HomeMy WebLinkAbout991544.tiff RESOLUTION
RE: APPROVE AMENDMENTS TO BY-LAWS OF WELD COUNTY LONG-TERM CARE
BIO-ETHICS COMMITTEE
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, by Resolution dated March 25, 1996, the Board of County Commissioners
did approve the Weld County Long-Term Care Bio-Ethics Committee By-Laws, and
WHEREAS, proposed amendments to said by-laws have been written and submitted to
the Board of County Commissioners for its review and approval, a copy of said by-laws being
attached hereto and referred to herein, and
WHEREAS, after study and review, the Board deems it advisable to approve said
proposed amendments.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that the amendments to the Weld County Long-Term Care Bio-Ethics
Committee By-Laws be, and hereby are, approved.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 28th day of June, A.D., 1999.
BOARD OF COUNTY COMMISSIONERS
COUNTY, LORADO
Llyai0/1
ATTEST: % Dale K. Hall, Chair
Weld County Clerk to t r Bo-,a
'ices Yir ip! EXCUSED DATE OF SIGNING (AYE)
t c.i �, ��t► art Barbara J. Kirkmeyer, Pro-Tem
BY: 7 •
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Deputy Clerk to the =t '� 1� eorg c . B x r
R E AS TO FORM:
. J. G ile
ounty Attorney 6/(±A
Glenn Vaad
/ 0 %/) 991544
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‘atTO: Diana Hutcheson, Ombudsman, Human Resources
FROM: Bruce T. Barker, Weld County Attorney
I , DATE: April 14, 1999
RE: Proposed Changes to Bylaws to Accommodate Standing
Positions
COLORADO
Attached are the following:
A. A revised version of the bylaws for the Weld County Long Term Care Bioethics
Committee, which allows for nine standing positions on the Committee. Six of the
standing positions will be for health care centers in Weld County. This change is in
response to your letter to Vicky Sprague dated February 25, 1999.
B. Two originals of the revised bylaws without the "strikeout" and "redlining." I
request that you sign the bylaws on behalf of the Weld County Area Agency on
Aging and ask the Chair of the Committee to sign and date the same. Send the two
originals to my office so that I may see that the bylaws are placed on the Boards
agenda for approval.
Please be advised that the Board of County Commissioners has already approved this bylaws change
in concept. Attached is a Memorandum to the Board from me dated April 6, 1999, discussing the
proposed change.
Vicky Sprague asked if it would be possible to have the Board refrain from going through the
appointment process for the standing members. In my opinion,there is no need for the Board to
make such appointments. Rather, all that is necessary is for the Board to be informed of the names of
the persons who are filling the standing positions. I therefore respectfully request that you provide
those names to Vicky on an annual basis, on or about January 1st of each year.
If you should have any questions or comments regardi his Memorandum or the attached, please
feel free to call me at extension 4390.
•
/ (
I B ce T. Barker
Weld County Attorney
BTB/db:Memo/Hutcheson
Attachments
pc: Vicky Sprague
TO: Weld County Board of County Commissioners
1 FROM: Bruce T. Barker, Weld County Attorney
J
DATE: April 6, 1999
RE: Proposed Change to Bylaws for Weld County Long Term
1111Der.
Care Bio-Ethics Committee
COLORADO
Attached is a copy of a letter received by Vicky Sprague from Diana Hutcheson, Ombudsman and
member of the Weld County Long Term Care Bio-Ethics Committee. Also attached is a
Memorandum which I received from Vicky.
As you can see, Ms. Hutcheson is asking for a change to the Bio-Ethics Committee Bylaws such that
the six positions for nursing home administrators be considered standing positions. The six facilities
are listed in Ms. Hutcheson's letter. Also attached is a copy of the Bio-Ethics Committee Bylaws
with the suggested changes included on pages 1 and 2.
The Bio-Ethics Committee was created in 1996 for the purpose of assisting the Ombudsman in
dealing with long term care issues. As you can see from the Bylaws, the numbers on the Committee
can go from 12 up to 30. The Bio-Ethics Committee does not necessarily vote on issues. Rather, it
meets to discuss various issues regarding long-term care. I therefore do not see any harm in listing
the six nursing home administrator positions as standing positions.
In order for the Board to approve the proposed changes to the Bylaws, it will need to be approved by
the Committee first. I thought it would be best, however, to preview the Board to see if you have any
objections to the change.
Place on Agenda Do Not Set
for Approval Approve Work Session
George Baxter
Mike Geile _
Dale Hall _
Barb Kirkmeyer _
Glen Vaad
Bruce T. Barker
Weld County Attorney
BTB/db:Mem o/BOC C/Bio-Ethics
Attachments
pc: Diane Hutcheson
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, i.nterdisciplinary, 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 is 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 bet rt nine 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,
Page 1 of 5 Pages
and an Adult Protection Services Case Worker from the Weld County Department of Social Services;
and the administrators for six nursing homes, including Bonell Good Samaritan Center, Centennial
Health Care Center Fairacres Manor, Kenton Manor, Life Care Center of Greeley, and Windsor
Health Care Center.
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, socioeconomic 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, biomedical 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);
d. Acknowledge the dignity and rights of privacy and confidentiality of
individuals involved in case consultations and reviews; and
e. Obtain prior Committee approval of any speeches, articles. or statements
Page 2 of 5 Pages
of opinion made by a Committee member, in which the Committee member
identifies himself as a member of this Committee. If such approval is granted
and the Committee member is making such speech, article, or statement of
opinion on his own behalf,then the member shall make it clear that such does
not necessarily reflect the position of the Committee.
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.
Upon motion of any Committee member, the Committee may consider the removal of one of its
members for good cause. After a motion for removal is made, notice shall be given to all Committee
members for the next meeting of the Committee that a vote will be taken upon the motion to remove
a Committee member. Upon the vote of a majority of the members of the Committee present at the •
time of the vote upon the motion, a recommendation for removal of the Committee member may be
approved. The recommendation for the removal of the Committee member will then be forwarded
to the Weld County Board of Commissioners for final approval.
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, or upon a motion for removal of a Committee member.
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.
Page 3 of 5 Pages
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 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.
Organization 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.
Members Subcommittee. This subcommittee will be responsible for actively seeking
additional members, and screening applicants for possible membership on the Committee.
Educational Subcommittee. 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 care giver identities.
States 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.
Page 4 of 5 Pages
Amendment_. 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.
Date Chairperson
Weld County Area Agency on Aging
i51 / 9 9 By: I� cCst� C_ 1.
Date
The foregoing By-laws of the Weld County Long Term Care Bio-Ethics Committee have been
approved by a resolution of the Board of County Commissioners of Weld County.
Date airperson, Board of County
Commissioners doff Weld Coun,
ATTEST: L
WELD COUNTY CLERK T• "
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BY: r
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DEPUTY CLERK TO TH
Page 5 of 5 Pages
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