On July 23, 2018 the United States House of Representatives passed HR 1676 approving grants to improve educational programs, research and workforce development in palliative medicine. Many outside the health care community, and even some inside the health care community, have little to no understanding of the purpose of palliative care. According to the proposed legislation, there will be no more than a one percent growth in the is physician workforce in 20 years while the persons eligible for palliative care will grow by over 20 percent. The proposed grants are intended to assist in developing a source of educators and health care providers to address this lack of resources and knowledge. The legislation known as the Palliative Care and Hospice Education and Training Act creates grants in several areas and amends the Public Health Service Act.
In most cases, the grants would be awarded to Palliative Care and Hospice Education Centers ("Center") who can establish that they meet specific requirements. In order to receive the funding, the Center must establish that it will improve training of health professionals in palliative care, develop and disseminate curricula relating to palliative treatment, support training and retraining of faculty to provide instruction in palliative care, support continuing education of health professionals who provide palliative care to patients, provides students with clinical training in palliative care in long term care facilities, home care, hospices, chronic and acute disease hospitals and ambulatory care centers, and establish traineeships for individuals preparing for advanced education nursing degrees, social work or physician assistant studies with a focus on palliative care.
As part of the proposed legislation, grant funding would be provided for the training of physician's in palliative medicine. These grants would be to schools of medicine, schools of osteopathic medicine, teaching hospitals and graduate medical education programs for the purpose of providing funding for the training of physicians who plan to teach palliative medicine. Fellowship programs accredited by the Accreditation Counsel for Graduate Medical Education would be eligible to receive this type of grant. In order to qualify, the schools must be staffed by full-time teaching physicians who have experience and training in palliative medicine and must also provide training in palliative medicine through a variety of service rotations.
There are two training options under this provision of the Act: (1) a one-year retraining program in hospice and palliative medicine for physicians who are faculty at schools of medicine and osteopathic medicine or (2) a one to two year training program that is designed to provide training in 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 Specialties.
Academic Career Development
The legislation also covers grants to assist in academic career development. These grants would be given to eligible individuals to promote career development in academic hospice and as palliative care physicians. The eligible recipients would be board certified or board eligible in hospice and palliative care and have a junior non-tenured faculty appointment at an accredited school of medicine or osteopathic medicine. Applicants for the grant must provide assurances that he or she will provide training in palliative care and hospice, including the training of interdisciplinary teams of health care professionals. An award for career development cannot exceed five years and would would be paid directly to the institution.
Workforce development is another area of grant funding and is designed to create fellowship programs to supplement training for faculty members in medical schools and other health profession schools with programs in psychology, pharmacy, nursing, social work, physician assistant education, chaplaincy or other health disciplines. The fellowship would be open to current faculty and to appropriately credentialed volunteer faculty and practitioners who do not have formal training in palliative care to upgrade their knowledge and clinical skills to care for individuals with serious or life threatening illnesses. The fellowship could be offered at a Palliative Care and Hospice Education Center or at approved medical schools. Participation in the fellowship program would count towards continuing health profession education requirements. Each award under this subsection would be in the amount of $150,000, and no more than 24 palliative care and hospice education centers may receive the award.
Career Incentive Awards
The final area of grant awards would be in the area of palliative care and hospice career incentive awards. These awards would be designed to foster greater interest among a variety of health professionals entering the field of palliative care. To be eligible, the individual would have to be an advanced practice nurse, a social worker, physician assistant, pharmacist, chaplain or student in psychology who is pursuing a doctorate, masters or other advanced degree with a focus in palliative care or related field in an accredited health profession school. As another condition of receiving the award or grant, the individual would have to agree that following the completion of the award period, he or she would teach or practice palliative care in a health related educational home, hospice or long-term care settings for a minimum of five years. The payment would be made directly to the institution and the Act authorizes $44.1 million through fiscal years 2018-2022 to carry out the purpose of the Act.
The bill will now go to the U.S. Senate for consideration (S. 693).
Alabama Initiatives on Palliative Care
For its part, Alabama has also taken efforts to educate the public and health care professionals on the importance and purpose of palliative care and hospice care. In 2015, the Alabama Legislature passed a resolution establishing the Alabama State Advisory Council on Palliative Care and Quality of Life. The council meets regularly to discuss and develop educational resources for the public. For more information on the State Advisory Council and its educational efforts, please visit the website at: