Sen. Tammy Baldwin (D-Wis.) and Shelley Moore Capito (R-W.Va.) have introduced the Palliative Care and Hospice Education and Training Act (PCHETA) in the U.S. Senate. The legislation would provide resources to support clinician training to reduce staff shortages in the industry and help providers meet continuously rising demand for those services as the population ages.
If enacted, the bill would establish fellowship programs within new palliative care and hospice education centers to provide short-term, intensive training on palliative care and hospice. The courses would provide supplemental training for medical school faculty as well as other educators in health care fields such as nursing, pharmacy, social work and chaplaincy. The centers would also develop curricula related to palliative care and support continuing education, retraining of faculty, practical clinical training and establish training programs for advanced practice nurses.
A version of the bill was introduced in the U.S. House of Representatives in April. The House Committee on Energy and Commerce is currently reviewing the House bill.
“I was raised by my maternal grandparents and later served as my grandmother’s primary caregiver as she grew older, so this issue is personal to me, and I want to make a difference for families experiencing serious health concerns,” Baldwin said in a statement. “I’m proud to work across party lines and reintroduce the bipartisan Palliative Care and Hospice Education and Training Act with my colleague Senator Capito. We must do more to grow our health care workforce to safeguard and improve the quality of care for the growing number of patients with serious or life-threatening illnesses.”
The United States has 13.35 hospice and palliative care specialists for every 100,000 adults 65 and older, according to an April 2018 study. The research estimated that by 2040 the patient population will need 10,640 to 24,000 specialists; supply is expected to range between 8,100 and 19,000.
Hospice and palliative care providers also experience shortages in non-physician disciplines, including chaplains, nurses, and social workers. As far back as 2008, the U.S. Centers for Medicare & Medicaid Service (CMS) began allowing hospice providers to use contracted nursing staff because not enough nurses were available to fill permanent positions.
“One of the things we have to address as an industry is the nursing shortage. The average age of the nurses that come to work for us is between 45 and 65. They are an older population of fabulous nurses that have a wealth of education and experience, but one thing we need to look at is getting more nurses integrated and involved in end of life care much earlier in their careers,” Regional Hospice & Palliative Care CEO Cynthia Emiry Roy recently told Hospice News.
In addition to establishing education centers, PCHETA would create grant programs to support education, workforce development and retention programs for palliative care and hospice nurses and would create grants for teaching hospitals and graduate medical education programs to train palliative care physicians. Programs receiving grants would be required to develop performance measures to ascertain trainee competency.
PCHETA would also direct the National Institutes of Health to use existing funds to expand palliative care research, as well as finance awareness programs to educate the public about hospice and palliative care.
Numerous hospice and palliative care organizations have come out in favor of the bill, as have a number of other health care and senior citizen interest groups. A bipartisan group of senators is cosponsoring the bill, including Sens. Angus King (I-Maine), Cindy Hyde-Smith (R-Miss.), Kyrsten Sinema (D-Ariz.), Kevin Cramer (R-N.D.), Jeanne Shaheen (D-N.H.) and John Hoeven (R-N.D.).
“We applaud Senate leaders for recognizing the need to increase the ranks of palliative and hospice care professionals and ensure all Americans are able to access person-centered and integrated care,” said Edo Banach, president and CEO of the National Hospice & Palliative Care Organization. “This bipartisan legislation would provide critical funding and resources to expand our palliative care workforce at a time when the number of individuals facing serious, advanced or life-limiting illness is rapidly growing.”