July 01, 2016

Advance Care Planning

The ABA conveyed its appreciation June 29 in a letter to Reps. Earl Blumenauer (D-Ore.) and Phil Roe (R-Tenn.) for their support for meaningful access to patient-centered advance care planning and for introducing H.R. 5555, the Personalize Your Care Act 2.0. ABA Governmental Affairs Director Thomas M. Susman wrote that the ABA has for decades strongly supported the use of advance care planning and advance heath care directives by all adults. In recent years the association has urged widespread support for Physicians Orders for Life-Sustaining Treatment (POLST); strengthening the Patient Self-Determination Act; and legislation and regulation that promotes access to and financing of high-quality, comprehensive long-term supportive services for persons with advanced illness.  “An ever-expanding body of medical literature continues to demonstrate the importance of recurring physician-patient-family communications as essential to making patients’ values and goals of care known and honored in the course of their health care,” Susman said. He noted that the Personalize Your Care Act 2.0 is an appropriate next step on the heels of the decision by the Centers for Medicare and Medicaid Services to provide reimbursement beginning this year for advance care planning conversations. Provisions in H.R. 5555 supported by the ABA include: integrating advance care planning into a holistic advanced illness management demonstration program; providing grants for establishing and expanding POLST; enhancing the portability of advance directives; creating standards for incorporating advance care planning documents into electronic health records; promoting quality measures for end-of-life care; and providing grants for improving professional education and training in advance care planning and palliative care. Susman noted that the bill would ensure portability of health care advance directives across the states and affirm the fundamental principle that, in the absence of an advance directive, any authentic expression of the patient’s wishes should be honored. He cautioned that advance directive laws can become a barrier when interpreted to require strict compliance with detailed legal rules and procedures. He suggested that, in order to facilitate practical implementation of this principle, the language in the bill should be worded to state that “any clear, undisputed expression of a person’s health care wishes should be honored, consistent with applicable law.”

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