Skip to main content

One Step Closer: Palliative Care and Hospice Education and Training Act (PCHETA)


by Paul Tatum (@doctatum)

This Labor Day weekend it is time to feel grateful for the politicians in Washington DC who are working together to improve health care.   The entire palliative care community should send a giant note of thank you to the members of the House Energy and Commerce Subcommittee on Health.  The Subcommittee on Health has scheduled the Palliative Care and Hospice Education and Training Act (PCHETA), House bill H.R. 3119, for a legislative hearing on Thursday, September 8, 2016 as part of a hearing entitled “Examining Legislation to Improve Public Health.”

PCHETA is a bipartisan bill which has broad support from both patient and provider organizations.  Forty-four separate organizations signed a letter from the Patient Quality of Life Coalition requesting a hearing for PCHETA. While PCHETA by now is well-known to regular readers of Geripal, the bill has had some improvements added from prior years.  If you don’t read the complete bill in the link above (the Senate companion bill is Senate bill S. 2748,) you can read more in detail about the bill here in the AAHPM summary (and please do read the summary if you have not). In short, the House Bill H.R. 3119 has three components:

  1. Education - expanded opportunities for interdisciplinary education in palliative care,  
  2. Awareness - an awareness campaign to inform patients and health care providers about the available services and benefits of palliative care, and 
  3. Research - strategic planning within the National Institute of Health (NIH) to expand palliative care research.


PCHETA fits the focus of this hearing, “Examining Legislation to Improve Public Health,” very well.  PCHETA really does improve public health because palliative care is really about caring for those with serious illness and their caregivers in ways that improve quality beyond what the traditional medical system has offered.

So a big thanks to the Health Subcommittee for bringing PCHETA into this hearing.   I hope that this will lead to advancing the bill to the full committee level and eventually to full consideration in the House. This is a good bill that improves public health and patient care.

And thanks to the palliative medicine community (including AAHPM, CAPC, HPNA, NHCPO, SWPN, and YOU)  for coming together from various professional disciplines to advocate for the cause of patients with serious illness in partnership with groups like American Cancer Society, the Alzheimer’s Association, the American Geriatrics Society and so many other groups to better the care of our sickest patients.  We do this for the health of society.

And if you just happen to live in a district with a House member on the Energy and Commerce Subcommittee on Health (check here), why don’t you give their office a call (or Facebook message or tweet—use #SubHealth) and continue to ask them to support PCHETA.  Also, if your district’s member is already one of PCHETAs cosponsors (check here), reach out and send a big thanks for their ongoing support!

If you’re not sure who your legislators are, visit AAHPM’s Legislative Action Center and just enter your zip code to find your legislators’ names, numbers email addresses, twitter handles, Facebook addresses, and more.  Remember to check both your work and home zip codes.

Comments

Popular posts from this blog

Geroscience and it's Impact on the Human Healthspan: A podcast with John Newman

Ok, I'll admit it. When I hear the phrase "the biology of aging" I'm mentally preparing myself to only understand about 5% of what the presenter is going to talk about (that's on a good day).  While I have words like telomeres, sirtuins, or senolytics memorized for the boards, I've never been able to see how this applies to my clinical practice as it always feels so theoretical.  Well, today that changed for me thanks to our podcast interview with John Newman, a "geroscientist" and geriatrician here at UCSF and at the Buck Institute for Research on Aging.

In this podcast, John breaks down what geroscience is and how it impacts how we think about many age-related conditions and diseases. For example, rather than thinking about multimorbidity as the random collection of multiple different clinical problems, we can see it as an expression of the fundamental mechanisms of aging. This means, that rather than treating individuals diseases, targeting …

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …

Length of Stay in Nursing Homes at the End of Life

One out of every four of us will die while residing in a nursing home. For most of us, that stay in a nursing home will be brief, although this may depend upon social and demographic variables like our gender, net worth, and marital status. These are the conclusions of an important new study published in JAGS by Kelly and colleagues (many of whom are geripal contributors, including Alex Smith and Ken Covinsky).

The study authors used data from the Health and Retirement Study (HRS) to describe the lengths of stay of older adults who resided in nursing homes at the end of life. What they found was that out of the 8,433 study participants who died between 1992 and 2006, 27.3% of resided in a nursing home prior to their death. Most of these patients (70%) actually died in the nursing home without being transferred to another setting like a hospital.

 The length of stay data were striking:

the median length of stay in a nursing home before death was 5 months the average length of stay was l…