,i #aafth ,,congress #ast ,session ,h4 ,r4 #fdg ,,in ,,the ,,house ,,of ,,representatives ,january #ag1 #bjai,mr4 ,engel 7for himself1 ,mr4 ,reed1 ,ms4 ,clarke of ,new ,york1 ,mr4 ,carter of ,georgia1 ,mr4 ,pallone1 and ,mr4 ,walden7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend the ,public ,health ,service ,act to increase the number of permanent faculty in palliative care at accredited allopathic and osteopathic medical schools1 nursing schools1 social work schools1 and other programs1 including physician assistant education programs1 to promote education and research in palliative care and hospice1 and to support the development of faculty careers in academic palliative medicine4 #a4 ,short title ,this ,act may be cited as the ,palliative ,care and ,hospice ,education and ,training ,act4 #b4 ,palliative care and hospice education and training 7a7 ,in general ,part ,d of title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid et seq47 is amended by inserting after section #gei the following3 #gei;,a4 ,palliative care and hospice education and training 7a7 ,palliative care and hospice education centers 7#a7 ,in general ,the ,secretary shall award grants or contracts under this section to entities described in paragraph 7#a71 7#c71 or 7#d7 of section #gii;,b1 and section #hja7b71 for the establishment or operation of ,palliative ,care and ,hospice ,education ,centers that meet the requirements of paragraph 7#b74 7#b7 ,requirements ,a ,palliative ,care and ,hospice ,education ,center meets the requirements of this paragraph if such ,center-- 7,a7 improves the interprofessional team-based training of health professionals in palliative care1 including residencies1 traineeships1 or fellowships2 7,b7 develops and disseminates interprofessional team-based curricula relating to the palliative treatment of the complex health problems of individuals with serious or life-threatening illnesses2 7,c7 supports the training and retraining of faculty to provide instruction in interprofessional team-based palliative care2 7,d7 supports interprofessional team-based continuing education of health professionals who provide palliative care to patients with serious or life-threatening illness2 7,e7 provides students 7including residents1 trainees1 and fellows7 with clinical training in interprofessional team-based palliative care in appropriate health settings1 including hospitals1 hospices1 home care1 long-term care facilities1 and ambulatory care centers2 7,f7 establishes traineeships for individuals who are preparing for advanced education nursing degrees1 social work degrees1 or advanced degrees in physician assistant studies1 with a focus in interprofessional team-based palliative care in appropriate health settings1 including hospitals1 hospices1 home care1 long-term care facilities1 and ambulatory care centers2 7,g7 supports collaboration between multiple specialty training programs 7such as medicine1 nursing1 social work1 physician assistant1 chaplaincy1 and pharmacy7 and clinical training sites to provide training in interprofessional team-based palliative care2 and 7,h7 does not duplicate the activities of existing education centers funded under this section or under section #gec or #hfe4 7#c7 ,expansion of existing centers ,nothing in this section shall be construed to-- 7,a7 prevent the ,secretary from providing grants to expand existing education centers1 including geriatric education centers established under section #gec or #hfe1 to provide for education and training focused specifically on palliative care1 including for non-geriatric populations2 or 7,b7 limit the number of education centers that may be funded in a community4 7b7 ,palliative medicine physician training 7#a7 ,in general ,the ,secretary may make grants to1 and enter into contracts with1 schools of medicine1 schools of osteopathic medicine1 teaching hospitals1 and graduate medical education programs for the purpose of providing support for projects that fund the training of physicians 7including residents1 trainees1 and fellows7 who plan to teach palliative medicine4 7#b7 ,requirements ,each project for which a grant or contract is made under this subsection shall-- 7,a7 be staffed by full-time teaching physicians who have experience or training in interprofessional team-based palliative medicine2 7,b7 be based in a hospice and palliative medicine fellowship program accredited by the ,accreditation ,council for ,graduate ,medical ,education2 7,c7 provide training in interprofessional team-based palliative medicine through a variety of service rotations1 such as consultation services1 acute care services1 extended care facilities1 ambulatory care and comprehensive evaluation units1 hospices1 home care1 and community care programs2 7,d7 develop specific performance-based measures to evaluate the competency of trainees2 and 7,e7 provide training in interprofessional team-based palliative medicine through one or both of the training options described in paragraph 7#c74 7#c7 ,training options ,the training options referred to in subparagraph 7,e7 of paragraph 7#b7 are as follows3 7,a7 #a-year retraining programs in hospice and palliative medicine for physicians who are faculty at schools of medicine and osteopathic medicine1 or others determined appropriate by the ,secretary4 7,b7 #a- or #b-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 ,specialties4 7#d7 ,definitions ,for purposes of this subsection1 the term graduate medical education means a program sponsored by a school of medicine1 a school of osteopathic medicine1 a hospital1 or a public or private institution that-- 7,a7 offers postgraduate medical training in the specialties and subspecialties of medicine2 and 7,b7 has been accredited by the ,accreditation ,council for ,graduate ,medical ,education or the ,american ,osteopathic ,association through its ,committee on ,postdoctoral ,training4 7c7 ,palliative medicine and hospice academic career awards 7#a7 ,establishment of program ,the ,secretary shall establish a program to provide awards1 to be known as the ,palliative ,medicine and ,hospice ,academic ,career ,awards1 to eligible individuals to promote the career development of such individuals as academic hospice and palliative care physicians4 7#b7 ,eligible individuals ,to be eligible to receive an award under paragraph 7#a71 an individual shall-- 7,a7 be board certified or board eligible in hospice and palliative medicine2 and 7,b7 have a junior 7non-tenured7 faculty appointment at an accredited 7as determined by the ,secretary7 school of medicine or osteopathic medicine4 7#c7 ,limitations ,no award under paragraph 7#a7 may be made to an eligible individual unless the individual-- 7,a7 has submitted to the ,secretary an application1 at such time1 in such manner1 and containing such information as the ,secretary may require1 and the ,secretary has approved such application2 7,b7 provides1 in such form and manner as the ,secretary may require1 assurances that the individual will meet the service requirement described in paragraph 7#f72 and 7,c7 provides1 in such form and manner as the ,secretary may require1 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 care4 7#d7 ,maintenance of effort ,an eligible individual who receives an award under paragraph 7#a7 shall provide assurances to the ,secretary that funds provided to the eligible individual under this subsection will be used only to supplement1 not to supplant1 the amount of ,federal1 ,state1 and local funds otherwise expended by the eligible individual4 7#e7 ,amount and term 7,a7 ,amount ,the amount of an award under this subsection shall be equal to the award amount provided for under section #gec7;c77#e77;,a7 for the fiscal year involved4 7,b7 ,term ,the term of an award made under this subsection shall not exceed #e years4 7,c7 ,payment to institution ,the ,secretary shall make payments for awards under this subsection to institutions1 including schools of medicine and osteopathic medicine4 7#f7 ,service requirement ,an individual who receives an award under this subsection shall provide training in palliative care and hospice1 including the training of interprofessional teams of health care professionals4 ,the provision of such training shall constitute a majority of the total funded obligations of such individual under the award4 7d7 ,palliative care workforce development 7#a7 ,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 7a77#a74 7#b7 ,application ,to be eligible for an award under paragraph 7#a71 an entity described in such paragraph shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#c7 ,use of funds ,amounts awarded under a grant or contract under paragraph 7#a7 shall be used to carry out the fellowship program described in paragraph 7#d74 7#d7 ,fellowship program 7,a7 ,in general ,pursuant to paragraph 7#c71 a ,palliative ,care and ,hospice ,education ,center that receives an award under this subsection shall use such funds to offer short-term intensive courses 7referred to in this subsection as a fellowship7 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 psychology1 pharmacy1 nursing1 social work1 physician assistant education1 chaplaincy1 or other health disciplines1 as approved by the ,secretary4 ,such a fellowship shall be open to current faculty1 and appropriately credentialed volunteer faculty and practitioners1 who do not have formal training in palliative care1 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 skills4 7,b7 ,location ,a fellowship under this paragraph shall be offered either at the ,palliative ,care and ,hospice ,education ,center that is sponsoring the course1 in collaboration with other ,palliative ,care and ,hospice ,education ,centers1 or at medical schools1 schools of nursing1 schools of pharmacy1 schools of social work1 schools of chaplaincy or pastoral care education1 graduate programs in psychology1 physician assistant education programs1 or other health professions schools approved by the ,secretary with which the ,centers are affiliated4 7,c7 ,continuing education credit ,participation in a fellowship under this paragraph shall be accepted with respect to complying with continuing health profession education requirements4 ,as a condition of such acceptance1 the recipient shall subsequently provide a minimum of #ah hours of voluntary instruction in palliative care content 7that has been approved by a palliative care and hospice education center7 to students or trainees in health-related educational1 home1 hospice1 or long-term care settings4 7#e7 ,targets ,a ,palliative ,care and ,hospice ,education ,center that receives an award under paragraph 7#a7 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 award1 as well as other parameters established by the ,secretary4 7#f7 ,amount of award ,each award under paragraph 7#a7 shall be in the amount of #aej1jjj4 ,not more than #bd ,palliative ,care and ,hospice ,education ,centers may receive an award under such paragraph4 7#g7 ,maintenance of effort ,a ,palliative ,care and ,hospice ,education ,center that receives an award under paragraph 7#a7 shall provide assurances to the ,secretary that funds provided to the ,center under the award will be used only to supplement1 not to supplant1 the amount of ,federal1 ,state1 and local funds otherwise expended by such ,center4 7e7 ,palliative care and hospice career incentive awards 7#a7 ,in general ,the ,secretary shall award grants or contracts under this subsection to individuals described in paragraph 7#b7 to foster greater interest among a variety of health professionals in entering the field of palliative care4 7#b7 ,eligible individuals ,to be eligible to receive an award under paragraph 7#a71 an individual shall-- 7,a7 be an advanced practice nurse1 a social worker1 physician assistant1 pharmacist1 chaplain1 or student of psychology who is pursuing a doctorate1 masters1 or other advanced degree with a focus in interprofessional team-based palliative care or related fields in an accredited health professions school2 and 7,b7 submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#c7 ,conditions of award ,as a condition of receiving an award under paragraph 7#a71 an individual shall agree that1 following completion of the award period1 the individual will teach or practice palliative care in health-related educational1 home1 hospice1 or long-term care settings for a minimum of #e years under guidelines established by the ,secretary4 7#d7 ,payment to institution ,the ,secretary shall make payments for awards under paragraph 7#a7 to institutions that include schools of medicine1 osteopathic medicine1 nursing1 social work1 psychology1 chaplaincy or pastoral care education1 dentistry1 and pharmacy1 or other allied health discipline in an accredited health professions school or program 7such as a physician assistant education program7 that is approved by the ,secretary4 7f7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section1 #ae1jjj1jjj for each of the fiscal years #bjbj through #bjbd4 4 7b7 ,effective date ,the amendment made by this section shall be effective beginning on the date that is #ij days after the date of enactment of this ,act4 #c4 ,hospice and palliative nursing 7a7 ,nurse education1 practice1 and quality grants ,section #hca7;b77#c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bifp7b77#c77 is amended by inserting hospice and palliative nursing1 after coordinated care14 7b7 ,palliative care and hospice education and training programs ,part ,d of title ,,viii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bifp et seq47 is amended by adding at the end the following3 #hcb4 ,palliative care and hospice education and training 7a7 ,program authorized ,the ,secretary shall award grants to eligible entities to develop and implement1 in coordination with programs under section #gei;,a1 programs and initiatives to train and educate individuals in providing interprofessional team-based palliative care in health-related educational1 hospital1 hospice1 home1 or long-term care settings4 7b7 ,use of funds ,an eligible entity that receives a grant under subsection 7a7 shall use funds under such grant to-- 7#a7 provide training to individuals who will provide palliative care in health-related educational1 hospital1 home1 hospice1 or long-term care settings2 7#b7 develop and disseminate curricula relating to palliative care in health-related educational1 hospital1 home1 hospice1 or long-term care settings2 7#c7 train faculty members in palliative care in health-related educational1 hospital1 home1 hospice1 or long-term care settings2 or 7#d7 provide continuing education to individuals who provide palliative care in health-related educational1 home1 hospice1 or long-term care settings4 7c7 ,application ,an eligible entity desiring a grant under subsection 7a7 shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may reasonably require4 7d7 ,eligible entity ,for purposes of this section1 the term eligible entity shall include a school of nursing1 a health care facility1 a program leading to certification as a certified nurse assistant1 a partnership of such a school and facility1 or a partnership of such a program and facility4 7e7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #e1jjj1jjj for each of fiscal years #bjbj through #bjbd4 4 #d4 ,dissemination of palliative care information ,part ,a of title ,,ix of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bii et seq47 is amended by adding at the end the following new section3 #ijd4 ,dissemination of palliative care information 7a7 ,in general ,under the authority under section #ijb7;a7 to disseminate information on health care and on systems for the delivery of such care1 the ,director may disseminate information to inform patients1 families1 and health professionals about the benefits of palliative care throughout the continuum of care for patients with serious or life-threatening illness4 7b7 ,information disseminated 7#a7 ,mandatory information ,if the ,director elects to disseminate information under subsection 7a71 such dissemination shall include the following3 7,a7 ,palliative care ,information1 resources1 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 7including cancer2 heart1 kidney1 liver1 lung1 and infectious diseases2 as well as neurodegenerative disease such as dementia1 ,parkinson's disease1 or amyotrophic lateral sclerosis74 7,b7 ,palliative care services ,specific information regarding the services provided to patients by professionals trained in hospice and palliative care1 including pain and symptom management1 support for shared decisionmaking1 care coordination1 psychosocial care1 and spiritual care1 explaining that such services may be provided starting at the point of diagnosis and alongside curative treatment and are intended to-- 7i7 provide patient-centered and family-centered support throughout the continuum of care for serious and life-threatening illness2 7ii7 anticipate1 prevent1 and treat physical1 emotional1 social1 and spiritual suffering2 7iii7 optimize quality of life2 and 7iv7 facilitate and support the goals and values of patients and families4 7,c7 ,palliative care professionals ,specific materials that explain the role of professionals trained in hospice and palliative care in providing team-based care 7including pain and symptom management1 support for shared decisionmaking1 care coordination1 psychosocial care1 and spiritual care7 for patients and families throughout the continuum of care for serious or life-threatening illness4 7,d7 ,research ,evidence-based research demonstrating the benefits of patient access to palliative care throughout the continuum of care for serious or life-threatening illness4 7,e7 ,population-specific materials ,materials targeting specific populations1 including patients with serious or life-threatening illness who are among medically underserved populations 7as defined in section #ccj7;b77#c77 and families of such patients or health professionals serving medically underserved populations4 ,such populations shall include pediatric patients1 young adult and adolescent patients1 racial and ethnic minority populations1 and other priority populations specified by the ,director4 7#b7 ,required publication ,information and materials disseminated under paragraph 7#a7 shall be posted on the ,internet websites of relevant ,federal agencies and departments1 including the ,department of ,veterans ,affairs1 the ,centers for ,medicare ,medicaid ,services1 and the ,administration on ,aging4 7c7 ,consultation ,the ,director shall consult with appropriate professional societies1 hospice and palliative care stakeholders1 and relevant patient advocate organizations with respect to palliative care1 psychosocial care1 and complex chronic illness with respect to the following3 7#a7 ,the planning and implementation of the dissemination of palliative care information under this section4 7#b7 ,the development of information to be disseminated under this section4 7#c7 ,a definition of the term serious or life-threatening illness for purposes of this section4 4 #e4 ,clarification ,none of the funds made available under this ,act 7or an amendment made by this ,act7 may be used to provide1 promote1 or provide training with regard to any item or service for which ,federal funding is unavailable under section #c of ,public ,law #aje-ab 7#db ,u4,s4,c4 #addjb74 #f4 ,enhancing ,,nih research in palliative care 7a7 ,in general ,part ,b of title ,,iv of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhd et seq47 is amended by adding at the end the following new section3 #dji,k4 ,enhancing research in palliative care ,the ,secretary1 acting through the ,director of the ,national ,institutes of ,health1 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 illnesses1 including cancer2 heart1 kidney1 liver1 lung1 and infectious diseases2 as well as neurodegenerative diseases such as dementia1 ,parkinson's disease1 or amyotrophic lateral sclerosis4 4 7b7 ,expanding trans-,,nih research reporting ,to include palliative care research ,section #djb;,a7c77#b77;,b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhb;a7c77#b77;,b77 is amended by inserting and1 beginning ,january #a1 #bjbj1 for conducting or supporting research with respect to palliative care after or national centers4