Palliative Care Education and Training Act (H.R. 687/S.2080)

On October 28^th, the House of Representatives passed PCHETA which was introduced by Rep. Eliot Engel in January and had amassed 294 bipartisan co-sponsors. The goal of PCHETA is to focus on the expansion of the training available for the hospice and palliative care workforce to assuage the pending workforce crisis in specialty palliative care. Some key aspects of the legislation are:

Palliative Care and Hospice Education Centers

The creation of palliative care and hospice education centers to improve the training of interdisciplinary health professionals in palliative care, develop and disseminate palliative care curricula, supporting continuing education, provide students with opportunities for clinical training at a variety of appropriate sites of care (including hospital, hospice, home, and long-term care settings), and support the training and retraining of faculty.

Additionally, fellowship programs would be developed within the education centers to provide short-term, intensive training on palliative care and hospice. The fellowships aim to provide supplemental training for faculty members in medical schools and other health professions schools (including pharmacy, social work, nursing, and chaplaincy) so that providers without formal training in palliative care can enhance their knowledge and skills for the care of individuals with serious or life-threatening illness as well as enhance their interdisciplinary teaching skills.

Training

PCHETA would allow for increased physician training through grants or contracts to schools of medicine, teaching hospitals, and graduate medical education to train physicians who plan to teach palliative medicine. Additionally, PCHETA creates special preferences in existing nurse education law for hospice and palliative nursing in the areas of education, practice, and quality grants, workforce development, and nurse retention projects.

Research and Awareness

PCHETA provides for the establishment of a national campaign to inform patients, families, and health professionals about the benefits of palliative care and services available to support patients with serious or life-threatening illnesses. PCHETA also directs the National Institutes of Health (NIH) to expand palliative care research with the goals of advancing clinical practice and improving care delivery.

PCHETA’s goals are very much aligned with LeadingAge’s overall efforts around the workforce. Specialty palliative care is looking at a “workforce valley” if no policy action is taken – i.e. a major shortage in qualified workforce to take care of a growing population in need of specialty palliative care services. This trend is consistent with findings and recommendations from LeadingAge’s Center for Workforce Solutions concerning the imperative to take policy actions to enhance the number of and retain workers in aging services overall. We will continue to monitor and support its progress through the Senate (S.2080) where the bill currently has 35 bipartisan co-sponsors.

Hospice Care Improvement Act of 2019 (S. 2807) 

The Hospice Care Improvement Act of 2019 was introduced on November 7^th by Senators Portman (R-OH) and Cardin (D-MD). Both Senators serve on the Senate Finance Committee which has jurisdiction over the Medicare Hospice Benefit.

The legislation was written in response to the July 2019 Office of the Inspector General reports on the Medicare Hospice Benefit: Hospice Deficiencies Pose Risks to Medicare Beneficiaries and Safeguards Must Be Strengthened to Protect Medicare Beneficiaries From Harm. The reports were met with intense media coverage that led to a response from Congress. The House Ways and Means Committee which has jurisdiction over hospice responded with a bipartisan letter to CMS Administrator Verma demanding more information to build on the content of the reports.

Senators Portman and Cardin worked collaboratively with the hospice community, including LeadingAge, LeadingAge Ohio, and LeadingAge Maryland, in the development of this legislation. If enacted, the legislation would implement new rules for oversight and transparency, including public reporting of hospice survey results, providing education to hospices and surveyors related to quality issues, and establishing penalties for providers that have a track record of poor quality or instances of abuse or neglect.

LeadingAge specifically worked with the Senate offices on provisions related to a more targeted approach to displaying data on Hospice Compare, requiring stakeholder consultation regarding what information goes on Hospice Compare, and a provision requiring joint training and education of hospices, state and local survey agencies, and approved accreditation agencies. LeadingAge also is engaged in ongoing discussions on what “alternative sanctions” will look like in the hospice space given our breadth of experience.

A companion bill in the House is expected shortly and LeadingAge continues to engage with members in both chambers on this important issue.