Senate Bill S1165B

                                 BILL NUMBER:  S1165

 TITLE OF BILL :  An act to amend the public health law, in relation
to deeming central venous lines as medically necessary

 PURPOSE :

To ensure as part of discharge planning for transplant patients, with
a central venous line, the designated caregiver shall be consulted on
his or her capabilities and limitations in administering medications
and providing proper central venous line care.

 SUMMARY OF PROVISIONS :

Section 1 is the short title and citation of this act as "Dream's
Law," which amends the public health law by adding a new section 28 27
which requires as part of discharge planning for transplant patients,
with a central venous line, the designated caregiver shall be
consulted as soon as possible, but not later than 24 hours prior to
discharge, regarding his or her capabilities and limitations in
administering medications and providing proper central venous line
care.

In the event that the designated caregiver is unable or unwilling to
confidently carry out these duties, the attending physician shall deem
it medically necessary for the patient to have a trained and
              

appropriate medical professional provide the care for the entirety of
the administration of the central venous line.

Section 2 is the effective date.

 JUSTIFICATION :

Dream Shepherd is an 11-year-old girl who has courageously battled
Sickle Cell Disease and who suffered a stroke in 2010 at the age of
five.

In December 2014, as part of a study, Dream received a stem cell
transplant as part of her treatment plan and fight against Sickle Cell
Disease. After the transplant she remained in the hospital for several
months, while Doctors worked to stabilize her immune system, which was
crucial to her discharge and transplant success.  Additionally while
in the hospital Dream had a Central Venous Line placed into her heart.
The Central Venous Line has strict care requirements.  In New York
State Health Facilities only Registered Nurses are legally allowed to
administer I.V. medications with use of a Central Venous Line; which
have to be properly managed to ensure that Dream, and other's with a
Central Line, do not acquire infections, especially if
immuno-compromised. This central line goes directly into the right
atrium of the heart, and requires immediate action should there be a
disconnection for any reason as a patient with this type of line can
exsanguinate should this go unmonitored or unnoticed.

In addition to the high risk of infections, other complications of
Central Venous Lines include Air Embolism, Pneumothorax, Pinch-off,
Syndrome, Drug Precipitates, Thrombosis, Catheter Occlusion, Catheter
Malposition, and Sepsis a severe blood infection caused by bacteria,
viruses, and fungi. Sepsis is extremely serious and can be
life-threatening.

Due to the high potential for dangerous infections, as part of
discharge planning, Dream's mother, who is not a medical professional,
made a request for a skilled private duty nurse to care for Dream's
central venous line. This request was denied by the insurance company
as it was "not deemed medically necessary." Due to this rejection by
the insurance company, the hospital informed Dream's mother, that she
was required to provide the necessary care to Dream's central venous
line. Not ensuring that Dream would have the correct and proper
skilled nurse to provide the care after discharge which could have
caused irreparable harm, including the worst outcome.  Attempting to
force the mother to provide the care would have required her to lose
her job and source of income, along with saddling her with the anxiety
of overseeing the medical attention that if not done properly, could
lead to the loss of her daughter's life. That is a position no family
member or friend should ever be in.

 LEGISLATIVE HISTORY :

S7293

 FISCAL IMPLICATIONS :

None to the state.

 EFFECTIVE DATE :
This act shall take effect immediately; provided, however, that
effective immediately, the addition, amendment and/or repeal of any
rule or regulation necessary for the implementation of this act on its
effective date are authorized and directed to be made and completed on
or before such effective date.

                                
 
BILL NUMBER: S1165A

SPONSOR: CARLUCCI
 
TITLE OF BILL:  An act to amend the public health law, in relation to
deeming central venous lines as medically necessary

 
PURPOSE:

To ensure as part of discharge planning for transplant patients, with a
central venous line, the designated caregiver shall be consulted on his
or her capabilities and limitations in administering medications and
providing proper central venous line care.

 
SUMMARY OF PROVISIONS:

Section 1 is the short title and citation of this act as "Dream's Law,"
which amends the public health law by adding a new section 28 27 which
requires as part of discharge planning for transplant patients, with a
central venous line, the designated caregiver shall be consulted as soon
as possible, but not later than 24 hours prior to discharge, regarding
his or her capabilities and limitations in administering medications and
              

providing proper central venous line care.

In the event that the designated caregiver is unable or unwilling to
confidently carry out these duties, the attending physician shall deem
it medically necessary for the patient to have a trained and appropriate
medical professional provide the care for the entirety of the adminis-
tration of the central venous line.

Section 2 is the effective date.

 
JUSTIFICATION:

Dream Shepherd is an 11-year-old girl who has courageously battled Sick-
le Cell Disease and who suffered a stroke in 2010 at the age of five.

In December 2014, as part of a study, Dream received a stem cell trans-
plant as part of her treatment plan and fight against Sickle Cell
Disease. After the transplant she remained in the hospital for several
months, while Doctors worked to stabilize her immune system, which was
crucial to her discharge and transplant success.  Additionally while in
the hospital Dream had a Central Venous Line placed into her heart. The
Central Venous Line has strict care requirements. In New York State
Health Facilities only Registered Nurses are legally allowed to adminis-
ter I.V. medications with use of a Central Venous Line; which have to be
properly managed to ensure that Dream, and other's with a Central Line,
do not acquire infections, especially if immuno-compromised. This
central line goes directly into the right atrium of the heart, and
requires immediate action should there be a disconnection for any reason
as a patient with this type of line can exsanguinate should this go
unmonitored or unnoticed.

In addition to the high risk of infections, other complications of
Central Venous Lines include Air Embolism, Pneumothorax, Pinch-off,
Syndrome, Drug Precipitates, Thrombosis, Catheter Occlusion, Catheter
Malposition, and Sepsis a severe blood infection caused by bacteria,
viruses, and fungi. Sepsis is extremely serious and can be life-threat-
ening.

Due to the high potential for dangerous infections, as part of discharge
planning, Dream's mother, who is not a medical professional, made a
request for a skilled private duty nurse to care for Dream's central
venous line. This request was denied by the insurance company as it was
"not deemed medically necessary." Due to this rejection by the insurance
company, the hospital informed Dream's mother, that she was required to
provide the necessary care to Dream's central venous line. Not ensuring
that Dream would have the correct and proper skilled nurse to provide
the care after discharge which could have caused irreparable harm,
including the worst outcome. Attempting to force the mother to provide
the care would have required her to lose her job and source of income,
along with saddling her with the anxiety of overseeing the medical
attention that if not done properly, could lead to the loss of her
daughter's life. That is a position no family member or friend should
ever be in.

 
LEGISLATIVE HISTORY:

S7293

 
FISCAL IMPLICATIONS:

None to the state.

 
EFFECTIVE DATE:
This act shall take effect immediately; provided, however, that effec-
tive immediately, the addition, amendment and/or repeal of any rule or
regulation necessary for the implementation of this act on its effective
date are authorized and directed to be made and completed on or before
such effective date.  2 of 21/23/2018, 8:41 AM