NASW’s Hospice Advocacy Efforts Continue

NASW continues to promote the welfare of clients and social workers involved with hospice and palliative care.

Advocacy efforts last year to include voluntary advance care planning as a service provided under the new Medicare annual wellness benefit were initially successful, until a White House reversal.

NASW Executive Director Elizabeth J. Clark had written a letter on behalf of the association to Health and Human Services Secretary Kathleen Sebelius and Donald Berwick, administrator for the Centers for Medicare & Medicaid Services, urging them to add voluntary advance care planning as a service offered under the new Medicare annual wellness benefit.

The letter explained that advance care planning enables individuals to consider and communicate their health care wishes — which may be expressed in a living will, appointment of health care agent, do-not-resuscitate orders and (in some cases) physicians’ orders for life-sustaining treatment — in case of serious illness or injury. As a member of the Hospice and Palliative Care Coalition, NASW signed onto a similar letter to Sebelius and Berwick.

The advocacy efforts appeared to be a victory; CMS added advance care planning to the list of services covered in the Medicare annual wellness visit, and the change was set to go into effect on Jan. 1. However, the Obama administration abruptly reversed the decision in early January. White House officials said the topic needed more time for public comment.

J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization, issued a statement after the announcement.

“We are surprised that the administration has decided to reverse the decision to include voluntary advance care planning consultations as part of Medicare beneficiaries’ annual wellness exam,” Schumacher said in the statement.

He noted that despite the action, NHPCO strongly encourages all Americans to think about their wishes for care at the end of life and engage in advance care planning.

One NASW staff member has volunteered his time to help the NHPCO and its efforts to serve veterans.

David Miller, administrative assistant to Clark, serves on NHPCO’s Veterans Advisory Council.

“I am very pleased to serve on this council as a veteran myself,” said Miller, who served 10 years in the U.S. Navy. “I enjoy giving back to the veteran community and this is one way I can do that.”

Miller said he considers his role on the council as a typical end-user of veteran services. “Because of my experience, I can offer a unique perspective,” he said.

The council reviews the content for the We Honor Veterans website, which promotes veterans outreach services. Miller also evaluates proposals for NHPCO’s Reaching Out grants program, which is funded through a contract with the Department of Veterans Affairs. The group reviews proposals and selects grant recipients from different hospice and palliative care organizations in the United States that best support the five specific Reaching Out model programs that are committed to increasing access to hospice and palliative care for rural and homeless veterans.

Not only do the grants support definitive, community-based programs, but they also help the VA in discovering new ways to reach veterans who are homeless or living in rural areas and need quality end-of-life care.

In other hospice and palliative care developments:

  • The NASW Center for Workforce Studies and Social Work Practice recently issued an occupational profile titled Social Workers in Hospice and Palliative Care. (PDF)
  • NASW continues to support the Hospice Foundation of America’s annual Living with Grief program. This year’s theme, Spirituality and End-of-Life Care, is a 2.5-hour program that will feature a panel discussion including two social workers: Carolyn Jacobs, dean of the Smith College School for Social Work, and Betty Kramer, Smith social work professor and a member of the Comprehensive Cancer Center at the University of Wisconsin-Madison. The program will be available as a webcast April 13, as well as by DVD.
  • The association is supporting the fourth annual National Healthcare Decisions Day, which will take place April 16. National Healthcare Decisions Day was established to encourage advance care planning for adults with decision-making capacity. National Healthcare Decisions Day urges organizations, health care providers and other key stakeholders to promote awareness, completion and discussion of advance directives.
  • Joan Levy Zlotnik, director of the NASW Foundation’s Social Work Policy Institute, was recently selected to serve on an end-of-life and hospice care evidenced-based committee hosted by John Hopkins University and supported by the Agency for Healthcare Research and Quality.