,,ii  #aai? ,,congress  #a/ ,session    
,s4 #bbhg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #ae1 #bjbe,ms4   
,baldw9 7= h]self1 ,mrs4 ,capito1 ,mr4  
,m]kley1 ,mr4 ,m>%all1 ,ms4 ,cantwell1  
,mr4 ,b>rasso1 ,mr4 ,wel*1 ,mrs4        
,hyde-,smi?1 ,mr4 ,re$1 ,mr4 ,r\nds1    
,ms4 ,ros51 ,ms4 ,murk[ski1 ,mr4 ,k+1   
,mrs4 ,blackburn1 ,mrs4 ,gillibr&1 ,ms4 
,coll9s1 ,mr4 ,:iteh\se1 & ,mr4         
,boozman7 introduc$ ! foll[+ bill2 :i* 0
 read twice & ref]r$ to ! ,committee on 
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d ! ,public ,heal?    
,s]vice ,act to increase ! numb] (      
p]man5t faculty 9 palliative c>e at     
accr$it$ allopa?ic & o/eopa?ic m$ical   
s*ools1 nurs+ s*ools & o!r programs1    
includ+ social "w1 physician assi/ant1 &
 *apla9cy education programs1 to promote
 education & rese>* 9 palliative c>e &  
hospice1 & to support ! developm5t (    
faculty c>e]s 9 academic palliative &   
hospice c>e4  #a4 ,%ort title ,?is ,act 
may be cit$ z ! ,palliative ,c>e &      

,hospice ,education & ,tra9+ ,act4  #b4 
,palliative c>e & hospice education &   
tra9+  7a7 ,9 g5]al ,"p ,d ( title ,,vii
 ( ! ,public ,heal? ,s]vice ,act 7#db   
,u4,s4,c4 #bid et seq47 is am5d$ by     
ins]t+ aft] section #gei ! foll[+3      
#gei;,a4 ,palliative c>e & hospice      
education & tra9+  7a7 ,palliative c>e &
 hospice education programs  7#a7 ,9    
g5]al ,! ,secret>y %all aw>d grants or  
contracts "u ?is section to entities    
describ$ 9 p>agraph 7#a71 7#c71 or 7#d7 
( section #gii;,b1 & section #hja7b71 = 
! e/abli%m5t or op]ation ( ,palliative  
,c>e & ,hospice ,education ,programs t  
meet ! requirem5ts ( p>agraph 7#b74     
7#b7 ,requirem5ts  7,a7 ,9 g5]al ,a     
,palliative ,c>e & ,hospice ,education  
,program receiv+ an aw>d "u ?is section 
%all support ! tra9+ ( heal?            
pr(essionals 9 palliative & hospice c>e1
 includ+ tra9ee%ips or fell[%ips4 ,su*  
programs %all emphasize1 z appropriate1 
pati5t & family engagem5t1 integration (
 palliative & hospice c>e ) prim>y &    

specialty c>e1 & collaboration )        
community p>tn]s to address gaps 9 heal?
 c>e = individuals ) s]i\s or           
life-?reat5+ illnesses4  7,b7           
,activities ,activities conduct$ by a   
program "u ?is section may include !    
foll[+3 7i7 ,cl9ical tra9+ on provid+   
integrat$ palliative & hospice c>e      
s]vices4  7ii7 ,int]pr(essional tra9+ to
 practition]s f multiple discipl9es &   
specialties1 includ+ tra9+ on !         
provision ( c>e to individuals ) s]i\s  
or life-?reat5+ illnesses4  7iii7       
,e/abli%+ or ma9ta9+ tra9+-relat$       
community-bas$ programs = individuals ) 
s]i\s or life-?reat5+ illnesses &       
c>egiv]s to improve quality ( life1 &   
:]e appropriate1 heal? outcomes =       
individuals :o h s]i\s or life-?reat5+  
illnesses4  7,c7 ,nonduplication ,a     
,palliative ,c>e & ,hospice ,education  
,program "u ?is section %all n duplicate
 ! activities ( exi/+ education c5t]s   
fund$ "u ?is section or "u section #gec 
or #hfe4  7#c7 ,priorities 9 mak+ aw>ds 

,9 aw>d+ grants & contracts "u p>agraph 
7#a71 ! ,secret>y-- 7,a7 %all give      
priority to programs t demon/rate       
coord9ation ) ano!r ,f$]al or ,/ate     
program1 or ano!r public or private     
entity2  7,b7 %all give priority to     
applicants ) programs or activities t   
are expect$ to sub/antially b5efit-- 7i7
 individuals 9 rural or m$ically        
und]s]v$ areas1 fronti] heal?           
pr(essional %ortage areas 7z def9$ 9    
section #gii;,b71 or ,indian ,tribes or 
,tribal organizations2  7ii7 p$iatric   
populations2 or  7iii7 racial & e?nic   
m9ority populations2 &  7,c7 may give   
priority to any program t-- 7i7         
integrates palliative & hospice c>e into
 prim>y c>e practice2  7ii7 provides    
tra9+ to integrate palliative & hospice 
c>e into o!r specialties across c>e     
sett+s1 includ+ practic+ cl9ical        
speciali/s1 heal? c>e adm9i/rators1     
faculty )\t backgr\nds 9 palliative or  
hospice c>e1 & /ud5ts f all heal?       
pr(essions2  7iii7 emphasizes           

integration ( palliative & hospice c>e  
into exi/+ s]vice deliv]y locations &   
c>e across sett+s1 includ+ prim>y c>e   
cl9ics1 m$ical homes1 ,f$]ally qualifi$ 
heal? c5t]s1 ambulatory c>e cl9ics1     
hospitals1 includ+ critical access      
hospitals1 em]g5cy c>e sett+s1 assi/$   
liv+ & nurs+ facilities1 & home- &      
community-bas$ sett+s2  7iv7 supports ! 
tra9+ & retra9+ ( faculty1 prim>y &     
specialty c>e provid]s1 o!r direct c>e  
provid]s1 & o!r appropriate pr(essionals
 on palliative or hospice c>e2  7v7     
emphasizes education & engagem5t (      
family or c>egiv]s on palliative &      
hospice c>e managem5t )9 ! context (    
*ronic disease managem5t & /rategies to 
meet ! ne$s ( su* family or c>egiv]s2 or
  7vi7 proposes to conduct outrea* to   
communities t h a %ortage ( palliative &
 hospice work=ce pr(essionals4  7#d7    
,expansion ( exi/+ programs ,no?+ 9 ?is 
section %all be con/ru$ to-- 7,a7 prev5t
 ! ,secret>y f provid+ grants or        
contracts to exp& exi/+ education       

programs1 includ+ g]iatric education    
programs e/abli%$ "u section #gec or    
#hfe1 to provide = education & tra9+    
focus$ specifically on palliative c>e1  
includ+ = non-g]iatric populations2 or  
7,b7 limit ! numb] ( education programs 
t may be fund$ 9 a community4  7b7      
,palliative m$ic9e physician tra9+  7#a7
 ,9 g5]al ,! ,secret>y may make grants  
to1 & ent] into contracts )1 s*ools (   
m$ic9e1 s*ools ( o/eopa?ic m$ic9e1 tea*+
 hospitals1 & graduate m$ical education 
programs = ! purpose ( provid+ support =
 projects t fund ! tra9+ ( physicians :o
 plan to tea* or practice palliative    
m$ic9e4  7#b7 ,requirem5ts ,ea* project 
= :i* a grant or contract is made "u ?is
 subsection %all-- 7,a7 be /aff$ by     
full-"t tea*+ physicians :o h exp]i5ce  
or tra9+ 9 int]pr(essional team-bas$    
palliative m$ic9e2  7,b7 be bas$ 9 a    
hospice & palliative m$ic9e fell[%ip    
program accr$it$ by ! ,accr$itation     
,c\ncil = ,graduate ,m$ical ,education2 
7,c7 provide tra9+ 9 int]pr(essional    

team-bas$ palliative m$ic9e ?r\gh a     
v>iety ( s]vice rotations1 su* z        
consultation s]vices1 acute c>e s]vices1
 ext5d$ c>e facilities1 ambulatory c>e &
 compreh5sive evaluation units1         
hospices1 home c>e1 & community c>e     
programs2  7,d7 develop specific        
p]=mance-bas$ measures to evaluate !    
compet5cy ( tra9ees2 &  7,e7 provide    
tra9+ 9 int]pr(essional team-bas$       
palliative m$ic9e ?r\gh "o or bo? ( !   
tra9+ options describ$ 9 p>agraph 7#c74 
7#c7 ,tra9+ options ,! tra9+ options    
ref]r$ to 9 subp>agraph 7,e7 ( p>agraph 
7#b7 are z foll[s3 7,a7 #a-ye> retra9+  
programs 9 hospice & palliative m$ic9e =
 physicians :o are faculty at s*ools (  
m$ic9e & o/eopa?ic m$ic9e1 or o!rs      
det]m9$ appropriate by ! ,secret>y4     
7,b7 #a- or #b-ye> tra9+ programs t are 
design$ to provide tra9+ 9              
int]pr(essional team-bas$ hospice &     
palliative m$ic9e = physicians :o h     
complet$ graduate m$ical education      
programs 9 any m$ical specialty lead+ to

 bo>d eligibility 9 hospice & palliative
 m$ic9e pursuant to ! ,am]ican ,bo>d (  
,m$ical ,specialties4  7#d7 ,def9itions 
,= purposes ( ?is subsection1 ! t]m     
graduate m$ical education means a       
program sponsor$ by a s*ool ( m$ic9e1 a 
s*ool ( o/eopa?ic m$ic9e1 a hospital1 or
 a public or private in/itution t-- 7,a7
 (f]s po/graduate m$ical tra9+ 9 !      
specialties & subspecialties ( m$ic9e2 &
  7,b7 has be5 accr$it$ by !            
,accr$itation ,c\ncil = ,graduate       
,m$ical ,education or ! ,am]ican        
,o/eopa?ic ,association ?r\gh its       
,committee on ,po/doctoral ,tra9+4  7c7 
,palliative c>e & hospice academic c>e] 
aw>ds  7#a7 ,e/abli%m5t ( program ,!    
,secret>y %all e/abli% a program to     
provide aw>ds1 to be kn[n z !           
,palliative ,c>e & ,hospice ,academic   
,c>e] ,aw>ds1 to allopa?ic & o/eopa?ic  
m$ical s*ools1 nurs+ s*ools1 & o!r      
programs1 includ+ social "w1 physician  
assi/ant1 & *apla9cy education programs1
 or o!r s*ools or programs id5tifi$ by !

 ,secret>y apply+ on behalf ( eligible  
individuals to promote ! c>e] developm5t
 ( su* individuals z academic hospice & 
palliative c>e speciali/s4  7#b7        
,eligible individuals ,= purposes ( ?is 
subsection1 ! t]m eligible individual   
means an individual :o-- 7,a7 is bo>d   
c]tifi$ or bo>d eligible 9 hospice &    
palliative m$ic9e or has complet$       
requir$ specialty tra9+ 9 palliative &  
hospice c>e 9 ! discipl9es ( nurs+1     
social "w1 physician assi/ant1 *apla9cy1
 or o!r discipl9e id5tifi$ by !         
,secret>y2 &  7,b7 has a junior         
7nont5ur$7 faculty appo9tm5t at an      
accr$it$ 7z det]m9$ by ! ,secret>y7     
allopa?ic or o/eopa?ic m$ical s*ool1    
nurs+ s*ool1 or o!r programs1 includ+   
social "w1 physician assi/ant1 *apla9cy1
 or o!r education programs id5tifi$ by !
 ,secret>y4  7#c7 ,limitations ,no aw>d 
"u p>agraph 7#a7 may be made to an      
eligible individual unless ! entity on  
behalf ( ! eligible individual-- 7,a7   
has submitt$ to ! ,secret>y an          

application1 at su* "t1 9 su* mann]1 &  
conta9+ su* in=mation z ! ,secret>y may 
require1 & ! ,secret>y has approv$ su*  
application2  7,b7 provides1 9 su* =m & 
mann] z ! ,secret>y may require1        
assurances t ! individual w meet !      
s]vice requirem5t describ$ 9 p>agraph   
7#f72 &  7,c7 provides1 9 su* =m & mann]
 z ! ,secret>y may require1 assurances t
 ! individual has a full-"t faculty     
appo9tm5t 9 a heal? pr(essions          
in/itution & docum5t$ commitm5t f su*   
in/itution to sp5d a majority ( ! total 
fund$ "t ( su* individual on tea*+ &    
develop+ skills 9 education 9           
int]pr(essional team-bas$ palliative    
c>e4  7#d7 ,ma9t5ance ( ef=t ,an entity 
:i* receives an aw>d "u p>agraph 7#a7   
%all provide assurances to ! ,secret>y t
 funds provid$ to ! eligible individual 
"u ?is subsection w be us$ only to      
supplem5t1 n to supplant1 ! am\nt (     
,f$]al1 ,/ate1 & local funds o!rwise    
exp5d$ by ! eligible individual4  7#e7  
,am\nt & t]m  7,a7 ,am\nt ,! am\nt ( an 

aw>d "u ?is subsection %all be equal to 
! aw>d am\nt provid$ = "u section       
#gec7;b77#e77;,a7 = ! fiscal ye>        
involv$4  7,b7 ,t]m ,! t]m ( an aw>d    
made "u ?is subsection %all n exce$ #e  
ye>s4  7,c7 ,paym5t to in/itution ,!    
,secret>y %all make paym5ts = aw>ds "u  
?is subsection to in/itutions1 includ+  
allopa?ic & o/eopa?ic m$ical s*ools1    
nurs+ s*ools1 & o!r programs1 includ+   
social "w1 physician assi/ant1 or       
*apla9cy education programs4  7#f7      
,s]vice requirem5t ,an individual :o    
receives an aw>d "u ?is subsection %all 
provide tra9+ 9 palliative c>e &        
hospice1 includ+ ! tra9+ (              
int]pr(essional teams ( heal? c>e       
pr(essionals4 ,! provision ( su* tra9+  
%all con/itute a majority ( ! total     
fund$ obligations ( su* individual "u ! 
aw>d4  7d7 ,palliative c>e work=ce      
developm5t  7#a7 ,9 g5]al ,! ,secret>y  
%all aw>d grants or contracts "u ?is    
subsection to entities t op]ate a       
,palliative ,c>e & ,hospice ,education  

,program pursuant to subsection 7a77#a74
  7#b7 ,application ,to be eligible = an
 aw>d "u p>agraph 7#a71 an entity       
describ$ 9 su* p>agraph %all submit to !
 ,secret>y an application at su* "t1 9  
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require4  7#c7 ,use (     
funds ,am\nts aw>d$ "u a grant or       
contract "u p>agraph 7#a7 %all be us$ to
 c>ry out ! fell[%ip program describ$ 9 
p>agraph 7#d74  7#d7 ,fell[%ip program  
7,a7 ,9 g5]al ,pursuant to p>agraph     
7#c71 a ,palliative ,c>e & ,hospice     
,education ,program t receives an aw>d  
"u ?is subsection %all use su* funds to 
(f] %ort-t]m int5sive c\rses 7ref]r$ to 
9 ?is subsection z a fell[%ip7 t focus  
on int]pr(essional team-bas$ palliative 
c>e t provide supplem5tal tra9+ =       
faculty memb]s 9 allopa?ic & o/eopa?ic  
m$ical s*ools1 nurs+ s*ools1 & o!r      
programs1 includ+ psy*ology1 ph>macy1   
social "w1 physician assi/ant1 &        
*apla9cy education programs1 or o!r     
heal? discipl9es1 z approv$ by !        

,secret>y4 ,su* a fell[%ip %all be op5  
to curr5t faculty1 & appropriately      
cr$5tial$ volunte] faculty &            
practition]s1 :o d n h =mal tra9+ 9     
palliative c>e1 to upgrade _! k &       
cl9ical skills = ! c>e ( individuals )  
s]i\s or life-?reat5+ illness & to      
enhance _! int]discipl9>y &             
int]pr(essional tea*+ skills4  7,b7     
,location ,a fell[%ip "u ?is p>agraph   
%all be (f]$ ei!r at ! ,palliative ,c>e 
& ,hospice ,education ,program t is     
sponsor+ ! c\rse1 9 collaboration ) o!r 
,palliative ,c>e & ,hospice ,education  
,programs1 or at allopa?ic & o/eopa?ic  
m$ical s*ools1 nurs+ s*ools1 or o!r     
programs1 includ+ ph>macy1 social "w1   
physician assi/ant1 *apla9cy1 &         
psy*ology education programs1 or o!r    
heal? pr(essions s*ools & programs      
approv$ by ! ,secret>y4  7#e7 ,t>gets ,a
 ,palliative ,c>e & ,hospice ,education 
,program t receives an aw>d "u p>agraph 
7#a7 %all meet t>gets approv$ by !      
,secret>y = provid+ tra9+ 9             

int]pr(essional team-bas$ palliative c>e
 to a c]ta9 numb] ( faculty or          
practition]s dur+ ! t]m ( ! aw>d1 z well
 z o!r p>amet]s e/abli%$ by ! ,secret>y4
  7#f7 ,am\nt ( aw>d ,ea* aw>d "u       
p>agraph 7#a7 %all be n m ?an #aej1jjj4 
,n m ?an #bd ,palliative ,c>e & ,hospice
 ,education ,programs may receive an    
aw>d "u su* p>agraph4  7#g7 ,ma9t5ance (
 ef=t ,a ,palliative ,c>e & ,hospice    
,education ,program t receives an aw>d  
"u p>agraph 7#a7 %all provide assurances
 to ! ,secret>y t funds provid$ to !    
,program "u ! aw>d w be us$ only to     
supplem5t1 n to supplant1 ! am\nt (     
,f$]al1 ,/ate1 & local funds o!rwise    
exp5d$ by su* ,program4  7e7 ,palliative
 c>e & hospice c>e] inc5tive aw>ds  7#a7
 ,9 g5]al ,! ,secret>y %all aw>d grants 
or contracts "u ?is subsection to       
in/itutions1 includ+ allopa?ic &        
o/eopa?ic m$ical s*ools1 nurs+ s*ools1 &
 o!r programs1 includ+ social "w1       
physician assi/ant1 psy*ology1 *apla9cy1
 & ph>macy education programs1 or o!r   

programs approv$ by ! ,secret>y1 apply+ 
on behalf ( individuals describ$ 9      
p>agraph 7#b7 to fo/] great] int]e/     
among a v>iety ( heal? pr(essionals 9   
ent]+ ! field ( palliative c>e4  7#b7   
,eligible individuals ,to be eligible to
 receive an aw>d "u p>agraph 7#a71 an   
individual %all-- 7,a7 be an advanc$    
practice nurse1 a social work]1         
physician assi/ant1 ph>maci/1 *apla91   
psy*ologi/1 or o!r heal? c>e pr(essional
 pursu+ a doctorate1 ma/]s1 or o!r      
advanc$ degree ) a focus 9              
int]pr(essional team-bas$ palliative c>e
 or relat$ fields 9 an accr$it$ s*ool or
 education program2 &  7,b7 submit to ! 
,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require4  7#c7 ,conditions
 ( aw>d ,z a condition ( receiv+ an aw>d
 "u p>agraph 7#a71 an individual %all   
agree t1 foll[+ completion ( ! aw>d     
p]iod1 ! individual w tea* or practice  
palliative c>e 9 heal?-relat$           
educational1 home1 hospice1 or long-t]m 

c>e sett+s = a m9imum ( #e ye>s "u      
guidel9es e/abli%$ by ! ,secret>y4  7#d7
 ,paym5t to in/itution ,! ,secret>y %all
 make paym5ts = aw>ds "u p>agraph 7#a7  
to in/itutions t include allopa?ic &    
o/eopa?ic m$ical s*ools1 nurs+ s*ools1 &
 o!r programs1 includ+ social "w1       
physician assi/ant1 psy*ology1 *apla9cy1
 & ph>macy education programs or o!r    
programs approv$ by ! ,secret>y4  7f7   
,au?orization ( appropriations ,!re are 
au?oriz$ to be appropriat$ to c>ry out  
?is section1 #ae1jjj1jjj = ea* ( !      
fiscal ye>s #bjbf ?r\gh #bjcj4  4  7b7  
,effective date ,! am5dm5t made by ?is  
section %all be effective beg9n+ on !   
date t is #ij days aft] ! date (        
enactm5t ( ?is ,act4  #c4 ,hospice &    
palliative nurs+  7a7 ,nurse education1 
practice1 & quality grants ,section     
#hca7;b77#c7 ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bifp7b77#c77 is    
am5d$ by ins]t+ hospice & palliative    
nurs+1 aft] coord9at$ c>e14  7b7        
,palliative c>e & hospice education &   

tra9+ programs ,"p ,d ( title ,,viii ( !
 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #bifp et seq47 is am5d$ by    
add+ at ! end ! foll[+3  #hcb4          
,palliative c>e & hospice education &   
tra9+  7a7 ,program au?oriz$ ,!         
,secret>y %all aw>d grants to1 or ent]  
into contracts )1 eligible entities to  
develop & implem5t1 9 coord9ation )     
programs "u section #gei;,a1 programs & 
initiatives to tra9 & educate           
individuals 9 provid+ int]pr(essional   
team-bas$ palliative c>e 9 heal?-relat$ 
educational1 hospital1 hospice1 home1 or
 long-t]m c>e sett+s4  7b7 ,use ( funds 
,an eligible entity t receives a grant  
"u subsection 7a7 %all use funds "u su* 
grant to-- 7#a7 provide tra9+ to        
individuals :o w provide palliative c>e 
9 heal?-relat$ educational1 hospital1   
home1 hospice1 or long-t]m c>e sett+s2  
7#b7 develop & dissem9ate curricula     
relat+ to palliative c>e 9 heal?-relat$ 
educational1 hospital1 home1 hospice1 or
 long-t]m c>e sett+s2  7#c7 tra9 faculty

 memb]s 9 palliative c>e 9 heal?-relat$ 
educational1 hospital1 home1 hospice1 or
 long-t]m c>e sett+s2 or  7#d7 provide  
cont9u+ education to individuals :o     
provide palliative c>e 9 heal?-relat$   
educational1 home1 hospice1 or long-t]m 
c>e sett+s4  7c7 ,application ,an       
eligible entity desir+ a grant "u       
subsection 7a7 %all submit an           
application to ! ,secret>y at su* "t1 9 
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may reasonably require4  7d7  
,eligible entity ,= purposes ( ?is      
section1 ! t]m eligible entity %all     
include a s*ool ( nurs+1 a heal? c>e    
facility1 a program lead+ to            
c]tification z a c]tifi$ nurse assi/ant1
 a p>tn]%ip ( su* a s*ool & facility1 or
 a p>tn]%ip ( su* a program & facility4 
7e7 ,au?orization ( appropriations ,!re 
are au?oriz$ to be appropriat$ to c>ry  
out ?is section #e1jjj1jjj = ea* ( !    
fiscal ye>s #bjbf ?r\gh #bjcj4  4  #d4  
,dissem9ation ( palliative c>e in=mation
 ,"p ,a ( title ,,ix ( ! ,public ,heal? 

,s]vice ,act 7#db ,u4,s4,c4 #bii et     
seq47 is am5d$ by add+ at ! end ! foll[+
 new section3  #ijd4 ,dissem9ation (    
palliative c>e in=mation  7a7 ,9 g5]al  
,"u ! au?ority "u section #ijb7;a7 to   
dissem9ate in=mation on heal? c>e & on  
sy/ems = ! deliv]y ( su* c>e1 !         
,director may dissem9ate in=mation to   
in=m pati5ts1 families1 & heal?         
pr(essionals ab\t ! b5efits ( palliative
 c>e ?r\gh\t ! cont9uum ( c>e = pati5ts 
) s]i\s or life-?reat5+ illness4  7b7   
,in=mation dissem9at$  7#a7 ,m&atory    
in=mation ,if ! ,director elects to     
dissem9ate in=mation "u subsection 7a71 
su* dissem9ation %all include ! foll[+3 
7,a7 ,palliative c>e ,in=mation1        
res\rces1 & communication mat]ials ab\t 
palliative c>e z an ess5tial "p ( !     
cont9uum ( quality c>e = pati5ts &      
families fac+ s]i\s or life-?reat5+     
illness 7includ+ canc]1 he>t1 kidney1   
liv]1 lung1 & infecti\s diseases2 z well
 z neurodeg5]ative disease su* z        
dem5tia1 ,p>k9son's disease1 or         

amyotrophic lat]al scl]osis74  7,b7     
,palliative c>e s]vices ,specific       
in=mation reg>d+ ! s]vices provid$ to   
pati5ts by pr(essionals tra9$ 9 hospice 
& palliative c>e1 includ+ pa9 & symptom 
managem5t1 support = %>$ decision mak+1 
c>e coord9ation1 psy*osocial c>e1 &     
spiritual c>e1 expla9+ t su* s]vices may
 be provid$ />t+ at ! po9t ( diagnosis &
 alongside curative treatm5t & are      
int5d$ to-- 7i7 provide pati5t-c5t]$ &  
family-c5t]$ support ?r\gh\t ! cont9uum 
( c>e = s]i\s & life-?reat5+ illness2   
7ii7 anticipate1 prev5t1 & treat        
physical1 emotional1 social1 & spiritual
 suff]+2  7iii7 optimize quality ( life2
 &  7iv7 facilitate & support ! goals & 
values ( pati5ts & families4  7,c7      
,palliative c>e pr(essionals ,specific  
mat]ials t expla9 ! role ( pr(essionals 
tra9$ 9 hospice & palliative c>e 9      
provid+ team-bas$ c>e 7includ+ pa9 &    
symptom managem5t1 support = %>$        
decision mak+1 c>e coord9ation1         
psy*osocial c>e1 & spiritual c>e7 =     

pati5ts & families ?r\gh\t ! cont9uum ( 
c>e = s]i\s or life-?reat5+ illness4    
7,d7 ,rese>* ,evid5ce-bas$ rese>*       
demon/rat+ ! b5efits ( pati5t access to 
palliative c>e ?r\gh\t ! cont9uum ( c>e 
= s]i\s or life-?reat5+ illness4  7,e7  
,population-specific mat]ials ,mat]ials 
t>get+ specific populations1 includ+    
b5efici>ies ( ,m$ic>e1 ,m$icaid1 & !    
,vet]ans ,heal? ,adm9i/ration1 & pati5ts
 ) s]i\s or life-?reat5+ illness :o are 
among m$ically und]s]v$ populations 7z  
def9$ 9 section #ccj7;b77#c77 & families
 ( su* pati5ts or heal? pr(essionals    
s]v+ m$ically und]s]v$ populations1     
includ+ p$iatric pati5ts1 "y adult &    
adolesc5t pati5ts1 racial & e?nic       
m9ority populations1 & o!r priority     
populations specifi$ by ! ,director4    
7#b7 ,requir$ publication ,in=mation &  
mat]ials dissem9at$ "u p>agraph 7#a7    
%all be po/$ on ! int]net websites (    
relevant ,f$]al dep>tm5ts & ag5cies1    
includ+ ! ,dep>tm5t ( ,vet]ans ,affairs1
 ! ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices1 

& ! ,adm9i/ration on ,ag+4  7c7         
,consultation ,! ,director %all consult 
) appropriate pr(essional societies1    
hospice & palliative c>e /akehold]s1 &  
relevant pati5t advocate organizations )
 respect to palliative c>e1 psy*osocial 
c>e1 & complex *ronic illness ) respect 
to ! foll[+3 7#a7 ,! plann+ &           
implem5tation ( ! dissem9ation (        
palliative c>e in=mation "u ?is section4
  7#b7 ,! developm5t ( in=mation to be  
dissem9at$ "u ?is section4  7#c7 ,a     
def9ition ( ! t]m s]i\s or life-?reat5+ 
illness = purposes ( ?is section4  4    
#e4 ,cl>ification  7a7 ,re/riction on ! 
use ( ,f$]al funds ,none ( ! funds made 
available "u ?is ,act 7or an am5dm5t    
made by ?is ,act7 may be us$ to provide1
 promote1 or provide tra9+ ) reg>d to   
any item or s]vice = :i* ,f$]al fund+ is
 unavailable "u section #c ( ,public    
,law #aje-ab 7#db ,u4,s4,c4 #addjb74    
7b7 ,additional cl>ification ,z us$ 9   
?is ,act 7or an am5dm5t made by ?is     
,act71 palliative c>e & hospice %all n  

be furni%$ = ! purpose ( caus+1 or !    
purpose ( assi/+ 9 caus+1 a pati5t's    
dea?1 = any reason4  #f4 ,enhanc+ ,,nih 
rese>* 9 palliative c>e  7a7 ,9 g5]al   
,"p ,b ( title ,,iv ( ! ,public ,heal?  
,s]vice ,act 7#db ,u4,s4,c4 #bhd et     
seq47 is am5d$ by add+ at ! end ! foll[+
 new section3  #dji,k4 ,enhanc+ rese>* 9
 palliative c>e ,! ,secret>y1 or 8 or h]
 designee1 %all develop & implem5t a    
/rategy to be appli$ across ! in/itutes 
& c5t]s ( ! ,national ,in/itutes (      
,heal? to exp& & int5sify national      
rese>* programs 9 palliative c>e 9 ord] 
to address ! quality ( c>e & quality (  
life = ! rapidly gr[+ population (      
pati5ts 9 ! ,unit$ ,/ates ) s]i\s or    
life-?reat5+ illnesses1 includ+ canc]2  
he>t1 kidney1 liv]1 lung1 & infecti\s   
diseases2 z well z neurodeg5]ative      
diseases su* z dem5tia1 ,p>k9son's      
disease1 or amyotrophic lat]al scl]osis4
  4  7b7 ,exp&+ ,,nih rese>* report+ ,to
 include palliative c>e rese>* ,section 
#djb;,a7c77#b77;,b7 ( ! ,public ,heal?  

,s]vice ,act 7#db ,u4,s4,c4             
#bhb;a7c77#b77;,b77 is am5d$ by ins]t+  
&1 beg9n+ ,janu>y #a1 #bjbf1 = conduct+ 
or support+ rese>* ) respect to         
palliative c>e aft] or national c5t]s4