[Congressional Record (Bound Edition), Volume 161 (2015), Part 4]
[Senate]
[Pages 5162-5163]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   NATIONAL HEALTHCARE DECISIONS DAY

  Mr. WARNER. Mr. President, I am pleased to recognize that today, 
April 16, 2015, is National Healthcare Decisions Day.
  National Healthcare Decisions Day exists to inspire, educate and 
empower the public and providers about the importance of advance care 
planning. Started by a Richmond attorney as a local, grassroots 
initiative in Virginia, NHDD became an annual event in 2008 and today 
is recognized across all 50 States. Faith-based groups, doctors and 
nurses, hospitals, patients, and caregivers alike are engaged in these 
efforts.
  It is critical that Virginians and all Americans--both patients and 
providers--engage in advance care planning, and that they have access 
to clear, consistent, and concise information on how to make these 
critical health care decisions. Today, on National Healthcare Decisions 
Day, it is important to discuss preferences and goals with family and 
friends--and this starts with filling out an advance directive. But 
advanced care planning is about much more than that, and in the last 
several years, there has been a growing awareness of the need to 
transform advanced care, both among providers and families.
  First, broader transformations in health care, especially the 
movement towards paying for quality, not volume, of services offer 
opportunities to speed the adoption of effective advanced care 
programs. Our health care system does a great job paying for 
procedures: surgery, chemotherapy, hip replacements. It does a not so 
good job paying for health care providers to spend face-to-face time 
with patients, helping them to choose among many options with uncertain 
outcomes. Improvements to care planning would give individuals and 
their families the ability to make smarter decisions. It would provide 
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and support so they can make informed choices based upon those values 
and goals.
  Meanwhile, across the country, people are innovating and creating new 
models of care to provide patients with the tools and support to make 
their own advanced care decisions. For example, in my own State of 
Virginia, a Richmond Academy of Medicine initiative called Honoring 
Choices Virginia promises to fill a critical hole. This innovative 
partnership involves the academy and three independent health care 
systems working to adopt nationally-recognized best practices, and 
adapting them to the needs of patients, families, doctors, and 
hospitals of the local community in Central Virginia. This commitment 
to patients and families in our region sets an example for the rest of 
the Commonwealth and the country.
  It is similarly essential that we consider how Federal policies 
impact patients and their families during times of serious illness. For 
example, the vast majority of these patients receive care funded by 
Medicaid and Medicare, and many of them are elderly or disabled. 
Medicare, however, does not adequately reimburse physicians or other 
important members of the care planning team, such as nurses or social 
workers, for systems to support patients and their families. Likewise, 
faced with an uneven patchwork of advance directive laws across States, 
providers too often base their actions on the technicalities of forms 
or on fear of being sued. Such hurdles make it difficult for health 
care providers to focus on what the patient really wants.
  In the 111th and 112th Congress, I introduced the Senior Navigation 
and Planning Act, to help people grapple with the challenges of caring 
for those with advanced illness. And in the 113th Congress, Senator 
Isakson and I introduced the Care Planning Act. The purpose of the Care 
Planning Act is to align the care people want with the level of care 
they get. It does not limit choices--it works to make sure people are 
made fully aware of the broad range of choices they have. I hope to 
reintroduce the Care Planning Act in the coming weeks.
  I believe this effort is critical, not just from my time serving as a 
Governor and as a Senator, but also through the eyes of a loved one who 
struggled with these issues. My mother suffered from Alzheimer's 
disease for 10 years, and for 9 of those years, she couldn't speak. My 
father, sister and I found grappling with the challenges of caring for 
her difficult. The difficulty was greater because, when she was first 
diagnosed, my family didn't take the opportunity to talk in an honest 
and fully informed way with her and her health care providers about the 
full array of health care options available, or about what her 
priorities would be during the final years of her life.
  It is not easy, and this is a subject that most people do their best 
to avoid. But it is critical. National Healthcare Decisions Day reminds 
us of the importance of discussing ways to improve advanced care 
planning at all levels--Federal, State, local--and above all, amongst 
Americans and their loved ones.

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