House Introduced Bill 4681

HOUSE BILL No. 4681

April 24, 1997, Introduced by Reps. Law, Gire, Hammerstrom, Griffin, Crissman, Profit, Ciaramitaro, Rocca, Raczkowski, Olshove, Leland, Green, Cassis, Kukuk and Dalman and referred to the Committee on Health Policy.

A bill to amend 1978 PA 368, entitled

"Public health code,"

by amending sections 16204a (MCL 333.16204a), as added by 1994 PA

232.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

1 Sec. 16204a. (1) Subject to subsection (2), an

2 interdisciplinary advisory committee on pain and symptom man-

3 agement is created in the department. The committee shall con-

4 sist of the following members APPOINTED IN THE FOLLOWING MANNER:

5 (a) Except as otherwise provided in this subdivision, each

6 board created under this article, not including the Michigan

7 board of sanitarians and the Michigan board of veterinary medi-

8 cine, and the joint task force on physician's assistants created

9 under this article shall appoint 1 member. The Michigan board of

10 medicine created in part 170 and the Michigan board of

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1 osteopathic medicine and surgery created in part 175 each shall

2 appoint 2 members, 1 of whom is a physician specializing in pri-

3 mary care and 1 of whom is a physician specializing in the

4 treatment of patients with chronic pain or terminal illness, or

5 both CERTIFIED IN THE SPECIALTY OF PAIN MEDICINE BY 1 OR MORE

6 NATIONAL PROFESSIONAL ORGANIZATIONS APPROVED BY THE DEPARTMENT OF

7 CONSUMER AND INDUSTRY SERVICES, INCLUDING, BUT NOT LIMITED TO,

8 THE AMERICAN BOARD OF MEDICAL SPECIALISTS OR THE AMERICAN BOARD

9 OF PAIN MEDICINE. The board of examiners of social workers cre-

10 ated under section 1602 of Act No. 299 of the Public Acts of

11 1980, being section 339.1602 of the Michigan Compiled Laws, shall

12 appoint 1 member. A member appointed under this subdivision need

13 not be a member of a licensing or registration board or task

14 force.

15 (B) ONE PSYCHOLOGIST APPOINTED BY THE MICHIGAN BOARD OF PSY-

16 CHOLOGY CREATED IN PART 182.

17 (C) ONE INDIVIDUAL APPOINTED BY THE GOVERNOR WHO IS REPRE-

18 SENTATIVE OF AN INSURER THAT DELIVERS OR ISSUES FOR DELIVERY AN

19 EXPENSE-INCURRED HOSPITAL, MEDICAL, OR SURGICAL POLICY OR CERTIF-

20 ICATE IN THIS STATE IN ACCORDANCE WITH THE INSURANCE CODE OF

21 1956, 1956 PA 218, MCL 500.100 TO 500.8302.

22 (D) ONE INDIVIDUAL APPOINTED BY THE GOVERNOR WHO IS REPRE-

23 SENTATIVE OF A HEALTH MAINTENANCE ORGANIZATION AS THAT TERM IS

24 DEFINED IN SECTION 21005.

25 (E) ONE INDIVIDUAL APPOINTED BY THE GOVERNOR WHO IS REPRE-

26 SENTATIVE OF A HEALTH CARE CORPORATION AS THAT TERM IS DEFINED IN

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1 SECTION 105 OF THE NONPROFIT HEALTH CARE CORPORATION REFORM ACT,

2 1980 PA 350, MCL 550.1105.

3 (F) ONE INDIVIDUAL APPOINTED BY THE GOVERNOR WHO IS REPRE-

4 SENTATIVE OF THE GENERAL PUBLIC.

5 (G) ONE REGISTERED PROFESSIONAL NURSE WITH TRAINING IN THE

6 TREATMENT OF INTRACTABLE PAIN, APPOINTED BY THE MICHIGAN BOARD OF

7 NURSING CREATED IN PART 172.

8 (H) ONE DENTIST WITH TRAINING IN THE TREATMENT OF INTRACTA-

9 BLE PAIN, APPOINTED BY THE MICHIGAN BOARD OF DENTISTRY CREATED IN

10 PART 166.

11 (I) ONE INDIVIDUAL APPOINTED BY THE GOVERNOR WHO IS REPRE-

12 SENTATIVE OF THE BUSINESS COMMUNITY AND 1 INDIVIDUAL APPOINTED BY

13 THE GOVERNOR WHO REPRESENTS THE MICHIGAN HOSPICE ORGANIZATION OR

14 ITS SUCCESSOR.

15 (J) (b) The director of the department OF CONSUMER AND

16 INDUSTRY SERVICES or his or her designee, who shall serve as

17 chairperson.

18 (K) (c) The director of public health THE DEPARTMENT OF

19 COMMUNITY HEALTH or his or her designee.

20 (2) Interdisciplinary advisory ADVISORY committee members

21 appointed under subsection (1)(a) THROUGH (I) shall receive per

22 diem compensation as established by the legislature and shall be

23 reimbursed for expenses under section 1216.

24 (3) THE TERMS OF OFFICE OF THE MEMBERS OF THE INTERDISCI-

25 PLINARY ADVISORY COMMITTEE CREATED BY THE 1994 AMENDATORY ACT

26 THAT ADDED THIS SECTION EXPIRE ON THE EFFECTIVE DATE OF THE

27 AMENDATORY ACT THAT ADDED THIS SUBSECTION.

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1 (4) (3) The initial interdisciplinary advisory committee

2 members appointed under subsection (1)(a) THROUGH (I) shall be

3 appointed within 45 days after the effective date of the amenda-

4 tory act that added this section SUBSECTION (3). The initial

5 interdisciplinary advisory committee shall complete its duties

6 under this section within 9 months after completion of the

7 appointment of the ITS initial members under subsection (1)(a)

8 THROUGH (I). Beginning in January of the first odd numbered

9 year after the year in which the initial interdisciplinary

10 advisory committee completes its duties under this section, and

11 biennially thereafter until January of 2003, a new interdisci-

12 plinary advisory committee shall be created pursuant to subsec-

13 tion (1) to review any changes occurring in pain and symptom man-

14 agement standards and education since the recommendations of the

15 previous interdisciplinary advisory committee. Each biennial

16 interdisciplinary advisory committee shall complete its duties

17 under this section within 180 days after completion of the

18 appointment of members under subsection (1)(a). A MEMBER OF THE

19 ADVISORY COMMITTEE SHALL SERVE FOR A TERM OF 2 YEARS OR UNTIL A

20 SUCCESSOR IS APPOINTED, WHICHEVER IS LATER. A VACANCY ON THE

21 ADVISORY COMMITTEE SHALL BE FILLED IN THE SAME MANNER AS THE

22 ORIGINAL APPOINTMENT.

23 (5) (4) The initial interdisciplinary advisory committee

24 shall do all of the following and each subsequent biennial

25 interdisciplinary advisory committee shall do all of the follow-

26 ing, as necessary:

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1 (a) Provide a forum that is open to all human health care

2 professions and to all hospices licensed under article 17 in

3 developing AT LEAST ONCE ANNUALLY CONSULT WITH ALL OF THE FOL-

4 LOWING BOARDS TO DEVELOP an integrated approach to understanding

5 and applying pain and symptom management techniques: .

6 (i) ALL LICENSURE BOARDS CREATED UNDER THIS ARTICLE, EXCEPT

7 THE MICHIGAN BOARD OF VETERINARY MEDICINE.

8 (ii) THE BOARD OF EXAMINERS OF SOCIAL WORKERS.

9 (b) Hold a public hearing in the same manner as provided for

10 a public hearing held under the administrative procedures act of

11 1969, within 90 days after the initial members OF THE ADVISORY

12 COMMITTEE are appointed under subsection (1)(a) (1) to gather

13 information from the general public on issues pertaining to pain

14 and symptom management.

15 (c) Develop and encourage the implementation of model core

16 curricula on pain and symptom management.

17 (d) Develop recommendations to the licensing and registra-

18 tion boards and the task force created under this article and to

19 the board of examiners of social workers on integrating pain and

20 symptom management into the customary practice of health care

21 professionals and identifying the role and responsibilities of

22 the various health care professionals in pain and symptom

23 management.

24 (e) Develop written materials explaining pain and symptom

25 management and hospice care for distribution to health care pro-

26 fessionals, HEALTH FACILITIES, health care payment and benefits

27 plans, and the public.

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1 (f) Advise the licensing and registration boards and task

2 force created under this article on the duration and content of

3 continuing education requirements for pain and symptom

4 management.

5 (g) Report their ANNUALLY REPORT ON THE activities OF THE

6 ADVISORY COMMITTEE and MAKE recommendations ON THE FOLLOWING

7 ISSUES to the DIRECTOR OF THE DEPARTMENT OF CONSUMER AND INDUSTRY

8 SERVICES AND TO THE standing committees in the senate and the

9 house of representatives with jurisdiction over matters pertain-

10 ing to public health: . Each subsequent biennial interdisci-

11 plinary advisory committee shall include in the report informa-

12 tion about the impact and effectiveness of the recommendations.

13 (i) PAIN MANAGEMENT PRIORITIES.

14 (ii) SHORT-TERM AND LONG-TERM COMPREHENSIVE, MULTIDISCI-

15 PLINARY PAIN MANAGEMENT PROGRAMS AND POLICIES, INCLUDING OUTCOME

16 DATA OR SUMMARIES OF OUTCOME DATA DESCRIBED IN SUBSECTION

17 (7)(A)(iv) THAT HAVE BEEN PROVIDED TO THE ADVISORY COMMITTEE FOR

18 THE YEAR THAT THE REPORT IS ISSUED.

19 (iii) PAIN MANAGEMENT EDUCATIONAL CURRICULA AND CONTINUING

20 EDUCATIONAL REQUIREMENTS OF INSTITUTIONS PROVIDING HEALTH CARE

21 EDUCATION.

22 (iv) INFORMATION ABOUT THE IMPACT AND EFFECTIVENESS OF PRE-

23 VIOUS RECOMMENDATIONS, IF ANY, THAT HAVE BEEN IMPLEMENTED.

24 (H) BEGINNING IN JANUARY OF THE FIRST YEAR AFTER THE EFFEC-

25 TIVE DATE OF SUBSECTION (3), ANNUALLY REVIEW ANY CHANGES OCCUR-

26 RING IN PAIN AND SYMPTOM MANAGEMENT STANDARDS AND EDUCATION SINCE

27 THE RECOMMENDATIONS OF THE PREVIOUS YEAR.

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1 (6) (5) In making recommendations and developing written

2 materials under subsection (4) (5), each interdisciplinary

3 THE advisory committee shall review guidelines on pain and symp-

4 tom management issued by the United States department of health

5 and human services.

6 (7) AS USED IN THIS SECTION:

7 (A) "COMPREHENSIVE, MULTIDISCIPLINARY PAIN MANAGEMENT

8 PROGRAM" MEANS A HOSPITAL OR OTHER HEALTH CARE FACILITY THAT DOES

9 ALL OF THE FOLLOWING:

10 (i) RETAINS A FULL-TIME MEDICAL DIRECTOR CERTIFIED IN THE

11 SPECIALTY OF PAIN MEDICINE BY A NATIONAL PROFESSIONAL ORGANIZA-

12 TION APPROVED BY THE DEPARTMENT OF CONSUMER AND INDUSTRY SERV-

13 ICES, INCLUDING, BUT NOT LIMITED TO, THE AMERICAN BOARD OF MEDI-

14 CAL SPECIALISTS OR THE AMERICAN BOARD OF PAIN MEDICINE.

15 (ii) PROVIDES ONGOING COMMUNITY PAIN-MANAGEMENT EDUCATIONAL

16 SERVICES.

17 (iii) PROVIDES ONGOING PAIN-MANAGEMENT EDUCATION FOR HEALTH

18 CARE PROFESSIONALS.

19 (iv) PROVIDES THE ADVISORY COMMITTEE CREATED IN THIS SECTION

20 WITH AN ANNUAL REPORT THAT IDENTIFIES THE EDUCATION AND SERVICES

21 THE PROGRAM IS PROVIDING, AND INCLUDES OUTCOME DATA ON ITS

22 PAIN-MANAGEMENT PROGRAMS.

23 (v) EMPLOYS, CONTRACTS WITH, OR MAKES AVAILABLE A RANGE OF

24 LICENSED HEALTH CARE PROFESSIONALS COORDINATED IN THEIR EFFORTS

25 AND OFFERING AT LEAST MEDICAL, NURSING, MENTAL HEALTH, AND REHA-

26 BILITATION PROGRAMMING.

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1 (B) "CONTROLLED SUBSTANCE" MEANS THAT TERM AS DEFINED IN

2 SECTION 7104.

3 (C) "INTRACTABLE PAIN" MEANS SEVERE, PERSISTENT, OR RECUR-

4 RING PAIN THAT IS ALL OF THE FOLLOWING:

5 (i) USUALLY DISABLING AND ACCOMPANIED BY VARIOUS DEGREES OF

6 SUFFERING.

7 (ii) AN IMPAIRMENT TO THE ACTIVITIES OF DAILY LIVING.

8 (iii) ATTRIBUTABLE TO A NUMBER OF CAUSES, INCLUDING, BUT NOT

9 LIMITED TO, CANCER, TRAUMA, MIGRAINE, AND OTHER DISEASE STATES.

10 (iv) INCAPABLE OF BEING SIGNIFICANTLY REDUCED OR AMELIO-

11 RATED, DESPITE REASONABLE TREATMENT EFFORTS BY PERSONS LICENSED

12 UNDER THIS ACT, DURING A PERIOD OF 6 OR MORE MONTHS.

13 Enacting section 1. This amendatory act does not take

14 effect unless all of the following bills of the 89th Legislature

15 are enacted into law:

16 (a) Senate Bill No. _____ or House Bill No. _____ (request

17 no. 00141'97 **).

18 (b) Senate Bill No. _____ or House Bill No. _____ (request

19 no. 00152'97 **).

20 (c) Senate Bill No.1_____ or House Bill No. _____ (request

21 no. 00250'97 **).

22 (d) Senate Bill No. _____ or House Bill No. _____ (request

23 no. 02457'97 *).

24 (e) Senate Bill No. _____ or House Bill No. _____ (request

25 no. 02458'97 *).

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