Access to vaccines and additional provider relief are top policy priorities for hospice and palliative care organizations as the Biden Administration takes shape. As Congress and the White House mull over a new $1.9 trillion COVID-19 stimulus package, serious illness care providers and industry groups are advocating for sorely needed assistance.
The House recently approved President Biden’s American Rescue Plan, which contains another wave of relief funding. The Senate is in process of considering the package, which is aimed to pass before unemployment assistance programs expire on March 14, according to a CNBC report. The House plan includes $20 billion for COVID-19 vaccination distribution and $50 billion for testing and tracing efforts. The amount that would go to hospice and palliative care providers is unclear.
Organizations such as Coalition to Transform Advanced Care (C-TAC), National Coalition for Hospice & Palliative Care (NCHPC) and senior care association LeadingAge each sent separate letters to the administration calling for rapid expansion of vaccination programs that include hospice and palliative care personnel, as well as funding to replace lost revenue and procure supplies, among other requests.
“The pandemic has opened up a view of the vulnerabilities that we have as a health system,” said Tom Koutsoumpas, C-TAC’s CEO and co-founder and president and CEO of Capital Caring Health. “One of the most tragic elements of this pandemic has been the challenges that people are facing who are very ill, who are dying in facilities and who have absolutely no access to their families, their loved ones and the support that brings them. Our voices need to be loud.”
Hospice providers nationwide have grappled to find financial footing as they weather storms from the coronavirus pandemic. They have faced challenges such as procuring limited and costly personal protective equipment (PPE) and struggling to access patients in facility settings. Vaccinations for staff, aid for PPE supplies and additional provider relief funding present significant needs for hospice and palliative care providers across the country.
Among the largest priorities for hospice providers is regaining access to patients in facilities that have closed their doors to limit spread and risk of exposure to COVID-19. Hospices have had limited in-person reach to those in skilled nursing and assisted living facilities. In LeadingAge’s letter, the agency called upon federal leadership to prioritize increasing staff access to vaccinations through a national retail pharmacy program, removing visitation restrictions and supplying resources such as PPE and testing kits to visitors during outbreaks.
Patient visitation was not mentioned in the current national strategy plan, as C-TAC noted in its letter to the administration, with the organization calling for strengthened long-term care facility guidance from the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services (HHS) that encourages visitation policies to include vaccination safety updates and support of accelerated vaccination distribution in residential care settings.
“Keeping people at home, helping them stay at home, helping them to have care delivered to them at home, all of these things are really critical in addressing these things from a cost perspective, is critical,” Koutsoumpas told Hospice News. “We need a simplified national strategy to be able to vaccinate people in their homes, especially with so many homebound during the pandemic and to provide better testing kits for in-home use.”
Providers are also seeking support to maintain staffing levels and build clinician resilience amid the stress of COVID.
According to NCHPC, hospices and community-based palliative care professionals have cared for unprecedented numbers of people with serious illness, reducing the risk of community spread and easing pressure on overburdened hospitals during COVID-19.
Providing enhanced mental health resources and meaningful support are essential to sustaining and growing a healthy workforce, with NCHPC. members calling on Congress to establish federal grants for health care professional training and delve further into research on health care worker mental health to prevent issues such as burnout from proliferating even more among the hospice and palliative care workforce.
Research indicated that more than 62% of hospice and palliative care clinicians nationwide have suffered from effects of burnout and amplifying widespread staffing shortage issues. The pandemic has compounded this issue as employees cope with longer hours, exhaustion, fatigue and a heavy emotional toll as patients fall ill or die in isolation, rolling into disenfranchised grief among families, caregivers and providers alike.
Many hospices have refocused on staff mental health care with lessons learned during COVID-19, but support at a federal level is still needed, according to NCHPC.
“There’s now a lot of evidence that the mental health and emotional resiliency for health care workers is tenuous,” said Amy Melnick, executive director for NCHPC. “Palliative care providers and hospice workers have almost been through a war during the pandemic. We need to think a little bit more broadly about that need for resources and then beyond that, of strategy.”