[Congressional Record Volume 159, Number 42 (Thursday, March 21, 2013)]
[Senate]
[Page S2149]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. WYDEN (for himself and Mr. Reed):
  S. 641. 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, and other programs, 
to promote education in palliative care and hospice, and to support the 
development of faculty careers in academic palliative medicine; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. WYDEN. Mr. President, I rise today to discuss the critical need 
in today's health care workforce for additional training related to 
palliative care. Palliative care is an interdisciplinary model of care 
focused on relieving the pain, stress and other debilitating symptoms 
of serious illness, such as cancer, cardiac disease, respiratory 
disease, kidney failure, Alzheimer's, AIDS, ALS, and MS. Its goal is to 
relieve suffering and provide the best possible quality of life for 
patients and their families.
  Many people mistakenly believe that palliative care is only 
beneficial when a cure is not possible. Actually, palliative care is 
not dependent on a life-limiting prognosis and may actually help 
individuals recover by relieving symptoms such as pain, anxiety or loss 
of appetite while they are undergoing sometimes difficult medical 
treatments or procedures, such as surgery or chemotherapy. Palliative 
care is provided by a team of doctors, nurses, social workers, 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 decision-making and coordination of care among 
specialists. Palliative care is appropriate for people of any age and 
at any stage in an illness, whether that illness is curable, chronic or 
life-threatening.
  There is a specific type of palliative care, called hospice, for 
people for whom a cure is no longer possible and who likely have 6 
months or less to live. Hospice care can be provided at one's home, a 
hospice facility, a hospital or a nursing home. Hospice care is about 
giving patients control, dignity and comfort so they have the best 
possible quality of life during the time they have. Hospice care also 
provides support and grief therapy for loved ones whose struggles are 
often cast aside or forgotten during treatment.
  A growing evidence base has demonstrated that palliative care, 
including hospice, improves quality, controls cost and enhances patient 
and family satisfaction for the rapidly expanding population of 
individuals with serious or life-threatening illness. Palliative care 
may also prolong the lives of some seriously ill patients.
  Over the last 10 years, the number of hospital-based palliative care 
programs has more than doubled due to the increasing number of 
Americans living with serious, complex and chronic illnesses and the 
realities of the care responsibilities faced by their families. Studies 
suggest that in states with more hospital-based palliative care 
programs, patients are less likely to die in the hospital, are likely 
to spend fewer days in the ICU, have better pain management and higher 
satisfaction with their health care.
  As usual, Oregon is ahead of the curve and I'm proud to say that in a 
2011 report ranking states on their citizens' access to hospital-based 
palliative care programs, Oregon was among the seven states who earned 
an ``A'' rating, with 88 percent of Oregon hospitals offering 
palliative care.
  Unfortunately, many seriously ill patients and their families lack 
the type of access available to Oregonians. Palliative care is a 
relatively new medical specialty and more must be done to ensure an 
adequate, well-trained palliative care workforce is available to 
provide comprehensive symptom management, intensive communication and a 
level of care coordination that addresses the episodic and long-term 
nature of serious, chronic illness. I believe that, with Federal 
support, we can help address the workforce gap between those currently 
practicing in palliative care and hospice and the number of health care 
professionals required to care for this expanding patient population. 
That is why today I am introducing the ``Palliative Care and Hospice 
Education and Training Act'' or PCHETA. This authoring legislation 
focuses on three key areas to grow the palliative care and hospice 
workforce: education centers to expand interdisciplinary training in 
palliative and hospice care; training of physicians who plan to teach 
palliative medicine and fellowships to encourage re-training for mid-
career physicians; and academic career awards and career incentive 
awards to support physicians and other health care providers who 
provide palliative and hospice care training.
  With this legislation, patients and families who are facing serious 
or life-threatening illness will have access to the high-quality 
palliative care and hospice services that can maximize their quality of 
life. I urge my colleagues to join me in this effort.
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