Living & Dying; Health Care

Provides legislation recommended by the Governor's Blue Ribbon
Panel on Living and Dying With Dignity with respect to health
care facilities.

THE SENATE                              S.B. NO.           851
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  Chapter 321, Hawaii Revised Statutes, is amended
 2 by adding a new section to be appropriately designated and to
 3 read as follows:
 4      "321-    Patient self-determination.  The department,
 5 pursuant to chapter 91, shall adopt rules to provide policies and
 6 sanctions for the regulation of:
 7      (1)  Patient self-determination during end of life medical
 8           care, including compliance with a patient's advance
 9           directives if a patient is transferred between medical
10           facilities.  For the purposes of this chapter, "advance
11           directive" means any expression of intent by a patient
12           with respect to end of life medical care that complies
13           with state law or the Patient Self-Determination Act
14           (42 U.S.C. 1395, et seq); and
15      (2)  Pain management during end of life care, including:
16           (A)  Establishing industry standards for the treatment
17                of pain based on the guidelines issued by the
18                Agency for Healthcare Policy and Research of the
19                United States Department of Health and Human

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                                     S.B. NO.           851

 1                Services at all applicable department certified or
 2                licensed facilities;
 3           (B)  Establishing a right to skilled pain management,
 4                requiring a pain management program, and including
 5                pain management in continuing education training
 6                at such facilities; and
 7           (C)  Requiring department licensing and certification
 8                teams to include pain management criteria in their
 9                overall review of patient care plans and
10                management."
11      SECTION 2.  Section 321-13, Hawaii Revised Statutes, is
12 amended to read as follows:
13      "321-13  Regulation of certain other occupations[.] or
14 services.  (a)  The department of health, with the approval of
15 the governor, may prescribe such rules as it deems necessary for
16 the public health or safety respecting:
17      (1)  The occupations, services, or practices of laboratory
18           directors, laboratory technologists, laboratory
19           supervisors, laboratory technicians, tattoo artists,
20           sanitarians, asbestos inspectors, asbestos management
21           planners, asbestos abatement project designers, lead
22           inspectors, lead risk assessors, lead abatement

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                                     S.B. NO.           851

 1           workers, lead abatement supervisors, [and] lead
 2           abatement project designers[;], and hospice care
 3           providers, caregivers, or services; provided that rules
 4           for hospice care providers, caregivers, or services
 5           shall be consistent with the National Hospice
 6           Organization's "Standards of Hospice Program of Care";
 7      (2)  The health, education, training, experience, habits,
 8           qualifications, or character of persons or services to
 9           whom certificates of registration or permits for these
10           occupations, services, or practices may be issued;
11      (3)  The health, habits, character, practices, standards, or
12           conduct of persons or services holding these
13           certificates or permits; or
14      (4)  The grounds or causes for revoking or suspending these
15           certificates or permits.
16 The rules shall have the force and effect of law.
17      (b)  It shall be unlawful for any person or service to
18 engage in or to attempt to engage in or to follow any of the
19 occupations, services, or practices referred to in this section,
20 unless the person or service first obtains and holds a valid
21 unrevoked certificate of registration or permit under such rules
22 [or regulations] as the department shall prescribe.

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                                     S.B. NO.           851

 1      (c)  The department may revoke or suspend any certificate of
 2 registration or permit issued under this section or issued prior
 3 to April 23, 1941, upon proof to its satisfaction of a violation
 4 of any rule [or regulation] of the department on the part of any
 5 person or service holding a certificate or permit; provided that
 6 no such certificate or permit shall be revoked or suspended
 7 except upon due notice to the person or service holding the same
 8 and the person or service shall be given an opportunity to be
 9 heard and present evidence in the person's or service's own
10 defense."
11      SECTION 3.  Statutory material to be repealed is bracketed.
12 New statutory material is underscored.
13      SECTION 4.  This Act shall take effect upon its approval.
15                           INTRODUCED BY:  _______________________