REPORT TITLE:
Hospice services


DESCRIPTION:
Authorizes the department of health to license hospice service
agencies and to allow hospice homes with five or fewer beds in
residential areas.  (SB851 HD1)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        851
THE SENATE                              S.B. NO.           S.D. 2
TWENTIETH LEGISLATURE, 1999                                H.D. 1
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                   A  BILL  FOR  AN  ACT

RELATING TO HEALTH CARE.



BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  The legislature finds that death is often
 
 2 accompanied by pain that is severe enough to make living
 
 3 unbearable.  On the other hand, an interdisciplinary approach to
 
 4 the palliation of pain can, in most instances, bring relief,
 
 5 comfort, and dignity during one's final days of life.  Hospice
 
 6 care facilitates pain management.  Its goal is to make dying as
 
 7 comfortable as possible for the dying person and family and
 
 8 friends.
 
 9      Hospice is a service that can be delivered at home in a
 
10 free-standing unit operated by the hospice, in nursing or care
 
11 homes, or even in beds set aside in acute care hospitals.  It is
 
12 a philosophy that accepts that an illness has progressed to a
 
13 terminal stage and that death cannot be avoided even with
 
14 aggressive medical treatment.
 
15      The legislature further finds that virtually every study of
 
16 hospice care has concluded that:
 
17      (1)  The primary benefit of hospice care is increased
 
18           patient satisfaction; and
 
19      (2)  Hospice care almost always costs less than hospital
 
20           care or other forms of acute care at the end of life.
 

 
Page 2                                                     851
                                     S.B. NO.           S.D. 2
                                                        H.D. 1
                                                        

 
 1      If pain management is improved and hospice care is
 
 2 increased, many of Hawaii's health care providers believe that
 
 3 few people would consider physician-assisted death or physician-
 
 4 assisted suicide, which may be viewed as "desirable" when pain is
 
 5 not controlled and when the patient foresees being in a sterile
 
 6 or strange hospital or other residential program.
 
 7      The governor's blue ribbon panel on living and dying with
 
 8 dignity unanimously recommended, among other things, that:
 
 9      (1)  Hospice care be made more available and offered more
 
10           expediently to the dying; and
 
11      (2)  Effective pain management programs be required in all
 
12           health care institutions.
 
13      In line with the blue ribbon panel's unanimous
 
14 recommendation, the legislature finds it necessary to ensure that
 
15 consistent, high-quality hospice care is maintained.
 
16      The purpose of this Act is to authorize the department of
 
17 health to license hospice service agencies and to allow hospice
 
18 homes with five or fewer beds in residential areas.
 
19      SECTION 2.  Chapter 46, Hawaii Revised Statutes, is amended
 
20 by adding a new section to be appropriately designated and to
 
21 read as follows:
 
22      "�46-     Hospice homes; permitted use in residential areas.
 
23 (a)  For the purposes of zoning, hospice homes shall be
 
24 considered a residential use of property and shall be a permitted
 

 
Page 3                                                     851
                                     S.B. NO.           S.D. 2
                                                        H.D. 1
                                                        

 
 1 use in all residentially designated zones including but not
 
 2 limited to zones for single-family dwellings.  No conditional use
 
 3 permit, variance, or special exception shall be required for
 
 4 residences used as hospice homes.
 
 5      (b)  For the purposes of this section, "hospice home" means
 
 6 any facility operated by a licensed hospice service agency
 
 7 providing twenty-four-hour living accommodations to no more than
 
 8 five unrelated persons who are admitted to the hospice program of
 
 9 care."
 
10      SECTION 3.  Chapter 321, Hawaii Revised Statutes, is amended
 
11 by adding a new section to be appropriately designated and to
 
12 read as follows:
 
13      "�321-     Hospice services.  (a)  The department of health
 
14 is authorized to license hospice service agencies.
 
15      (b)  For the purpose of this section:
 
16      "Hospice" means a hospice service agency or the provision of
 
17 hospice services in an in-patient facility or a hospice home.
 
18      "Hospice home" means any facility operated by a licensed
 
19 hospice service agency providing twenty-four-hour living
 
20 accommodations to no more than five unrelated persons who are
 
21 admitted to the hospice program of care.
 
22      "Hospice service" means a program of palliative and
 
23 supportive care for terminally ill persons and their families or
 
24 caregivers.
 

 
Page 4                                                     851
                                     S.B. NO.           S.D. 2
                                                        H.D. 1
                                                        

 
 1      "Hospice service agency" means an agency or organization, or
 
 2 a subdivision of that agency or organization, that is engaged in
 
 3 providing hospice services at the place of residence of its
 
 4 clients."
 
 5      SECTION 4.  New statutory material is underscored.
 
 6      SECTION 5.  This Act shall take effect upon its approval.