Health Care Reform

National Health Care Reform - Advance Care Planning Consultation

NEW! Relevant sections on Advance Care Planning in the House bill released 10/29/09. 
           This replaces HR 3200 Section 1233 Advance Care Planning Consultation

It is imperative that national health care reform initiatives recognize, and be based upon,the value of informed discussions between patients and their health provider that focus on the patient's goals for care and guide the patient's treatment preferences for their last months and years of life. Further, once these tough conversations occur,it is essential that health care professionals follow these medical orders in an emergency. This is the essence of the "Orders for Life-Sustaining Treatment" Program.

Take Action Today

Let your voice be heard about the importance of advance care planning. Send a letter supporting the following legislation to your senators and congressperson.

• HR 3200 Section 1233 Advance Care Planning
• HR 1898: Life Sustaining Treatment Preferences Act of 2009
• S 1150: Advance Planning and Compassionate Care Act of 2009

Personal Stories

Understand the importance of advance care planning discussions as you read the personal stories of people who have gone through the experience with their loved ones and family.

• Afternoon Tea with Lady Fern
• Follow My Mother's Advice: Conversations Change Lives
• She Made Her Own Decisions for Her End of Life
• Completing the MOLST Forms to Ensure that My Father's Wishes Were Followed
• She Was at Peace with Her Choices

Op-ed and News Articles

Read what professionals and people in the community are saying about the importance of advance care planning.

• Roundtable Discussion Highlights Vital Role for Palliative Care in Health Care Reform
• The Unwitting Birthplace of the 'Death Panel' Myth, published by The Washington Post  
• 'Death panel' demagoguery shouldn't kill sensible policy, published by Post-Standard Editorial
• At the End, Offering Not a Cure but Comfort
• Sisters Face Death With Dignity and Reverence
• Good end-of-life care requires advance planning
• Health care bill won't ‘kill Grandma'
• End of life counseling should remain in bill

Legislative Testimony

Read testimony delivered at state and national hearings. Please forward testimony to Karen.Kremer@excellus.com.

• New York State Senate Committe on Aging. Testemonial on Public Hearing on 3200, America's Affordable Health Choices Act of 2009, Section 1233, Advance Care Planning Consultation, presented by, Kathy A. McMahon, President and CEO, Hospice and Palliative Care Association of New York State

Congressional Town Hall Schedules

Participate in town hall meetings. Please forward town hall schedules to Karen.Kremer@excellus.com.

Facebook and Twitter

Become a fan. Compassion and Support has joined Facebook and Twitter. Engage in the "Discussions" on advance care planning.

The Facts

Quality Improvement in End-of-life Care Needed

• Advance care planning is person-centered and based on an individual's goals for care. Conversations are best had at a time when a person can express what is important to them and understand the options.
  
• Surveys reveal 80-90% of individuals would prefer to die peacefully at home.
  
• More expensive care is not always better care. Recent research shows thoughtful advance care planning discussions result in less aggressive treatment, lower stress, earlier hospice referral and a better quality of life for the person who is dying as well as comfort and support for those who are grieving the loss of their loved ones. Higher costs were associated with worse quality of death and worse bereavement adjustment.

Advance Care Planning Consultations Needed

• According to the End-of-Life Care Survey of Upstate New Yorkers: Advance Care Planning Values and Actions, Summary Report, 2008, nearly nine of ten local adults said it is important to have someone close to them making medical decisions for them if they were to have an irreversible terminal condition and were unable to make decisions. Yet, fewer than half had designated a "health care agent" to ensure their wishes are carried out.

Advance Care Planning – Regional Solutions

• Community Conversations on Compassionate Care (CCCC) Program
  The CCCC Program is an award-winning program that combines storytelling with "Five Easy Steps" to promote conversations that help you complete your Health Care Proxy and Living Will.
• Medical Orders for Life-Sustaining Treatment (MOLST) Program
  The Community-wide End-of-life/Palliative Care Initiative developed the Medical Orders for Life-Sustaining Treatment (MOLST) Program, New York State's Physician Orders for Life-Sustaining Treatment (POLST) Paradigm Program. Collaborators across New York are working on statewide implementation.
• Physician Reimbursement for Advance Care Counseling
  Currently, physicians do not receive adequate reimbursement for having thoughtful conversations on advance care planning.
  
• Overcoming Functional Health Illiteracy
  Nationally there is a lack of consumer education, tools and resources provided or made available to patients and families on advance care planning. The Community-wide End-of-life/Palliative Care Initiative developed the CompassionAndSupport.org Web site in 2002 to educate the community on advance care planning, MOLST, palliative care, pain management and hospice care and related topics.