An Act concerning palliative care and hospice care and supplementing Title 26 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. As used in this act:

"Appropriate" means consistent with applicable legal, health, and professional standards, the patient's clinical and other circumstances, and the patient's reasonably known wishes and beliefs.

"Hospice care" means a coordinated program of home, outpatient, and inpatient care and services that is operated by a public agency or private organization, or subdivision of either of these entities, and that provides care and services to hospice patients and to hospice patients' families, through a medically directed interdisciplinary team, under interdisciplinary plans of care in order to meet the physical, psychological, social, spiritual, and other special needs that are experienced during the final stages of illness, dying, and bereavement. A hospice care program includes: nursing care by or under the supervision of a registered professional nurse; physical, occupational, or speech or language therapy; medical social services by a certified or licensed social worker under the direction of a physician; services of a certified home health aide; medical supplies, including drugs and biologicals, and the use of medical appliances related to terminal diagnosis; physician's services; short-term inpatient care, including both palliative and respite care and procedures; spiritual and other counseling for hospice patients and hospice patients' families; services of volunteers under the direction of the provider of the hospice care program; and bereavement services for hospice patients' families.

"Medical care" means services provided, requested, or supervised by a physician, physician assistant, or advanced practice nurse.

"Palliative care" means patient-centered and family-centered medical care that optimizes quality of life by anticipating, preventing, and treating suffering caused by serious illness. Palliative care throughout the continuum of illness involves addressing physical, emotional, social, and spiritual needs and facilitating patient autonomy, access to information, and choice. Palliative care includes, but is not limited to: comprehensive pain and symptom management and discussion of treatment options appropriate to the patient, including hospice care, when appropriate.

"Serious illness" means any medical illness or physical injury or condition that substantially impacts quality of life for more than a short period of time. Serious illness includes, but is not limited to: cancer; heart, renal, or liver failure; lung disease; and Alzheimer's disease and related dementias.

2. a. There is established a "Palliative Care and Hospice Care Consumer and Professional Information and Education Program" in the Department of Health.

b. The purpose of the program is to maximize the effectiveness of palliative care and hospice care initiatives in the State by ensuring that comprehensive and accurate information and education about palliative care and hospice care are available to the public, to health care providers, and to health care facilities.

c. The Palliative Care and Hospice Care Advisory Council, established pursuant to section 4 of P.L. , c. (C. ) (pending before the Legislature as this bill) shall, in collaboration with the Cancer Institute of New Jersey, develop and implement the program established under this section, including developing and implementing any initiatives regarding palliative care and hospice care services and education that the council determines would further the purposes of this section.

3. a. Every hospital, nursing home, extended care facility, ambulatory health care facility providing long-term care services, and rehabilitation facility licensed in this State shall provide information about appropriate palliative care and hospice care services to patients and residents with a serious illness or, in the event the patient or resident lacks capacity to make health care decisions, to a family member or other person legally authorized to make health care decisions for the patient or resident.

b. If a hospital, nursing home, or facility fails to comply with the requirements of subsection a. of this section, the Commissioner of Health may require the hospital, nursing home, or facility to provide a plan of action to bring the hospital, nursing home, orfacility into compliance.

c. In implementing the provisions of this section, the department shall:

(1) consult with the Palliative Care and Hospice Care Advisory Council established pursuant to section 4 of P.L. , c. (C. ) (pending before the Legislature as this bill); and

(2) take into account factors that may impact the ability of a hospital, nursing home, or facility to comply with the requirements of subsection a. of this section. These factors may include, but are not limited to: the size of the hospital, nursing home, or facility; access and proximity to palliative care and hospice care services, including the availability of palliative care and hospice care board-certified practitioners and related workforce staff; and geographic factors.

4. a. There is established in the Department of Health a Palliative Care and Hospice Care Advisory Council.

b. It shall be the duty of the council, in collaboration with the Cancer Institute of New Jersey, to implement the provisions of P.L. , c. (C. ) (pending before the Legislature as this bill), including establishing the Palliative Care and Hospice Care Consumer and Professional Information and Education Program pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill), developing and facilitating the provision of information about palliative care and hospice care for the purposes of section 3 of P.L. , c. (C. ) (pending before the Legislature as this bill), and developing resources and programs to facilitate access to palliative care and hospice care services for patients and residents.

c. (1) The council shall comprise nine members, to be appointed as follows: one member of the Senate appointed by the Senate President; one member of the General Assembly appointed by the Speaker of the General Assembly; two public members appointed by the Senate President; two public members appointed by the Speaker of the General Assembly; and three public members appointed by the Governor.

(2) In selecting the public members, the Senate President, the Speaker of the General Assembly, and the Governor shall seek to include persons who have experience, training, or academic background in issues related to the provision of palliative care or hospice care. Selections of public members may be made in consultation with: the State Board of Medical Examiners, the New Jersey Board of Nursing, the Physician Assistant Advisory Committee, the Board of Pharmacy, the New Jersey Hospital Association, the Health Care Association of New Jersey, the Medical Society of New Jersey, the New Jersey Association of Osteopathic Physicians and Surgeons, the New Jersey State Nurses Association, the Home Health Assembly of New Jersey, and the New Jersey Hospice and Palliative Care Organization.

d. All appointments shall be made within 30 days after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill).

e. The public members shall serve for a term of five years; but, of the members first appointed, two shall serve for a term of three years, two for a term of four years, and three for a term of five years. Members are eligible for reappointment upon the expiration of their terms. Vacancies in the membership shall be filled in the same manner as the original appointments.

f. The council shall organize as soon as is practicable upon the appointment of a majority of its members, and shall select a chairperson from among the members.

g. The members of the council shall serve without compensation but may be reimbursed, within the limits of funds made available to the council, for necessary travel expenses incurred in the performance of their duties.

h. The council shall be entitled to call to its assistance and avail itself of the services of the employees of any State, county, or municipal department, board, bureau, commission, or agency as it may require and as may be available for its purposes.

i. The Department of Health shall provide staff support to the council.

5. This act shall take effect on the first day of the fourth month next following enactment.

STATEMENT

This bill establishes certain requirements concerning palliative care and hospice care.

Palliative care is patient-centered and family-centered medical care that optimizes quality of life by anticipating, preventing, and treating suffering caused by serious illness. Palliative care may involve addressing physical, emotional, social, and spiritual needs, as well as facilitating patient autonomy, access to information, and choice. Specific examples of palliative care include comprehensive pain and symptom management and discussion of treatment options appropriate to the patient, such as hospice care.

Hospice care is a coordinated program of home, outpatient, and inpatient care and services that provides care and services to hospice patients and to hospice patients' families, through a medically directed interdisciplinary team, under interdisciplinary plans of care in order to meet the physical, psychological, social, spiritual, and other special needs that are experienced during the final stages of illness, dying, and bereavement.

The bill would establish the "Palliative Care and Hospice Care Consumer and Professional Information and Education Program" in the Department of Health (DOH). The purpose of the program would be to ensure that comprehensive and accurate information and education about palliative care and hospice care are available to the public, to health care providers, and to health care facilities.

The bill will require every hospital, nursing home, extended care facility, ambulatory health care facility providing long-term care services, and rehabilitation facility licensed in this State to provide information about appropriate palliative care and hospice care services to patients and residents with a serious illness. The Commissioner of Health may require a hospital, nursing home, or facility that fails to comply with these requirements to provide a plan of action to bring the hospital, nursing home, orfacility into compliance. In implementing these requirements, DOH would be required to take into account the size of the facility; access and proximity to palliative care and hospice care services, including the availability of hospice and palliative care board-certified practitioners and related workforce staff; geographic factors; and any other factors that may impact the ability of a hospital, nursing home, or facility to comply.

The bill establishes the Palliative Care and Hospice Care Advisory Council in DOH. It would be the duty of the council, in collaboration with the Cancer Institute of New Jersey, to implement the provisions of the bill, including establishing the Palliative Care and Hospice Care Consumer and Professional Information and Education Program, developing the information to be provided to patients and residents by hospitals, nursing homes, and other facilities and facilitating the provision of this information, and developing resources and programs to facilitate access to palliative care and hospice care services for patients and residents.

The council will comprise nine members, to be appointed as follows: one member of the Senate appointed by the Senate President; one member of the General Assembly appointed by the Speaker of the General Assembly; two public members appointed by the Senate President; two public members appointed by the Speaker of the General Assembly; and three public members appointed by the Governor. In selecting the public members, the Senate President, the Speaker of the General Assembly, and the Governor would be required to seek to include persons who have experience, training, or academic background in issues related to the provision of palliative care or hospice care, and would be permitted to consult with various professional boards and stakeholders.

The bill would require all appointments to be made within 30 days after the effective date of the bill. The public members would serve for a term of five years; except that, of the members first appointed, two would serve for a term of three years, two for a term of four years, and three for a term of five years. Members will be eligible for reappointment upon the expiration of their terms, and vacancies in the membership would be filled in the same manner as the original appointments. The council will organize as soon as is practicable upon the appointment of a majority of its members, and select a chairperson from among the members.

The members of the council will serve without compensation but may be reimbursed, within the limits of funds made available to the council, for necessary travel expenses incurred in the performance of their duties. The council will be entitled to call to its assistance and avail itself of the services of the employees of any State, county, or municipal department, board, bureau, commission, or agency as it may require and as may be available for its purposes. DOH will provide staff support to the council.