Thursday, August 1, 2013
Allows those with advanced illness to align care they get with care they want
U.S. Sens. Mark R. Warner (D-VA) and Johnny Isakson (R-GA) introduced legislation today designed to give people with serious illness the freedom to make more informed choices about their care, and the power to have those choices honored. The Care Planning Act of 2013 creates a Medicare and Medicaid benefit for patient-centered care planning for people with serious illness. It will reimburse a team of healthcare professionals for providing a voluntary, structured discussion about the patient’s goals, illness, and treatment options. A written plan will reflect the informed choices made by patients in consultation with their health care team, faith leaders, family members and friends. The Care Planning Act also provides resources for public and professional education materials about care planning.
“When faced with a serious illness, you want the freedom to control how you will live. The Care Planning Act will help align the care you receive with the care you want – no more, no less,” Sen. Warner said. “People don't like to talk about sickness or death, and families tend to put off confronting what might happen if individuals become seriously ill or unable to make decisions about their own medical care. This patient-centered approach will help your doctors and your hospital know about the choices that you and your loved ones have made. If a patient prefers to explore every possible treatment option, that choice should be respected. And if an individual prefers a different approach after informed consultations with their health team, their family and others, those choices should be documented and honored, too.”
“I’m proud to join Sen. Warner in introducing the Care Planning Act today because it gives people who have been diagnosed with a serious illness, and their loved ones, an opportunity to have face-to-face conversations with their doctors, nurses and/or religious leaders to develop a care plan,” Sen. Isakson said. “I know from my own family’s experience that having a plan makes a world of difference in ensuring a high quality of life during a loved one’s last days. I encourage my colleagues to support this legislation because it will go a long way in honoring patients’ wishes and empowering people to take charge of their own health care.”
The Care Planning Act:
- Establishes Medicare and Medicaid reimbursement for healthcare professionals to provide a voluntary and structured discussion about the goals and treatment options for individuals with serious illness, resulting in a documented care plan that reflects the informed choices made by patients in consultation with members of their health care team, faith leaders, family members and friends.
- Tests new models for more intensive services for those with advanced illness, and provides funding to support the development of a public information campaign to encourage effective care planning. It also provides grants to develop materials and maintain a web site with information about advanced care planning, portable treatment orders, palliative care, hospice, and planning services, and directs the U.S. Dept. of Health & Human Services (HHS) to include information about advanced care planning in the official Medicare & You handbook.
- Puts structures in place to focus providers on evidence of patient preferences, such as directives from other states or past discussions about treatment goals, and requires documentation of plans made prior to discharge from health facilities to assure that care plans travel with patients after discharge.
- Directs the HHS to develop quality metrics that will measure synchronicity among the individual’s stated goals, values, and preferences with documented care plans, the treatment that is delivered, and the outcome of treatment.
- Creates a Senior Navigation Advisory Board, comprised of a diverse range of individuals including faith leaders, health care professionals and patient advocates, which will monitor and advise HHS throughout implementation of the Act.
- Explicitly prohibits the use of funds in violation of the Assisted Suicide Funding Restriction Act of 1997, and further requires that all services be free from discrimination based on advanced age, disability status, or the presence of advanced illness.
“I have been interested in having an intelligent conversation about advanced care planning for many years, both as a policymaker and as a son whose mother suffered from Alzheimer’s and could not communicate with our family during her final decade of life,” Sen. Warner said. “Grappling with her health care challenges was much more difficult because we did not take the opportunity to talk with her in a frank and fully informed way when she was first diagnosed and capable of expressing her wishes. I regret that we never discussed with her the full array of care options available to her.”
The Care Planning Act of 2013 has been endorsed by a broad range of health care, health provider, senior and patient advocacy organizations.
- “AARP recognizes the importance of care planning, advance care planning and making sure individuals have options and resources to plan for their future and have their wishes respected,” said Joyce Rogers, AARP senior vice president for government affairs. “The Care Planning Act of 2013 recognizes the important role family caregivers play in supporting individuals as they age and we're happy to support this bipartisan legislation.”
- “Sen. Warner has brought faith leaders into this discussion. As Christians, we should affirm efforts that are directed toward honoring the dignity of individuals and their families by giving them what they need to make the end of life decisions that honor their lives,” said Rev. Jim Wallis, president of Sojourners.
- “The Care Planning Act would ensure that patients and families are able to navigate the journey at the end of life with the necessary information and support that will bring dignity, quality care, and hope when they are most needed,” said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization. “For more than 30 years, hospices have been providing high-quality, coordinated interdisciplinary care to people at one of life’s most challenging times. The Planning Services benefit and the Advanced Illness Coordination Services demonstration project proposed in The Care Planning Act, in particular, use the knowledge and expertise of the hospice and palliative care community in valuable new ways. We could not be more excited about the potential of this legislation,” added Schumacher.
In addition, the legislation has been endorsed by the American Association for Long-Term Care Nursing, ARCH National Respite Coalition, Critical Care Roundtable, Gundersen Lutheran Health System, and Well Spouse Association. In Virginia, the Act has been endorsed by The Virginia Hospital and Healthcare Association, the University of Virginia Medical Center and Virginia Commonwealth University Health System.