LEGISLATIVE FISCAL ESTIMATE
[Second Reprint]
ASSEMBLY, No. 312
STATE OF NEW JERSEY
218th LEGISLATURE
DATED: MAY 28, 2019
SUMMARY
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Synopsis: |
Requires certain health care facilities to provide information concerning palliative care and hospice care services. |
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Type of Impact: |
Indeterminate increase in State and county expenditures. |
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Agencies Affected: |
Department of Health; Department of Military and Veterans Affairs; and certain county governments. |
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Fiscal Impact |
Annual |
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State Cost Increase |
Indeterminate |
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County Cost Increase |
Indeterminate |
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· The Office of Legislative Services (OLS) estimates that the Department of Health (DOH) may incur indeterminate costs under the bill in supporting the work of the Palliative Care and Hospice Care Advisory Council, as established under the bill. However, it is possible that the department may be able to integrate these costs into its existing budget, thereby minimizing expenditures. Furthermore, certain State costs may be minimized through collaboration with the Cancer Institute of New Jersey (CINJ), as required by the bill.
· The DOH may also incur indeterminate expenses in enforcing requirements regarding the distribution of palliative care and hospice care information by certain facilities. As monitoring licensed State facilities reflects the department’s current duties, the costs of this provision may be absorbed into the DOH’s existing budget.
· The OLS finds that nursing homes operated by the Department of Military and Veterans Affairs (DMAVA) and certain county governments may incur indeterminate increases in annual operating expenditures through compliance with the provisions of the bill that require certain facilities to provide information about appropriate palliative care and hospice care services to patients and residents with a serious illness. These costs may be minimized to the extent that these State and county nursing homes currently have those procedures in place.
BILL DESCRIPTION
This bill establishes certain requirements concerning palliative care and hospice care. The bill establishes the Palliative Care and Hospice Care Advisory Council in the DOH. The council, in collaboration with the CINJ, would have the responsibility to establish the Palliative Care and Hospice Care Consumer and Professional Information and Education Program; to develop the information to be provided to patients and residents by hospitals, nursing homes, and other facilities and facilitating the provision of this information; and to develop resources and programs to facilitate access to palliative care and hospice care services for patients and residents. The purpose of the Palliative Care and Hospice Care Consumer and Professional Information and Education 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 council would be comprised of eleven members, including nine public members that are required to have experience, training, or an academic background in issues related to the provision of palliative or hospice care. The members of the council would 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 would 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. The DOH would provide staff support to the council.
The bill would also require every hospital, nursing home, rehabilitation facility, and other facility which is identified by the Commissioner of Health to be appropriate and which is 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, or facility into compliance. In implementing these requirements, the 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.
FISCAL ANALYSIS
EXECUTIVE BRANCH
None received.
OFFICE OF LEGISLATIVE SERVICES
The OLS estimates that this bill would result in an indeterminate increase in State and county expenditures.
The DOH may incur indeterminate costs under the bill in supporting the work of the Palliative Care and Hospice Care Advisory Council. The responsibilities of establishing the Palliative Care and Hospice Care Consumer and Professional Information and Education Program, developing informational resources, and facilitating the provision of such resources to certain facilities, could result in initial costs to develop, print, and distribute materials, as well as ongoing costs for any continuing educational initiatives. Without additional information from the Executive, the OLS cannot quantify these expenses. However, it is possible that the department may be able to integrate the costs of these responsibilities into its existing budget, thereby minimizing expenditures. Furthermore, certain State costs may be minimized through collaboration with the CINJ. Historically, the CINJ receives an annual State appropriation from the DOH. The proposed appropriation for FY 2020 is $28.0 million, unchanged for the FY 2019 adjusted appropriation.
Independent of the council, the department may also incur indeterminate expenses in enforcing the requirements regarding the distribution of palliative care and hospice care information by certain facilities. As monitoring licensed State facilities reflects the department’s current duties, the costs of this provision may be absorbed into the DOH’s overall budget.
The OLS also finds that nursing homes operated by the DMAVA and certain county governments may incur indeterminate increases in annual operating expenditures in complying with the provisions of the bill that require certain facilities to provide information about appropriate palliative care and hospice care services to patients and residents with a serious illness. Currently, the DMAVA operates three facilities, while there are nine county facilities: three in Bergen County; two in Middlesex County; and one each in Atlantic County, Cape May County, Gloucester County, and Passaic County. The OLS does not have access to information regarding the existing policies concerning the distribution of palliative care and hospice care information at these facilities. Therefore, the fiscal impact of the bill on these entities is indeterminate.
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Section: |
Human Services |
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Analyst: |
Senior Research Analyst |
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Approved: |
Frank W. Haines III Legislative Budget and Finance Officer |
This legislative fiscal estimate has been produced by the Office of Legislative Services due to the failure of the Executive Branch to respond to our request for a fiscal note.
This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.).