Bill to Allow Hospice Gets Swift OK : Passage Caps 3-Year Effort to Build Center for the Dying

Acting with extraordinary speed, the state Senate on Thursday approved emergency legislation that paves the way for San Diego Hospice to open its planned center for the terminally ill on Vauclain Point above Mission Valley.

The measure, by Assemblywoman Lucy Killea (D-San Diego), was whisked through a hastily called committee hearing on a 9-0 vote, approved 32-4 on the Senate floor, and sent to Gov. George Deukmejian, who is expected to sign it.

The bill would allow the hospice to be licensed as a newly designated “special hospital” that could care for acutely ill patients without the surgery and anesthesiology services required of other acute-care hospitals licensed by the state.

The lack of those emergency services has so far prevented the hospice from obtaining a license from the state Health Department.

But hospice supporters argue that the center’s purpose--to ease the pain of the terminally ill--means that it will not need to perform emergency surgery. Patients who require surgery could be transferred to nearby Mercy Hospital or UC San Diego Medical Center.

“The idea is that this is an easing of dying rather than a saving of life,” Killea said.

Treat for Pain, Send Home

Unlike residential hospices, where patients go to spend the final days or weeks of their lives, the San Diego hospice will treat patients temporarily, relieve their pain, and then send them home. The average stay is expected to be about 12 days.

Construction of the 24-bed center, funded by an $18 million grant from the Joan B. Kroc Foundation, will be an expansion of the hospice’s already existing home-care program, which treated about 1,000 patients last year.

The hospice is expected to be completed and operating by the middle of 1990, according to Holly Lorentson, president of the hospice.

The quick, final passage of Killea’s bill capped a nearly three-year effort to find a way to license the San Diego hospice. Two previous legislative attempts to create an exemption for the hospice failed. One was vetoed by Deukmejian in 1987 and the other failed on the Assembly floor on the final night of the 1988 legislative session.

Opposition came primarily from the hospital industry, which reportedly feared competition from new hospitals that could provide less expensive care because they would not have to pay for surgical and anesthesiology equipment and services. The hospitals’ opposition was removed when the legislation was rewritten to allow the licensing exemption only as part of a three-hospice pilot project.

Part of Study

The San Diego hospice and two as-yet unnamed facilities will be studied for four years to determine whether they are an effective way to care for the terminally ill.

Because the center’s proponents said their $18-million grant was threatened by the licensing delay, the Senate on Thursday waived its rules so the bill could be heard early. Although the Senate, meeting for only the second time this year, has not yet formed its committees for the 1989-1990 session, nine members of the Health and Human Services Committee were appointed to consider only the Killea bill. The bill was given a 15-minute hearing in a room off the Senate floor.

Los Angeles and Bay Area senators tried to amend the bill in committee to ensure that hospices in their areas could also be licensed. But they backed down after Killea warned that the legislation was a delicately crafted compromise that might fall apart if changed in any way.

Although Deukmejian has not taken a position on the bill, Sen. Ken Maddy of Fresno, the Republican leader in the Senate, said the Administration supports the measure.

“The governor is aware of the issue but has not seen the final version of the bill,” said Tom Beermann, a Deukmejian spokesman. “He is expected to look favorably upon it.”