Groundbreaking legislation designed to make palliative care and end-of-life care more accessible to patients and families by supporting outreach and enhanced education for healthcare professionals was passed this week by the U.S. House of Representatives.
The bill—known as the Palliative Care and Hospice Education and Training Act (PCHETA)—had broad bipartisan support and was passed by a voice vote on Monday. Healthcare advocates and educators rejoiced at the news.
“In this era of political divisiveness, it’s encouraging to see we can all agree on the need to better care for patients and families experiencing what is arguably the most difficult time in their lives,” said Jennifer Moore Ballentine, Executive Director of the California State University Shiley Institute for Palliative Care. “I commend the compassionate lawmakers who sponsored and supported this legislation that could ultimately help transform care for millions of vulnerable Americans encountering serious illness.”
Expanding Palliative Care
Palliative care is a patient-centered, whole-person approach to care that helps people with serious or life-limiting disease live well, from diagnosis until death. PCHETA, among other things, supports palliative care education for doctors, nurses, clinical social workers and others who make up the interdisciplinary teams integral to the delivery of palliative care.
Ballentine said the Institute stands ready to do its part. Since 2012, it has educated thousands of healthcare professionals in fundamental and advanced palliative care skills through interactive online courses geared for palliative care specialists as well as generalist clinicians. The Institute is poised to expand its training efforts, and assist other academic medical centers, pre-professional schools, and continuing education programs to deepen their offerings in palliative care, Ballentine said.
Goal of PCHETA
In remarks on the House floor prepared for Monday’s vote, PCHETA author Rep Eliot L. Engel (D-New York) said the bill “expands opportunities for training in palliative and hospice care, aims to better educate patients, families and health professionals about palliative care’s benefits, and encourages NIH to expand research around this topic.”
“I think every one of us has felt the pain and stress of a serious illness, either personally or standing alongside a loved one,” Engel said. “By passing this bill, we’ll take an important step to bring much, much needed relief to both patients and their loved ones.”
Palliative Care Workforce Shortage Looms
Though hospice and palliative medicine was officially recognized as a medical subspecialty in 2006 by the American Board of Medical Subspecialties, to date there’s only roughly one palliative care physician per 1,700 patients living with life-threatening illness (and 1 per 20,000 living with severe chronic illness.)
That shortfall underscores the need for all clinicians—not just palliative specialists—to learn to deliver basic palliative care that can ease suffering for seriously ill patients and families, Ballentine and other palliative care advocates have argued.
Role of Generalists in Palliative Care
The Institute recently unveiled new education aimed at equipping primary care physicians, nurse practitioners, physician assistants, and other generalists with essential palliative care skills.
“Over the past 10 years one of the constant themes from the palliative care specialty field has been ‘we’ve got to get the generalists trained,’” Ballentine said during a recent policy summit in California on the state’s progress in advancing care for people with serious illness. “Primary care physicians are actually doing palliative care a good amount of the time whether they call it that or not, and there’s an opportunity to hone those skills like prognostication, advance care planning conversations, managing pain, etc.”
What’s Ahead for PCHETA
In Washington, D.C., PCHETA now heads to the Senate, where a similar bill is backed by more than two dozen senators. Dr. Karl Steinberg, a member of the CSU Shiley Institute for Palliative Care’s National Advisory Board and the American Academy of Hospice and Palliative Medicine’s Public Policy Committee, said he expects more good news about the legislation in the months ahead.
“Workforce shortage issues in the palliative care field are a real problem, and PCHETA is a great step forward to increase access to specialty palliative medicine,” Steinberg said. “This bill has been around for several years, and it’s wonderful to see the bipartisan support, especially in these adversarial political times. PCHETA also has strong bipartisan sponsorship in the Senate, and we are optimistic about its prospects of becoming law this year.”