New Legal Guide for the Seriously Ill

Legal Guide for the Seriously Ill Written by the American Bar Association

Guide Commissioned by NHPCO and Created by American Bar Association Commission on Law and Aging

(Alexandria, Va) -- The onset of a serious illness or injury can affect much more than a person’s health. Knowing what steps to take to get one’s financial and legal affairs in order is often vitally important not only to the affected individual, but to his or her loved ones as well.

The "Legal Guide for the Seriously Ill" -- a project by the American Bar Association Commission on Law and Aging commissioned by the National Hospice and Palliative Care Organization -- was designed for both the seriously ill individual and those caring for someone who is seriously ill. The guide explains “Seven Key Steps” in a brief, clear way while offering additional tips and resources for readers looking for more detailed information and guidance.

The recently released guide addresses societal issues that have gained prominent media attention in recent years, such as paying for health care, managing health and personal decisions, and patient rights. In addition, the Legal Guide for the Seriously Ill sheds light on recent legislative and regulatory changes, such as the recently enacted American Recovery and Reinvestment Act of 2009, which provides a 35 percent subsidy of the COBRA premium for up to nine months.

“The Legal Guide for the Seriously Ill is a great resource for anyone facing a serious illness. The book provides critical tools that help readers understand their options, make informed decisions, and minimize some of the anxiety they may be feeling about their financial and legal affairs at this stage of life,” said ABA President Carolyn Lamm.

J. Donald Schumacher, president and CEO of NHPCO added, “Hospice and palliative care organizations are frequently asked for information regarding end-of-life planning and decision-making. This guide will be a tremendous resource to them as well as faith communities, caregiver organizations, aging service providers, hospitals and others who work to support people living with a serious illness.

Ellen M. Klem, staff attorney of the ABA Commission on Law and the Aging, reminded readers that the book does not give legal advice, but will “arm readers with knowledge about the options they have during this difficult time.”

The views expressed in the book have not been approved by the House of Delegates or the Board of Governors of the American Bar Association and, accordingly, should not be construed as representing the policy of the ABA.

"Legal Guide for the Seriously Ill" is available online at the Caring Connections Web site.

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With nearly 400,000 members, the American Bar Association is the largest voluntary professional membership organization in the world. As the national voice of the legal profession, the ABA works to improve the administration of justice, promotes programs that assist lawyers and judges in their work, accredits law schools, provides continuing legal education, and works to build public understanding around the world of the importance of the rule of law.

NHPCO is the oldest and largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. NHPCO’s mission is to lead and mobilize social change for improved care at the end of life. NHPCO's Caring Connections provides free resources and information to help people make decisions about end-of-life care and services before a crisis. Learn more at caringinfo.org or by calling the HelpLine at 1-800-658-8898.

Media Contact:
Tina Lanier, ABA
Phone:202-662-1792
tlanier@staff.abanet.org

Or:

Jon Radulovic, NHPCO
Phone: 703-837-3139
jradulovic@nhpco.org

For more information visit, http://www.nhpco.org

NHPCO Releases Updated Resource Manual

NHPCO Releases New Hospice Volunteer Resource Manual to Support Volunteer Programs and the Nation's 550,000 Hospice Volunteers

(Alexandria, Va) – The National Hospice and Palliative Care Organization reports that more than 550,000 individuals across the nation are giving of their time and talents as trained hospice volunteers. These volunteers contribute more than 25 million hours of service annually and reach 1.5 million patients and their family caregivers every year.

These figures, part of the NHPCO report Facts & Figures: Hospice Care in America were shared at NHPCO’s recent 6^th National Conference on Volunteerism and Family Caregiving held last weekend in Orlando, Fla.

As part of the conference events, NHPCO released the newly revised edition of The Hospice Volunteer Program Resource Manual.

Hospice organizations have a responsibility to ensure that volunteers are well trained and well cared for and this manual will contribute to those efforts.

“Hospice volunteers are individuals who have stepped forward to make a difference in the lives of other people in their communities and they are vital members of the hospice and palliative care interdisciplinary team,” said J. Donald Schumacher, NHPCO president and CEO.

“The help, kindness and support that patients and families receive from hospice volunteers often profoundly changes their experience at the end of life.”

The manual has been updated to reflect the 2008 hospice Conditions of Participation—the federal requirements that all hospices must meet—and includes fresh ideas on recruitment, retention, training, volunteer manager skills development, program development, and more.

The publication includes a CD-ROM that assists managers in personalizing a volunteer program that meets the specific needs of an organization. Materials that can be adapted include competency checklists, surveys, policies and procedures, visit logs, job descriptions, training outlines, and more.

To ensure that volunteers remain an integral part of hospice care, it is federally mandated that at least five percent of patient care hours be provided by trained volunteers. Providers must track and document this carefully.

When a hospice invests in establishing a fully-functioning volunteer support program, the five percent rule becomes a guidepost, instead of burden.

“I know it costs money to run a well-coordinated volunteer program, however, on every level the benefits exceed the costs. Volunteers and their gift of service can have a huge impact on both the quality of the care your organization provides and its bottom line. A well-trained, engaged volunteer who spends time with patients and families can pick up on changes or challenges before they become crises,” noted Schumacher.

The Hospice Volunteer Program Resource Manual (item #820114) is available from the NHPCO Marketplace and may be ordered online, nhpco.org/marketplace, by phone at 1-800-646-6460, or by downloading and returning theVolunteer Manual order form.

For more information visit, http://www.nhpco.org

Wishing You a Peaceful Holiday Season

As the year comes to a close, I would like to thank each one of you, our members, who have offered so much support to NHPCO throughout this very busy year. There have been issues, large and small, that we have had to confront together and I think we’ve risen to the challenge time and time again.

I am so proud of the spirit of collaboration that is so palpable within our community. For this willingness to work together and support one another, I am indeed grateful.

During this holiday season, I encourage you to cherish time spent with your families and loved ones. On a personal note, this holiday season will be particularly poignant for me as I prepare to welcome my first grandchild.

We care for people on a daily basis, most often during one of life’s most challenging journeys. I hope that every one of you find the same peace and kindness that you so generously provide to the people you serve. Enjoy the special gifts found in quiet moments of reflection and in unexpected acts of kindness.

On behalf of the NHPCO board of directors, our staff and our affiliate organizations, I wish you a peaceful holiday season and a happy New Year!

Don

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For more information visit, http://www.nhpco.org

Engage with Grace at www.engagewithgrace.org. Join the Blog Rally. Pass it on. #EWG

Some Conversations are Easier than Others
Take Time this Holiday Season to Ask Your Loved Ones about Their End-of-Life Wishes

Last Thanksgiving weekend, many of bloggers across the Internet participated in the first documented “blog rally” to promote Engage With Grace – a movement to get more and more people talking about their end of life wishes.

It was a great success, with over 100 bloggers in the healthcare space and beyond participating and spreading the word. Plus, it was timed to coincide with Thanksgiving weekend when most of us are with the very people with whom we should be having these tough conversations – our closest friends and family.

At the heart of Engage With Grace are five questions designed to get the conversation started. National Hospice and Palliative Care Organization wants to share these questions with you. They’re not easy questions, but they are important. Think about them, document them, share them.

Over the past year there’s been a lot of discussion around end of life. Throughout the year, the Engage With Grace team has been fortunate to hear many uplifting stories, as folks have used these five questions to initiate the conversation.

One man shared how surprised he was to learn that his wife’s preferences were not what he expected. Befitting this holiday, The One Slide, seen below, now stands sentry on their fridge.

National Hospice and Palliative Care Organization’s Caring Connections provides a wide range of materials to help families talk about the care they would want and take steps to make their wishes know. This includes state-specific advance directive forms that can be downloaded free-of-charge. Visit Caring Connections at www.caringinfo.org or call 1-800-658-8898.

Learn more about Engage With Grace at http://www.engagewithgrace.org/.

To download The One Slide or for suggestions on using it, go to http://engagewithgrace.org/Download.aspx.

Don's November Message

For more information visit, http://www.nhpco.org

New Facts & Figures - Concern over short stays.

NHPCO Cites Concern Over Growing Short Length of Service in New Facts and Figures on Hospice Care in the U.S.

New Report on Hospice Care in America Released as November’s National Hospice/Palliative Care Month Begins

(Alexandria, Va) – More than 35 percent (35.4) of patients served by hospices in 2008 died or were discharged in seven days or less reports the National Hospice and Palliative Care Organization. This reflects a 4.6 percent increase from 2007, when 30.8 percent of patients had what is considered a short hospice experience.

Patients and families receiving care for seven days or less are often unable to take full advantage of the range of benefits that the hospice interdisciplinary team provides. These benefits include psychosocial support and spiritual care for patients and their families as well as pain management and symptom control,

While the average length of service increased from 67.4 days in 2007 to 69.5 days in 2008, the jump in patients receiving care for a short time is of concern to hospice providers and NHPCO.

Only 12.1 percent of those served died or were discharged with service of 180 days or more.

These statistics are featured in the report, “NHPCO Facts and Figures: Hospice Care in America,” which was released by NHPCO as the hospice and palliative care community begins to mark National Hospice/Palliative Care Month, an annual month of awareness and outreach celebrated every November.

NHPCO emphasizes the value of hospice care over the last months of a person’s life, not just the last days.

“More awareness of the care options available when facing a serious or life-limiting illness—among both the public and healthcare professionals—is still needed,” said J. Donald Schumacher, NHPCO president and CEO.

“The advance care planning provision that has been so hotly debated in health care reform discussions could be an important mechanism for helping dying Americans avoid hospice experiences that are too short to fully help them or their family caregivers.”

Learning about options before a patient and family are faced with a health crisis is strongly recommended by NHPCO. Hospices frequently provide information to community members interested in advance care planning.

Additional information about hospice, palliative care, and advance care planning is available from NHPCO’s Caring Connections at www.caringinfo.org or by calling the HelpLine at 800-658-8898.

“NHPCO Facts and Figures: Hospice Care in America,” is available in the News Room at www.nhpco.org.

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Contact:
Jon Radulovic
Vice President of Communications
Ph: 703-837-3139
jradulovic@nhpco.org.

For more information visit, http://www.nhpco.org

National Hospice/Palliative Care Month

November is National Hospice/Palliative Care Month. This year’s theme, Preserving a legacy…treasuring memories, reminds us that every person we care for is a unique individual with a lifetime of experiences, relationships and gifts to share. Hospice and palliative care community honor patients and families and support them during the journey at life’s end.

Materials & Resources for NHPCO Members
A variety of outreach materials have been created for NHPCO members and coalitions to use during Hospice/Palliative Care Month and all year long. Visit www.nhpco.org/outreach access all available resources.

NHPCO and Caring Connections offer the following informational articles that may be used to help inform audiences about the importance of quality end-of-life care.

Collection of Articles
NHPCO offers the following articles to those who may wish to learn more or to use them in hospice outreach and educational efforts.

• Ten Important Facts About Hospice Care


• Hospice and Palliative Care: Leaving a Legacy of Compassion


• Are You Traveling Without a Map? A Layperson’s Guide to Advance Care Planning


• How to Help a Grieving Loved One During the Holidays

Hospice Facts and Figures
NHPCO’s research team has just released updated Facts & Figures about hospice care in the U.S.

NHPCO’s Marketplace
The Marketplace offers a range of products inspired by the National Hospice/Palliative Care Month quilt. Download the Marketplace hospice/palliative care merchandise flyer (PDF) or contact Marketplace at 1-800-646-6460.

Additional Information for the Public
NHPCO’s Caring Connections offers a wide range of helpful information about hospice, palliative care, advance care planning, dealing with pain, family caregiving, grief and more. Brochures and fact sheets are available at no charge. Additional materials for organizations and community coalitions working to educate the public and their communities about end of life care is also available free of charge. Visit http://www.caringinfo.org/ or call the HelpLine at 1-800-658-8898.

Support the Work of NHPCO
The National Hospice Foundation is NHPCO’s affiliate organization that accepts and administers charitable contributions on behalf of the NHPCO and FHSSA. NHF envisions a world where everyone facing serious illness, death, and grief will experience the best that humankind can offer. By making a contribution today to the NHF General Fund, you can help us create that world.

Media Contact for additional information on hospice and palliative care or NHPCO:
Jon Radulovic
Vice President of Communications
Ph: 703-837-3139
jradulovic@nhpco.org

Misinformation, Health Care Reform, and the Media

A Message from J. Donald Schumacher
August 14, 2009

Misinformation, Health Care Reform, and the Media

As many people know, NHPCO has been working actively to clarify misinformation among national and regional media regarding health care reform legislation. An important part of our outreach has been to correctly explain the advance care planning provision and stress the value of this benefit for all Americans.

NHPCO leadership have spoken with reporters and producers with all the major network news outlets, ABC, NBC, CBS, and CNN, as well as the Associated Press, Wall Street Journal, NY Times, Washington Post, and many others.

Some highlights include NHPCO's Kathy Brandt interview on National Public Radio's "Morning Edition" and Jon Keyserling’s interview on CNBC. NHPCO also provided information for the new feature that debuted on ABC Evening News with Charlie Gibson, "Fact Check," where the inaugural issue on this new segment was the misinformation about the advance care planning provision.

It's difficult to hear false and misleading statements in the media but rest assured that we are responding as effectively as possible. NHPCO offers some information that may be helpful. This includes:

• Talking Points on advance care planning and health care reform.
• NHPCO’s press release from August 7.
• NHPCO’s analysis about the advance care planning provision in the House’s bill.

NHPCO’s Caring Connections has some useful information about advance care planning that helps explain what it is, including a new piece that uses metaphor to explain the concepts:

• What is Advance Care Planning
• Healthcare Agents: Choosing One and Being One
• Preparing Your Advance Directives
• NEW - Are You Traveling without a Map? A layperson's guide to advance care planning (PDF)

There have been any number of excellent news reports, articles and op-eds that clarify the misinformation but those are often overshadowed by the conflict. Here are some links of interest that people may be interested in looking over:

• "Honest Talk About the End," Newsweek, by Eleanor Clift, 07/31/09.
• "Elderly Americans should read the health care bill: It won't kill them," Cleveland Plain Dealer, by Connie Schultz, 08/02/09.
• "Getting health care healthy: Accepting death outside the hospital," * Chicago Tribune, by Anne Moore, 08/05/09.
• "Health Care Reform: The Assault on Truth," AARP Bulletin Today, 08/14/09.
• “Here’s the truth, Granny,” Obit Magazine, by Judy Bachrach, 08/11/09.
• "Health Care: Will Section 1233 Hasten Patient Deaths?" American Center for Law & Justice (from Christianity Today), 08/11/09.
• "Three Myths about the Ethics of Health Care Reform," Association of Bioethics Program Directors.
• "Advance-directives section fueling concern and, hospice officials say, misunderstanding," Winston-Salem Journal, 08/13/09.
• “While others rant, hospice keeps helping,” Orlando Sentinel, 08/14/09.
• “Doctors Providing End-Of-Life Counseling See Benefit In Current Controversy,” Kaiser Health News, 08/14/09.


At NHPCO, we will continue to do our best to provide accurate information that we hope will help Americans understand the value of advance care planning.

The importance of patient wishes have always been integral to the hospice philosophy of care and we understand why the provision in the House bill would only serve to benefit Americans. We also understand how complicated and challenging issues surrounding death and dying are for many people. And when faced with what seems like sweeping change in health care reform discussions, it is understandable that many people are passionate—and frightened. Yet, I have faith that in the days ahead, the truth about caring for people at the end of life and the importance of advance care planning will begin to spread where there has been misinformation and false accusation.

To cite our outreach materials, hospice and palliative care are about how you live. Making one’s wishes know is an important part of life’s journey.

I encourage all hospice and palliative care providers to continue with the important work they do to help patients and families and their broad communities. I am proud to be working with such a dedicated community—all those providing hospice and palliative care.

Thank you.

J. Donald Schumacher
President and CEO


For more information visit, http://www.nhpco.org

Solutions to Not Only Survive, But Thrive

Leading and Managing in Tough Economic Times is a unique program designed to provide hospice CEOs and other organizational leaders with specific tools and resources to help their programs survive and thrive in the months and years to come.



Date: September 24-25, 2009
Location: Hyatt Regency Denver and Colorado Convention Center, Denver, CO


For more information visit, http://www.nhpco.org/ctc2009

NHPCO & Alliance to Offer Health Care Reform Phone Forum Next Week

The negotiations, progress and temporary set-backs of health care reform continue, and the hospice community has never had more on the line. Will the BNAF rate cuts be addressed in the bill? Will Congress modernize the Medicare Hospice Benefit and expand access to hospice? Could access be hindered by the health overhaul? Will we suffer more cuts to help pay for reform?

Please join NHPCO President/CEO Donald Schumacher, Vice President of Public Policy Jonathan Keyserling, and members of the Alliance for Care at the End of Life lobbying team on Wednesday, July 29 at 3pm EDT for an update and responses to your questions on the timing, substance and process of what’s to come in health care reform.

Register for the Phone Forum Here

This unprecedented opportunity is being offered at no charge for NHPCO members; however, please be considerate of this generous offer by restricting your registrations to one phone line per hospice program.

Register for the Phone Forum Here

Important Information: Registration closes at noon (EDT) on Monday, July 27. Registrants will receive the call instructions on Tuesday, July 28. CEUs will not be offered for this event. Please send any questions to advocacy@nhpco.org.
We hope you will join this important discussion!

For more information visit, http://www.nhpco.org

More Reasons to Attend NHPCO's 10th Clinical Team Conference

The Best Content and the Best Value. Discover why NHPCO's 10th Clinical Team Conference is the best educational value for hospice and palliative care professionals of all disciplines.

The CTC is the only educational event designed to educate the entire interdisciplinary team, offering advanced, intermediate and introductory content for all clinicians.

Plenary Speakers:

• Vyjeyanthi (VJ) Periyakoil, MD
• Frank Ostaseski
• Gary Gardia, MEd, LCSW, CT
• Brad Montgomery, CSP
  Learn more about these exciting plenary speakers.

The CTC is four conferences in one. The conference features the Facility-Based Hospice Forum, Pediatric Intensive and Scientific Symposium running seamlessly within the Clinical Team Conference.

Learn more online today.

New Leadership Program to be Offered at CTC

NHPCO Announces New Professional Development Program for Hospice Leaders to be Part of the 10th Clinical Team Conference

Curriculum will Focus on Leading and Managing in Tough Economic Times

(Alexandria, Va) – With the healthcare reform debate, threats to reimbursement, increased regulatory demands and an economic downturn, hospice leaders are reeling and reaching out for guidance and practical solutions to weather this period of change and transition. In response to the needs of the hospice community, NHPCO has announced a two-day professional development intensive that will be part of its Clinical Team Conference in Denver, CO, September 24-25, 2009.

A survey conducted by NHPCO earlier this year indicates that the recent economic downturn has negatively impacted hospices across the country, with nearly 75 percent of respondents reporting an overall negative financial impact in 2008. A majority of respondents (58.4%) said they experienced a reduction in revenue in 2008. Over three-quarters of respondents (77.9%) said they had implemented reductions in spending in 2008. (Learn more about the findings from NHPCO’s economic impact survey in July’s NewsLine, pg. 6.)

Leading and Managing in Tough Economic Times is a unique program designed to provide hospice CEOs and other organizational leaders with specific tools and resources to help their programs survive and thrive in the months and years to come.

The program's education agenda runs throughout the first two days of the 10th Clinical Team Conference. Attendees of this program may attend all or some of these sessions as well as programs and events offered during the first two days of the CTC (September 24-25), including plenary and concurrent sessions, networking and conference exhibit hall events.

“In years to come if asked how you responded to these financial challenges will
you be able to say you proactively developed and executed a plan?” asked J.
Donald Schumacher, president and CEO of NHPCO. “We’ve created this intensive
specifically to address the needs and concerns we hear from provides in the
field.”

Confirmed Speakers include: Mark Murray, The Center for Hospice & Palliative Care, South Bend, IN; Charlene M. Bunts, WellStar Community Hospice, Austell, GA; Christie Franklin, Bristol Hospice, Salt Lake City; Mary Sheehan, Midwest Palliative & Hospice CareCenter, Glenview, IL; and Greg Wood, Hospice of North Central Oklahoma, Ponca City.

Registration is now open for Leading and Managing in Tough Economic Times. Visit nhpco.org/ctc2009 for more information on this timely program.

Agenda

Thursday, September 24, 2009

• 8:30 AM – 10:00 AM CTC Opening Plenary
• 10:15 AM – 11:45 AM Quick Cuts, Contingency Plans and Long-range Planning: Developing a Road Map for an Uncertain Future – Charlene and Mary
• 11:45 AM – 1:30 PM Complimentary Box Lunch
• Noon – 1:15 PM Discipline-Specific Networking Meetings (NCHPP)
• 1:30 PM – 2:30 PM Creating a Culture of Belt-Tightening
• 2:45 PM – 3:45 PM Doing More with Less? Yes, It Can Be Done
• 5:00 PM – 7:00 PM CTC Welcome Reception and Exhibition

Friday, September 25, 2009

• 8:15 AM – 9:30 AM General Plenary II
• 9:30 AM – 10:30 AM Networking Break with Exhibitors
• 10:45 AM – 11:45 AM Utilizing Financial Data to Enhance Patient Care
• 11:45 AM – 1:15 PM Networking Lunch with Exhibitors
• 1:30 PM – 3:00 PM Downsizing with Compassion
• 3:15 PM – 4:15 PM Panel: Been There, Done That and Still Learning as We Go
• 4:30 PM – 5:30 PM General Plenary III

For more information on this program, contact NHPCO member services team at 1-800-646-6460 or visit nhpco.org/ctc2009.

Google Health and Caring Connections

National Hospice and Palliative Care Organization’s Caring Connections and Google Health Offer New Way to Access Advance Directives Online

Alexandria, VA – Ensuring that one’s healthcare wishes are known and will be honored in the event of a healthcare crisis is what advance care planning is all about. Today, the National Hospice and Palliative Care Organization’s Caring Connections, a leading provider of advance care planning information, and Google Health™ have come together to increase the availability and accessibility of advance care planning information and resources online.

Advance directives, also known as living wills and healthcare power of attorney forms, allow an individual to express their wishes if they are in a medical crisis and unable to communicate. These documents provide specific information to healthcare professionals and can help guide family caregivers called upon to make decisions on behalf of someone who is not able to speak for themselves.

“How can medical professionals honor your healthcare wishes and preferences if they don’t know what they are?” said J. Donald Schumacher, president and CEO of NHPCO. “Advance directives are useless unless they are available during emergency healthcare situations. Google Health will make these documents accessible online and will eliminate a huge barrier of access during times of need.”

A new feature on Google Health enables users to download a free, state-specific advance directive and store the scanned documents securely online. This will help overcome a common barrier in emergency healthcare situations, where it can be difficult to access a patient’s advance directive.

Google Health is a secure, online Personal Health Record (PHR) that allows consumers to store, organize, and share important healthcare information. Google chose to work with Caring Connections because they are the only provider that offers free, state-specific, online advance directives. In the past three years, Caring Connections has distributed more than 2.5 million advance directive forms. They also provide information to help people understand advance care planning and begin conversations with family and healthcare professionals.

The process to store an advance directive form in Google Health is easy:

1. Go to your Google Health account at google.com/health, or create a new account if you don’t have one already.


2. Download and print the advance directive form for your state at caringinfo.org/googlehealth


3. Complete the form and sign it.


4. Scan the signed document and upload it to your Google Health account.

By taking time to do these simple steps, you are making your healthcare wishes available to those who may need them in a time of crisis. Not only is this an important step to take for your own well-being but it’s a gift for your family members and loved ones who may need to act on your behalf.

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Contact:
Jon Radulovic
NHPCO
Ph: 703-837-3139
jradulovic@nhpco.org
www.caringinfo.org
Caring Connections is a program of the National Hospice and Palliative Care Organization. Learn more at CaringInfo.org.

Visitors to NHF Website find new features

For the first time, visitors to the National Hospice Foundation Web site will find new ways to interact with the philanthropic arm of NHPCO.

Completely redesigned and launched just last week, www.nationalhospicefoundation.org offers these new features, among others:
1. Clear and comprehensive information about what your dollars support
2. A place to “Share Your Story” and read others’ hospice stories
3. Links to NHPCO’s Twitter account and to NHF’s Facebook page
4. An easy-to-use form making monthly giving a snap
5. A wealth of information about ensuring a legacy through planned gifts

Come check it all out! We’d love to hear your feedback – send it directly to Susan Messina, Director of Development Communications, NHF.

NHPCO Calls for Hospice Community to Make its Voice Heard

More Cuts to Hospice Announced: Hospice Community Responds
with Virtual Lobby Day on July 15

(Alexandria, Va) – The nation’s hospice providers are facing proposed cuts of $2.3 billion over a five-year period and $9.8 billion over a ten-year period in the preliminary estimates of the House of Representatives health reform proposal, released last week by the Congressional Budget Office.

These cuts are in addition to the cuts scheduled to go into effect on October 1 as a result of the elimination of the Budget Neutrality Adjustment Factor (BNAF), an issue the hospice community has been fighting to overturn for some time.

This new development makes the need to stop the BNAF cuts even more urgent for hospice providers. On Wednesday, July 15, NHPCO and The Alliance for Care at the End of Life are sponsoring a nationwide Virtual Lobby Day. All Hospice Advocates are called to join together to protect patient access to compassionate and high-quality end-of-life care.

If the BNAF cuts move forward on October 1, just 80 days from now, the hospice community is potentially facing a 6.4 percent reimbursement cut in federal fiscal year 2010 (October 1, 2009 - September 30, 2010).

“The situation facing the hospice community is clear: we are now facing cuts on top of cuts. When you take these proposed cuts, and place them on top of the BNAF scheduled cuts, it is simply unacceptable,” said J. Donald Schumacher, NHPCO president and CEO.

Here's how Virtual Lobby Day will work:

• On Wednesday, July 15, all Hospice Advocates registered on NHPCO’s Legislative Action Center will receive the Virtual Lobby Day information via email.

• The email with include instructions about who to contact, how to contact them, and specific talking points.

• Participants will call and write throughout the day on July 15.

People who have not previously registered on NHPCO’s Legislative Action Center can sign up now—it’s free and open to any interested individual. Go to nhpco.org/advocacy and click the “Legislative Action Center” box.

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Contact:
Angie Truesdale
Ph: 703-647-5163
atruesdale@nhpco.org
or
Jon Radulovic
Ph: 703-837-3139
jradulovic@nhpco.org

For more information visit, http://www.nhpco.org

Monthly Message from NHPCO's President and CEO Don Schumacher

July 2009


Exploring Multiple Pathways to Earlier Referrals


Our cover story this month draws needed attention to the myths surrounding palliative care. Much like hospice, palliative care is not being fully utilized within our nation’s healthcare system due to sheer misunderstanding on the part of patients and physicians. As the author notes, there are nearly one million patients who are dying in hospitals or other institutions each year who are unaware of the palliative care services available to them—care that would not only help them, but would also reduce hospital and pharmacy costs.


While it’s certainly our collective responsibility to help educate our communities about palliative care, we are missing a very important opportunity if we don’t do more—if we don’t expand into palliative care ourselves. In one of my first conference plenary addresses as president/CEO of NHPCO, I urged members to “think outside the Medicare Hospice Benefit box” and explore palliative care as a pathway to earlier referrals. I was not asking members to do something I had not done myself. While president/CEO of a hospice program in Buffalo, I was one of the first providers to integrate palliative care into our continuum of care and saw firsthand the many benefits of such expansion.


Today, with healthcare reform very much a reality and with CMS now looking at ways to serve more Americans more cost effectively, there is even greater reason to expand our expertise into other cost-effective services. Palliative care is a natural fit for hospice providers.


Opportunities at the National Level


This month’s secondary feature recaps findings from NHPCO’s recent Economic Impact Survey. Understandably, most programs reported a reduction in revenue, with reasons ranging from reductions in average daily census to expected reductions in philanthropic contributions and changes in payment rates. First, on behalf of NHPCO, my thanks to all of you who took time to respond. Secondly, NHPCO hears you.


While NHPCO can’t address all of the factors that are impacting your bottom line, we are committing significant resources to the one that poses the greatest threat to the majority of members—Medicare Hospice Benefit rates. In partnership with The Alliance for Care at the End of Life, protecting these rates remains our top priority (see page 16 for an update on our advocacy efforts). However, we are also exploring other ways to improve your bottom line through expansion of the Benefit. NHPCO’s Public Policy Committee recently approved two potential demonstration projects to examine concurrent care and transitional care, both of which would enable hospice providers to build relationships with patients and families earlier in the illness trajectory and, in so doing, improve hospice utilization.


A favorite expression of mine reminds us that there are, indeed, many paths up a mountain. In today’s hospice environment, we must be open—and willing—to explore them all.

Don

Read July NewsLine

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For more information visit, http://www.nhpco.org

The Latest News on Hospice & Health Care Reform

As Congress prepares to depart Washington for the July 4th District Work Period, health care reform activities refuse to wind down. Higher than expected cost estimates by the Congressional Budget Office (CBO) sent Washington into a flurry of activity over the past few weeks, as stakeholders try to rein in the price tag associated with the reform effort. Here’s what’s been going on:

The President
President Obama continues to reiterate his two goals for the overhaul – reducing overall health care costs and covering the uninsured. At the same time, the President has demanded that larger members of the health sector come up with their own savings to pay for the plan, and the pharmaceutical industry responded this week with $80 billion over 10 years.

Senate Activity
The mark-up of the proposal drafted by the Senate Finance Committee, the committee which was previously out in front on health care reform, has stalled due to the lack of a bipartisan consensus. Chairman Max Baucus and the committee staff continue to work around the clock to refine their bill to gain support on both sides of the aisle.
The Senate Health, Education, Labor and Pensions (HELP) Committee was been holding a week-long marathon of a mark-up on its proposal. NHPCO has been asked by Committee staff to comment on proposed amendments that would expand efforts to increase utilization of Advance Directives. This mark-up is expected to continue through the week, and may need to reconvene after next week’s District Work Period.

House Activity
Late last week, the committees of jurisdiction in the House of Representatives released a nearly 900-page draft of the House health care reform proposal. Buried in that draft document is a reduction in the productivity factor, which amounts to an across-the-board rate reduction for all Medicare providers. This is an early draft of one Chamber’s proposal, and we don’t know whether it will come out in the final package. We are still combing through the hefty document to determine if there are other provisions that might impact hospice.
The Ways & Means Committee continues its hearings on health care reform this week, and is expected to begin mark-up of the proposal after the District Work Period. The Energy & Commerce Committee heard testimony from Department of Health & Human Services Secretary Kathleen Sebelius this week and also continues hearings on health care reform.

NHPCO
ABC News hosted a Healthcare Reform Town Hall Meeting on June 24, at the White House. The program was moderated by Diane Sawyer and Charlie Gibson and featured a cross section of Americans asking President Obama questions about healthcare issues as they relate to their personal needs. NHPCO provided information on end-of-life care to ABC News producers, and helped the news team covering this town hall meeting to find additional professional contacts in the field.
NHPCO and the Alliance for Care at the End of Life continue to be in contact with the key Committees of jurisdiction, and try to advance end-of-life care proposals that would pave the pave the way for modernizing the Medicare Hospice Benefit in the future. Check out of the proposals endorsed by NHPCO in recent weeks.
Please stay tuned for future health care reform updates. The President continues to push for passage of bill by the end of the summer and the coming weeks will be full of activity as the various Committees of jurisdiction try to meld their proposals together and pass their bills.

New Health Care Reform Resource Center
Please visit the new Hospice & Health Care Reform Resource Center. There, you can find our current and past updates on health care reform activities. You’ll also find what we are sending to the Hill on hospice and health care reform, and many other valuable resources.
Providers with questions may contact NHPCO's Public Policy Team at advocacy@nhpco.org.

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For more information visit, http://www.nhpco.org