Palliative Care and Hospice Education and Training Act
This bill requires the Department of Health and Human Services (HHS) to take a series of actions relating to palliative-care training.
Specifically, HHS must provide support for Palliative Care and Hospice Education Centers. The centers must improve the training of health professionals in palliative care and establish traineeships for individuals preparing for advanced-education nursing degrees, social-work degrees, or advanced degrees in physician-assistant studies in palliative care.
HHS may provide support to medical schools, teaching hospitals, and graduate medical-education programs for training physicians who plan to teach palliative medicine.
HHS must (1) provide Palliative Medicine and Hospice Academic Career Awards to individuals to promote their career development, (2) support entities that operate a Palliative Care and Hospice Education Center, (3) support individuals in specified fields who are pursuing an advanced degree in palliative care or related fields, and (4) award grants to nursing programs to train individuals in providing palliative care.
The Agency for Healthcare Research and Quality must provide for a national education and awareness campaign to inform patients, families, and health professionals about the benefits of palliative care.
The National Institutes of Health must expand national research programs in palliative care.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 2080 Introduced in Senate (IS)]
<DOC>
116th CONGRESS
1st Session
S. 2080
To amend the Public Health Service Act to increase the number of
permanent faculty in palliative care at accredited allopathic and
osteopathic medical schools, nursing schools, social work schools, and
other programs, including physician assistant education programs, to
promote education and research in palliative care and hospice, and to
support the development of faculty careers in academic palliative
medicine.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 10, 2019
Ms. Baldwin (for herself, Mrs. Capito, Mr. King, Mrs. Hyde-Smith, Ms.
Sinema, Mr. Cramer, Mrs. Shaheen, and Mr. Hoeven) introduced the
following bill; which was read twice and referred to the Committee on
Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to increase the number of
permanent faculty in palliative care at accredited allopathic and
osteopathic medical schools, nursing schools, social work schools, and
other programs, including physician assistant education programs, to
promote education and research in palliative care and hospice, and to
support the development of faculty careers in academic palliative
medicine.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Palliative Care and Hospice
Education and Training Act''.
SEC. 2. PALLIATIVE CARE AND HOSPICE EDUCATION AND TRAINING.
(a) In General.--Part D of title VII of the Public Health Service
Act (42 U.S.C. 294 et seq.) is amended by inserting after section 759
the following:
``SEC. 759A. PALLIATIVE CARE AND HOSPICE EDUCATION AND TRAINING.
``(a) Palliative Care and Hospice Education Centers.--
``(1) In general.--The Secretary shall award grants or
contracts under this section to entities described in paragraph
(1), (3), or (4) of section 799B, and section 801(2), for the
establishment or operation of Palliative Care and Hospice
Education Centers that meet the requirements of paragraph (2).
``(2) Requirements.--A Palliative Care and Hospice
Education Center meets the requirements of this paragraph if
such Center--
``(A) improves the interprofessional team-based
training of health professionals in palliative care,
including residencies, traineeships, or fellowships;
``(B) develops and disseminates interprofessional
team-based curricula relating to the palliative
treatment of the complex health problems of individuals
with serious or life-threatening illnesses;
``(C) supports the training and retraining of
faculty to provide instruction in interprofessional
team-based palliative care;
``(D) supports interprofessional team-based
continuing education of health professionals who
provide palliative care to patients with serious or
life-threatening illness;
``(E) provides students (including residents,
trainees, and fellows) with clinical training in
interprofessional team-based palliative care in
appropriate health settings, including hospitals,
hospices, home care, long-term care facilities, and
ambulatory care centers;
``(F) establishes traineeships for individuals who
are preparing for advanced education nursing degrees,
social work degrees, or advanced degrees in physician
assistant studies, with a focus in interprofessional
team-based palliative care in appropriate health
settings, including hospitals, hospices, home care,
long-term care facilities, and ambulatory care centers;
``(G) supports collaboration between multiple
specialty training programs (such as medicine, nursing,
social work, physician assistant, chaplaincy, and
pharmacy) and clinical training sites to provide
training in interprofessional team-based palliative
care; and
``(H) does not duplicate the activities of existing
education centers funded under this section or under
section 753 or 865.
``(3) Expansion of existing centers.--Nothing in this
section shall be construed to--
``(A) prevent the Secretary from providing grants
to expand existing education centers, including
geriatric education centers established under section
753 or 865, to provide for education and training
focused specifically on palliative care, including for
non-geriatric populations; or
``(B) limit the number of education centers that
may be funded in a community.
``(b) Palliative Medicine Physician Training.--
``(1) In general.--The Secretary may make grants to, and
enter into contracts with, schools of medicine, schools of
osteopathic medicine, teaching hospitals, and graduate medical
education programs for the purpose of providing support for
projects that fund the training of physicians (including
residents, trainees, and fellows) who plan to teach palliative
medicine.
``(2) Requirements.--Each project for which a grant or
contract is made under this subsection shall--
``(A) be staffed by full-time teaching physicians
who have experience or training in interprofessional
team-based palliative medicine;
``(B) be based in a hospice and palliative medicine
fellowship program accredited by the Accreditation
Council for Graduate Medical Education;
``(C) provide training in interprofessional team-
based palliative medicine through a variety of service
rotations, such as consultation services, acute care
services, extended care facilities, ambulatory care and
comprehensive evaluation units, hospices, home care,
and community care programs;
``(D) develop specific performance-based measures
to evaluate the competency of trainees; and
``(E) provide training in interprofessional team-
based palliative medicine through one or both of the
training options described in paragraph (3).
``(3) Training options.--The training options referred to
in subparagraph (E) of paragraph (2) are as follows:
``(A) 1-year retraining programs in hospice and
palliative medicine for physicians who are faculty at
schools of medicine and osteopathic medicine, or others
determined appropriate by the Secretary.
``(B) 1- or 2-year training programs that are
designed to provide training in interprofessional team-
based 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.
``(4) Definitions.--For purposes of this subsection, the
term `graduate medical education' means a program sponsored by
a school of medicine, a school of osteopathic medicine, a
hospital, or a public or private institution that--
``(A) offers postgraduate medical training in the
specialties and subspecialties of medicine; and
``(B) has been accredited by the Accreditation
Council for Graduate Medical Education or the American
Osteopathic Association through its Committee on
Postdoctoral Training.
``(c) Palliative Medicine and Hospice Academic Career Awards.--
``(1) Establishment of program.--The Secretary shall
establish a program to provide awards, to be known as the
`Palliative Medicine and Hospice Academic Career Awards', to
eligible individuals to promote the career development of such
individuals as academic hospice and palliative care physicians.
``(2) Eligible individuals.--To be eligible to receive an
award under paragraph (1), an individual shall--
``(A) be board certified or board eligible in
hospice and palliative medicine; and
``(B) have a junior (non-tenured) faculty
appointment at an accredited (as determined by the
Secretary) school of medicine or osteopathic medicine.
``(3) Limitations.--No award under paragraph (1) may be
made to an eligible individual unless the individual--
``(A) has submitted to the Secretary an
application, at such time, in such manner, and
containing such information as the Secretary may
require, and the Secretary has approved such
application;
``(B) provides, in such form and manner as the
Secretary may require, assurances that the individual
will meet the service requirement described in
paragraph (6); and
``(C) provides, in such form and manner as the
Secretary may require, assurances that the individual
has a full-time faculty appointment in a health
professions institution and documented commitment from
such institution to spend a majority of the total
funded time of such individual on teaching and
developing skills in education in interprofessional
team-based palliative care.
``(4) Maintenance of effort.--An eligible individual who
receives an award under paragraph (1) shall provide assurances
to the Secretary that funds provided to the eligible individual
under this subsection will be used only to supplement, not to
supplant, the amount of Federal, State, and local funds
otherwise expended by the eligible individual.
``(5) Amount and term.--
``(A) Amount.--The amount of an award under this
subsection shall be equal to the award amount provided
for under section 753(c)(5)(A) for the fiscal year
involved.
``(B) Term.--The term of an award made under this
subsection shall not exceed 5 years.
``(C) Payment to institution.--The Secretary shall
make payments for awards under this subsection to
institutions, including schools of medicine and
osteopathic medicine.
``(6) Service requirement.--An individual who receives an
award under this subsection shall provide training in
palliative care and hospice, including the training of
interprofessional teams of health care professionals. The
provision of such training shall constitute a majority of the
total funded obligations of such individual under the award.
``(d) Palliative Care Workforce Development.--
``(1) In general.--The Secretary shall award grants or
contracts under this subsection to entities that operate a
Palliative Care and Hospice Education Center pursuant to
subsection (a)(1).
``(2) Application.--To be eligible for an award under
paragraph (1), an entity described in such paragraph shall
submit to the Secretary an application at such time, in such
manner, and containing such information as the Secretary may
require.
``(3) Use of funds.--Amounts awarded under a grant or
contract under paragraph (1) shall be used to carry out the
fellowship program described in paragraph (4).
``(4) Fellowship program.--
``(A) In general.--Pursuant to paragraph (3), a
Palliative Care and Hospice Education Center that
receives an award under this subsection shall use such
funds to offer short-term intensive courses (referred
to in this subsection as a `fellowship') that focus on
interprofessional team-based palliative care that
provide supplemental training for faculty members in
medical schools and other health professions schools
with programs in psychology, pharmacy, nursing, social
work, physician assistant education, chaplaincy, or
other health disciplines, as approved by the Secretary.
Such a fellowship shall be open to current faculty, and
appropriately credentialed volunteer faculty and
practitioners, who do not have formal training in
palliative care, to upgrade their knowledge and
clinical skills for the care of individuals with
serious or life-threatening illness and to enhance
their interdisciplinary and interprofessional teaching
skills.
``(B) Location.--A fellowship under this paragraph
shall be offered either at the Palliative Care and
Hospice Education Center that is sponsoring the course,
in collaboration with other Palliative Care and Hospice
Education Centers, or at medical schools, schools of
nursing, schools of pharmacy, schools of social work,
schools of chaplaincy or pastoral care education,
graduate programs in psychology, physician assistant
education programs, or other health professions schools
approved by the Secretary with which the Centers are
affiliated.
``(C) Continuing education credit.--Participation
in a fellowship under this paragraph shall be accepted
with respect to complying with continuing health
profession education requirements. As a condition of
such acceptance, the recipient shall subsequently
provide a minimum of 18 hours of voluntary instruction
in palliative care content (that has been approved by a
palliative care and hospice education center) to
students or trainees in health-related educational,
home, hospice, or long-term care settings.
``(5) Targets.--A Palliative Care and Hospice Education
Center that receives an award under paragraph (1) shall meet
targets approved by the Secretary for providing training in
interprofessional team-based palliative care to a certain
number of faculty or practitioners during the term of the
award, as well as other parameters established by the
Secretary.
``(6) Amount of award.--Each award under paragraph (1)
shall be in the amount of $150,000. Not more than 24 Palliative
Care and Hospice Education Centers may receive an award under
such paragraph.
``(7) Maintenance of effort.--A Palliative Care and Hospice
Education Center that receives an award under paragraph (1)
shall provide assurances to the Secretary that funds provided
to the Center under the award will be used only to supplement,
not to supplant, the amount of Federal, State, and local funds
otherwise expended by such Center.
``(e) Palliative Care and Hospice Career Incentive Awards.--
``(1) In general.--The Secretary shall award grants or
contracts under this subsection to individuals described in
paragraph (2) to foster greater interest among a variety of
health professionals in entering the field of palliative care.
``(2) Eligible individuals.--To be eligible to receive an
award under paragraph (1), an individual shall--
``(A) be an advanced practice nurse, a social
worker, physician assistant, pharmacist, chaplain, or
student of psychology who is pursuing a doctorate,
masters, or other advanced degree with a focus in
interprofessional team-based palliative care or related
fields in an accredited health professions school; and
``(B) submit to the Secretary an application at
such time, in such manner, and containing such
information as the Secretary may require.
``(3) Conditions of award.--As a condition of receiving an
award under paragraph (1), an individual shall agree that,
following completion of the award period, the individual will
teach or practice palliative care in health-related
educational, home, hospice, or long-term care settings for a
minimum of 5 years under guidelines established by the
Secretary.
``(4) Payment to institution.--The Secretary shall make
payments for awards under paragraph (1) to institutions that
include schools of medicine, osteopathic medicine, nursing,
social work, psychology, chaplaincy or pastoral care education,
dentistry, and pharmacy, or other allied health discipline in
an accredited health professions school or program (such as a
physician assistant education program) that is approved by the
Secretary.
``(f) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, $15,000,000 for each of the
fiscal years 2020 through 2024.''.
(b) Effective Date.--The amendment made by this section shall be
effective beginning on the date that is 90 days after the date of
enactment of this Act.
SEC. 3. HOSPICE AND PALLIATIVE NURSING.
(a) Nurse Education, Practice, and Quality Grants.--Section
831(b)(3) of the Public Health Service Act (42 U.S.C. 296p(b)(3)) is
amended by inserting ``hospice and palliative nursing,'' after
``coordinated care,''.
(b) Palliative Care and Hospice Education and Training Programs.--
Part D of title VIII of the Public Health Service Act (42 U.S.C. 296p
et seq.) is amended by adding at the end the following:
``SEC. 832. PALLIATIVE CARE AND HOSPICE EDUCATION AND TRAINING.
``(a) Program Authorized.--The Secretary shall award grants to
eligible entities to develop and implement, in coordination with
programs under section 759A, programs and initiatives to train and
educate individuals in providing interprofessional team-based
palliative care in health-related educational, hospital, hospice, home,
or long-term care settings.
``(b) Use of Funds.--An eligible entity that receives a grant under
subsection (a) shall use funds under such grant to--
``(1) provide training to individuals who will provide
palliative care in health-related educational, hospital, home,
hospice, or long-term care settings;
``(2) develop and disseminate curricula relating to
palliative care in health-related educational, hospital, home,
hospice, or long-term care settings;
``(3) train faculty members in palliative care in health-
related educational, hospital, home, hospice, or long-term care
settings; or
``(4) provide continuing education to individuals who
provide palliative care in health-related educational, home,
hospice, or long-term care settings.
``(c) Application.--An eligible entity desiring a grant under
subsection (a) shall submit an application to the Secretary at such
time, in such manner, and containing such information as the Secretary
may reasonably require.
``(d) Eligible Entity.--For purposes of this section, the term
`eligible entity' shall include a school of nursing, a health care
facility, a program leading to certification as a certified nurse
assistant, a partnership of such a school and facility, or a
partnership of such a program and facility.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $5,000,000 for each of fiscal
years 2020 through 2024.''.
SEC. 4. DISSEMINATION OF PALLIATIVE CARE INFORMATION.
Part A of title IX of the Public Health Service Act (42 U.S.C. 299
et seq.) is amended by adding at the end the following new section:
``SEC. 904. DISSEMINATION OF PALLIATIVE CARE INFORMATION.
``(a) In General.--Under the authority under section 902(a) to
disseminate information on health care and on systems for the delivery
of such care, the Director may disseminate information to inform
patients, families, and health professionals about the benefits of
palliative care throughout the continuum of care for patients with
serious or life-threatening illness.
``(b) Information Disseminated.--
``(1) Mandatory information.--If the Director elects to
disseminate information under subsection (a), such
dissemination shall include the following:
``(A) Palliative care.--Information, resources, and
communication materials about palliative care as an
essential part of the continuum of quality care for
patients and families facing serious or life-
threatening illness (including cancer, heart, kidney,
liver, lung, and infectious diseases; as well as
neurodegenerative disease such as dementia, Parkinson's
disease, or amyotrophic lateral sclerosis).
``(B) Palliative care services.--Specific
information regarding the services provided to patients
by professionals trained in hospice and palliative
care, including pain and symptom management, support
for shared decision making, care coordination,
psychosocial care, and spiritual care, explaining that
such services may be provided starting at the point of
diagnosis and alongside curative treatment and are
intended to--
``(i) provide patient-centered and family-
centered support throughout the continuum of
care for serious and life-threatening illness;
``(ii) anticipate, prevent, and treat
physical, emotional, social, and spiritual
suffering;
``(iii) optimize quality of life; and
``(iv) facilitate and support the goals and
values of patients and families.
``(C) Palliative care professionals.--Specific
materials that explain the role of professionals
trained in hospice and palliative care in providing
team-based care (including pain and symptom management,
support for shared decision making, care coordination,
psychosocial care, and spiritual care) for patients and
families throughout the continuum of care for serious
or life-threatening illness.
``(D) Research.--Evidence-based research
demonstrating the benefits of patient access to
palliative care throughout the continuum of care for
serious or life-threatening illness.
``(E) Population-specific materials.--Materials
targeting specific populations, including patients with
serious or life-threatening illness who are among
medically underserved populations (as defined in
section 330(b)(3)) and families of such patients or
health professionals serving medically underserved
populations. Such populations shall include pediatric
patients, young adult and adolescent patients, racial
and ethnic minority populations, and other priority
populations specified by the Director.
``(2) Required publication.--Information and materials
disseminated under paragraph (1) shall be posted on the
Internet websites of relevant Federal agencies and departments,
including the Department of Veterans Affairs, the Centers for
Medicare & Medicaid Services, and the Administration on Aging.
``(c) Consultation.--The Director shall consult with appropriate
professional societies, hospice and palliative care stakeholders, and
relevant patient advocate organizations with respect to palliative
care, psychosocial care, and complex chronic illness with respect to
the following:
``(1) The planning and implementation of the dissemination
of palliative care information under this section.
``(2) The development of information to be disseminated
under this section.
``(3) A definition of the term `serious or life-threatening
illness' for purposes of this section.''.
SEC. 5. CLARIFICATION.
(a) Restriction on the Use of Federal Funds.--None of the funds
made available under this Act (or an amendment made by this Act) may be
used to provide, promote, or provide training with regard to any item
or service for which Federal funding is unavailable under section 3 of
Public Law 105-12 (42 U.S.C. 14402).
(b) Additional Clarification.--As used in this Act (or an amendment
made by this Act), palliative care and hospice shall not be furnished
for the purpose of causing, or the purpose of assisting in causing, a
patient's death, for any reason.
SEC. 6. ENHANCING NIH RESEARCH IN PALLIATIVE CARE.
(a) In General.--Part B of title IV of the Public Health Service
Act (42 U.S.C. 284 et seq.) is amended by adding at the end the
following new section:
``SEC. 409K. ENHANCING RESEARCH IN PALLIATIVE CARE.
``The Secretary, acting through the Director of the National
Institutes of Health, shall develop and implement a strategy to be
applied across the institutes and centers of the National Institutes of
Health to expand and intensify national research programs in palliative
care in order to address the quality of care and quality of life for
the rapidly growing population of patients in the United States with
serious or life-threatening illnesses, including cancer; heart, kidney,
liver, lung, and infectious diseases; as well as neurodegenerative
diseases such as dementia, Parkinson's disease, or amyotrophic lateral
sclerosis.''.
(b) Expanding Trans-NIH Research Reporting To Include Palliative
Care Research.--Section 402A(c)(2)(B) of the Public Health Service Act
(42 U.S.C. 282a(c)(2)(B)) is amended by inserting ``and, beginning
January 1, 2020, for conducting or supporting research with respect to
palliative care'' after ``or national centers''.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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