Should Palliative Care Be Reformed?

Legislators in Sacramento and Washington, D.C., are considering bills changing the way health care systems deal with palliative care.

In Sacramento, several bills deal directly and indirectly with palliative care:

• SB 1004, by Sen. Ed Hernandez (D-Sacramento) and Sen. Lois Wolk (D-Davis), calls for Medi-Cal to launch a pilot project to determine whether the state’s Medicaid system should be offering palliative care benefits to beneficiaries.
• AB 2139, by Assembly member Susan Eggman (D-Stockton),  would require health care providers when making a diagnosis of terminal illness to notify patients or patients’ guardian/agent of the right to comprehensive information and counseling regarding end-of-life care options.
• Two other bills authored by Eggman — AB 1571 and AB 1572 — would create a public rating system and oversight for California residential care facilities for the elderly.

In Washington, D.C., two bills are making their way through Congress that would expand palliative care and the medical subspecialty focused on relieving pain:

• The Palliative Care and Hospice Education and Training Act — S 641, by Sen. Ron Wyden (D-Ore.), and HR 1339, by Eliot Engel (D-N.Y.) — is aimed at preparing the health care workforce for the growing need for palliative and hospice care.
• HR 1666, by Rep. Emanuel Cleaver (D-Mo.), seeks to expand research, establish a workforce training initiative and convene health care stakeholders to develop a plan to manage pain and treatment associated with chronic disease.

California last month received a “B+” in a policy report card from  the American Cancer Society Cancer Action Network rating states’ policies and practices in palliative care.

We asked stakeholders, experts and legislators what policy moves were needed to improve palliative care.

We received responses from: