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HomeMy WebLinkAbout960514.tiff RESOLUTION RE: APPROVE BY-LAWS OF WELD COUNTY LONG-TERM CARE BIO-ETHICS COMMITTEE, APPOINT MEMBERS, AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, one of the duties of the Weld County Department of Human Services is to assist surrogate medical decision makers in promoting and protecting " the best interests" of those persons who cannot make such decisions for themselves, and WHEREAS, the Department of Human Services provides such services through its Weld County Area Agency on Aging Long-Term Care Ombudsman, and WHEREAS, a group of committed volunteer professionals in the community desire to create a community based, interdisciplinary, volunteer advisory committee to assist the Ombudsman in performing such duties, and WHEREAS, the Board of County Commissioners deems it warranted and advisable to appoint the members to said committee and to approve by-laws for said committee in order for said committee to operate effectively, and WHEREAS, proposed by-laws have been written and submitted to the Board of County Commissioners for its review and approval, copy of said by-laws being attached hereto and referred to herein as Exhibit "A", and WHEREAS, a list of the proposed members has also been submitted to the Board of County Commissioners for its review and approval, with said list being attached hereto and referred to herein as Exhibit "B." NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Weld County Long-Term Care Bio-ethics Committee by-laws, as shown in Exhibit "A", be and hereby are, approved. pC: H51iS('cG;/V /15 c4 HR0002 RE: LONG-TERM CARE BIO-ETHICS COMMITTEE PAGE 2 BE IT FURTHER RESOLVED by the Board that the initial membership of said Weld County Long-Term Care Bio-Ethics Committee shall consist of those persons listed in Exhibit"B", with their terms of membership as set forth therein. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 25th day of March, A.D., 1996. BOARD OF COUNTY COMMISSIONERS WM4 WELD COUNTY, COLORADO e`,r 'Barbar J. Kirkmeyer, C it ty Clerk to the Board t s, is Y,?iy >- '/ G7)2rs1/í' eZBaxter, Pro Ten �� 1" e ut Clerl o the Board Dale K. Hall j APPR D AS TO FO C-11y2-5.2"f,,,.tt/ r Ad.•j� Constance L. Harb rt 1 f" 9 u ty Attorne / , iF p. W. H. Webster 960514 HR0002 WELD COUNTY LONG-TERM CARE BIO-ETHICS COMMITTEE BY-LAWS Purpose and Functions of the Committee: The purpose of the Weld County Long-Term Care Bio-Ethics Committee is to create a community-based, interdisciplinary, volunteer advisory committee to assist health care decision makers and providers in clarifying and resolving bio-ethical dilemmas . The Committee will assist surrogate medical decision makers in promoting and protecting "the best interests" of those persons who cannot make decisions for themselves . The Committee will also assist health care patients, professionals, family members and Weld County organizations in health care decisions that involve ethical dilemmas . The functions of the Committee include education, consultation and case review, and the development of guidelines related to medical decision making in long-term care facilities and with patients receiving home health care. The Committee' s educational function includes informing committee members, family members and community members about ethical principles in health care decision making and their relation to current issues, cases, and options . The Committee' s consultation and case review function involves two activities : (1) on-call review of current cases and dilemmas; and (2) retrospective case reviews in the regularly scheduled monthly meetings . The Committee' s guideline development function includes promoting advance medical directives, designing appropriate surrogate decision making protocols, and reviewing established procedures for meeting the needs of long-term care recipients . THE COMMITTEE DOES NOT MAKE DECISIONS IN BIO-ETHICAL DILEMMAS, BUT ACTS AS A RESOURCE AND FORUM FOR INFORMED DISCUSSION. Composition, Selection, Training, and Responsibilities Committee Composition. The Committee will consist of at least twelve members and up to thirty members . It will be interdisciplinary and may include social workers, physicians, nurses, nursing home administration representatives, attorneys, clergy, ethicists, long-term care recipients, advocates of the elderly and disabled, home health care representatives, mental health professionals, certified nurses aides, nursing home staff members, children with parents receiving long-term care, and any other persons interested in the work of the Committee. In addition to the Committee members described above, there will be three standing or permanent members of the Committee: The Weld County Long-Term Care Ombudsman, a Case Manager from the Weld County Area Agency on Aging, and an Adult Protection Services Case Worker from the Weld County Department of Social Services . EXHIBIT "A" 960E1,1 Committee Member Selection. Prospective Committee members can be nominated by any active committee member or they can apply directly to the Committee . Individuals interested in becoming active members must submit an application upon the form approved by the Committee for Weld County Advisory Board Applications to be submitted to the Weld County Commissioners . Applicants will be interviewed and approved by the Committee as a whole. The final approval and appointment of the person as a member of the Committee shall be made by the Weld County Board of County Commissioners . Committee selection will encourage diversity in gender, age, ethnicity, education, socio-economic status, and values orientation. Terms of Membership. Each member of the Committee will be nominated to serve a term of three years, with the possibility of one additional renewal term. The terms of committee members shall commence on January 1 of the first year of the membership . Members ' terms shall be staggered so that no more than one-third of the committee membership will be scheduled for appointment by the Weld County Board of County Commissioners in any one year. By staggering the terms of memberships of the committee members, this will help provide for continuity of the committee membership and functions . This provision does not apply to the standing members of the Committee. Committee Member Training. The committee members are committed to educating themselves in bio-ethical theory, issues and decision making related to the purpose and functions of the Committee . Training and education are continual and include awareness of current ethical thought, bio-medical advances, and relevant legal applications . Committee members agree to familiarize themselves with the basic textbook and material studied by the committee members, collect relevant literature and case studies, share pertinent information with other committee members, and attend, when possible, ethics seminars, workshops and lectures . Committee Responsibilities . Committee members agree to do the following: a. Serve for a minimum of one term; b. Respect the diversity and range of ethical outlooks expressed by other committee members; c . Contribute regularly to the committee process (education, case review and guideline formation) ; and d. Acknowledge the dignity and rights of privacy and confidentiality of individuals involved in case consultations and reviews . 2 36(X:14 Removal of Committee Members . If a committee member has more than three unexcused absences in a given calendar year, she/he will be removed from the membership roster. A member may be excused by notifying the chairperson in advance of the meeting of their inability to attend. Committee Member Liability The Weld County Long Term Care Bio-Ethics Committee is not a decision maker. This obligation falls to the legal guardian, family member, health care proxy, or agent of the incapacitated individual . Since the Committee is advisory only, there should be little basis to which any liability can attach. The Committee is a separate and distinct advisory committee under the supervision and approval of the Weld County Area Agency on Aging. Committee members shall be appointed and subject to removal by the Weld County Board of County Commissioners . The Committee therefore is a volunteer organization organized pursuant to the Weld County Home Rule Charter and subject to the control and direction of the Weld County Board of County Commissioners . Committee Operations Officers . The Committee will annually elect a chairperson who will be responsible for coordinating meeting agendas and other committee activities . Meetings . Regularly scheduled meetings will be held monthly for approximately one and one-half to two hours at a date and time set by the chairperson. The agenda for the meetings will be distributed by the chairperson prior to the meeting. No voting in the meetings shall be permitted except on matters of policy and procedure . Any action to be taken by the Committee shall be approved by a majority vote of those Committee members present at the meeting. The meetings of the Committee are not open to the public, and no person shall be allowed to attend except members of the Committee and those persons invited in accordance with the policies contained herein. Review of a Specific Case. The request for a meeting of the Committee for consideration of a bio-ethical situation requiring the review of a specific case shall be made in writing on the form prescribed by the chairperson. The request will be reviewed by the chairperson, or a designated representative, to determine whether the issues presented in the request are issues which are within the purpose and function of the Committee . If a meeting is set by the chairperson for the review of a specific case, all members of the Committee will be invited to attend by adequate prior notice. No quorum shall be necessary for conducting a meeting. In no event 3 360 T.44 will a meeting be held concerning a specific case unless and until the treating physician, the responsible patient care staff, and the patient/surrogate medical decision maker for the patient have been invited to attend. Scheduling of the meeting will be made to accommodate the attendance of the physician, responsible nursing staff, patient and family. On-Call Subcommittee. A subcommittee of four committee members will meet as needed to provide consultation on active cases in which circumstances require urgent action. Subcommittee members shall serve one month during each rotation. Organizational Subcommittee. The organizational subcommittee shall be responsible for preparation of agendas for meetings, distribution of agendas and notices to members, and all other matters regarding the organization of meetings and consultations of the committee. Membership Subcommittee . This subcommittee will be responsible for actively seeking additional members, and screening applicants for possible membership on the committee . Educational SuIpcQTJnittee. The members of this committee will be responsible for organizing materials, speakers and other education opportunities for presentation at the committee meetings . Access to the Committee . Upon request and advance notification, any interested party to a case can appear before the Committee or to seek information and clarification of issues and options . Documentation. A brief record of Committee activities will be kept . The record will include issues discussed, actions taken, and cases reviewed. All committee members shall maintain strict confidentiality of patient information, patient identity, and caregiver identities . Costs of Operation: Any expenses or costs for the operations of the Committee must be agreed upon by representatives of the five nursing home facilities in Weld County. The nursing home facilities (Bonell Good Samaritan Center, Kenton Manor Living Center, Centennial Health Care Center, Fairacres Manor, Inc . , and Windsor Health Care Center) shall share equally all mutually agreed upon costs and expenditures for operations of the Committee . The Weld County Board of County Commissioners shall not be obligated to pay any of the costs of operation of the Committee . Effective Date of By-laws : These By-laws shall become effective after approval by a vote of the committee members, subsequent approval by the Weld County Area Agency on Aging, and final approval by the Weld County Board of County Commissioners . 4 Amendments . These By-laws may be amended or repealed by a vote of the majority of the members present at a regularly scheduled meeting of the Committee. Recommendations for amendments must then be submitted to the Weld County Area Agency on Aging for its approval of the amendments, and final approval of any amendments to the By-laws must be made by a vote of the Weld County Board of County Commissioners . CERTIFICATE I hereby certify that the foregoing By-laws have been approved by the Weld County Long Term Care Bio-Ethics Committee . //%74 S c- 7/O 4 y Date Chairperson Weld�-y County Area Agency on Aging /2/e)S/ 9s By: . , "`C�-ct.J �. '�°'`'� '/ Date The foregoing c 16 e Weld County Long Term Care Bio- Ethics Committee e ved by a resolution of the Weld County Board of Co ntC rs . 7 L�3AzsMce. o 1Lt,_„ tic_ • / � , c Date 5 O - Chairperson, £ld Coaty Board (Lf W of County Commissioners 5 964:1. Weld County Lona Term Care Bio-Ethics Committee Initial members and term expiration dates Terms expiring 01-01-97: Elmer L. Burkhard Kaylynn Michelle Duvall John Robert Henderson, Jr. Doyle E. Karst James W. Parker Mary M. Russell Roxanna L. Smock Karen Kline Terms expiring 01-01-98 : Charles J. Connell Susan E. Udell-Emond Sharon S. Jacksi Kim Magalee Dee J. Perkins Susan K. Sabas Charles A. Weishaupt John Morosco Terms expiring 01-01-99: Sieglinde G. Donohue Daniel William Gauger Nancy L. Jones Patricia Anne Miller Tami J. Reich Jennifer Lynn Small Ruth Varallo Standing positions (no term expiration dates) : Weld County Long-Term Care Ombudsman - Mindy Rickard Weld County Area Agency on Aging Case Manager - Michele McDonnell Adult Protection Services Case Worker (Weld County Department of Social Services) - kc-\\ \v 1 EXHIBIT B 5360:-711% (`fi/dde_ 1 41:A BAXTER V of County Commissioners HALL T. Barker, Weld County Attorney I IHARBERT J �_ ry 20, 1996 vi KIRKMEYER shment of Weld County Long Term Care Bio-Ethics WEBSTER J ttee COLO'ILZSJw In September, 1995. the Board of County Commissioners had a work session to discuss the establishment of the Weld County Long Term Care Bio-Ethics Committee. Present at that work session were Walt Speckman and Linda Piper. Ms. Piper asked the Board to authorize the establishment of the Committee for the purpose of helping the Weld County Area Agency on Aging Long Term Care Omsbudsman in her duty of assisting nursing homes and other health care providers making difficult biomedical ethical decisions. The main reason for the request was to bring the Committee under the County's insurance umbrella. The County's insurance pool allows for coverage of committees and their members if those committees are appointed and ultimately controlled by the Commissioners. At the work session, the Board approved the idea of establishing the Committee and instructed me to ask local attorney Charles Connell to write the Committee's by-laws. Mr. Connell was also asked to provide a list of names for appointment to the Committee. Copies of various explanatory documents are attached. Mr. Connell sent to me in late November, 1995, draft by-laws and initial appointments for the Committee. Linda Piper reviewed the by-laws but asked that a change be made to allow three individuals to have standing positions. Specifically, Ms. Piper wanted to make sure that the Committee include the Omsbudsman, a Case Manager from the Weld County Area Agency on Aging. and an Adult Protection Services Case Worker from the Weld County Department of Social Services. Ms. Piper further explained to me that it did not make sense for these persons to be appointed for set terms, given that they may stay in their jobs for longer than six years (two three year terms). I suggested to her the idea of the standing positions. Attached are the latest draft by-laws from Mr. Connell. As you can see, he has included the Omsbudsman, the Area Agency on Aging Case Manager, and an Adult Protection Services Case Worker from the Department of Social Services as standing or permanent members. They are exempt from the term requirements. Also attached are various applications from individuals who wish to be on the committee. I recommend that the Board do the following: 1. Approve the proposed by-laws for the Weld County Long Term Care Bio-ethics Committee. 36W.:"1.4 Memo, Board of Commissioners February 20, 1996 Page 2 2. Appoint the individuals who have applied for membership on the Committee. The resolution of appointment should make it clear that the Omsbudsman has a permanent membership on the Committee as long as he or she holds that employment position. I recommend that the resolution authorize Walt Speckman and Judy Griego to appoint the Weld County Area Agency on Aging Case Manager and the Adult Protection Services Case Worker, respectively. Please let me know if you agree with my recommendations. If you do, I will see that this matter is placed on the Board's agenda for formal consideration. If you wish do discuss this matter further, I will be happy to schedule a work session. /7 Bre61. Barker Weld County Attorney Attachments pc: Linda Piper Don Warden Btb/db:memoAboard of county commissioners V longterm-db 866`=?.. CHARLES J. CONNELL ATTORNEY AT LAW Suite 200•The Nix Building (303)353-2507 800 8th Avenue•Greeley, CO 80631 FAX(303)353-9977 February 13 , 1996 o E C E$I\f1E I rl1 FEB 1 5 1996 Mr. Bruce Barker WELD COUNTY Weld County Attorney r ATT'ORNEY'S OFFICE P.O. Box 1948 Greeley, CO 80632 RE: Weld County Long-Tenn Care Bio-Ethics Committee Dear Bruce: I have made the changes to the proposed By-Laws for the Committee as you had requested. The changes indicate that there will be the three standing members of the Committee who will not be governed by the provisions regarding term limitations. I have also included a sentence to make it very clear that the Weld County Board of County Commissioners is not obligated to pay any of the costs of operations of the Committee. I have spoken with Linda Piper and Mr. Dan Gauger, the individuals who had signed the prior draft of the By-Laws that I had sent to you. They had no objection to my simply adding the material in the previous pages and sending to you the new By-Laws . This will enable us to save time and not have to have the By-Laws signed again by them. Please find enclosed the original of the first four pages of the new proposed By-Laws with those changes . Also please find enclosed application forms for three additional individuals that we had not sent in the packet to you before . I would request that you add these applications to your packet . The terms of office for these individuals would be as follows : Karen Kline - one year term John Morosco - two year term Ruth Varallo - three year term I would request that you submit the packet and the proposed By-Laws to the Board of County Commissioners at your earliest convenience . I would then request that once they are approved that you send back to me a copy of the signed By-Laws for our Committee file. Also please send back to me a copy of the Resolution of the Board of County Commissioners adopting the By-Laws and approving the terms of the individual members. Mr. Bruce Barker January 31, 1996 Page Two Thank you for all of your assistance in this matter. If there is anything else you need or if I can do anything else at all, please give me a call. Very truly yours, 2 - Charles J. Connell Attorney at Law CJC/lsb Enclosures pc: Ms. Linda Piper, Weld County Area Agency on Aging Mr. Daniel W. Gauger, Windsor Health Care Center CHARLES J. CONNELL ATTORNEY AT LAW Suite 200•The Mix Building (970)353-2507 800 8th Avenue•Greeley,CO 80631 FAX(970)353-9977 November 29, 1995 Bruce Barker Weld County Attorney P.O. Box 1948 Greeley, CO 80632 RE: Weld County Long-Term Care Bio-Ethics Committee Dear Bruce: This letter will be accompanying the submission to you of the proposed By-Laws for the Weld County Long-Term Care Bio-Ethics Committee for review and approval by the County Board of Commissioners. Attached to the By-Laws will also be all of the application forms for the individuals who will serve as the initial members of the committee. The following is the break-down of the terms of office for the initial terms to be served by the proposed members: One Year Terms Two Year Terms Elmer L. Burkhard Charles J. Connell Kaylynn Michelle Duvall Susan E. Udell-Emond John Robert Henderson, Jr. Sharon S. Jacksi Doyle E. Karst Kim Magalee James W. Parker Dee J. Perkins Mary M. Russell Susan K. Sabas Roxanna L. Smock Charles A. Weishaupt Three Year Terms Sieglinde G. Donohue Daniel William Gauger Nancy L. Jones Patricia Anne Miller Tami J. Reich Jennifer Lynn Small If you need any further information or any further documentation, please let me know. Thank you very much for your assistance and cooperation. Very truly,yo l . i Char s J. Connell A orney at Law CJC/lsb Enclosures 360:1 4 interoffice MEMORANDUM to: Bruce Barker, County Attoory thet." from: Linda E. Piper /VCsubject: Long-Term Care Bio-Ethits Committee date: December 4, 1995 I have reviewed the enclosed bylaws and applications which were forwarded to me by Charles Connell. Other than not knowing if the by laws meet all the requirements that your office would need addressed; I do have one other question. There are three members currently on the committee who are Weld County employees. They arc the Ombudsman and one case manager from the Area Agency on Aging and and an adult protection worker from Social Services. It would be important to always have these components represented on the committee. As county positions, do they need to be officially appointed. It is unclear to me how this would be handled. I will be taking quite a lot of vacation time beginning the week of December 11 and on through the remainder of the month. Certainly you and Chuck Connell can communicate directly on this to work through any changes you might require. Otherwise, I will be tracking my messages. Thanks, Bruce for helping us get this committee off the ground. I believe it will be offering a valuable and needed service to the community. 360e:t.,1 CHARLES J. CONNELL ATTORNEY AT LAW (970)353-2507 SuiteA •The Any Building FAX(970)353-9977 B00 8th Avenue•Greeley,CO 80631 November 29 , 1995 Ms. Linda Piper, Director Weld County Area Agency on Aging P.O. Box 1805 Greeley, CO 80632 RE: Long-Term Care Bio-Ethics Committee Dear Linda: Please find enclosed the Originals of the By-Laws for the Committee as well as the applications for the committee members. You will also find enclosed a letter that I have directed to Bruce Barker in regard to the committee members and the length of the terms they will be serving initially. From our previous telephone conversation, you indicated that it may be better for me to submit the entire packet to you and then you have it submitted directly on to the County officials for approval by the Board of County Commissioners. For this reason, I am enclosing all of these original documents. If you decide it would be better for me to send it on to Bruce Barker I can do so and you can just send the originals back to me. Please review the By-Laws and sign them where indicated on page 5 on behalf of the Weld County Area Agency on Aging and date it next to your name. If you decide to go ahead and submit the documents yourself, just let me know. Thanks for your attention to this matter. Very truly yours, a es . Connell Attor y at Law C /lsb Enclosures sec(.Y:t' Al 1.4 TO: Board of County Commissioners FROM:0 DATE Bruce IT Barker, County Attorney August 21, 1995 • COLORADO RE: Request from Linda Piper Attached is a copy of a Memorandum which I received from Linda Piper regarding the sponsorship of a "Long Term Care Ethics Committee 'I The group of volunteers comprising the Ethics Committee desire liability protection. They believe that an affiliation with Weld County will enable them to come under the County's umbrella liability coverage through the Colorado (iovernmental Amunity Act and through the County's extensive insurance coverage for excess liability, including federal claims. It is my understanding that the Ethics Committee will not make decisions regarding the health care of any specific patients_ Instead, the Committee will provide advice to nursing homes and other health care institutions about various ethical dilemmas they are faced with in particular cases. Committee volunteers intend to distance themselves from the specifics of a case and deal only with hypothetical facts as they are presented for ethical consideration. Effie Ethics Committee apparently will operate in much the same fashion as the Colorado Bar Association Ethics Committee, where general facts are presented to the Committee for ethical consideration without ever disclosing the names of parties involved_) The county's insurance pool allows for insurance coverage of committees and their members if those committees are appointed and ultimately controlled by the Board of County Commissioners'. Most, if not all, of the committees which the Board appoints have bylaws governing the procedures for appointment and procedures for conduct of.business. I believe that the volunteers comprising the Long Term Care Ethics Committee are proposing this type of arrangement. The activities of the Long Term are Ethics Committee are those which normally should be performed by the Area Agency on Aging Health Care Ombudsman. The Ombudsman Program has been operating for a number of years. Weld County currently extends its liability coverage for the Ombudsman and the Program's volunteers_ Request from Linda Piper August 21, 1995 Page 2. Ile key question in my mind is whether Weld County should he associated with the Ethics Committee. Although it appears to be a useful community service, I wonder why the County should be involved just so those persons who voluteer as members can receive liability coverage - I suggest the Board consider this request at a work session. / / 1 Bruce T: Barker Weld County Attorney Attachment pc- Linda Piper. I finnan Services Don Warden M'.AAVPF II-I[sem Nioaio1( Ii'II'i.R wi fflEfflORAflDU1fl Wine Bruce Barket , County Attorney August 8, 1995 - f'- Linda E. Piper, Director Weld County Agency on Agi. COLORADO Long 'term Care Ethics Committee Sponsorship Subject --- __.. — ..The Weld County Area Agency on Aging is exploring the possibility of providing sponsorship of a long term care ethics committee. The impetus for such a cotrmittee arose from the fact that. our community, along with communities nation wide, is concerned about growing numbers of individuals whose autonomy is compromised or destroyed by dementia. developmental disability, mental illness, traumatic brain injuries, and persistent or permanent vegetative states. A group of volunteers (approximately IS) representing various agencies and disciplines, including the Area Agency Long Term Care Ombudsman, have been meeting regularly lot approximately nine months to participate in formal training. This training has been for the purpose of learning about current federal and state health care law related to medical practices, advanced directives, guardianships, pat ientlresident rights. and the science of biomedical ethics. The c'xptessed purpose of this Long Term Care Ethics Committee is to help decision makers clarify issues and opt ions in long term care. This coumit.t.ee wi I 1 be a community-based (as opposed to hospital based) resource for organizations and other decision makers including family that wish to consult on difficult health care decisions in long term care. At this point in time committee members are developing policies. procedures. and guidelines that will direct their work. Of primary concern to the committee members is affiliation and the need for liability protection even though the committee will not be inking health care decisions on behalf of patients 01 interested parties. The Weld County Agency on Aging believes that sponsorship of this committee is well within our mission and mandates under the Older Americans Act to be an advocate for older persons and to help older persons live in dignity including during the last months and days of life. This committee would tenuity very little staffing support; however some support for memos, atrangement of meeting dates and times, and some photo copying would be provided through the participation of the Area Agency Long Term Carte Ombudsman. Organizationally, the committee could be advisory to the Long Term Care Ombudsman Pt ogram. a sub committee of the Area Agency on Aging Adv i sot y Board. or a group of formally registered volunteers for the At ea Agency .ott Aging_ We are seeking a flexible coutse of action which would not generate an excess of work and oversight for the Agency on Aging or the Board of Commissioners, but could provide the committee with a formal affiliation. Hello