2005 Legislation
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SENATE BILL NO. 1141 – Skilled nursing facilty/peer review


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Bill Status

S1141.................................................by HEALTH AND WELFARE
SKILLED NURSING FACILITIES - Amends existing law to include skilled nursing
facilities within procedures specified for peer review.
02/14    Senate intro - 1st rdg - to printing
02/15    Rpt prt - to Health/Wel
02/18    Rpt out - rec d/p - to 2nd rdg
02/21    2nd rdg - to 3rd rdg
02/22    3rd rdg - PASSED - 27-0-8
      AYES -- Andreason, Broadsword, Bunderson, Cameron, Coiner, Compton,
      Corder, Darrington, Davis, Gannon, Geddes, Jorgenson, Kelly, Keough,
      Langhorst, Little, Lodge, Malepeai, Marley, McGee, McKenzie, Pearce,
      Richardson, Schroeder, Stegner, Stennett, Werk
      NAYS -- None
      Absent and excused -- Brandt, Burkett, Burtenshaw, Goedde, Hill,
      Noble, Sweet, Williams
    Floor Sponsor - Darrington
    Title apvd - to House
02/23    House intro - 1st rdg - to Health/Wel
03/01    Rpt out - rec d/p - to 2nd rdg
03/02    2nd rdg - to 3rd rdg
03/09    3rd rdg - PASSED - 64-0-6
      AYES -- Anderson, Andrus, Barraclough, Barrett, Bastian, Bayer, Bell,
      Bilbao, Black, Block, Boe, Bolz, Bradford, Cannon, Chadderdon, Clark,
      Collins, Deal, Denney, Edmunson, Ellsworth, Field(18), Garrett, Hart,
      Harwood, Henbest, Henderson, Jaquet, Jones, Kemp, Lake, LeFavour,
      Loertscher, Martinez, Mathews, McGeachin, McKague, Mitchell, Moyle,
      Nielsen, Nonini, Pasley-Stuart, Pence, Ring, Ringo, Roberts, Rusche,
      Rydalch, Sali, Sayler, Schaefer, Shepherd(2), Shepherd(8), Shirley,
      Skippen, Smith(30), Smith(24), Smylie, Snodgrass, Stevenson, Trail,
      Wills, Wood, Mr. Speaker
      NAYS -- None
      Absent and excused -- Bedke, Crow, Eskridge, Field(23), Miller,
    Floor Sponsor - Ring
    Title apvd - to Senate
03/10    To enrol
03/11    Rpt enrol - Pres signed
03/14    Sp signed
03/15    To Governor
03/21    Governor signed
         Session Law Chapter 103
         Effective: 07/01/05

Bill Text

  ]]]]              LEGISLATURE OF THE STATE OF IDAHO             ]]]]
 Fifty-eighth Legislature                   First Regular Session - 2005
                                       IN THE SENATE
                                    SENATE BILL NO. 1141
                              BY HEALTH AND WELFARE COMMITTEE
  1                                        AN ACT
  6    Be It Enacted by the Legislature of the State of Idaho:
  7        SECTION 1.  That Section 39-1392a, Idaho Code, be, and the same is  hereby
  8    amended to read as follows:
  9        39-1392a.  DEFINITIONS. The following terms shall have the following mean-
 10    ings when used in this section:
 11        (1)  "Emergency  medical  services personnel" means emergency medical ser-
 12    vices providers certified by the department of health and welfare pursuant  to
 13    section 56-1011 et seq., Idaho Code, and ambulance-based clinicians as defined
 14    in  the  rules  governing  emergency  medical  services  as promulgated by the
 15    department of health and welfare.
 16        (2)  "Group medical practice" means a  partnership,  corporation,  limited
 17    liability  company,  or  other  association formed for the purpose of offering
 18    health care services through physicians and other licensed or otherwise autho-
 19    rized health care providers who are partners, shareholders,  members,  employ-
 20    ees, or contractors of such group medical practice.
 21        (3)  "Health  care  organization"  means  a  hospital, in-hospital medical
 22    staff committee, medical society, managed care  organization,  licensed  emer-
 23    gency medical service, or group medical practice, or skilled nursing facility.
 24        (4)  "Hospital"  means a facility in Idaho licensed under sections 39-1301
 25    through 39-1314, Idaho Code, and defined in section 39-1301(a)(1), Idaho Code.
 26        (5)  "In-hospital medical staff committees" means  any  individual  doctor
 27    who is a hospital staff member, or any hospital employee, or any group of such
 28    doctors and/or hospital employees, who are duly designated a committee by hos-
 29    pital  staff bylaws, by action of an organized hospital staff, or by action of
 30    the board of directors of a hospital, and which  committee  is  authorized  by
 31    said bylaws, staff or board of directors, to conduct research or study of hos-
 32    pital patient cases, or of medical questions or problems using data and infor-
 33    mation from hospital patient cases.
 34        (6)  "Licensed  emergency medical service" means an ambulance service or a
 35    non-transport nontransport service licensed by the department  of  health  and
 36    welfare pursuant to section 56-1011 et seq., Idaho Code.
 37        (7)  "Managed care organization" means a public or private person or orga-
 38    nization which offers a managed care plan.
 39        (8)  "Managed care plan" means a contract of coverage given to an individ-
 40    ual,  family  or  group  of  covered individuals pursuant to which a member is
 41    entitled to receive a defined set of health care benefits through an organized
 42    system of health care providers in  exchange  for  defined  consideration  and
 43    which requires the member to use, or creates financial incentives for the mem-
  1    ber  to  use,  health care providers owned, managed, employed by or under con-
  2    tract with the managed care organization.
  3        (9)  "Medical society" means any duly constituted, authorized  and  recog-
  4    nized  professional  society or entity made up of physicians licensed to prac-
  5    tice medicine in Idaho, having as its purpose the maintenance of high  quality
  6    in the standards of health  care provided in Idaho or any region or segment of
  7    the  state,  operating with the approval of the Idaho state board of medicine,
  8    or any official committee appointed by the Idaho state board of medicine.
  9        (10) "Patient care records" means written or otherwise recorded, preserved
 10    and maintained records of the medical or  surgical  diagnostic,  clinical,  or
 11    therapeutic  care of any patient treated by or under the direction of licensed
 12    professional personnel, including emergency  medical  services  personnel,  in
 13    every  health  care organization subject to this act, whether as an in-patient
 14    inpatient or out-patient outpatient of the health care organization.
 15        (11) "Peer review" means the collection, interpretation  and  analysis  of
 16    data  by a health care organization for the purpose of bettering the system of
 17    delivery of health care or to improve the  provision  of  health  care  or  to
 18    otherwise  reduce  patient  morbidity and mortality and improve the quality of
 19    patient care. Peer review activities by a health  care  organization  include,
 20    without limitation:
 21        (a)  Credentialing, privileging or affiliating of health care providers as
 22        members of, or providers for, a health care organization;
 23        (b)  Quality  assurance and improvement, patient safety investigations and
 24        analysis, patient adverse outcome reviews,  and  root-cause  analysis  and
 25        investigation activities by a health care organization; and
 26        (c)  Professional  review action, meaning an action or recommendation of a
 27        health care organization which is taken or made in  the  conduct  of  peer
 28        review,  that  is  based  on  the competence or professional conduct of an
 29        individual physician or emergency medical services  personnel  where  such
 30        conduct  adversely affects or could adversely affect the health or welfare
 31        of a patient or the physician's privileges, employment  or  membership  in
 32        the  health care organization or in the case of emergency medical services
 33        personnel, the emergency medical services personnel's scope  of  practice,
 34        employment or membership in the health care organization.
 35        (12) "Peer  review  records"  means  all  evidence of interviews, reports,
 36    statements, minutes, memoranda, notes, investigative graphs  and  compilations
 37    and  the  contents thereof, and all physical materials relating to peer review
 38    of any health care organization.  "Peer  review  records"  does  not  mean  or
 39    include  patient  care records; provided however, that the records relating to
 40    the identification of which particular patient care records were selected for,
 41    or reviewed, examined or discussed in peer review by a health  care  organiza-
 42    tion  and  the methodology used for selecting such records shall be considered
 43    peer review records.
 44        (13) "Skilled nursing facility" means a facility  licensed  under  chapter
 45    13, title 39, Idaho Code, to provide skilled care to recipients.
 46        SECTION  2.  That Section 39-1392e, Idaho Code, be, and the same is hereby
 47    amended to read as follows:
 49    event of a claim or civil action against a physician, emergency  medical  ser-
 50    vices  personnel, or a hospital or a skilled nursing facility arising out of a
 51    particular physician-patient, emergency medical services personnel-patient, or
 52    hospital-patient relationship, or skilled nursing facility-patient,  or  which
 53    concerns  the  sufficiency of the delivery of particular health care to a spe-
  1    cific patient, any health care organization having  information  of  the  kind
  2    covered by section 39-1392b, Idaho Code, shall, when interrogated as hereinaf-
  3    ter provided, advise any such claimant who is or was such a patient or who, in
  4    a  representative  capacity,  acts  on behalf of such patient or his heirs, as
  5    follows:
  6        (1)  Whether it has conducted or has in progress an inquiry, proceeding or
  7        disciplinary matter regarding the quality or propriety of the health  care
  8        involved,  which  concerns the subject patient while he was under the care
  9        or responsibility of a member of such health care organization or while he
 10        was a patient in such hospital or facility; and, if so,
 11        (2)  Whether disposition of any kind resulted or  will  result  therefrom;
 12        and, if so,
 13        (3)  What  the  disposition  was, or, if not yet determined, approximately
 14        when it will be determined.
 15    Such  disclosure  of  information  shall  be  limited  to  the   health   care
 16    organization's  actions  in  connection  with the physician, emergency medical
 17    services personnel, or hospital or skilled nursing facility against whom  such
 18    claim is asserted.
 19        (b)  Such  a claimant shall likewise be entitled to inquire of such health
 20    care organization respecting the names  and  addresses  of  persons  who  such
 21    health  care  organization  knows to have direct knowledge of the provision of
 22    the health care in question, such inquiry to be limited, however, to the  par-
 23    ticular patient and the particular times and occasions germane to the specific
 24    occurrences  on  which  the  claim is based; provided, names shall not be dis-
 25    closed respecting persons who have gained secondary knowledge or formed  opin-
 26    ions  respecting  the  matter solely by participating as witnesses, officials,
 27    investigators or otherwise on, for, or in connection with such a  health  care
 28    organization committee, staff, governing board or the state board of medicine.
 29        (c)  Such  limited, conditional discovery and disclosure of information as
 30    provided above shall be allowed only in response to inquiries directed to such
 31    a health care organization, and then only if initially propounded by a  claim-
 32    ant  of  the type above described. If the matter is in litigation, inquiry may
 33    be by customary means of discovery under the Idaho rules of  civil  procedure,
 34    or,  if  pending  in a United States court, then under discovery as allowed by
 35    its applicable rules; provided, pendency of the claim  in  the  United  States
 36    court  or before any other tribunal shall not operate to broaden the exception
 37    to the rules of privilege, confidentiality and immunity set down in this act.
 38        (d)  Such disclosures may be voluntarily made without  judicial  order  or
 39    formal  discovery  if  all  disciplined, accused or investigated physicians or
 40    emergency medical services personnel consent thereto,  and  if  privileged  or
 41    confidential  information  regarding  any  other patient, physician, emergency
 42    medical services personnel, or person will not be disclosed thereby. When  the
 43    terms  of  this paragraph are complied with, such voluntary disclosures may be
 44    made without civil liability therefor as if in due response to valid  judicial
 45    process or order.
 46        (e)  If  any claimant makes such inquiry of any such health care organiza-
 47    tion, he shall be deemed to have consented  to  like  inquiry  and  disclosure
 48    rights  for  the  benefit of all parties against whom he asserts such claim or
 49    brings such suit or action, and all other persons  who  are  parties  to  such
 50    action,  and thereafter all such persons and parties may invoke the provisions
 51    of this section, seeking and securing specific information as herein  provided
 52    for the benefit of such claimant, to the same extent as the same is allowed to
 53    such claimant.
 54        (f)  If any physician, emergency medical services personnel, patient, per-
 55    son,  organization  or  entity whose conduct, care, chart, behavior, health or
  1    standards of ethics or professional practice is the subject of  investigation,
  2    comment,  testimony,  dispositive order of any kind or other written or verbal
  3    utterance or publication or act of any such health care  organization  or  any
  4    member  or  committee  thereof  in the course of research, study, disciplinary
  5    proceeding or investigation of the sort contemplated by this act, makes  claim
  6    or brings suit  on account of such health care organization activity, then, in
  7    the  defense  thereof, confidentiality and privilege shall be deemed waived by
  8    the making of such claim, and such health care organization and the members of
  9    their  staffs and committees shall be allowed to use and resort to such other-
 10    wise protected information for the purpose of presenting proof  of  the  facts
 11    surrounding  such matter, and this provision shall apply whether such claim be
 12    for equitable or legal relief or for intentional or unintentional tort of  any
 13    kind  and  whether pressed by a patient, physician, emergency medical services
 14    personnel, or any other person, but such waiver shall  only  be  effective  in
 15    connection  with  the  disposition  or litigation of such claim, and the court
 16    shall, in its discretion, enter appropriate orders protecting, and as fully as
 17    it reasonably can do so, preserving the confidentiality of such materials  and
 18    information.

Statement of Purpose / Fiscal Impact

                       STATEMENT OF PURPOSE

                             RS 14877

The peer review privilege and immunity has been found in Idaho
laws for many years.  The peer review process helps lead to
effective internal investigations and reviews which require frank
and candid disclosures and evaluations by those participating in
the process, including facility employees, staff, and physicians. 
Similar protection is provided physicians for the same reasons
under the Health Care Quality Improvement Act, 42 U.S.C. 11101 et
seq.  Unfortunately, however, when the peer review statute was
originally drafted, skilled nursing facilities were simply not
included.  The requested amendment is designed to cure the
oversight and provide skilled nursing facilities the protection
offered to other health care organizations in order to facilitate
effective quality improvement investigations, peer review, and
improve over all health care.

                              FISCAL NOTE

There is no fiscal impact of this bill.

Name:  Robert Vande Merwe Executive Director
       Idaho Health Care Association
       802 W. Bannock,Suite 304 
       Boise, ID 83702
Phone: 343-9735