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Hospice and hospital representatives warn House committee that caregiver‑presence language in SB680 could delay care
Summary
At a June 12 hearing on Senate Bill 680 Sub A, hospice physician Ed Martin and Care New England official Robert Dolcey told the House Health Committee that a statutory requirement that a patient's caregiver "shall be present" during medical decisions could impede timely care, undermine patient autonomy, and create operational problems; committee members asked about capacity, 'shall' vs. 'may,' and 'if practical' language.
The House Committee on Health and Human Services heard testimony June 12 on Senate Bill 680 Sub A, a measure addressing consent to medical and surgical care that would provide patients a right to have a caregiver present when medical decisions are discussed.
Dr. Ed Martin, a hospice and palliative-medicine physician and chief medical officer at Hope Health, told the committee that while the bill appears well intended, its current language — notably the phrase that "the patient's caregiver shall be present whenever any medical decisions are discussed by the hospice healthcare team with the patient" — could have negative clinical consequences. Martin said requiring caregiver presence "if practical" is ambiguous and that mandating a caregiver be present could delay time-sensitive decisions and erode patients' ability to make autonomous choices. He described scenarios, including patients who ask to change care immediately or pediatric and specialty situations where a given hospice may not be clinically suited to accept a case and where flexibility is necessary.
Committee members asked Martin follow-up questions about decision-making capacity and current practice. Martin said clinicians routinely assess capacity and that many patients retain the ability to make health-care decisions; he emphasized that consent requirements should not substitute for capacity assessments.
Robert Dolcey, director of government affairs for Care New England, testified that hospice and visiting-nurse organizations generally provide options for caregivers to be present during conversations, and urged the committee to heed providers' operational concerns in drafting statutory language. Dolcey said written testimony he provided to the committee raised multiple drafting issues and recommended further stakeholder discussions; he agreed the bill "has room for a lot of improvements."
Committee members raised specific drafting questions: several suggested changing mandatory language from "shall" to "may" or clarifying the meaning of "if practical" to avoid creating barriers to care when caregivers are unavailable. Representative Handy asked about patients who lack capacity or the ability to communicate; Martin responded that capacity varies by decision and that safeguards already exist in clinical practice.
No floor action on SB680 Sub A was recorded in the transcript; the committee closed the hearing after testimony and moved on to adjournment.
Sources: Testimony from Ed Martin (Hope Health) and Robert Dolcey (Care New England) and committee Q&A recorded on the June 12, 2025 committee transcript.
