[Congressional Record Volume 164, Number 123 (Monday, July 23, 2018)]
[House]
[Pages H6602-H6605]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         PALLIATIVE CARE AND HOSPICE EDUCATION AND TRAINING ACT

  Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1676) 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, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1676

       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. 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 interprofessional team-based training of 
     health professionals in palliative care, including 
     residencies, traineeships, or fellowships;
       ``(B) develops and disseminates interprofessional team-
     based 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 interprofessional team-based 
     palliative care;
       ``(D) supports interprofessional team-based 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 interprofessional team-
     based palliative care in appropriate health settings, 
     including hospitals, hospices, home care, long-term care 
     facilities, 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 interprofessional team-based palliative care 
     in appropriate health settings, including hospitals, 
     hospices, home care, long-term care facilities, and 
     ambulatory care centers;
       ``(G) supports collaboration between multiple specialty 
     training programs (such as medicine, nursing, social work, 
     physician assistant, chaplaincy, and pharmacy) and clinical 
     training sites to provide training in interprofessional team-
     based palliative care; and
       ``(H) 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 interprofessional team-based 
     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 interprofessional team-based 
     palliative medicine through a variety of service rotations, 
     such as consultation services, acute care services, extended 
     care facilities, ambulatory care and comprehensive evaluation 
     units, hospices, home care, and community care programs;
       ``(D) develop specific performance-based measures to 
     evaluate the competency of trainees; and
       ``(E) provide training in interprofessional team-based 
     palliative medicine through one or both of the training 
     options described in 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 interprofessional team-based 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 education in 
     interprofessional team-based 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.

[[Page H6603]]

       ``(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 
     interprofessional 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 interprofessional team-based 
     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 paragraph (1) shall meet 
     targets approved by the Secretary for providing training in 
     interprofessional team-based palliative care 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 paragraph (1) 
     shall be in the amount of $150,000. Not more than 24 
     Palliative Care and Hospice Education Centers may receive an 
     award under such paragraph.
       ``(7) Maintenance of effort.--A Palliative Care and Hospice 
     Education Center that receives an award under paragraph (1) 
     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 interprofessional team-based 
     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 paragraph (1), 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 paragraph (1) to institutions that 
     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, 
     $15,000,000 for each of the fiscal years 2019 through 
     2023.''.
       (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. 3. HOSPICE AND PALLIATIVE NURSING.

       (a) Nurse Education, Practice, and Quality Grants.--Section 
     831(b)(3) of the Public Health Service Act (42 U.S.C. 
     296p(b)(3)) is amended by inserting ``hospice and palliative 
     nursing,'' after ``coordinated care,''.
       (b) 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 
     interprofessional team-based palliative care in health-
     related educational, hospital, 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, hospital, 
     home, hospice, or long-term care settings;
       ``(2) develop and disseminate curricula relating to 
     palliative care in health-related educational, hospital, 
     home, hospice, or long-term care settings;
       ``(3) train faculty members in palliative care in health-
     related educational, hospital, 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 2019 through 2023.''.

     SEC. 4. DISSEMINATION OF PALLIATIVE CARE INFORMATION.

       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. DISSEMINATION OF PALLIATIVE CARE INFORMATION.

       ``(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 may disseminate 
     information 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.--If the Director elects to 
     disseminate information under subsection (a), such 
     dissemination shall include 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;

[[Page H6604]]

       ``(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 targeting 
     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) Required publication.--Information and materials 
     disseminated under paragraph (1) shall be posted on the 
     Internet websites of relevant Federal agencies and 
     departments, including the Department of Veterans Affairs, 
     the Centers for Medicare & Medicaid Services, and the 
     Administration on Aging.
       ``(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 dissemination 
     of palliative care information 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. 5. 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. 6. 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.

       ``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 and intensify 
     national research programs in palliative care in order 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 diseases 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, 2019, for 
     conducting or supporting research with respect to palliative 
     care'' after ``or national centers''.

     SEC. 7. CUT-GO OFFSET.

       The total amount authorized to be appropriated to the 
     Office of the Secretary of Health and Human Services for each 
     of fiscal years 2019 through 2023 is the amount that is 
     $20,000,000 below the total amount appropriated to such 
     Office for fiscal year 2018.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Oregon (Mr. Walden) and the gentleman from Texas (Mr. Gene Green) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Oregon.


                             General Leave

  Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous materials in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Oregon?
  There was no objection.
  Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 1676. As we have heard, 
this is the Palliative Care and Hospice Education and Training Act, and 
it is sponsored by my colleague from New York, Representative Eliot 
Engel.
  This bipartisan legislation will authorize the Department of Health 
and Human Services to award grants or contracts for palliative care and 
hospice education centers, promote the career development of nurses and 
physicians in palliative care, and promote research and outreach in the 
delivery of care for patients with serious or life-threatening 
illnesses at the National Institutes of Health.
  Now, I have heard about this bill's impact from palliative care 
specialists and disease advocates all across Oregon. Dawn Frazier in 
Bend, Oregon, told me about her daughter, Rhonda, who tragically passed 
away at the age of 34. She suffered from early onset Alzheimer's.
  In an opinion piece that Dawn had published in the Bend Bulletin, she 
wrote: ``Palliative and hospice care are vital services for people with 
Alzheimer's and other dementias. For people with advanced dementia, 
team-based care--which focuses on managing and easing symptoms, 
reducing pain and stress, and increasing comfort--improves quality of 
life, controls costs, and enhances patient and family satisfaction.''
  She wrote: ``Here in Oregon, 19 percent of people in hospice have a 
primary diagnosis of dementia. Yet, the availability and quality of 
palliative and hospice care is a concern.''
  Dawn went on to say that this bill will help make critical palliative 
care and hospice services available to millions of patients across the 
country.
  I have long been a supporter of this bipartisan legislation and 
programs for palliative and hospice care. My own parents both received 
valuable care in this regard, especially hospice care, as their lives 
came to a close.
  This is all part of why I am a cosponsor, along with 284 of my 
colleagues in the House, and why I have worked with Representative 
Engel and our subcommittee chair on the Energy and Commerce 
Subcommittee for Health, Chairman Burgess, to move this legislation 
forward in the Energy and Commerce Committee, where, by the way, it 
received unanimous votes in both our Health Subcommittee and in our 
full committee.
  So, Mr. Speaker, I urge my colleagues to vote ``yes'' on this 
important measure. Let's advance our public health.
  Mr. Speaker, I reserve the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I rise today in support of H.R. 1676, the Palliative 
Care and Hospice Education and Training Act.
  Mr. Speaker, I thank my colleague and our committee member, 
Congressman Eliot Engel, for introducing this important legislation. I 
would also like to thank other cosponsors: Congressman Buddy Carter, 
also a member on our committee, and Representative  Tom Reed for their 
work and support on this legislation.
  Palliative care complements efforts to treat or cure illness by 
focusing on patients' quality of life. It is appropriate for patients 
with serious illnesses, starting at the point of diagnosis through 
treatment, and onward through hospice and the end of life.
  Palliative care entails communication with patients and their 
families to coordinate care, determine patient preferences, and assist 
with medical decisionmaking.
  A growing body of research has documented the benefits of high-
quality palliative and hospice care for patients in hospitals and 
payers, and the healthcare system as a whole.
  Palliative and hospice care have been associated with enhanced 
quality of life for patients, reduced hospital expenditures and lengths 
of stay, and other positive outcomes, including longer patient survival 
time.
  Despite the benefits of palliative care, many Americans aren't aware 
of the supports available to them. There is also a shortage of educated 
providers who can offer quality palliative care.
  The Palliative Care and Hospice Education and Training Act will 
address these issues.
  This legislation will help create an infrastructure to improve 
palliative care training for healthcare providers, encourage the 
National Institutes of Health to expand its research on palliative care 
and pain management, and ensure Americans have an understanding of how 
palliative care may benefit them and their loved ones.

[[Page H6605]]

  I am a proud cosponsor of this legislation. In fact, this bill has 
285 cosponsors, two-thirds of the entire House of Representatives.
  I ask my colleagues to join me in supporting this important 
legislation that will expand our Nation's research and infrastructure 
on palliative care and pain management.
  Mr. Speaker, I reserve the balance of my time.
  Mr. WALDEN. Mr. Speaker, I yield 2 minutes to the gentleman from New 
York (Mr. Reed), who has been a real leader on this issue and several 
others related to healthcare, and especially on diabetes.
  Mr. REED. Mr. Speaker, I thank the chairman for recognizing me and 
for the opportunity to speak, and my colleagues on the other side of 
the aisle for the efforts that they have put into the Palliative Care 
and Hospice Education and Training Act.

  Mr. Speaker, I rise in strong support of this bill, because hospice 
and palliative care is an underutilized piece of medical treatment in 
America. This bill is designed to promote not only the care that is 
provided under palliative and hospice care, but also to empower the 
workforce of today and tomorrow to provide these critical healthcare 
delivery systems to our aging population, to our family members, and to 
our dear fellow citizens.
  Mr. Speaker, I am strongly in support of this legislation, because 
this is something that is personal, as I lost my mom 9 months to the 
day she was diagnosed with lymphoma and passed in my arms. The woman 
who taught me how to live, and my 11 older brothers and sisters, also 
taught me how to die.
  We in America need to have a conversation across this entire Nation 
about how important it is to recognize that we are all mortal and that, 
at the end of our life, we need to face that critical question of what 
type of healthcare we want to receive to make sure that our quality of 
life is preserved and the quantity of life is extended as much as 
possible in order to enjoy that life.
  Under this act, Mr. Speaker, one of the key components of it is to 
provide the professionalism that is necessary to have that conversation 
with families, with children like myself in that situation. I hope that 
we will have this conversation with our loved ones much sooner rather 
than at that end of times.
  By engaging in this legislation, Mr. Speaker, we will promote 
palliative and hospice care, and make sure that all Americans know that 
this care is available to them. Not only will it allow them to enjoy 
peace in their final days, but it will provide a quality of life that 
no other care that I know of does. That is palliative and hospice care 
to make you comfortable and enjoy your loved ones as we end our time on 
this Earth.
  Mr. Speaker, I urge my colleagues to support this legislation and 
join us in this effort.
  Mr. WALDEN. Mr. Speaker, I reserve the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield 4 minutes to the 
gentleman from New York (Mr. Engel), a member of our Energy and 
Commerce Committee and cosponsor of this bill.
  Mr. ENGEL. Mr. Speaker, I thank the gentleman for yielding to me. Mr. 
Speaker, I want to thank my colleagues on both sides of the aisle. This 
is clearly a bipartisan collaboration.
  I am proud to be the main sponsor of H.R. 1676, the Palliative Care 
and Hospice Education and Training Act, and I urge my colleagues to 
support this important bill.
  The goal of palliative care is to alleviate suffering for patients 
and their loved ones, accompanying efforts to treat or cure illness. So 
while the illness is being treated, there is support being given to the 
person who is sick and for their loved ones as well.
  It entails support from a team of doctors, nurses, social workers, 
physician assistants, clergy persons, and other specialists who provide 
an extra layer of assistance, including help with medical 
decisionmaking and coordination of care across multiple settings. It is 
appropriate at any age and at any stage in a serious illness.
  Palliative and hospice care have been associated with enhanced 
quality of life for patients, but too many people simply don't know 
about these benefits. On top of that, there is a shortage of educated 
providers who can offer quality palliative and hospice care.
  That is where this bill comes in.
  The Palliative Care and Hospice Education and Training Act addresses 
these issues by expanding opportunities for training in palliative and 
hospice care.
  This bill also aims to better educate patients, families, and health 
professionals about palliative care's benefits, and encourages NIH to 
expand research around this topic.
  Ultimately, this bill will help us ensure that there is a well-
trained palliative care workforce available to care for patients, a 
goal that I believe will also be critical to turning the tide of the 
ongoing opioid epidemic.
  One of the goals of palliative care is to provide relief from the 
pain of a serious illness. By creating the infrastructure needed to 
better educate health professionals on palliative care, this 
legislation will also help ensure health professionals are able to 
properly manage patients' pain and practice appropriate evidence-based 
prescribing, a space where, as the opioid crisis has shown, we need to 
do much better.
  Mr. Speaker, I want to thank Chairman Walden, Ranking Member Pallone, 
Chairman Burgess, and Ranking Member Green for helping to move this 
bill forward. I also want to thank Congressman  Tom Reed and 
Congressman Buddy Carter, who coauthored the bill, and all of its 285 
bipartisan cosponsors. This is about as bipartisan as you can get.
  We are dealing with issues that people sometimes don't like to talk 
about, end of life issues, issues of that nature, but it is something 
that must be talked about, because families need help. This will give 
the families the help that they need.
  I think every one of us has felt the pain and stress of a serious 
illness either personally or standing alongside a loved one. By passing 
this bill, we will take an important step to bring much, much needed 
relief to both patients and their loved ones.
  Mr. Speaker, I want to thank my colleagues on the committee and all 
the people who worked to make this bill bipartisan. We can all be proud 
of this when it becomes law.
  Mr. Speaker, I urge my colleagues to support this legislation.
  Mr. GENE GREEN of Texas. Mr. Speaker, we have no further speakers, 
and I yield back the balance of my time.

  Mr. WALDEN. Mr. Speaker, I will close by again thanking my colleagues 
on both sides of the aisle. Thanks to the gentleman from New York, the 
gentleman from Texas, my colleagues on this side of the aisle. I know 
Dr. Phil Roe, who chairs our Veterans' Affairs Committee, a very strong 
advocate and supporter of this, could not be here to speak on it 
because of a conflict.
  Mr. Speaker, let me just say this is really important. It will change 
lives. It will improve lives. With that, I hope our colleagues will 
join us in supporting this very important measure.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Oregon (Mr. Walden) that the House suspend the rules and 
pass the bill, H.R. 1676, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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