[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 693 Introduced in Senate (IS)]

<DOC>






115th CONGRESS
  1st Session
                                 S. 693

   To amend the Public Health Service Act to increase the number of 
   permanent faculty in palliative care at accredited allopathic and 
osteopathic medical schools, nursing schools, social work schools, and 
 other programs, including physician assistant education programs, to 
 promote education and research in palliative care and hospice, and to 
   support the development of faculty careers in academic palliative 
                               medicine.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 22, 2017

  Ms. Baldwin (for herself and Mrs. Capito) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to increase the number of 
   permanent faculty in palliative care at accredited allopathic and 
osteopathic medical schools, nursing schools, social work schools, and 
 other programs, including physician assistant education programs, to 
 promote education and research in palliative care and hospice, and to 
   support the development of faculty careers in academic palliative 
                               medicine.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Palliative Care and Hospice 
Education and Training Act''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Palliative care is interdisciplinary, patient- and 
        family-centered health care for people with serious illnesses. 
        This type of care is focused on providing patients with relief 
        from the symptoms, pain, and stress of a serious illness, 
        whatever the diagnosis. The goal of palliative care is to 
        relieve suffering and improve quality of life for both patients 
        and their families. Palliative care is provided by a team of 
        doctors, nurses, social workers, physician assistants, 
        chaplains, and other specialists who work with a patient's 
        other health care providers to provide an extra layer of 
        support, including assistance with difficult medical 
        decisionmaking and coordination of care among specialists. 
        Palliative care is appropriate at any age and at any stage in a 
        serious illness, and can be provided together with curative 
        treatment. Palliative care is not dependent on a life-limiting 
        prognosis and may actually help an individual recover from 
        illness by relieving symptoms, such as pain, anxiety, or loss 
        of appetite, while undergoing sometimes difficult medical 
        treatments or procedures, such as surgery or chemotherapy.
            (2) Hospice is palliative care for patients in their last 
        year of life. Considered the model for quality compassionate 
        care for individuals facing a life-limiting illness, hospice 
        provides expert medical care, pain management, and emotional 
        and spiritual support expressly tailored to the patient's needs 
        and wishes. In most cases, care is provided in the patient's 
        home but may also be provided in freestanding hospice centers, 
        hospitals, nursing homes, and other long-term care facilities. 
        In 2014, an estimated 1,600,000 to 1,700,000 patients received 
        services from hospice, including non-Medicare beneficiaries. 
        Nearly 48 percent of all Medicare decedents in 2014 received 
        care from a hospice program. Hospice is a covered benefit under 
        the Medicare program. There were 4,025 Medicare-certified 
        hospices serving more than 1,300,000 Medicare beneficiaries in 
        2014.
            (3) Despite a high intensity of medical treatment, many 
        seriously ill patients experience troubling symptoms, unmet 
        psychological and personal care needs, and high caregiver 
        burden. Numerous studies have shown that adding palliative care 
        can improve pain and symptom control, quality of life, and 
        family satisfaction with care.
            (4) Health care providers need better education about pain 
        management and palliative care. Students graduating from 
        medical, nursing and other health professional schools today 
        have very little, if any, training in the core precepts of pain 
        and symptom management, advance care planning, communication 
        skills, and care coordination for patients with serious or 
        life-threatening illness. Even for specialists, training is 
        lacking. For example, the Accreditation Council for Graduate 
        Medical Education requires oncology fellowship programs to 
        integrate competence in palliative care into their curriculum 
        and the American Society of Clinical Oncology has recommended 
        the integration of palliative care services into standard 
        oncology practice at the time a person is diagnosed with 
        metastatic or advanced cancer. Yet a 2015 national survey found 
        that hematology/oncology fellows were ``inadequately prepared'' 
        to provide palliative care to their patients. Less than half 
        had a rotation in palliative care and 25 percent of fellows 
        reported no explicit teaching on key skills such as assessing 
        prognosis, conducting a family meeting to discuss treatment 
        options, and referral to palliative care.
            (5) The American Board of Medical Specialties and the 
        Accreditation Council for Graduate Medical Education provided 
        formal subspecialty status for hospice and palliative medicine 
        in 2006, and the Centers for Medicare & Medicaid Services 
        recognized hospice and palliative medicine as a medical 
        subspecialty in October of 2008.
            (6) As of February 2017, there were a total of 127 hospice 
        and palliative medicine training programs accredited by the 
        Accreditation Council for Graduate Medical Education. For the 
        2016-2017 academic year, these programs were training 327 
        physicians in hospice and palliative medicine. Some programs 
        include an additional track in pediatrics, geriatrics, 
        research, or public health. Fewer than a dozen of these ACGME-
        accredited training programs focus solely on pediatric 
        palliative medicine though data show an increasing prevalence 
        of children with complex chronic conditions who could benefit 
        from such specialized care.
            (7) There is a large gap between the number of healthcare 
        professionals with palliative care training and the number 
        required to meet the needs of the growing population of 
        individuals with serious or life-threatening illness. In 2015, 
        75 percent of United States hospitals with 50 or more beds had 
        a palliative care program though not all these programs have in 
        place the interdisciplinary team necessary to provide 
        comprehensive, high-quality palliative care. Hospital data 
        reported to the National Palliative Care Registry show that in 
        2015 only 44 percent of programs met national staffing 
        standards set by the Joint Commission, even when including 
        unfunded positions. Among the 56 percent of programs without 
        complete interdisciplinary teams, 30 percent have no physician, 
        10 percent have no advanced practice registered nurse or RN, 54 
        percent have no social worker, and 70 percent have no chaplain. 
        Looking at just physician specialists, 2017 projections by the 
        George Washington University Health Workforce Institute show 
        that current training capacity for hospice and palliative 
        medicine is not sufficient to provide hospital-based care and 
        keep pace with growth in the population of adults over 65 years 
        old. The shortages are exacerbated when considering the current 
        rapid expansion of community-based palliative care, such as in 
        outpatient and home-based settings. A separate survey of 
        physicians in the field found that, if the rate of those 
        entering and leaving hospice and palliative medicine maintains, 
        there will be no more than 1 percent absolute growth in this 
        physician workforce in 20 years, during which time the number 
        of persons eligible for palliative care will grow by over 20 
        percent. The study's authors project this will result in a 
        ratio of one palliative medicine physician for every 26,000 
        seriously ill patients by 2030.
            (8) According to the National Academy of Medicine, there is 
        a ``need for better understanding of the role of palliative 
        care among both the public and professionals across the 
        continuum of care so that hospice and palliative care can 
        achieve their full potential for patients and their families''.

SEC. 3. PALLIATIVE CARE AND HOSPICE EDUCATION AND TRAINING.

    (a) In General.--Part D of title VII of the Public Health Service 
Act (42 U.S.C. 294 et seq.) is amended by inserting after section 759 
the following:

``SEC. 759A. PALLIATIVE CARE AND HOSPICE EDUCATION AND TRAINING.

    ``(a) Palliative Care and Hospice Education Centers.--
            ``(1) In general.--The Secretary shall award grants or 
        contracts under this section to entities described in paragraph 
        (1), (3), or (4) of section 799B, and section 801(2), for the 
        establishment or operation of Palliative Care and Hospice 
        Education Centers that meet the requirements of paragraph (2).
            ``(2) Requirements.--A Palliative Care and Hospice 
        Education Center meets the requirements of this paragraph if 
        such Center--
                    ``(A) improves the training of health professionals 
                in palliative care, including residencies, 
                traineeships, or fellowships;
                    ``(B) develops and disseminates curricula relating 
                to the palliative treatment of the complex health 
                problems of individuals with serious or life-
                threatening illnesses;
                    ``(C) supports the training and retraining of 
                faculty to provide instruction in palliative care;
                    ``(D) supports continuing education of health 
                professionals who provide palliative care to patients 
                with serious or life-threatening illness;
                    ``(E) provides students (including residents, 
                trainees, and fellows) with clinical training in 
                palliative care in long-term care facilities, home 
                care, hospices, chronic and acute disease hospitals, 
                and ambulatory care centers;
                    ``(F) establishes traineeships for individuals who 
                are preparing for advanced education nursing degrees, 
                social work degrees, or advanced degrees in physician 
                assistant studies, with a focus in palliative care in 
                long-term care facilities, home care, hospices, chronic 
                and acute disease hospitals, and ambulatory care 
                centers; and
                    ``(G) does not duplicate the activities of existing 
                education centers funded under this section or under 
                section 753 or 865.
            ``(3) Expansion of existing centers.--Nothing in this 
        section shall be construed to--
                    ``(A) prevent the Secretary from providing grants 
                to expand existing education centers, including 
                geriatric education centers established under section 
                753 or 865, to provide for education and training 
                focused specifically on palliative care, including for 
                non-geriatric populations; or
                    ``(B) limit the number of education centers that 
                may be funded in a community.
    ``(b) Palliative Medicine Physician Training.--
            ``(1) In general.--The Secretary may make grants to, and 
        enter into contracts with, schools of medicine, schools of 
        osteopathic medicine, teaching hospitals, and graduate medical 
        education programs, for the purpose of providing support for 
        projects that fund the training of physicians (including 
        residents, trainees, and fellows) who plan to teach palliative 
        medicine.
            ``(2) Requirements.--Each project for which a grant or 
        contract is made under this subsection shall--
                    ``(A) be staffed by full-time teaching physicians 
                who have experience or training in palliative medicine;
                    ``(B) be based in a hospice and palliative medicine 
                fellowship program accredited by the Accreditation 
                Council for Graduate Medical Education;
                    ``(C) provide training in palliative medicine 
                through a variety of service rotations, such as 
                consultation services, acute care services, extended 
                care facilities, ambulatory care and comprehensive 
                evaluation units, hospice, home health, and community 
                care programs;
                    ``(D) develop specific performance-based measures 
                to evaluate the competency of trainees; and
                    ``(E) provide training in palliative medicine 
                through one or both of the training options described 
                in subparagraphs (A) and (B) of paragraph (3).
            ``(3) Training options.--The training options referred to 
        in subparagraph (E) of paragraph (2) are as follows:
                    ``(A) 1-year retraining programs in hospice and 
                palliative medicine for physicians who are faculty at 
                schools of medicine and osteopathic medicine, or others 
                determined appropriate by the Secretary.
                    ``(B) 1- or 2-year training programs that are 
                designed to provide training in hospice and palliative 
                medicine for physicians who have completed graduate 
                medical education programs in any medical specialty 
                leading to board eligibility in hospice and palliative 
                medicine pursuant to the American Board of Medical 
                Specialties.
            ``(4) Definitions.--For purposes of this subsection the 
        term `graduate medical education' means a program sponsored by 
        a school of medicine, a school of osteopathic medicine, a 
        hospital, or a public or private institution that--
                    ``(A) offers postgraduate medical training in the 
                specialties and subspecialties of medicine; and
                    ``(B) has been accredited by the Accreditation 
                Council for Graduate Medical Education or the American 
                Osteopathic Association through its Committee on 
                Postdoctoral Training.
    ``(c) Palliative Medicine and Hospice Academic Career Awards.--
            ``(1) Establishment of program.--The Secretary shall 
        establish a program to provide awards, to be known as the 
        `Palliative Medicine and Hospice Academic Career Awards', to 
        eligible individuals to promote the career development of such 
        individuals as academic hospice and palliative care physicians.
            ``(2) Eligible individuals.--To be eligible to receive an 
        award under paragraph (1), an individual shall--
                    ``(A) be board certified or board eligible in 
                hospice and palliative medicine; and
                    ``(B) have a junior (non-tenured) faculty 
                appointment at an accredited (as determined by the 
                Secretary) school of medicine or osteopathic medicine.
            ``(3) Limitations.--No award under paragraph (1) may be 
        made to an eligible individual unless the individual--
                    ``(A) has submitted to the Secretary an 
                application, at such time, in such manner, and 
                containing such information as the Secretary may 
                require, and the Secretary has approved such 
                application;
                    ``(B) provides, in such form and manner as the 
                Secretary may require, assurances that the individual 
                will meet the service requirement described in 
                paragraph (6); and
                    ``(C) provides, in such form and manner as the 
                Secretary may require, assurances that the individual 
                has a full-time faculty appointment in a health 
                professions institution and documented commitment from 
                such institution to spend a majority of the total 
                funded time of such individual on teaching and 
                developing skills in interdisciplinary education in 
                palliative care.
            ``(4) Maintenance of effort.--An eligible individual who 
        receives an award under paragraph (1) shall provide assurances 
        to the Secretary that funds provided to the eligible individual 
        under this subsection will be used only to supplement, not to 
        supplant, the amount of Federal, State, and local funds 
        otherwise expended by the eligible individual.
            ``(5) Amount and term.--
                    ``(A) Amount.--The amount of an award under this 
                subsection shall be equal to the award amount provided 
                for under section 753(c)(5)(A) for the fiscal year 
                involved.
                    ``(B) Term.--The term of an award made under this 
                subsection shall not exceed 5 years.
                    ``(C) Payment to institution.--The Secretary shall 
                make payments for awards under this subsection to 
                institutions, including schools of medicine and 
                osteopathic medicine.
            ``(6) Service requirement.--An individual who receives an 
        award under this subsection shall provide training in 
        palliative care and hospice, including the training of 
        interdisciplinary teams of health care professionals. The 
        provision of such training shall constitute a majority of the 
        total funded obligations of such individual under the award.
    ``(d) Palliative Care Workforce Development.--
            ``(1) In general.--The Secretary shall award grants or 
        contracts under this subsection to entities that operate a 
        Palliative Care and Hospice Education Center pursuant to 
        subsection (a)(1).
            ``(2) Application.--To be eligible for an award under 
        paragraph (1), an entity described in such paragraph shall 
        submit to the Secretary an application at such time, in such 
        manner, and containing such information as the Secretary may 
        require.
            ``(3) Use of funds.--Amounts awarded under a grant or 
        contract under paragraph (1) shall be used to carry out the 
        fellowship program described in paragraph (4).
            ``(4) Fellowship program.--
                    ``(A) In general.--Pursuant to paragraph (3), a 
                Palliative Care and Hospice Education Center that 
                receives an award under this subsection shall use such 
                funds to offer short-term intensive courses (referred 
                to in this subsection as a `fellowship') that focus on 
                palliative care that provide supplemental training for 
                faculty members in medical schools and other health 
                professions schools with programs in psychology, 
                pharmacy, nursing, social work, physician assistant 
                education, chaplaincy, or other health disciplines, as 
                approved by the Secretary. Such a fellowship shall be 
                open to current faculty, and appropriately credentialed 
                volunteer faculty and practitioners, who do not have 
                formal training in palliative care, to upgrade their 
                knowledge and clinical skills for the care of 
                individuals with serious or life-threatening illness 
                and to enhance their interdisciplinary and 
                interprofessional teaching skills.
                    ``(B) Location.--A fellowship under this paragraph 
                shall be offered either at the Palliative Care and 
                Hospice Education Center that is sponsoring the course, 
                in collaboration with other Palliative Care and Hospice 
                Education Centers, or at medical schools, schools of 
                nursing, schools of pharmacy, schools of social work, 
                schools of chaplaincy or pastoral care education, 
                graduate programs in psychology, physician assistant 
                education programs, or other health professions schools 
                approved by the Secretary with which the Centers are 
                affiliated.
                    ``(C) Continuing education credit.--Participation 
                in a fellowship under this paragraph shall be accepted 
                with respect to complying with continuing health 
                profession education requirements. As a condition of 
                such acceptance, the recipient shall subsequently 
                provide a minimum of 18 hours of voluntary instruction 
                in palliative care content (that has been approved by a 
                palliative care and hospice education center) to 
                students or trainees in health-related educational, 
                home, hospice, or long-term care settings.
            ``(5) Targets.--A Palliative Care and Hospice Education 
        Center that receives an award under this subsection shall meet 
        targets approved by the Secretary for providing palliative care 
        training to a certain number of faculty or practitioners during 
        the term of the award, as well as other parameters established 
        by the Secretary.
            ``(6) Amount of award.--Each award under this subsection 
        shall be in the amount of $150,000. Not more than 24 Palliative 
        Care and Hospice Education Centers may receive an award under 
        this subsection.
            ``(7) Maintenance of effort.--A Palliative Care and Hospice 
        Education Center that receives an award under this subsection 
        shall provide assurances to the Secretary that funds provided 
        to the Center under the award will be used only to supplement, 
        not to supplant, the amount of Federal, State, and local funds 
        otherwise expended by such Center.
    ``(e) Palliative Care and Hospice Career Incentive Awards.--
            ``(1) In general.--The Secretary shall award grants or 
        contracts under this subsection to individuals described in 
        paragraph (2) to foster greater interest among a variety of 
        health professionals in entering the field of palliative care.
            ``(2) Eligible individuals.--To be eligible to receive an 
        award under paragraph (1), an individual shall--
                    ``(A) be an advanced practice nurse, a social 
                worker, physician assistant, pharmacist, chaplain, or 
                student of psychology who is pursuing a doctorate, 
                masters, or other advanced degree with a focus in 
                palliative care or related fields in an accredited 
                health professions school; and
                    ``(B) submit to the Secretary an application at 
                such time, in such manner, and containing such 
                information as the Secretary may require.
            ``(3) Conditions of award.--As a condition of receiving an 
        award under this subsection, an individual shall agree that, 
        following completion of the award period, the individual will 
        teach or practice palliative care in health-related 
        educational, home, hospice, or long-term care settings for a 
        minimum of 5 years under guidelines established by the 
        Secretary.
            ``(4) Payment to institution.--The Secretary shall make 
        payments for awards under this subsection to institutions which 
        include schools of medicine, osteopathic medicine, nursing, 
        social work, psychology, chaplaincy or pastoral care education, 
        dentistry, and pharmacy, or other allied health discipline in 
        an accredited health professions school or program (such as a 
        physician assistant education program) that is approved by the 
        Secretary.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $44,100,000 for each of the 
fiscal years 2018 through 2022.''.
    (b) Effective Date.--The amendment made by this section shall be 
effective beginning on the date that is 90 days after the date of 
enactment of this Act.

SEC. 4. HOSPICE AND PALLIATIVE NURSING.

    (a) Preference for Grants or Awards for Nursing Workforce 
Development Projects.--Section 805 of the Public Health Service Act (42 
U.S.C. 296d) is amended--
            (1) by striking ``or help'' and inserting ``help''; and
            (2) by inserting the following before the period at the 
        end: ``, or for education and training in hospice and 
        palliative nursing''.
    (b) Advanced Education Nursing Grants.--Section 811 of the Public 
Health Service Act (42 U.S.C. 296j) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by striking ``and'' at the 
                end;
                    (B) by redesignating paragraph (2) as paragraph 
                (3); and
                    (C) by inserting after paragraph (1), the following 
                new paragraph:
            ``(2) palliative care and hospice career incentive awards 
        under section 759A(e); and''; and
            (2) in subsection (g)(2), by inserting ``or for education 
        and training in hospice and palliative nursing'' after 
        ``section 332''.
    (c) Nurse Education, Practice, and Quality Grants.--Section 831 of 
the Public Health Service Act (42 U.S.C. 296p) is amended--
            (1) in subsection (a)--
                    (A) by striking ``or'' at the end of paragraph (1);
                    (B) by striking the period at the end of paragraph 
                (2) and inserting ``; or''; and
                    (C) by adding at the end the following new 
                paragraph:
            ``(3) education and training in hospice and palliative 
        nursing.''; and
            (2) in subsection (b)(3), by inserting ``hospice and 
        palliative nursing,'' after ``coordinated care,''.
    (d) Nurse Retention Grants.--Section 831A of the Public Health 
Service Act (42 U.S.C. 296p-1) is amended--
            (1) in subsection (c)(2), by inserting ``, and to 
        applicants with programs that include initiatives to train 
        nurses in hospice and palliative nursing'' before the period; 
        and
            (2) in subsection (d), by inserting ``, and to train nurses 
        in hospice and palliative nursing'' before the period.
    (e) Additional Palliative Care and Hospice Education and Training 
Programs.--Part D of title VIII of the Public Health Service Act (42 
U.S.C. 296p et seq.) is amended by adding at the end the following:

``SEC. 832. PALLIATIVE CARE AND HOSPICE EDUCATION AND TRAINING.

    ``(a) Program Authorized.--The Secretary shall award grants to 
eligible entities to develop and implement, in coordination with 
programs under section 759A, programs and initiatives to train and 
educate individuals in providing palliative care in health-related 
educational, hospice, home, or long-term care settings.
    ``(b) Use of Funds.--An eligible entity that receives a grant under 
subsection (a) shall use funds under such grant to--
            ``(1) provide training to individuals who will provide 
        palliative care in health-related educational, home, hospice, 
        or long-term care settings;
            ``(2) develop and disseminate curricula relating to 
        palliative care in health-related educational, home, hospice, 
        or long-term care settings;
            ``(3) train faculty members in palliative care in health-
        related educational, home, hospice, or long-term care settings; 
        or
            ``(4) provide continuing education to individuals who 
        provide palliative care in health-related educational, home, 
        hospice, or long-term care settings.
    ``(c) Application.--An eligible entity desiring a grant under 
subsection (a) shall submit an application to the Secretary at such 
time, in such manner, and containing such information as the Secretary 
may reasonably require.
    ``(d) Eligible Entity.--For purposes of this section, the term 
`eligible entity' shall include a school of nursing, a health care 
facility, a program leading to certification as a certified nurse 
assistant, a partnership of such a school and facility, or a 
partnership of such a program and facility.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $5,000,000 for each of fiscal 
years 2018 through 2022.''.

SEC. 5. NATIONAL PALLIATIVE CARE EDUCATION AND AWARENESS CAMPAIGN.

    Part A of title IX of the Public Health Service Act (42 U.S.C. 299 
et seq.) is amended by adding at the end the following new section:

``SEC. 904. NATIONAL PALLIATIVE CARE EDUCATION AND AWARENESS CAMPAIGN.

    ``(a) In General.--Under the authority under section 902(a) to 
disseminate information on health care and on systems for the delivery 
of such care, the Director shall provide for the planning and 
implementation of a national education and awareness campaign to inform 
patients, families, and health professionals about the benefits of 
palliative care throughout the continuum of care for patients with 
serious or life-threatening illness.
    ``(b) Information Disseminated.--
            ``(1) Mandatory information.--The campaign under subsection 
        (a) shall include dissemination of the following:
                    ``(A) Palliative care.--Information, resources, and 
                communication materials about palliative care as an 
                essential part of the continuum of quality care for 
                patients and families facing serious or life-
                threatening illness (including cancer; heart, kidney, 
                liver, lung, and infectious diseases; as well as 
                neurodegenerative disease such as dementia, Parkinson's 
                disease, or amyotrophic lateral sclerosis).
                    ``(B) Palliative care services.--Specific 
                information regarding the services provided to patients 
                by professionals trained in hospice and palliative 
                care, including pain and symptom management, support 
                for shared decisionmaking, care coordination, 
                psychosocial care, and spiritual care, explaining that 
                such services may be provided starting at the point of 
                diagnosis and alongside curative treatment and are 
                intended to--
                            ``(i) provide patient-centered and family-
                        centered support throughout the continuum of 
                        care for serious and life-threatening illness;
                            ``(ii) anticipate, prevent, and treat 
                        physical, emotional, social, and spiritual 
                        suffering;
                            ``(iii) optimize quality of life; and
                            ``(iv) facilitate and support the goals and 
                        values of patients and families.
                    ``(C) Palliative care professionals.--Specific 
                materials that explain the role of professionals 
                trained in hospice and palliative care in providing 
                team-based care (including pain and symptom management, 
                support for shared decisionmaking, care coordination, 
                psychosocial care, and spiritual care) for patients and 
                families throughout the continuum of care for serious 
                or life-threatening illness.
                    ``(D) Research.--Evidence-based research 
                demonstrating the benefits of patient access to 
                palliative care throughout the continuum of care for 
                serious or life-threatening illness.
                    ``(E) Population-specific materials.--Materials 
                shall be developed that target specific populations, 
                including patients with serious or life-threatening 
                illness who are among medically underserved populations 
                (as defined in section 330(b)(3)) and families of such 
                patients or health professionals serving medically 
                underserved populations. Such populations shall include 
                pediatric patients, young adult and adolescent 
                patients, racial and ethnic minority populations, and 
                other priority populations specified by the Director.
            ``(2) Other information.--In addition to the information 
        described in paragraph (1), such campaign may include 
        dissemination of such other information as the Director 
        determines to be relevant.
            ``(3) Information format.--The information and materials 
        required to be disseminated under paragraph (1) and any 
        information disseminated under paragraph (2) shall be presented 
        in a variety of formats (such as posted online, in print, and 
        through public service announcements).
            ``(4) Required publication.--The information and materials 
        required to be disseminated under paragraph (1) and any 
        information disseminated under paragraph (2) shall be posted on 
        the Internet websites of relevant Federal agencies and 
        Departments, including the Agency for Healthcare Research and 
        Quality, the Centers for Medicare & Medicaid Services, the 
        Administration on Aging, the Centers for Disease Control and 
        Prevention, and the Department of Veterans Affairs.
    ``(c) Consultation.--The Director shall consult with appropriate 
professional societies, hospice and palliative care stakeholders, and 
relevant patient advocate organizations with respect to palliative 
care, psychosocial care, and complex chronic illness with respect to 
the following:
            ``(1) The planning and implementation of the national 
        palliative care education and awareness campaign under this 
        section.
            ``(2) The development of information to be disseminated 
        under this section.
            ``(3) A definition of the term `serious or life-threatening 
        illness' for purposes of this section.''.

SEC. 6. CLARIFICATION.

    None of the funds made available under this Act (or an amendment 
made by this Act) may be used to provide, promote, or provide training 
with regard to any item or service for which Federal funding is 
unavailable under section 3 of Public Law 105-12 (42 U.S.C. 14402).

SEC. 7. ENHANCING NIH RESEARCH IN PALLIATIVE CARE.

    (a) In General.--Part B of title IV of the Public Health Service 
Act (42 U.S.C. 284 et seq.) is amended by adding at the end the 
following new section:

``SEC. 409K. ENHANCING RESEARCH IN PALLIATIVE CARE.

    ``(a) In General.--The Secretary, acting through the Director of 
the National Institutes of Health, shall develop and implement a 
strategy to be applied across the institutes and centers of the 
National Institutes of Health to expand national research programs in 
palliative care.
    ``(b) Research Programs.--The Director of the National Institutes 
of Health shall expand and intensify research programs in palliative 
care to address the quality of care and quality of life for the rapidly 
growing population of patients in the United States with serious or 
life-threatening illnesses, including cancer; heart, kidney, liver, 
lung, and infectious diseases; as well as neurodegenerative disease 
such as dementia, Parkinson's disease, or amyotrophic lateral 
sclerosis.''.
    (b) Expanding Trans-NIH Research Reporting To Include Palliative 
Care Research.--Section 402A(c)(2)(B) of the Public Health Service Act 
(42 U.S.C. 282a(c)(2)(B)) is amended by inserting ``and, beginning 
January 1, 2018, for conducting or supporting research with respect to 
palliative care'' after ``or national centers''.
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