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.SEC. 2. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.SECTION 1.Section 1746 of the Health and Safety Code is amended to read:1746.For the purposes of this chapter, the following definitions apply:(a)Bereavement services means those services available to the surviving family members for a period of at least one year after the death of the patient, including an assessment of the needs of the bereaved family and the development of a care plan that meets these needs, both prior to and following the death of the patient.(b)Home health aide has the same meaning as that term is defined in subdivision (c) of Section 1727.(c)Home health aide services means those services described in subdivision (d) of Section 1727 that provide for the personal care of the seriously or terminally ill patient and the performance of related tasks in the patients home in accordance with the plan of care in order to increase the level of comfort and to maintain personal hygiene and a safe, healthy environment for the patient.(d)Hospice means 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 all of the following criteria:(1)Considers the patient and the patients family, in addition to the patient, as the unit of care.(2)Utilizes an interdisciplinary team to assess the physical, medical, psychological, social, and spiritual needs of the patient and the patients family.(3)Requires the interdisciplinary team to develop an overall plan of care and to provide coordinated care that emphasizes supportive services, including, but not limited to, home care, pain control, and limited inpatient services. Limited inpatient services are intended to ensure both continuity of care and appropriateness of services for those patients who cannot be managed at home because of acute complications or the temporary absence of a capable primary caregiver.(4)Provides for the palliative medical treatment of pain and other symptoms associated with a terminal disease, but does not provide for efforts to cure the disease.(5)Provides for bereavement services following death to assist the family in coping with social and emotional needs associated with the death of the patient.(6)Actively utilizes volunteers in the delivery of hospice services.(7)To the extent appropriate, based on the medical needs of the patient, provides services in the patients home or primary place of residence.(e)Hospice facility means a health facility as defined in subdivision (n) of Section 1250.(f)Inpatient care arrangements means arranging for those short inpatient stays that may become necessary to manage acute symptoms or because of the temporary absence, or need for respite, of a capable primary caregiver. The hospice shall arrange for these stays, ensuring both continuity of care and the appropriateness of services.(g)An interdisciplinary team means the hospice care team that includes, but is not limited to, the patient and patients family, a physician and surgeon, a registered nurse, a social worker, a volunteer, and a spiritual caregiver. The team shall be coordinated by a registered nurse and shall be under medical direction. The team shall meet regularly to develop and maintain an appropriate plan of care.(h)Medical direction means those services provided by a licensed physician and surgeon who is charged with the responsibility of acting as a consultant to the interdisciplinary team, a consultant to the patients attending physician and surgeon, as requested, with regard to pain and symptom management, and a liaison with physician and surgeons in the community.(i)Multiple location means a location or site from which a hospice makes available basic hospice services within the service area of the parent agency. A multiple location shares administration, supervision, policies and procedures, and services with the parent agency in a manner that renders it unnecessary for the site to independently meet the licensing requirements.(j)Palliative care means 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.(k)Parent agency means the part of the hospice that is licensed pursuant to this chapter and that develops and maintains administrative control of multiple locations. All services provided from each multiple location and parent agency are the responsibility of the parent agency.(l)Plan of care means a written plan developed by the attending physician and surgeon, the medical director or physician and surgeon designee, and the interdisciplinary team that addresses the needs of a patient and family admitted to the hospice organization. The hospice shall retain overall responsibility for the development and maintenance of the plan of care and quality of services delivered.(m)Preliminary services means those services authorized pursuant to subdivision (d) of Section 1749.(n)Skilled nursing services means nursing services provided by or under the supervision of a registered nurse under a plan of care developed by the interdisciplinary team and the patients physician and surgeon to a patient and his or her family that pertain to the palliative, supportive services required by patients with a serious or terminal illness. Skilled nursing services include, but are not limited to, patient assessment, evaluation and case management of the medical nursing needs of the patient, the performance of prescribed medical treatment for pain and symptom control, the provision of emotional support to both the patient and his or her family, and the instruction of caregivers in providing personal care to the patient. Skilled nursing services shall provide for the continuity of services for the patient and his or her family. Skilled nursing services shall be available on a 24-hour on-call basis.(o)Social services/counseling services means those counseling and spiritual care services that assist the patient and his or her family to minimize stresses and problems that arise from social, economic, psychological, or spiritual needs by utilizing appropriate community resources, and maximize positive aspects and opportunities for growth.(p)Terminal disease or terminal illness means a medical condition resulting in a prognosis of life of one year or less, if the disease follows its natural course.(q)Volunteer services means those services provided by trained hospice volunteers who have agreed to provide service under the direction of a hospice staff member who has been designated by the hospice to provide direction to hospice volunteers. Hospice volunteers may be used to provide support and companionship to the patient and his or her family during the remaining days of the patients life and to the surviving family following the patients death.(r)Serious illness means a condition that may result in death, regardless of the estimated length of the individuals remaining period of life.SEC. 2.Section 1749 of the Health and Safety Code is amended to read:1749.(a)To qualify for a license under this chapter, an applicant shall satisfy all of the following:(1)Be of good moral character. If the applicant is a franchise, franchisee, firm, association, organization, partnership, business trust, corporation, company, political subdivision of the state, or governmental agency, the person in charge of the hospice for which the application for a license is made shall be of good moral character.(2)Demonstrate the ability of the applicant to comply with this chapter and any rules and regulations promulgated under this chapter by the state department.(3)File a completed application with the state department that was prescribed and furnished pursuant to Section 1748.(b)In order for a person, political subdivision of the state, or other governmental agency to be licensed as a hospice it shall satisfy the definition of a hospice contained in Section 1746, and also provide, or make provision for, the following basic services:(1)Skilled nursing services.(2)Social services/counseling services.(3)Medical direction.(4)Bereavement services.(5)Volunteer services.(6)Inpatient care arrangements.(7)Home health aide services.(c)The services required to be provided pursuant to subdivision (b) shall be provided in compliance with the Standards for Quality Hospice Care, 2003, as available from the California Hospice and Palliative Care Association, until the state department adopts regulations establishing alternative standards pursuant to subdivision (e).(d)(1)Notwithstanding any other law, to meet the unique needs of the community, licensed hospices may provide, in addition to hospice services authorized in this chapter, any of the following preliminary services for any person in need of those services, as determined by the physician and surgeon, if any, in charge of the care of a patient, or at the request of the patient or family:(A)Preliminary palliative care consultations.(B)Preliminary counseling and care planning.(C)Preliminary grief and bereavement services.(2)Preliminary services authorized pursuant to this subdivision may be provided concurrently with curative treatment to a person who does not have a terminal prognosis or who has not elected to receive hospice services only by licensed and certified hospices. These services shall be subject to the schedule of benefits under the Medi-Cal program, pursuant to subdivision (w) of Section 14132 of the Welfare and Institutions Code.(e)(1)Notwithstanding any other law, a licensed hospice is further authorized to provide any of the same interdisciplinary hospice services, as defined in this chapter, to a patient with a serious illness, as determined by the physician and surgeon in charge of the care of the patient, including a patient who continues to receive curative treatment from other licensed health care professionals.(2)This subdivision is not intended to modify the provision of hospice care required under Section 1368.2.(f)The state department may adopt regulations establishing standards for any or all of the services required to be provided under subdivision (b). The regulations of the state department adopted pursuant to this subdivision shall supersede the standards referenced in subdivision (c) to the extent the regulations duplicate or replace those standards.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 1747.3 is added to the Health and Safety Code, to read:1747.3. (a) Notwithstanding any other law, beginning January 1, 2018, a licensee pursuant to this chapter may provide any interdisciplinary hospice services described in this chapter, including, but not limited to, palliative care, to a patient with a serious illness as determined by the physician and surgeon in charge of the care of the patient, including, among other kinds of patients, a patient who continues to receive curative treatment from other licensed health care professionals.(b) A licensee that elects to provide palliative care pursuant to this section shall provide the department with the date the licensee intends to begin providing the palliative care no less than 45 days before that date and all of the following:(1) The completed relevant portions of a form HS 200, or a successor form, as determined by the department.(2) A complete federal form CMS 417, or a successor form, as determined by the department.(c) (1) The department shall not require the documents submitted pursuant to subdivision (b) to be approved prior to the licensee providing palliative care pursuant to this section.(2) The department shall not charge an application fee to provide any care or services pursuant to this section.(d) On or before January 1, 2019, January 1, 2020, and January 1, 2021, a licensee shall provide the department with all of the following information for the period of time the licensee provided palliative care pursuant to this section on a form prescribed by the department:(1) The number of non-hospice patients who received palliative care pursuant to this section.(2) The number of patients enrolled in hospice.(3) The primary diagnoses of the patients for which the licensee provided palliative care pursuant to this section.(4) The numbers and types of providers hired during the previous 12 months.(5) The numbers and types of providers who left employment during the previous 12 months.(6) Complaints received by the licensee during the previous 12 months that related to all the following:(A) Events that caused or were likely to cause serious injury, harm, impairment, or death.(B) Events or incidents that negatively impacted a patients mental, physical, or psychosocial status and were of such consequence to the patients well-being that a rapid response was required.(C) Delays in patient care for hospice and non-hospice patients who received palliative care pursuant to this section.(D) Qualifications of staff.(e) During the period of time a licensee provides palliative care pursuant to this section, the licensee shall simultaneously submit to the department all information the licensee provides to the Office of Statewide Health Planning and Development.(f) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific the provisions of this section by means of all-facility letters, or similar instructions, without taking regulatory action.(g) If the licensee ceases to provide palliative care services pursuant to this section on or before January 1, 2022, the licensee shall submit to the department the same documents as required in subdivision (b).(h) The provisions of this section shall not be applicable to a hospice facility established pursuant to subdivision (n) of Section 1250, or Section 1339.30 or 1339.40.(i) This section shall not be deemed to modify the provision of hospice care required pursuant to Section 1368.2.(j) On or before June 1, 2021, the department shall convene a stakeholder meeting to discuss the results of the information collected pursuant to this section. The department may, at its discretion, use electronic means, such as a webinar, to convene the stakeholder meeting.(k) For purposes of this section, serious illness shall mean a condition that may result in death, regardless of the estimated length of the patients remaining period of life.(l) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
SECTION 1. Section 1747.3 is added to the Health and Safety Code, to read:
### SECTION 1.
1747.3. (a) Notwithstanding any other law, beginning January 1, 2018, a licensee pursuant to this chapter may provide any interdisciplinary hospice services described in this chapter, including, but not limited to, palliative care, to a patient with a serious illness as determined by the physician and surgeon in charge of the care of the patient, including, among other kinds of patients, a patient who continues to receive curative treatment from other licensed health care professionals.(b) A licensee that elects to provide palliative care pursuant to this section shall provide the department with the date the licensee intends to begin providing the palliative care no less than 45 days before that date and all of the following:(1) The completed relevant portions of a form HS 200, or a successor form, as determined by the department.(2) A complete federal form CMS 417, or a successor form, as determined by the department.(c) (1) The department shall not require the documents submitted pursuant to subdivision (b) to be approved prior to the licensee providing palliative care pursuant to this section.(2) The department shall not charge an application fee to provide any care or services pursuant to this section.(d) On or before January 1, 2019, January 1, 2020, and January 1, 2021, a licensee shall provide the department with all of the following information for the period of time the licensee provided palliative care pursuant to this section on a form prescribed by the department:(1) The number of non-hospice patients who received palliative care pursuant to this section.(2) The number of patients enrolled in hospice.(3) The primary diagnoses of the patients for which the licensee provided palliative care pursuant to this section.(4) The numbers and types of providers hired during the previous 12 months.(5) The numbers and types of providers who left employment during the previous 12 months.(6) Complaints received by the licensee during the previous 12 months that related to all the following:(A) Events that caused or were likely to cause serious injury, harm, impairment, or death.(B) Events or incidents that negatively impacted a patients mental, physical, or psychosocial status and were of such consequence to the patients well-being that a rapid response was required.(C) Delays in patient care for hospice and non-hospice patients who received palliative care pursuant to this section.(D) Qualifications of staff.(e) During the period of time a licensee provides palliative care pursuant to this section, the licensee shall simultaneously submit to the department all information the licensee provides to the Office of Statewide Health Planning and Development.(f) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific the provisions of this section by means of all-facility letters, or similar instructions, without taking regulatory action.(g) If the licensee ceases to provide palliative care services pursuant to this section on or before January 1, 2022, the licensee shall submit to the department the same documents as required in subdivision (b).(h) The provisions of this section shall not be applicable to a hospice facility established pursuant to subdivision (n) of Section 1250, or Section 1339.30 or 1339.40.(i) This section shall not be deemed to modify the provision of hospice care required pursuant to Section 1368.2.(j) On or before June 1, 2021, the department shall convene a stakeholder meeting to discuss the results of the information collected pursuant to this section. The department may, at its discretion, use electronic means, such as a webinar, to convene the stakeholder meeting.(k) For purposes of this section, serious illness shall mean a condition that may result in death, regardless of the estimated length of the patients remaining period of life.(l) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
1747.3. (a) Notwithstanding any other law, beginning January 1, 2018, a licensee pursuant to this chapter may provide any interdisciplinary hospice services described in this chapter, including, but not limited to, palliative care, to a patient with a serious illness as determined by the physician and surgeon in charge of the care of the patient, including, among other kinds of patients, a patient who continues to receive curative treatment from other licensed health care professionals.(b) A licensee that elects to provide palliative care pursuant to this section shall provide the department with the date the licensee intends to begin providing the palliative care no less than 45 days before that date and all of the following:(1) The completed relevant portions of a form HS 200, or a successor form, as determined by the department.(2) A complete federal form CMS 417, or a successor form, as determined by the department.(c) (1) The department shall not require the documents submitted pursuant to subdivision (b) to be approved prior to the licensee providing palliative care pursuant to this section.(2) The department shall not charge an application fee to provide any care or services pursuant to this section.(d) On or before January 1, 2019, January 1, 2020, and January 1, 2021, a licensee shall provide the department with all of the following information for the period of time the licensee provided palliative care pursuant to this section on a form prescribed by the department:(1) The number of non-hospice patients who received palliative care pursuant to this section.(2) The number of patients enrolled in hospice.(3) The primary diagnoses of the patients for which the licensee provided palliative care pursuant to this section.(4) The numbers and types of providers hired during the previous 12 months.(5) The numbers and types of providers who left employment during the previous 12 months.(6) Complaints received by the licensee during the previous 12 months that related to all the following:(A) Events that caused or were likely to cause serious injury, harm, impairment, or death.(B) Events or incidents that negatively impacted a patients mental, physical, or psychosocial status and were of such consequence to the patients well-being that a rapid response was required.(C) Delays in patient care for hospice and non-hospice patients who received palliative care pursuant to this section.(D) Qualifications of staff.(e) During the period of time a licensee provides palliative care pursuant to this section, the licensee shall simultaneously submit to the department all information the licensee provides to the Office of Statewide Health Planning and Development.(f) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific the provisions of this section by means of all-facility letters, or similar instructions, without taking regulatory action.(g) If the licensee ceases to provide palliative care services pursuant to this section on or before January 1, 2022, the licensee shall submit to the department the same documents as required in subdivision (b).(h) The provisions of this section shall not be applicable to a hospice facility established pursuant to subdivision (n) of Section 1250, or Section 1339.30 or 1339.40.(i) This section shall not be deemed to modify the provision of hospice care required pursuant to Section 1368.2.(j) On or before June 1, 2021, the department shall convene a stakeholder meeting to discuss the results of the information collected pursuant to this section. The department may, at its discretion, use electronic means, such as a webinar, to convene the stakeholder meeting.(k) For purposes of this section, serious illness shall mean a condition that may result in death, regardless of the estimated length of the patients remaining period of life.(l) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
1747.3. (a) Notwithstanding any other law, beginning January 1, 2018, a licensee pursuant to this chapter may provide any interdisciplinary hospice services described in this chapter, including, but not limited to, palliative care, to a patient with a serious illness as determined by the physician and surgeon in charge of the care of the patient, including, among other kinds of patients, a patient who continues to receive curative treatment from other licensed health care professionals.(b) A licensee that elects to provide palliative care pursuant to this section shall provide the department with the date the licensee intends to begin providing the palliative care no less than 45 days before that date and all of the following:(1) The completed relevant portions of a form HS 200, or a successor form, as determined by the department.(2) A complete federal form CMS 417, or a successor form, as determined by the department.(c) (1) The department shall not require the documents submitted pursuant to subdivision (b) to be approved prior to the licensee providing palliative care pursuant to this section.(2) The department shall not charge an application fee to provide any care or services pursuant to this section.(d) On or before January 1, 2019, January 1, 2020, and January 1, 2021, a licensee shall provide the department with all of the following information for the period of time the licensee provided palliative care pursuant to this section on a form prescribed by the department:(1) The number of non-hospice patients who received palliative care pursuant to this section.(2) The number of patients enrolled in hospice.(3) The primary diagnoses of the patients for which the licensee provided palliative care pursuant to this section.(4) The numbers and types of providers hired during the previous 12 months.(5) The numbers and types of providers who left employment during the previous 12 months.(6) Complaints received by the licensee during the previous 12 months that related to all the following:(A) Events that caused or were likely to cause serious injury, harm, impairment, or death.(B) Events or incidents that negatively impacted a patients mental, physical, or psychosocial status and were of such consequence to the patients well-being that a rapid response was required.(C) Delays in patient care for hospice and non-hospice patients who received palliative care pursuant to this section.(D) Qualifications of staff.(e) During the period of time a licensee provides palliative care pursuant to this section, the licensee shall simultaneously submit to the department all information the licensee provides to the Office of Statewide Health Planning and Development.(f) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific the provisions of this section by means of all-facility letters, or similar instructions, without taking regulatory action.(g) If the licensee ceases to provide palliative care services pursuant to this section on or before January 1, 2022, the licensee shall submit to the department the same documents as required in subdivision (b).(h) The provisions of this section shall not be applicable to a hospice facility established pursuant to subdivision (n) of Section 1250, or Section 1339.30 or 1339.40.(i) This section shall not be deemed to modify the provision of hospice care required pursuant to Section 1368.2.(j) On or before June 1, 2021, the department shall convene a stakeholder meeting to discuss the results of the information collected pursuant to this section. The department may, at its discretion, use electronic means, such as a webinar, to convene the stakeholder meeting.(k) For purposes of this section, serious illness shall mean a condition that may result in death, regardless of the estimated length of the patients remaining period of life.(l) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
1747.3. (a) Notwithstanding any other law, beginning January 1, 2018, a licensee pursuant to this chapter may provide any interdisciplinary hospice services described in this chapter, including, but not limited to, palliative care, to a patient with a serious illness as determined by the physician and surgeon in charge of the care of the patient, including, among other kinds of patients, a patient who continues to receive curative treatment from other licensed health care professionals.
(b) A licensee that elects to provide palliative care pursuant to this section shall provide the department with the date the licensee intends to begin providing the palliative care no less than 45 days before that date and all of the following:
(1) The completed relevant portions of a form HS 200, or a successor form, as determined by the department.
(2) A complete federal form CMS 417, or a successor form, as determined by the department.
(c) (1) The department shall not require the documents submitted pursuant to subdivision (b) to be approved prior to the licensee providing palliative care pursuant to this section.
(2) The department shall not charge an application fee to provide any care or services pursuant to this section.
(d) On or before January 1, 2019, January 1, 2020, and January 1, 2021, a licensee shall provide the department with all of the following information for the period of time the licensee provided palliative care pursuant to this section on a form prescribed by the department:
(1) The number of non-hospice patients who received palliative care pursuant to this section.
(2) The number of patients enrolled in hospice.
(3) The primary diagnoses of the patients for which the licensee provided palliative care pursuant to this section.
(4) The numbers and types of providers hired during the previous 12 months.
(5) The numbers and types of providers who left employment during the previous 12 months.
(6) Complaints received by the licensee during the previous 12 months that related to all the following:
(A) Events that caused or were likely to cause serious injury, harm, impairment, or death.
(B) Events or incidents that negatively impacted a patients mental, physical, or psychosocial status and were of such consequence to the patients well-being that a rapid response was required.
(C) Delays in patient care for hospice and non-hospice patients who received palliative care pursuant to this section.
(D) Qualifications of staff.
(e) During the period of time a licensee provides palliative care pursuant to this section, the licensee shall simultaneously submit to the department all information the licensee provides to the Office of Statewide Health Planning and Development.
(f) Notwithstanding the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement, interpret, or make specific the provisions of this section by means of all-facility letters, or similar instructions, without taking regulatory action.
(g) If the licensee ceases to provide palliative care services pursuant to this section on or before January 1, 2022, the licensee shall submit to the department the same documents as required in subdivision (b).
(h) The provisions of this section shall not be applicable to a hospice facility established pursuant to subdivision (n) of Section 1250, or Section 1339.30 or 1339.40.
(i) This section shall not be deemed to modify the provision of hospice care required pursuant to Section 1368.2.
(j) On or before June 1, 2021, the department shall convene a stakeholder meeting to discuss the results of the information collected pursuant to this section. The department may, at its discretion, use electronic means, such as a webinar, to convene the stakeholder meeting.
(k) For purposes of this section, serious illness shall mean a condition that may result in death, regardless of the estimated length of the patients remaining period of life.
(l) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 2. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
SEC. 2. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
SEC. 2. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
### SEC. 2.
For the purposes of this chapter, the following definitions apply:
(a)Bereavement services means those services available to the surviving family members for a period of at least one year after the death of the patient, including an assessment of the needs of the bereaved family and the development of a care plan that meets these needs, both prior to and following the death of the patient.
(b)Home health aide has the same meaning as that term is defined in subdivision (c) of Section 1727.
(c)Home health aide services means those services described in subdivision (d) of Section 1727 that provide for the personal care of the seriously or terminally ill patient and the performance of related tasks in the patients home in accordance with the plan of care in order to increase the level of comfort and to maintain personal hygiene and a safe, healthy environment for the patient.
(d)Hospice means 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 all of the following criteria:
(1)Considers the patient and the patients family, in addition to the patient, as the unit of care.
(2)Utilizes an interdisciplinary team to assess the physical, medical, psychological, social, and spiritual needs of the patient and the patients family.
(3)Requires the interdisciplinary team to develop an overall plan of care and to provide coordinated care that emphasizes supportive services, including, but not limited to, home care, pain control, and limited inpatient services. Limited inpatient services are intended to ensure both continuity of care and appropriateness of services for those patients who cannot be managed at home because of acute complications or the temporary absence of a capable primary caregiver.
(4)Provides for the palliative medical treatment of pain and other symptoms associated with a terminal disease, but does not provide for efforts to cure the disease.
(5)Provides for bereavement services following death to assist the family in coping with social and emotional needs associated with the death of the patient.
(6)Actively utilizes volunteers in the delivery of hospice services.
(7)To the extent appropriate, based on the medical needs of the patient, provides services in the patients home or primary place of residence.
(e)Hospice facility means a health facility as defined in subdivision (n) of Section 1250.
(f)Inpatient care arrangements means arranging for those short inpatient stays that may become necessary to manage acute symptoms or because of the temporary absence, or need for respite, of a capable primary caregiver. The hospice shall arrange for these stays, ensuring both continuity of care and the appropriateness of services.
(g)An interdisciplinary team means the hospice care team that includes, but is not limited to, the patient and patients family, a physician and surgeon, a registered nurse, a social worker, a volunteer, and a spiritual caregiver. The team shall be coordinated by a registered nurse and shall be under medical direction. The team shall meet regularly to develop and maintain an appropriate plan of care.
(h)Medical direction means those services provided by a licensed physician and surgeon who is charged with the responsibility of acting as a consultant to the interdisciplinary team, a consultant to the patients attending physician and surgeon, as requested, with regard to pain and symptom management, and a liaison with physician and surgeons in the community.
(i)Multiple location means a location or site from which a hospice makes available basic hospice services within the service area of the parent agency. A multiple location shares administration, supervision, policies and procedures, and services with the parent agency in a manner that renders it unnecessary for the site to independently meet the licensing requirements.
(j)Palliative care means 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.
(k)Parent agency means the part of the hospice that is licensed pursuant to this chapter and that develops and maintains administrative control of multiple locations. All services provided from each multiple location and parent agency are the responsibility of the parent agency.
(l)Plan of care means a written plan developed by the attending physician and surgeon, the medical director or physician and surgeon designee, and the interdisciplinary team that addresses the needs of a patient and family admitted to the hospice organization. The hospice shall retain overall responsibility for the development and maintenance of the plan of care and quality of services delivered.
(m)Preliminary services means those services authorized pursuant to subdivision (d) of Section 1749.
(n)Skilled nursing services means nursing services provided by or under the supervision of a registered nurse under a plan of care developed by the interdisciplinary team and the patients physician and surgeon to a patient and his or her family that pertain to the palliative, supportive services required by patients with a serious or terminal illness. Skilled nursing services include, but are not limited to, patient assessment, evaluation and case management of the medical nursing needs of the patient, the performance of prescribed medical treatment for pain and symptom control, the provision of emotional support to both the patient and his or her family, and the instruction of caregivers in providing personal care to the patient. Skilled nursing services shall provide for the continuity of services for the patient and his or her family. Skilled nursing services shall be available on a 24-hour on-call basis.
(o)Social services/counseling services means those counseling and spiritual care services that assist the patient and his or her family to minimize stresses and problems that arise from social, economic, psychological, or spiritual needs by utilizing appropriate community resources, and maximize positive aspects and opportunities for growth.
(p)Terminal disease or terminal illness means a medical condition resulting in a prognosis of life of one year or less, if the disease follows its natural course.
(q)Volunteer services means those services provided by trained hospice volunteers who have agreed to provide service under the direction of a hospice staff member who has been designated by the hospice to provide direction to hospice volunteers. Hospice volunteers may be used to provide support and companionship to the patient and his or her family during the remaining days of the patients life and to the surviving family following the patients death.
(r)Serious illness means a condition that may result in death, regardless of the estimated length of the individuals remaining period of life.
(a)To qualify for a license under this chapter, an applicant shall satisfy all of the following:
(1)Be of good moral character. If the applicant is a franchise, franchisee, firm, association, organization, partnership, business trust, corporation, company, political subdivision of the state, or governmental agency, the person in charge of the hospice for which the application for a license is made shall be of good moral character.
(2)Demonstrate the ability of the applicant to comply with this chapter and any rules and regulations promulgated under this chapter by the state department.
(3)File a completed application with the state department that was prescribed and furnished pursuant to Section 1748.
(b)In order for a person, political subdivision of the state, or other governmental agency to be licensed as a hospice it shall satisfy the definition of a hospice contained in Section 1746, and also provide, or make provision for, the following basic services:
(1)Skilled nursing services.
(2)Social services/counseling services.
(3)Medical direction.
(4)Bereavement services.
(5)Volunteer services.
(6)Inpatient care arrangements.
(7)Home health aide services.
(c)The services required to be provided pursuant to subdivision (b) shall be provided in compliance with the Standards for Quality Hospice Care, 2003, as available from the California Hospice and Palliative Care Association, until the state department adopts regulations establishing alternative standards pursuant to subdivision (e).
(d)(1)Notwithstanding any other law, to meet the unique needs of the community, licensed hospices may provide, in addition to hospice services authorized in this chapter, any of the following preliminary services for any person in need of those services, as determined by the physician and surgeon, if any, in charge of the care of a patient, or at the request of the patient or family:
(A)Preliminary palliative care consultations.
(B)Preliminary counseling and care planning.
(C)Preliminary grief and bereavement services.
(2)Preliminary services authorized pursuant to this subdivision may be provided concurrently with curative treatment to a person who does not have a terminal prognosis or who has not elected to receive hospice services only by licensed and certified hospices. These services shall be subject to the schedule of benefits under the Medi-Cal program, pursuant to subdivision (w) of Section 14132 of the Welfare and Institutions Code.
(e)(1)Notwithstanding any other law, a licensed hospice is further authorized to provide any of the same interdisciplinary hospice services, as defined in this chapter, to a patient with a serious illness, as determined by the physician and surgeon in charge of the care of the patient, including a patient who continues to receive curative treatment from other licensed health care professionals.
(2)This subdivision is not intended to modify the provision of hospice care required under Section 1368.2.
(f)The state department may adopt regulations establishing standards for any or all of the services required to be provided under subdivision (b). The regulations of the state department adopted pursuant to this subdivision shall supersede the standards referenced in subdivision (c) to the extent the regulations duplicate or replace those standards.