Archive for April, 2016

Advancing PCHETA: We Need YOU!

By Gregg VandeKieft, MD MA FAAFP FAAHPM
Chair, AAHPM Advocacy & Awareness Strategic Coordinating Committee

This week (4/5/16), Senator Tammy Baldwin (D-WI) (shown in photo addressing Academy leaders during AAHPM’s 2015 Capitol Hill Days) reintroduced the Palliative Care and Hospice Education and Training Act (PCHETA) in the U.S. Senate as S. 2748. The bill is already pending in the U.S. House (H.R. 3119) where it enjoys the support of 99 bipartisan cosponsors. Having served as co-chair of AAHPM’s Public Policy Committee the last two years, and as a regular member of the committee prior to that, it has been gratifying to see the advancement of this legislation that the Academy worked so long to develop.

PCHETA will help address the current palliative care workforce shortage by expanding opportunities for interdisciplinary education and training in the field, including establishing education centers and career incentive awards for physicians, nurses, physician assistants, social workers and other health professionals. The bill would also implement an awareness campaign, to inform patients and health professionals about the benefits of palliative care and hospice and the services available to support patients with serious or life-threatening illness, as well as direct funding toward palliative care research to strengthen clinical practice and health care delivery. (Access a bill summary.)

As a physician specializing in hospice and palliative medicine, I am excited about PCHETA’a potential to substantially impact the care of patients and families facing serious illness. At the same time, I’ve learned through my involvement in grassroots advocacy that the process requires focus and perserverence. An earlier, more limited version of the bill (the Palliative Care Training Act) was introduced back in 2004. We introduced an expanded PCHETA in Congress in 2012, and have reintroduced in each of the subsequent congressional sessions. This Congress, the bill was further expanded. AAHPM worked with other stakeholders to add new provisions related to nurse workforce training, palliative care awareness, and research funding.

We look to build support year by year… it’s just a part of the policy process. (I think this is what the German philosopher Max Weber meant when he described politics as the “strong and slow boring of hard wood.”)  Further, we know legislation like this rarely passes on its own. Bills are typically packaged together in a broader theme, so we’ll look for a vehicle to which PCHETA (or even parts of the bill) could be attached. In the meantime, it’s important to keep building momentum and to keep our eye on the goal. The introduced legislation offers us a chance to educate members of Congress about our field, our patients, and the need to expand access to palliative care and build the workforce accordingly. Reaching a certain threshold of support will allow us to push for a hearing. Getting lawmakers on board as cosponsors of PCHETA also builds visible support so, when the opportunity presents itself, there are members of Congress to push it over the finish line and know that people back home are watching.

So, today, I encourage you to take a moment to reach out to your elected officials and ask them to support PCHETA Policymakers need to understand the unique needs of patients with serious illness. Tell them your stories from the front lines of health care. Believe it or not – hearing from an “expert” constituent really does make a difference!

Here are a few ways you can be the voice for your patients and the field and help advance PCHETA:

  • E-mail your members of Congress and urge them to cosponsor PCHETA. Be sure to define and localize the benefit. An action alert with suggested talking points is available at AAHPM’s Legislative Action Center, making it easy to look up your lawmakers and send a personalized e-mail.
  • Engage in media outreach. You can write a letter to the editor (palliative care workforce needs; need for broader access to palliative care) or participate on social media (follow your member of Congress; use #PCHETA and #HPM)
  • Request time to meet with your members of Congress during the District Work Periods (they work in their district or state office about one week each month and are there many weekends) or attend a Town Hall meeting or other event in which your Member participates. Check out their websites, and sign up for their e-mail updates to learn of local events and opportunities.
  • Invite your members of Congress to visit your practice. This is a very effective way to directly show them what you do and the important impact on patient care.
  • If you already have a relationship with a federal lawmaker, or plan to be in DC and want help arranging a meeting with your members of Congress to discuss PCHETA, e-mail AAHPM’s public policy team at advocacy@aahpm.org.

Don’t forget the words of Thomas Jefferson, “We in America do not have a government by the majority. We have a government by the majority who participate.”

Highlights of the April Issue of the Journal of Pain and Symptom Management

Listed below are a few articles from the most recent issue of the journal:

Special Series on Measuring What Matters

Concordance of Advance Care Plans with Inpatient Directives in the Electronic Medical Record for Older Patients Admitted from the Emergency Department
Corita R. Grudzen, Philip Buonocore, Jonathan Steinberg, Joanna M. Ortiz, Lynne D. Richardson, and the AAHPM Research Committee Writing Group

Original Articles

Prevalence and Predictors of Burnout Among Hospice and Palliative Care Clinicians in the U.S.
Arif H. Kamal, Janet H. Bull, Steven P. Wolf, Keith M. Swetz, Tait D. Shanafelt, Katherine Ast, Dio Kavalieratos, Christian T. Sinclair, amd Amy P. Abernethy

Are Hospice Admission Practices Associated with Hospice Enrollment for Older African Americans and Whites?
Kimberly S. Johnson, Richard Payne, Maragatha N. Kuchibhatla, and James A. Tulsky

Special Article

Unmet Supportive Care Needs in United States Dialysis Centers and Lack of Knowledge of Available Resources to Address Them
Stacey Culp, Dale Lupu, Cheryl Arenella, Nancy Armistead, and Alvin H. Moss

Palliative Care Rounds

Locked-In Syndrome:  Case Report and Discussion of Decisional Capacity
Samuel Maiser, Ashish Kabir, David Sabsevitz, and Wendy Peltier

To access the articles, you must subscribe to JPSM or be a member of the American Academy of Hospice and Palliative Medicine (AAHPM). For further information on the Academy, call 847.375.4712 or visit aahpm.org.

Submitted by: David J. Casarett, MD, MA, Senior Associate Editor, JPSM