[Congressional Record (Bound Edition), Volume 155 (2009), Part 11]
[Extensions of Remarks]
[Page 15531]
[From the U.S. Government Publishing Office, www.gpo.gov]




INTRODUCTION OF THE ADVANCE CARE PLANNING AND COMPASSIONATE CARE ACT OF 
                                  2009

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                          HON. EARL BLUMENAUER

                               of oregon

                    in the house of representatives

                        Wednesday, June 17, 2009

  Mr. BLUMENAUER. Madam Speaker, today I am proud to introduce the 
Advance Care Planning and Compassionate Care Act of 2009. This 
important legislation will provide the tools and resources necessary to 
dramatically improve care at the end of life.
  As we approach health care reform, there is no other area more vital 
for honest discussion and careful analysis than what happens at the end 
of a patient's life. For most of us, the majority of our lifetime 
health care will be administered in that last year. Indeed for some, 
the last few months is when we will use the most doctor care, the most 
medical procedures, and spend the most days in a hospital.
  Advances in health care have led to an aging population facing 
increasingly complex end of life health care decisions. These strains 
make complicated decision-making regarding medical care incredibly 
difficult. Too often, decisions are avoided until a crisis occurs, 
resulting in inadequate planning, unknown patient preferences, and 
families left struggling with the burden of determining their loved 
ones' wishes. For both families and patients, this is a time of 
incredible stress, confusion, and pain.
  This legislation will provide valuable resources to patients, their 
families, and health care providers to ensure that care at the end of 
life is aligned with patient wishes and values.
  The Advance Planning and Compassionate Care Act of 2009 would:
  Improve consumer information about advance care planning and end-of-
life care. This legislation would provide critically needed information 
and assistance to consumers and their families in order to guarantee 
that an individual's final wishes for care are carried out.
  Improve provider education and training about advance care planning 
and end-of-life care. This legislation would establish a National 
Geriatric and Palliative Care Service Corps modeled after the National 
Health Service Corps.
  Require portability of advance directives. The legislation would 
improve the portability of advance directives from one state to 
another, and require any existing advance directives to be prominently 
placed in a patient's medical record so they are easily visible.
  Authorize funding for new and innovative approaches to advance care 
planning. Grants would be made available to states for development of 
electronic advance directive registries. Grants would also be made 
available to develop systems to identify that a person has an advance 
directive using driver's licenses, similar to how organ donor status is 
indicated.
  Provide Medicare, Medicaid, and CHIP coverage for advance care 
planning consultations. This legislation provides Medicare, Medicaid, 
and CHIP coverage for advance care planning so that patients can 
routinely talk to their physicians about their wishes for end-of-life 
care.
  Improve consumer access to hospice and palliative care. This 
legislation provides greater consumer information about hospice and 
palliative care, so the public is well informed of the care options 
available at the end of life.
  Provide concurrent care for children. This legislation requires that 
concurrent care--the provision of both curative and hospice care at the 
same time--is available to children who qualify for hospice. This will 
make it possible for children to receive the palliative services they 
need from hospice while still pursuing potentially curative treatments.
  Require the development of quality measures to assess end-of-life 
care. The Secretary of HHS, acting through the Director of the Agency 
for Healthcare Research and Quality, shall require specific end-of-life 
care quality measures for each relevant provider setting. The 
legislation would also develop and implement accreditation standards 
and processes for hospital-based palliative care teams.
  Establish the National Center on Palliative and End-of-Life Care at 
the NIH. Biomedical and health services research is vital across all 
phases of life. A new National Center on Palliative and End-of-Life 
Care at the NIH will lead biomedical research on palliative and end of-
life care.

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