[Congressional Record Volume 165, Number 170 (Monday, October 28, 2019)]
[House]
[Pages H8521-H8526]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PALLIATIVE CARE AND HOSPICE EDUCATION AND TRAINING ACT
Ms. SCHAKOWSKY. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 647) 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. 647
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).
[[Page H8522]]
``(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.
``(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 2020 through
2024.''.
(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.
[[Page H8523]]
``(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 2020 through 2024.''.
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;
``(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 authorized 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, 2020, for
conducting or supporting research with respect to palliative
care'' after ``or national centers''.
The SPEAKER pro tempore (Mr. Stanton). Pursuant to the rule, the
gentlewoman from Illinois (Ms. Schakowsky) and the gentleman from Texas
(Mr. Burgess) each will control 20 minutes.
The Chair recognizes the gentlewoman from Illinois.
General Leave
Ms. SCHAKOWSKY. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days in which to revise and extend their remarks
and include extraneous materials on H.R. 647.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from Illinois?
There was no objection.
Ms. SCHAKOWSKY. Mr. Speaker, I yield 2 minutes to the gentleman from
New York (Mr. Engel), the author of this important legislation.
Mr. ENGEL. Mr. Speaker, I thank my colleague for yielding to me.
Mr. Speaker, I am proud to sponsor H.R. 647, the Palliative Care and
Hospice Education and Training Act, which has 296 bipartisan cosponsors
and endorsements from 54 national organizations, including the American
Cancer Society and the American Academy of Hospice and Palliative
Medicine.
The goal of palliative care is to provide patients relief from the
symptoms of a serious illness. This form of medical care can accompany
treatments and even cures. Often, an interdisciplinary team of
healthcare providers consisting of doctors, nurses, social workers, and
chaplains provide palliative care. In this capacity, these
professionals often help patients with medical decisionmaking and care
coordination.
Palliative and hospice care has been shown to improve health outcomes
for patients, but not many people are aware of the benefits.
Furthermore, our Nation has a shortage of qualified palliative and
hospice care professionals.
The Palliative Care and Hospice Education and Training Act will help
remedy these issues. This bill will create programs to train the next
generation of providers of palliative and hospice care. It will also
better educate patients, families, and health professionals about
palliative care's benefits, and it encourages the National Institutes
of Health to expand research in this field.
Nearly every one of us has felt the pain and stress of a serious
illness, either personally or standing beside a loved one. By passing
this bill, we will take an important step forward in bringing relief to
patients suffering from serious illnesses.
Mr. Speaker, I want to thank Chairman Pallone and Ranking Member
Walden for their leadership on this issue and Congressman Reed and
Congressman Carter, who coauthored this bill with me.
Mr. Speaker, I include in the Record a letter of support from 54
national organizations and 35 State organizations.
[[Page H8524]]
May 6, 2019.
Hon. Eliot Engel,
House of Representatives,
Washington, DC.
Hon. Frank Pallone, Jr.,
Chair, Energy & Commerce Committee,
House of Representatives,
Washington, DC.
Hon. Yvette D. Clarke,
House of Representatives,
Washington, DC.
Hon. Tom Reed
House of Representatives,
Washington, DC.
Hon. Greg Walden,
Ranking Member, Energy & Commerce Committee, House of
Representatives,
Washington, DC.
Hon. Buddy Carter,
House of Representatives, Washington, DC.
Re: Support for the Palliative Care and Hospice Education and
Training Act (PCHETA)
Dear Representatives Engel, Reed, and Carter, Chairman
Pallone, Ranking Member Walden, and Vice Chair Clarke: The
undersigned organizations write to express our support for
H.R. 647, the Palliative Care and Hospice Education and
Training Act (PCHETA). This bipartisan legislation will make
a difference in the lives of millions of patients living with
serious or life-threatening illness and their caregivers.
Despite a high intensity of medical treatment, many
seriously ill individuals still experience troubling
symptoms, unmet psychological and personal care needs,
fragmented care, poor communication with their health care
providers, and enormous strains on their family caregivers.
However, numerous studies have shown that adding palliative
care can improve pain and symptom control, quality of life,
and patient and family satisfaction.
Palliative care is an interdisciplinary model of care
focused on relief of 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.
Palliative care can be offered simultaneously with life-
prolonging and curative therapies for persons living with
serious, complex, and eventually terminal illness and
includes hospice care. By its very nature, palliative care is
patient-centered care--translating patient goals to
appropriate treatments.
We appreciate your leadership in recognizing the
significant role palliative care and hospice can play in
creating lasting change across the health care system. With
PCHETA's focus on expanding the interdisciplinary palliative
care workforce, promoting awareness of the benefits of
palliative care among patient and providers, and improving
the evidence base for this care, you have demonstrated a
strong commitment to addressing key barriers to palliative
care access for the growing number of Americans with serious
or life-threatening illness.
Delivery of high-quality palliative care cannot take place
without sufficient numbers of health care professionals with
appropriate training and skills. Students graduating from
medical, nursing or health care 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. Further, there is a
large gap between the number of health care professionals
with palliative care training and the number required to meet
the needs of the expanding population of seriously ill
patients. PCHETA would go a long way towards bridging this
gap by establishing education centers and career incentive
awards to improve the training of doctors, nurses, physician
assistants, social workers and other health professionals in
palliative care.
PCHETA also aims to strengthen clinical practice and
improve health care delivery for patients living with serious
or life-threatening illness, as well as their families, by
directing funding toward palliative care research. Research
funding for palliative care and pain and symptom management
comprises less than 0.1 percent of the National Institutes of
Health annual budget. PCHETA would direct an expansion and
intensification of research in these important areas.
At the same time, more must be done to ensure patients and
providers are aware of the benefits of palliative care.
According to the Institute 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.'' PCHETA would direct the implementation of a national
education and awareness campaign so that patients, families,
and health professionals understand the essential role of
palliative care in ensuring high-quality care for individuals
facing serious or life-threatening illness.
Through your leadership last Congress, PCHETA passed the
House of Representatives with overwhelming bi-partisan
support. We appreciate your continued support and dedication
to this important issue. We look forward to working with you
toward quick passage of this legislation in the 116th
Congress.
Sincerely,
Alzheimer's Association, Alzheimer's Impact Movement,
American Academy of Hospice and Palliative Medicine, American
Academy of Physician Assistants, American Cancer Society
Cancer Action Network, American College of Surgeons
Commission on Cancer, American Geriatrics Society, American
Heart Association ? American Stroke Association,
American Psychological Association, American Psychosocial
Oncology Society, American Society of Clinical Oncology,
Association of Oncology Social Work, Association of Pediatric
Hematology/Oncology Nurses, Association of Professional
Chaplains, The California State University Institute for
Palliative Care.
Cambia Health Solutions, Cancer Support Community, Catholic
Health Association of the United States, Center to Advance
Palliative Care, Children's National Health System, Coalition
for Compassionate Care of California, Colorectal Cancer
Alliance, Compassus, Courageous Parents Network,
ElevatingHOME ? Visiting Nurses Associations of
America, The Gary and Mary West Health Institute, The George
Washington Institute for Spirituality and Health, HealthCare
Chaplaincy Network, Hospice and Palliative Nurses
Association, Leukemia & Lymphoma Society.
Lung Cancer Alliance, Motion Picture & Television Fund,
National Alliance for Caregiving, National Association for
Home Care & Hospice, National Association of Social Workers,
National Brain Tumor Society, National Coalition for Cancer
Survivorship, National Coalition for Hospice and Palliative
Care, National Hospice and Palliative Care Organization,
National Palliative Care Research Center, National Patient
Advocate Foundation, National POLST Paradigm, Oncology
Nursing Society, Pediatric Palliative Care Coalition,
Physician Assistants in Hospice and Palliative Medicine.
Prevent Cancer Foundation, Resolution-Care Network, Social
Work Hospice & Palliative Care Network, Society of Palliative
Care Pharmacists, St. Baldrick's Foundation, Supportive Care
Matters, Susan G. Komen, Supportive Care Coalition, Trinity
Health.
____
State Associations Supporting PCHETA
Arizona Hospice and Palliative Care Organization, Home Care
Association of Arkansas, California Association for Health
Services at Home (CAHSAH), Home Care Association of Colorado,
Connecticut Association for Health Care at Home, Home Care
Association of Florida, Georgia Association for Home Health
Agencies, Illinois HomeCare & Hospice Council, Indiana
Association for Home Care and Hospice, Healthcare Association
of Hawaii, Kansas Home Care & Hospice Association, Kentucky
Home Care Association.
HomeCare Association of Louisiana, Home Care & Hospice
Alliance of Maine, Home Care Alliance of Massachusetts,
Michigan HomeCare and Hospice Association, Minnesota HomeCare
Association, Nebraska Home Care Association, Home Care,
Hospice and Palliative Care Alliance of New Hampshire, Home
Care Association of New York State (HCA), New York State
Association of Healthcare Providers, Association for Home &
Hospice Care of North Carolina, LeadingAge Ohio, Ohio Council
for Home Care & Hospice.
Oklahoma Association for Home Care & Hospice, Oregon
Association for Home Care, Pennsylvania HomeCare Association,
Rhode Island Partnership for Home Care, South Carolina Home
Care and Hospice Association, Tennessee Association for Home
Care, Texas Association for Home Care & Hospice, VNAs of
Vermont, Virginia Association for Home Care & Hospice, Home
Care Association of Washington, West Virginia Council of Home
Care Agencies.
Mr. ENGEL. Mr. Speaker, I urge my colleagues to support this
important legislation.
Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in support of H.R. 647, the Palliative Care and
Hospice Education and Training Act, by Representatives Engel and Tom
Reed and cosponsored by many Members of the House. This helps build our
palliative and hospice care workforce by establishing and supporting
palliative care and hospice education centers through Federal grants,
while enhancing research in palliative care at the National Institutes
of Health.
1.5 million Medicare beneficiaries were enrolled in hospice care for
some time during 2017. With the American population aging, we need to
be sure that our workforce is prepared to handle the influx of patients
transitioning into palliative and hospice care.
The bill's sponsors and advocates have worked hard for the past few
years to get this legislation to the President's desk. As the chairman
of the Energy and Commerce Health Subcommittee last year, I made it a
priority to move this bill.
I also think that this bill complements the House of Representatives'
work on the opioid crisis. It is appropriate that we are passing this
bill now as we come to the 1-year anniversary of passage of the SUPPORT
Act.
The bill before us today could address the issue from a different
angle. With the growing scrutiny on doctors prescribing opioids in the
midst of the
[[Page H8525]]
opioid crisis, we must remember that there are patients with legitimate
chronic pain. While the use of opioids can lead to substance use
disorder, these patients still need access to their pain medications,
particularly if they have been successfully maintained and managed on
opioids in close consultation with their doctors.
This bill will ensure that we have a palliative and hospice care
workforce that is adequately trained to manage patients with serious
illness, which frequently includes some aspect of chronic pain or the
need for pain relief.
I am disappointed that we did not include a provision that
stakeholders believe is necessary in order for this bill to become law.
Senate language included this small but necessary change, and I expect
that this issue will be resolved prior to the bill's arrival at the
President's desk.
Mr. Speaker, with a commitment to including this legislative
language, I urge Members to support H.R. 647, and I reserve the balance
of my time.
Ms. SCHAKOWSKY. Mr. Speaker, I rise in support of H.R. 647, the
Palliative Care and Hospice Education and Training Act.
This bill, introduced by Representatives Engel, Reed, Clarke, and
Carter, would establish palliative care and hospice education centers
to improve training of interdisciplinary professionals and faculty
members in palliative care.
The bill would promote career development of physicians who practice
hospice and palliative medicine. It also helps train the next
generation of practitioners by authorizing funds to train and retain
nurses, social workers, pharmacists, and others who are pursuing
advanced degrees in palliative care and related fields.
H.R. 647 will help patients facing serious conditions at the end of
their lives and improve hospice care availability and treatment.
I just want to say this bill is personal to me. My father, who lived
with me at the end of his life, we were the beneficiaries of hospice,
and it made all the difference in the final days of his life.
This bill has the support of 294 bipartisan cosponsors, as well as 89
different organizations. I would certainly urge all of my colleagues to
endorse, support, and vote for this important piece of legislation.
Mr. Speaker, I reserve the balance of my time.
{time} 1930
Mr. BURGESS. Mr. Speaker, I am pleased to yield 3 minutes to the
gentleman from New York (Mr. Reed), the co-author of the bill.
Mr. REED. Mr. Speaker, first, I thank my colleagues, Mr. Engel and
the members of the Energy and Commerce Committee, for their leadership
on this bill, as well as, in particular, my colleague, Mr. Carter, for
helping push this bill through, and Dr. Burgess for his assistance in
leading the floor debate.
Mr. Speaker, I rise in strong support of the bill before us, because
as we all know, when loved ones become deathly ill, we are often left
feeling helpless, wanting to step in and somehow ease the burden, but
not sure how.
When my own mother became sick, there was nothing I wouldn't have
done, Mr. Speaker, to cure her. The woman who taught me how to live,
taught me how to die. She taught me that what truly mattered to her in
those times at the end of her life was the comfort of her home, the
comfort of her family, and that quality time spent with her loved ones
and her friends. Surrounded by a wonderful team of family, friends,
but, in particular, hospice care providers, we watched as her wishes
were met.
Physicians, nurses, social workers, and aides made sure her symptoms
were managed and that she was physically comfortable. But just as
important, if not more so, were the hospice volunteers who stepped in
to give mom companionship, normalcy at the end of her illness, and a
much-needed break by the loved ones who were caring for her, such as
myself and my brothers and sisters.
The experience changed my perspective on death and dying. Even now, I
am enormously thankful to the hospice staff and volunteers who stepped
in to give my mom, and countless others in the community and folks
across the country, quality of life when their days and her days were
limited.
We must ensure that there is a properly trained workforce to care for
those closest to us as they increase in age and become chronically and
terminally ill. Estimates show that there will be no more than 1
percent growth in the palliative care and hospice physician workforce
in the next 20 years, while the number of people eligible for
palliative care will increase by over 20 percent, Mr. Speaker.
Without a boost for palliative care education and training, there
will only be one palliative physician for every 26,000 seriously ill
patients by 2030. This bill promotes a strong American workforce when
it comes to our palliative and hospice volunteers and caregivers and
advanced training for those healthcare providers providing those
services amongst us.
Mr. Speaker, I thank my colleagues, and I urge all of my colleagues
to support this legislation and vote ``yes'' this evening.
Ms. SCHAKOWSKY. Mr. Speaker, I think what you heard from Mr. Reed and
myself, and those people who have experienced the use of hospice care,
what a great and wonderful blessing it can be to our families.
Mr. Speaker, I support the legislation, and I reserve the balance of
my time.
Mr. BURGESS. Mr. Speaker, I am pleased to yield 3 minutes to the
gentleman from Georgia (Mr. Carter), a valuable member of the Health
Subcommittee of the Committee on Energy and Commerce.
Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for
yielding.
Mr. Speaker, I rise today in support of H.R. 647, the Palliative Care
and Hospice Education and Training Act. I am proud to be a co-lead on
this much-needed piece of legislation.
In my years as a pharmacist working in long-term care, I saw how
patients with all types of illnesses face the challenges of end-of-life
care. Whether you are talking about patients with cancer, Alzheimer's,
or some other ailment, critical to our healthcare system is valuing a
patient's quality of life. That is why palliative and hospice care are
an important piece of our healthcare system.
As our population ages, the need for quality, well-trained hospice
and palliative providers is only growing. The George Washington
University Health Workforce Institute projects the number of patients
who could benefit from palliative care could increase by 20 percent
over the next 20 years. By establishing palliative care and hospice
education centers to train and educate new providers, this bill is a
critical step in meeting the needs of future patients.
Additionally, this bill enhances the NIH's research into palliative
care, improving our capability to care for patients in even more
effective ways.
Finally, PCHETA also establishes a nationwide campaign to better
inform patients, their families, and their healthcare providers about
palliative care services. This is critical to ensuring patients have a
clear picture of all of their options so they and their families can
make informed decisions of the care that they want.
This bill is an important investment towards a patient-centered
healthcare system that values and improves a patient's quality of life.
I applaud Representatives Engel, Reed, Clarke, Pallone, and Walden
for their leadership on this bill, and I urge my fellow Members to
support H.R. 647.
Ms. SCHAKOWSKY. Mr. Speaker, I reserve the balance of my time.
Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, I urge support of the bill, and I yield back the balance
of my time.
Ms. SCHAKOWSKY. Mr. Speaker, I think you could hear from the factual
and the heartfelt testimony you have heard about this bill that will
make hospice and palliative care more available that we all here urge
passage of this legislation.
Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentlewoman from Illinois (Ms. Schakowsky) that the House suspend the
rules and pass the bill, H.R. 647, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
[[Page H8526]]
A motion to reconsider was laid on the table.
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