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THURSDAY, JANUARY 29, 2009
ROOM 250 STATE CAPITOL
Members Present: Sen. D. Chris Buttars, Chair
Sen. Allen M. Christensen
Sen. David Hinkins
Sen. Pat Jones
Sen. Luz Robles
Member Excused: Sen. Greg Bell
Staff Present: Mark D. Andrews, Policy Analyst
Cami Deavila, Committee Secretary
Public Speakers Present: Maureen Henry, Utah Commission on Aging
Lora Mengucci, Citizen
Charlie Thronson, Utah Association of Justice
Michelle McOmber, Utah Medical Association
Kelly Atkinson, Utah Health Insurance Association
Mike Weibel, Utah Medical Reserve Corps
A list of visitors and a copy of handouts are filed with the committee minutes.
Sen. Buttars called the meeting to order at 8:20 a.m.
1. SB0087, Preferred Drug List Revisions (A. Christensen)
S.B. 87 was not considered.
2. SB0117, Advance Health Care Directive Act Amendments (A. Christensen)
Sen. Christensen introduced the bill.
Ms. Henry spoke for the bill.
Ms. Mengucci spoke against the bill.
MOTION: Sen. Christensen moved to amend S.B. 117, Advance Health Care Directive Act Amendments, as follows:
1. Page 1, Line 16 :
16 . authorizes a physician assistant
{
,
}
or
a psychologist
{
, or a clinical
social worker
}
to
2. Page 3, Line 77 through Page 6, Line 164 :
77
{
(7) "Clinical social worker" means a person licensed as a clinical social
worker under
78 Title 58, Chapter 60, Mental Health Professional Practice Act. }
79
{
[
}
(7)
{
]
}
{
(8)
}
"Declarant" means an adult who has completed and
signed or directed the
80 signing of an advance health care directive.
81
{
[
}
(8)
{
]
}
{
(9)
}
"Default surrogate" means the adult who may make
decisions for an individual
82 when either:
83 (a) an agent or guardian has not been appointed; or
84 (b) an agent is not able, available, or willing to make decisions for an adult.
85
{
[
}
(9)
{
]
}
{
(10)
}
"Emergency medical services provider" means a
person who is licensed,
86 designated, or certified under Title 26, Chapter 8a, Utah Emergency Medical Services System
87 Act.
88
{
[
}
(10)
{
]
}
{
(11)
}
"Generally accepted health care standards":
89 (a) is defined only for the purpose of:
90 (i) this chapter and does not define the standard of care for any other purpose under
91 Utah law; and
92 (ii) enabling health care providers to interpret the statutory form set forth in Section
93 75-2a-117 ; and
94 (b) means the standard of care that justifies a provider in declining to provide life
95 sustaining care because the proposed life sustaining care:
96 (i) will not prevent or reduce the deterioration in the health or functional status of a
97 person;
98 (ii) will not prevent the impending death of a person; or
99 (iii) will impose more burden on the person than any expected benefit to the person.
100
{
[
}
(11)
{
]
}
{
(12)
}
"Health care" means any care, treatment, service,
or procedure to improve,
101 maintain, diagnose, or otherwise affect a person's physical or mental condition.
102
{
[
}
(12)
{
]
}
{
(13)
}
"Health care decision":
103
(a) means a decision about an adult's health care made by, or on behalf of, an adult,
that103
104 is communicated to a health care provider;
105 (b) includes:
106 (i) selection and discharge of a health care provider and a health care facility;
107 (ii) approval or disapproval of diagnostic tests, procedures, programs of medication,
108 and orders not to resuscitate; and
109 (iii) directions to provide, withhold, or withdraw artificial nutrition and hydration and
110 all other forms of health care; and
111 (c) does not include decisions about an adult's financial affairs or social interactions
112 other than as indirectly affected by the health care decision.
113
{
[
}
(13)
{
]
}
{
(14)
}
"Health care decision making capacity" means an
adult's ability to make an
114 informed decision about receiving or refusing health care, including:
115 (a) the ability to understand the nature, extent, or probable consequences of health
116 status and health care alternatives;
117 (b) the ability to make a rational evaluation of the burdens, risks, benefits, and
118 alternatives of accepting or rejecting health care; and
119 (c) the ability to communicate a decision.
120
{
[
}
(14)
{
]
}
{
(15)
}
"Health care facility" means:
121 (a) a health care facility as defined in Title 26, Chapter 21, Health Care Facility
122 Licensing and Inspection Act; and
123 (b) private offices of physicians, dentists, and other health care providers licensed to
124 provide health care under Title 58, Occupations and Professions.
125
{
[
}
(15)
{
]
}
{
(16)
}
"Health care provider" is as defined in Section
78B-3-403
, except that it
126 does not include an emergency medical services provider.
127
{
[
}
(16)
{
]
}
{
(17)
}
(a) "Life sustaining care" means any medical
intervention, including
128 procedures, administration of medication, or use of a medical device, that maintains life by
129 sustaining, restoring, or supplanting a vital function.
130 (b) "Life sustaining care" does not include care provided for the purpose of keeping a
131 person comfortable.
132
{
[
}
(17)
{
]
}
{
(18)
}
"Life with dignity order" means an order,
designated by the Department of
133
Health under Section
75-2a-106
(5)(a), that gives direction to health care providers, health
care133
134 facilities, and emergency medical services providers regarding the specific health care
135 decisions of the person to whom the order relates.
136
{
[
}
(18)
{
]
}
{
(19)
}
"Minor" means a person who:
137 (a) is under 18 years of age; and
138 (b) is not an emancipated minor.
139
{
[
}
(19)
{
]
}
{
(20)
}
"Physician" means a physician and surgeon or
osteopathic surgeon licensed
140 under Title 58, Chapter 67, Utah Medical Practice Act or Chapter 68, Utah Osteopathic
141 Medical Practice Act.
142
{
(21)
}
(20)
"Physician assistant" means a person licensed as a physician
assistant under Title
143 58, Chapter 70a, Physician Assistant Act.
144
{
(22)
}
(21)
"Psychologist" means a person licensed as a psychologist
under Title 58, Chapter
145 61, Psychologist Licensing Act.
146 [
{
(23)
}
(22)
"Reasonably available" means:
147 (a) readily able to be contacted without undue effort; and
148 (b) willing and able to act in a timely manner considering the urgency of the
149 circumstances.
150 [
{
(24)
}
(23)
"Substituted judgment" means the standard to be applied
by a surrogate
151 when making a health care decision for an adult who previously had the capacity to make
152 health care decisions, which requires the surrogate to consider:
153 (a) specific preferences expressed by the adult:
154 (i) when the adult had the capacity to make health care decisions; and
155 (ii) at the time the decision is being made;
156 (b) the surrogate's understanding of the adult's health care preferences;
157 (c) the surrogate's understanding of what the adult would have wanted under the
158 circumstances; and
159 (d) to the extent that the preferences described in Subsections [
160 are unknown, the best interest of the adult.
161 [
{
(25)
}
(24)
"Surrogate" means a health care decision maker who is:
162 (a) an appointed agent;
163 (b) a default surrogate under the provisions of Section 75-2a-108 ; or
164 (c) a guardian.
3. Page 6, Lines 171 through 181 :
171 (2) To overcome the presumption of capacity, a physician, physician assistant,
172 psychologist,
{
clinical social worker,
}
or an APRN who has personally examined
the adult and
173 assessed the adult's health care decision making capacity must:
174 (a) find that the adult lacks health care decision making capacity;
175 (b) record the finding in the adult's medical chart including an indication of whether
176 the adult is likely to regain health care decision making capacity; and
177 (c) make a reasonable effort to communicate the determination to:
178 (i) the adult;
179 (ii) other health care providers or health care facilities that the [
180 person who makes the finding would routinely inform of such a finding; and
181 (iii) if the adult has a surrogate, any known surrogate.
The motion passed unanimously.
MOTION: Sen. Christensen moved to pass S.B. 117, Advance Health Care Directive Act Amendments, as amended, out of committee with a favorable recommendation.
The motion passed unanimously.
Sen. Christensen assumed the chair.
3. SB0119, Hospital Emergency Room Task Force (D.C. Buttars)
Sen. Buttars introduced the bill.
Mr. Thronson, Ms. McOmber, and Mr. Atkinson spoke for the bill.
Mr. Weibel spoke to the bill.
MOTION: Sen. Buttars moved to pass S.B. 119, Hospital Emergency Room Task Force, out of committee with a favorable recommendation.
The motion passed unanimously.
Sen. Buttars resumed the chair.
4. SB0111, Health Care Workforce Financial Assistance Program Amendments (G. Davis)
Sen. Gene Davis introduced the bill.
Sen. Robles moved to amend S.B. 111, Health Care Workforce Financial Assistance Program Amendments, as follows:
1. Page 3, Lines 60 through 66 :
60 26-46-102. Creation of program -- Duties of department.
61 (1) There is created within the department the Utah Health Care Workforce Financial
62 Assistance Program to provide, within funding appropriated by the Legislature for this purpose:
63 (a) professional education scholarships and loan repayment assistance to health care
64 professionals who locate or continue to practice in underserved areas[
65 (b) loan repayment assistance to geriatric professionals
{
, regardless of whether
the
66 geriatric professionals provide services in underserved areas } .
The motion passed unanimously.
Sen. Christensen moved to pass S.B. 111, Health Care Workforce Financial Assistance Program Amendments, as amended, out of committee with a favorable recommendation.
The motion passed unanimously.
Sen. Christensen moved to adjourn the meeting.
The motion passed unanimously.
The meeting adjourned at 9:10 a.m.
Minutes were reported by Cami Deavila, Secretary.
_______________________________________
D. Chris Buttars, Committee Chair