BILL NUMBER: S474

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

 
PURPOSE OR GENERAL IDEA OF BILL:

The purpose of this legislation is to ensure that the discharge planning
for a patient with a central venous line will include an identified
caregiver consultation about administering medications and providing
proper central venous line care, and that appropriate services will be
available to them should they be unable to provide such care.

 
SUMMARY OF PROVISIONS:

Section 1. A new subdivision 4 is added to Section 2994-11 of the Public
Health Law, and reads as follows: 4. Discharge of any patients who have
a condition that requires a central venous line. As part of discharge
planning for patients who will be discharged from the hospital with a
central venous line, the identified caregiver shall be consulted as soon
              

as possible, but not later than twenty-four hours prior to discharge,
regarding his or her capabilities and limitations in administering medi-
cations and providing proper central venous line care. In the event that
the identified caregiver is unwilling or unable to confidently provide
proper care of the central venous line, appropriate services, which may
include but not be limited to home health care services, shall be
ordered.

Section 2. Establishes the effective date.

 
DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE):

 
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. While in the hospital,
Dream had a Central Venous Line (CVL) placed into her heart. The CVL 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 CVL; which have to be properly managed to ensure that
Dream, and others, do not acquire infections, especially if they are
immuno-compromised. This CVL 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 CVL
include Air Embolism, Pneumothorax, Pinch-off, Syndrome, Drug Precipi-
tates, 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 CVL. 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 CVL. By not ensuring that Dream would have
the correct and proper skilled nurse to provide care after discharge,
she could have faced irreparable harm. 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 have encounter.

 
PRIOR LEGISLATIVE HISTORY:

S. 1165-B and A. 5514-C of 2017/2018
S. 7293 of 2015/2016

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

There are no fiscal implications associated with the passage of this
legislation.

 
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.