BP BHEAD INT S [atlas:bill]

AN ACT Relating to an end-of-life care center; adding a new chapter to Title 70 RCW; and making an appropriation.

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

NEW SECTION. Sec. 1. The legislature finds that although medical technology enables some patients to live longer, many at the end of life still suffer from pain, fear, unresolved personal issues, and psychosocial discomfort. There is growing concern in the medical and legal community and among patients and their families and friends that care at the end of life needs to become more compassionate, varied, and enhanced by special services such as hospice, and by the support and sensitivity of caregivers in a variety of settings.

The legislature intends to set a model for the United States, by addressing end-of-life concerns in a creative way, through the establishment of a Washington state end-of-life care center. The legislature intends for the mission of the end-of-life care center to be improvement of medical education regarding terminality; better public and patient understanding of advance directives and care options; and creation of a special educational, treatment, and outreach center for the palliative care of children. The legislature's goal is to increase public understanding of the dying process and, by improving communication between patients and health care professionals, to assure more Washingtonians compassionate care at the end of life.

The legislature intends to establish the end-of-life care center as a public-private partnership, enabling the medical, legal, and insurance communities, as well as concerned citizens, business, and charitable organizations to become involved in developing a new model of terminality.

NEW SECTION. Sec. 2. The Washington state end-of-life care center is established at the University of Washington, for the purpose of increasing knowledge and understanding of end-of-life care issues in order to benefit patients and their families. The goals of the end-of- life care center include:

(1) Improving training for physicians and other health care professionals in end-of-life care, including developing medical school, nursing school, and continuing medical education curricula regarding palliative care, pain management, the role of hospice, and the psychosocial needs of terminal patients, including children;

(2) Providing, with cooperation by the office of the attorney general and the department of health, public education regarding end-of-life legal and medical decision making, as well as provision of information regarding available state and community resources, including home health and hospice services, and information on organ donation; and

(3) Establishing a teaching and resource center in palliative care for children in order to improve the quality and availability of such care throughout the state.

NEW SECTION. Sec. 3. (1) The end-of-life care center shall be governed by a board of directors consisting of seven members as follows:

(a) A person appointed by the University of Washington school of medicine;

(b) A person appointed by the University of Washington school of nursing;

(d) A representative of the health care insurance community, appointed by the governor;

(e) A patient advocate, appointed by the governor;

(f) A person appointed by agreement of the house of representatives and the senate; and

(g) A representative of the department of health, appointed by the secretary of the department of health.

(2) Members of the board of directors shall serve four-year terms of office, except that three of the initial seven board members shall serve two-year terms. A vacancy shall be filled in the same manner as the original appointment was made, and the person appointed to fill a vacancy shall serve for the remainder of the unexpired term of the office for the position to which he or she was appointed.

(3) A director appointed by the governor or by a state agency may be removed from office by the governor. Any other director may be removed from office by the action of the appointing authority or at least two-thirds of the legislature for legislative appointments.

NEW SECTION. Sec. 4. (1)(a) The board of directors of the end-of-life care center shall adopt a resolution that may be amended from time to time establishing the basic requirements governing methods and amounts of reimbursement payable to directors and employees for travel and other business expenses incurred on behalf of the end-of-life care center. The resolution shall establish procedures for approving expenses, and requirements regarding the use of credit cards. The resolution may also establish procedures for payment of per diem to board members. The state auditor shall, as provided by law, cooperate with the end-of-life care center in establishing adequate procedures for regulating and auditing the reimbursement of all such expenses.

(b) The board may authorize payment of actual and necessary expenses of board members and employees for lodging, meals, and travel-related costs incurred in attending meetings or conferences on behalf of the end-of-life care center, and strictly in the public interest and for public purposes. Directors and employees may be advanced sufficient sums to cover anticipated expenses, in accordance with rules adopted by the state auditor.

(2) Each member of the board of directors may receive compensation of fifty dollars per day for attending meetings or conferences on behalf of the end-of-life care center, not to exceed three thousand dollars per year. A director may waive all or a portion of his or her compensation under this section as to a month or months during his or her term of office, by a written waiver filed with the end-of-life care center. The compensation provided in this section is in addition to reimbursement for expenses paid to the directors.

(3) The board may purchase liability insurance, with such limits as the directors may deem reasonable, for the purpose of protecting and holding personally harmless the board members against liability for personal or bodily injuries and property damage arising from their acts or omissions while performing or in good faith purporting to perform their official duties.

NEW SECTION. Sec. 5. The end-of-life care center may accept and expend funds or other contributions that may be donated for the purposes of the end-of-life care center. The end-of-life care center shall encourage the voluntary participation of legal, health care, and other professionals in the work of the end-of-life care center. The end-of-life care center shall seek corporate and charitable grant funding to the fullest extent possible.

NEW SECTION. Sec. 6. (1) The end-of-life care center constitutes a body corporate, and shall possess all the usual powers of a corporation for public purposes, as well as other powers that may now or hereafter be specifically conferred by statute, including without limitation, the authority to hire employees and staff, to enter into contracts, and to sue and be sued.

(2) The end-of-life care center has the following specific authority:

(a) To contract with public and private entities, including private nonprofit entities, for facilities, goods, and services to establish and maintain the end-of-life care center;

(b) To seek grants from public and private foundations, research, and charitable entities for the establishment, development, research, outreach, and programs of the end-of-life care center;

(c) To research, create, make available, and present public education programs regarding end-of-life issues, in order to increase public awareness. Such programs may include education regarding advance directives, home health and hospice services, improved communication between patient, family, and health care providers, and availability of state and community resources to assist patients and their families with end-of-life care. Public education may include community forums, written materials, audiotapes, and videotapes; and

(d) To accept donation from businesses, corporations, and individuals for the work of the end-of-life care center.

NEW SECTION. Sec. 7. The legislature finds that as many as a thousand Washington state children suffer from life-limiting conditions that require special care. In many cases, this special care cannot be obtained in the child's home community, and the child and family relies upon the children's hospital and medical center affiliated with the University of Washington and other resources for relevant care. The legislature intends to enlarge upon the special expertise and varied resources available through the children's hospital and medical center affiliated with the University of Washington by establishing a pediatric palliative care center focused on education, research, and direct service to address the diverse needs of patients, families, providers, and communities more completely. The legislature intends that the pediatric palliative care center serve as a consulting and outreach resource for health care professionals throughout Washington state, eventually enabling more local communities to be supported in providing terminal care to children with life-limiting conditions.

NEW SECTION. Sec. 8. (1) The pediatric palliative care center is established with the cooperation of the children's hospital and medical center affiliated with the University of Washington and the end-of-life care center, under the direction of the end-of-life care center. Funding for the pediatric palliative care center is provided through the Washington state end-of-life care center's public-private partnership.

(2) The goals of the pediatric palliative care center are to:

(a) Work with existing medical and nursing school programs to improve palliative care curricula to include culturally sensitive information on end-of-life and palliative care for children;

(b) Assist health care professionals in coordination of care and interdisciplinary communication, improve the transition of care from curative to palliative to terminal, and span clinical and organizational relationships;

(c) Improve, through education and training, clinical practice regarding pain and symptom management for children, and to teach providers and parents optimal pain and symptom relief;

(d) Provide the availability of an inpatient or palliative care clinic setting for children, focusing on comfort care, not cure, and on parental support as well as the needs of the child patient;

(e) Where feasible, act as a resource and referral to connect children with appropriate hospice care in their communities; and

(f) Act as a state-wide resource for physicians with questions regarding pediatric palliative care.

NEW SECTION. Sec. 9. This chapter may be known and cited as the Washington state end-of-life care center act.

NEW SECTION. Sec. 10. Sections 1 through 9 of this act constitute a new chapter in Title 70 RCW.

NEW SECTION. Sec. 11. The sum of . . . dollars, or as much thereof as may be necessary, is appropriated for the fiscal year ending June 30, 1999, from the general fund to the University of Washington school of medicine for the purposes of this act.

NEW SECTION. Sec. 12. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.