NHPCO’s Banach: Hospices Need More Federal Support During COVID-19

Edo Banach, president and CEO of the National Hospice & Palliative Care Organization (NHPCO), attended a public briefing by President Donald Trump at the White House on Thursday that addressed the needs of seniors during the COVID-19 pandemic, including the establishment of of a national commission on safety in nursing homes.

Banach took the helm at NHPCO in 2017 after years of legal practice and government posts with the City of New York and the U.S. Centers for Medicare & Medicaid Services (CMS). NHPCO is the largest nonprofit membership organization for hospice and palliative care providers and professionals.

Banach and NHPCO have praised the Trump administration’s efforts to support seniors and make considerations for hospice and palliative care providers, but also say that more support is necessary.

Banach recently sat down with Hospice News to talk about his visit to the White House and the types of federal action that hospice and palliative care providers need during the novel coronavirus outbreak. 

You were present at a public event yesterday afternoon at the White House. Did you have any additional meetings or discussions at the White House?

We did have the opportunity for informal discussions with senior policy specialists, but not with the president or the vice president.

We’ve been consistent [in discussions with policymakers]. One was around our work with veterans. I had the opportunity to speak with [U.S. Secretary for Veterans Affairs (VA) Robert Wilkie]. We have a veterans program is a partnership that we have with the VA and it’s one that we want to grow, especially in that grief and bereavement area as well. 

We have seen just a massive amount of grief and bereavement across the country. The VA has actually been very good on COVID-19, but there is work we can do together on grief and bereavement. 

The other is a community-based palliative care [Medicare] demo whose time has really come. The need right now is for a community-based serious illness benefit that doesn’t really exist in Medicare.

Is there need for further support for bereavement beyond your work with the VA, at the home and community level? 

Generally, hospice and palliative care providers are providing grief and bereavement services not only to their patients and the families of their patients, but to their whole communities. That’s not anything that we’re really paid to do, but it’s something we do in the wake of any tragedy, It’s probably time that we take a look at receiving compensation for the robust services given — that are needed not only for communities, but also for first responders. There’s a real need there. 

The president’s remarks yesterday focused a great deal on hospitals and nursing homes. Do you feel like hospice is kind of getting lost in the shuffle to some extent?

The short answer would be no, but I think that we need to continue to do our best to make clear that hospice is the community-based interdisciplinary care model that is really needed right now. 

There is a need for [personal protective equipment (PPE)]. It’s great that PPE is made available to nursing homes. We have advocated for it to be made available at a higher priority to hospice as well. That’s a high priority. 

You can’t argue that nursing homes shouldn’t be a priority. They are hotspots, and they are inevitably going to receive additional scrutiny and additional support. However, on the downside of this [COVID-19] curve — and on the upside of the next one — we’re going to see increased demand for [hospice and palliative care] services. It’s going to be important that we’re protected and supported as well.

Can you say more about the reasons now would be the time for a palliative care demo?

If you think about the example of someone who gets waylaid from the hospital because their symptoms aren’t severe enough, or someone who’s sheltering in place, a lot of the needs that they have are not acute in nature. They have palliative needs. They have needs for comfort. They need help. Those are all things that the Medicare system is really well suited to help with. 

[The health care system] is a really medically, institutionally acute-driven model of care. Unless you’re on Medicaid, there are very few tools available to help you quarantine in place, because adequate isolation often equates to lack of support and will lead eventually to that dreaded 911 call when things go south. We want to head that off.

NHPCO and other advocacy groups for seniors have written to congressional leaders a number of times regarding the needs of hospice providers during the pandemic. Which among those would you say are the top priorities? 

The top four would be PPE, grief and bereavement support, a community-based palliative care benefit that we can wrap our arms around, and then testing. I think it’s fair to say that everybody should have access to a rapid test similar to the one that Abbott [Laboratories (NYSE: ABT)] has developed.