Provides that all patients who have not executed an advance health-care directive or have no surrogate or guardian shall receive basic life support assistance and all other medical care required to prolong the patient's life; requires insurance providers to extend hospice care coverage to patients with not more than two years to live.

A BILL FOR AN ACT

SECTION 1. The legislature finds all adults should execute an advance health-care directive to ensure that after their health has deteriorated and they are near death, their wishes are known and compassionately followed. However, there will be many who will choose not to take this action because the process of conveying a person's last wishes is very emotional and personal.

The legislature recognizes that human life is immensely important and believes that in the absence of a clear statement of the patient's wishes, or of a surrogate or guardian who can make decisions in the patient's best interest, all reasonable actions should be taken to prolong the patient's life.

The legislature further finds that hospice palliative care increases quality of life and comfort for patients who are dying and their families. Yet, hospice coverage is generally limited to those who have six months or less to live.

The purpose of this Act is to provide patients who are near death with as much support as necessary in their time of need by:

SECTION 2. Section 327E-7, Hawaii Revised Statutes, is amended to read as follows:

"[[]§327E-7[]] Obligations of health-care provider. (a) Before implementing a health-care decision made for a patient, a supervising health-care provider, if possible, shall promptly communicate to the patient the decision made and the identity of the person making the decision.

(b) A supervising health-care provider who knows of the existence of an advance health-care directive, a revocation of an advance health-care directive, or a designation or disqualification of a surrogate, shall promptly record its existence in the patient's health-care record and, if it is in writing, shall request a copy and if one is furnished shall arrange for its maintenance in the health-care record.

(c) A supervising health-care provider who makes or is informed of a determination that a patient lacks or has recovered capacity, or that another condition exists which affects an individual instruction or the authority of an agent, guardian, or surrogate, shall promptly record the determination in the patient's health-care record and communicate the determination to the patient, if possible, and to any person then authorized to make health-care decisions for the patient.

(d) Except as provided in subsections (e) and (f), a health-care provider or institution providing care to a patient shall:

(e) A health-care provider may decline to comply with an individual instruction or health-care decision for reasons of conscience. A health-care institution may decline to comply with an individual instruction or health-care decision if the instruction or decision is contrary to a policy of the institution which is expressly based on reasons of conscience and if the policy was timely communicated to the patient or to a person then authorized to make health-care decisions for the patient.

(f) A health-care provider or institution may decline to comply with an individual instruction or health-care decision that requires medically ineffective health care or health care contrary to generally accepted health-care standards applicable to the health-care provider or institution.

(g) A health-care provider or institution that declines to comply with an individual instruction or health-care decision shall:

(h) A health-care provider or institution may not require or prohibit the execution or revocation of [[]an[]] advance health-care directive as a condition for providing health care.

(i) If a patient does not have an advance health-care directive, surrogate, or guardian, a health-care provider shall provide all basic life support care as well as invasive patient care designed to stabilize and support a patient's condition and shall make every reasonable effort to prolong the patient's life."

SECTION 3. Section 431:10A-119, Hawaii Revised Statutes, is amended to read as follows:

"[[]§431:10A-119[]] Hospice care coverage. (a) Any other law to the contrary notwithstanding, [commencing on January 1, 2000,] all authorized insurers that provide for payment of or reimbursement for hospice care[,] shall reimburse hospice care services for each insured policyholder covered for hospice care according to the following:

(b) Every insurer shall provide notice to its policyholders regarding the coverage required by this section. Notice shall be in writing and in literature or correspondence sent to policyholders[, beginning with calendar year 2000,] along with any other mailing to policyholders[, but in no case later than July 1, 2000].

(c) All authorized insurers that provide for payment or reimbursement for hospice care shall accept as eligible for hospice care coverage, persons with a life expectancy certification of two years or less."

SECTION 4. Section 432:1-608, Hawaii Revised Statutes, is amended to read as follows:

"[[]§432:1-608[]] Hospice care coverage. (a) Any other law to the contrary notwithstanding, [commencing on January 1, 2000,] all mutual benefit societies issuing or renewing an individual and group hospital or medical service plan, policy, contract, or agreement in this [State] state that provides for payment of or reimbursement for hospice care, shall reimburse hospice care services for each insured member covered for hospice care according to the following:

(b) Every insurer shall provide notice to its members regarding the coverage required by this section. Notice shall be in writing and in literature or correspondence sent to members[, beginning with calendar year 2000,] along with any other mailing to members[, but in no case later than July 1, 2000].

(c) All authorized insurers that provide for payment or reimbursement for hospice care shall accept as eligible for hospice care coverage, persons with a life expectancy certification of two years or less."

SECTION 5. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun, before its effective date.

SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 7. This Act shall take effect upon its approval.