OIG Virtual Town Hall for NHPCO Members

NHPCO will host a free Virtual Town Hall for members on Thursday, October 24, 2019 from 1:00 – 2:00 p.m. ET with the Office of Inspector General for the Department of Health and Human Services.

As providers are likely to remember, in July 2019, two OIG reports were released (PDF) that identified concerns with the large number of hospices with survey deficiencies and examples of hospice patients in immediate jeopardy for harm. These two reports have received media and policymaker attention since their release.

This virtual town hall offers members a unique opportunity to learn more about the OIG's specific findings and the suggested reforms OIG is recommending for both CMS and Congress to undertake.

Participants will have the opportunity to learn and ask questions with the authors of the reports including Assistant Inspector General Erin Bliss, Assistant Inspector General for Evaluation and Inspections at HHS Office of Inspector General, Nancy Harrison, Deputy Regional Inspector General Office of Evaluation and Inspections in New York and Jodi Nudelman, Regional Inspector General for the Office of Evaluation and Inspections in New York.

Prior to registering for the Virtual Town Hall, members should review the OIG talking points (PDF) prepared by NHPCO.

Members will find a registration link in NewsBriefs issued September 26, 2019 and available online.

NHPCO Hospice Ambassadors on Capitol Hill

Hospice providers from NHPCO are on Capitol Hill, September 17 and 18, to advocate for reforms that would increase access to hospice and palliative care in America’s rural towns and improve hospice care quality.

“All Americans should be given access to quality hospice care, no matter their zip code,” said Sandy Kuhlman, Executive Director of Hospice Services of Northwest Kansas and one of NHPCO’s visiting My Hospice Ambassadors.  “For this reason, we are bringing our message to Washington and asking our representatives to improve and reform hospice and palliative care policies that will increase access, refine oversight, advance education and improve transparency for providers and consumers alike.” 

Hospice advocates are urging lawmakers to support the Rural Access to Hospice Act of 2019 (H.R. 2594), bipartisan legislation introduced by Representatives Ron Kind (D-WI) and Jackie Walorski (R-IN) that will allow Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs) to receive payment for serving as the hospice attending physician. If passed, the legislation would fix a technical glitch that currently prevents terminally ill beneficiaries in underserved and rural communities from utilizing the physician of their choice when entering hospice care.

NHPCO members will also talk to lawmakers about the organization’s Program Integrity Initiative, which overviews provider supported reforms and opportunities for proactive collaboration with Congress and federal regulators to increase oversight, education, and transparency.

“We look forward to working with the Administration and Congress to simplify and streamline the hospice benefit and compliance process to ensure taxpayer resources are spent wisely,” noted Kuhlman. “More oversight of new and poor-performing hospice providers would protect the most vulnerable, while easing unnecessary governmental red tape on honest and law-abiding hospice providers so they can continue to provide high-quality, person-centered care.  Accountability leads to credibility. Our goal is to ensure patients and their families have the utmost confidence in their hospice program.” 

Learn more about the My Hospice Campaign.

My Hospice Ambassadors with members of the board at NHPCO offices on September 17.

Final Day of Virtual Hill Week - Take Action!

Activity throughout Virtual Hill Week (September 9 – 13) has been amazing. Almost 400 advocates have taken over 2,500 Advocacy Actions! This morning, Hospice Action Network announced that there are 18 (!!) New Bill Cosponsors for legislation the hospice community supports.Click here for the list of new cosponsors.

HAN really want to get up to 500 Advocates and 3,000 Advocacy Actions, as well as ensure that every state has their voices heard! Today is the final day of Virtual Hill Day 2019. If you haven’t yet contacted your Members of Congress, please take five minutes to do so.

If you are very short on time, the most important action you can take is making a phone call on behalf of the Rural Access to Hospice Act. When you log in to the Take Action Module and put in your home address, look for the phone icon on the far left to get the phone numbers and short script. Phone calls have a higher likelihood of making an impact, so we encourage everyone to PLEASE, make your phone calls and send emails!

Hospice Action Networks thanks everyone who has participated so far: it is amazing to see the impact you can have in just a few days.

Hello and Goodbye: Perinatal Loss Doula Volunteers

The Suncoast Hospice Perinatal Loss Program started in 2004, has recently grown to include a new focus on early first trimester losses and expanded training of volunteer perinatal loss doulas. Our program offers specialized comfort, education, and support to patients and families who may experience, or have already experienced, a pregnancy loss, stillbirth, or death of a baby shortly after birth. Our compassionate team of expert nurses, social workers, chaplains, and trained doula volunteers help patients and their families find understanding and peace through every step of their journeys.

Perinatal loss is often disregarded, its impact negated, leaving the woman and her family struggling emotionally and spiritually. Our doulas (also known as birth companions) understand that birth is a key life experience. They listen thoughtfully to what is important to the woman and her family regarding the birth, providing insight on options for managing the labor and delivery. Doulas offer physical and emotional support to mothers and their partners during labor, delivery, and the immediate postpartum period. They provide a quiet, consistent presence throughout this experience.

After delivery, memory making is an important service that our doulas provide. This involves bathing and dressing the baby, creating hand and foot prints and molds, and obtaining hair locks. Empath Health sewing volunteers make special clothes and blankets used for the baby. These items are placed in a memory box for them to keep. Support pamphlets, brochures, and resources are given to the mother and family as applicable.

In addition, our counselors provide counseling prior to and after the loss. If the pregnancy results in a live birth, our team can work with the family and hospital staff to create a meaningful experience no matter the length of the child’s life. When appropriate, the family can be transferred home to receive care from our Suncoast Hospice pediatric team.

Our Perinatal Loss Program continues to grow and evolve which includes expansion to other hospitals. In turn, we have, and continue to expand the number of volunteer doulas in the program. This entails enhanced doula recruitment and training. To accomplish this, we continue to develop closer collaboration with our Empath Health volunteer department.

This session is intended to develop an increased recognition of the role of the doula during a perinatal loss. Provide a description of the special recruitment and training needs and requirements of Empath Health perinatal loss doula volunteers. Present and describe strategies to develop and implement a perinatal loss program using volunteer doulas.

By Vicki Haywood MSN,  RN, CPAN
Senior Staff Nurse/Care Team Manager
Children’s Program
Empath Health

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Vicki Haywood is among the faculty for NHPCO's 2019 Interdisciplinary Conference at the Gaylord Palms in Orlando, Florida. She will be presenting as part of the session, "Hello and Goodbye: Perinatal Loss Doula Volunteers," on Wednesday, November 6, 2019.

Virtual Hill Week Starts Today!

September 9-13, 2019, all hospice and palliative care advocates and supporters should join in Virtual Hill Week and contact their elected officials regarding the importance of hospice and palliative care and some of the legislation that will help improve access.

The Hospice Action Network makes participation easy. Visit the HAN online Take Action Module and you will find everything you need, from reviewing key messaging to finding your legislators and contacting them.

Should you want to take a couple extra minutes to familiarize yourself with this year's policy asks, so you can feel prepared, there is information on the HAN website.

All this week - Monday through Friday - join thousands of hospice and palliative care advocates to make your voice heard on Capitol Hill.  As a participant in Virtual Hill Week, you are standing up for patients and families!

Take action - and spread the word via social media with hashtag #MyHospice.

Fearing Death Can Cause Suffering

When in life does one come to confront the tough truth that each of us will eventually die? In my years as an internist caring for young and old alike, some people understand this early, and some people never get it. In denying death, we intensify our fear of it. Usually, however, it is sometime during their 50s that people first look into the eyes of death. Put it off as we may, the hard certainty is that we are all aging and one day an end will come. Shakespeare described advanced age in his play As You Like It, Act II, Scene VII (All the world’s a stage):

“. . . Last scene of all, That ends this strange eventful history, Is second childishness and mere oblivion, Sans (without) teeth, sans eyes, sans taste, sans everything.”

Shakespeare’s description of advanced age during the 1600s is rather bleak and scary. I think, with modern medicine and the support of a loving family, we could do better. I clearly believe that advanced age and facing our own death should not fill us with dread. The following is a more hopeful version to end Shakespeare’s excerpt:

“. . . He did not have to end his life alone; If over time he’d shared his caring, raised the worth of others, fed the love he’d sown. His death would find him kindly prized and praised, While kin sang festive songs of joy, amazed.”

Fear comes from the oldest reptilian part of our brain. Fear helps us run from attackers but can also make us run from making important choices about our health. Fear can even bring us to push forward with treatment that may cause significant suffering, even when we are very old and even when treatment is futile and it’s time to quit.

Fear of dying can prevent us from making plans about end-of-life care and, most importantly, prevent us from talking to our families about those wishes. How do we want to be cared for if we should lose mental capacity from a stroke or dementia? Do we wish to have a feeding tube, resuscitation, antibiotics when there is no quality of life left, when one doesn’t recognize family and when the only option will be residing in a bed somewhere “sans everything.”

I would rather die and be:

“. . . kindly prized and praised, While kin sing festive songs of joy, amazed.”

By Richard P. Holm, MD
Medical Director
Brookings Hospital Hospice

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Dr. Holm is among the faculty for NHPCO's 2019 Interdisciplinary Conference at the Gaylord Palms in Orlando, Florida. His session, "How the Fear of Death Can Be Dangerous To Your Health," will be offered on day one of the IDC.

About the Author
A native of De Smet, South Dakota, Holm earned his B.S. in medicine in 1973 from the University of South Dakota and his M.D. from Emory University School of Medicine in 1975. Holm taught at Emory for three years and practiced medicine in Brookings, South Dakota for 38 years. He was inducted into the South Dakota Hall of Fame and cited as “South Dakota’s Voice of Healthcare” in 2017. His television show, a state-wide weekly call-in show on South Dakota Public Broadcasting is entering its 18th season and his musings on health, Prairie Doc® Perspectives are currently published as weekly columns in more than 100 newspapers in five states including South Dakota, North Dakota, Wyoming, Nebraska and Kansas. “Life’s Final Season: A Guide for Aging and Dying with Grace” is currently available from Amazon.com. Holm participates as a Goodreads Author and ongoing updates about his work can be found on the Prairie Doc® Facebook page and website.
Holm is semi-retired and continues to serve as Hospice Medical Director in Brookings.

Magical Orlando Opportunity for Pediatric Patients and Families During NHPCO’s 2019 IDC

In conjunction with the National Hospice and Palliative Care Organization’s 2019 Interdisciplinary Conference at the Gaylord Palms Resort and Convention Center in Orlando, Florida, fundraising affiliate National Hospice Foundation (NHF) is partnering with Give Kids the World Village to provide a special experience to a limited number of pediatric hospice or palliative care patients and their families.  

This trip would include theme park tickets, all meals and lodging for the patient and their parents and siblings, and travel reimbursement from NHF’s Lighthouse of Hope Fund.

“We are excited to offer pediatric patients and families this special opportunity to visit Orlando while hundreds of hospice and palliative care team members from across the country will be there for our annual Interdisciplinary Conference,” said President and CEO of NHPCO and NHF Edo Banach.

“Maximizing quality of life for patients and family caregivers is at the heart of the hospice philosophy of care. As part of our commitment to leading person- and family-centered care, NHPCO is honored to help some special young people make treasured memories with loved ones,” Banach added. 

Eligible patients for this opportunity are between the ages of 3-18, are under the care of an NHPCO member provider, and have not had a prior experience through a wish-granting organization. More information about this opportunity and the application form are available on NHF’s website.

Applications from NHPCO provider members are due October 14; questions may be directed to info@nationalhospicefoundation.org.

About NHPCO’s Interdisciplinary Conference 

The 2019 Interdisciplinary Conference offers a unique blend of keynotes, educational sessions, preconference learning and networking opportunities grounded in the philosophy of the interdisciplinary team.  Attendees engage with colleagues from across the country as they learn about new approaches, successful models, and innovations from the field.