[Congressional Record Volume 160, Number 59 (Thursday, April 10, 2014)]
[Senate]
[Page S2375]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   NATIONAL HEALTHCARE DECISIONS DAY

  Mr. NELSON. Mr. President, I wish to recognize National Healthcare 
Decisions Day, which is next Wednesday, April 16, a day to educate the 
public about advance care planning and encourage them to have 
conversations with loved ones to plan for end-of-life decisions. I am 
pleased that over 50 organizations--representing health providers, 
communities of faith, the legal community, and the public sector--in 
Florida are participating in the day's events.
  This issue has been important to me throughout my career, and as the 
chairman of the Senate's Special Committee on Aging, I had the 
opportunity to chair a hearing on end-of-life care last June. We found 
that polls show most Americans would like to talk about their advanced 
care needs, but they do not know how or with whom to have these 
conversations. In fact, only about 20 percent of Americans have 
executed an advanced directive, in part due to a lack of knowledge 
about planning.
  Our hearing also touched on some commonsense solutions that 
individuals have used to broach this topic with their loved ones. For 
example, Aging with Dignity, an organization based in my home State of 
Florida, has created a simple resource called Five Wishes that is 
focused on things that are meaningful for patients and families, rather 
than a system of advance care planning dictated exclusively by the 
terms of doctors and lawyers. Five Wishes takes into account personal, 
emotional, and spiritual needs as well as medical wishes. With a 
straightforward, easy-to-complete questionnaire, Five Wishes takes end-
of-life decision-making out of the emergency room and into the living 
room.
  There are also areas where the Federal Government could help 
alleviate some of the barriers individuals face in trying to complete 
an advance directive. We know many people could use the assistance of a 
trusted health care provider in completing an advance directive. In 
2010, the Centers for Medicare and Medicaid Services--CMS--included 
advance care planning as a reimbursable item as part of the annual 
wellness visit for Medicare beneficiaries under the Affordable Care 
Act. Unfortunately, just a short time later, CMS reversed itself and 
removed this service as reimbursable. I hope this decision is 
revisited.
  At the same time, there are efforts at the State level. For example, 
in Florida, a consortium of health care providers, faith-based groups, 
and the legal profession are collaborating to establish the Physician 
Orders for Life-Sustaining Treatment program to ensure that advance 
directives are honored.
  It is my hope Congress will support the goals of National Healthcare 
Decisions Day. Advance care planning is a desired health service and 
should be a normal part of health care. Advance care planning can 
empower individuals and allow adults to voice their medical treatment 
preferences. Together, we can ensure Americans' wishes for medical care 
at the end of their lives are respected and achieved.

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