Madam Speaker, today I am proud to introduce the Personalize Your Care Act of 2010. Advances in healthcare have led to increasingly complex health care decisions and more treatment options than we have ever had the benefit, or the burden,…
Madam Speaker, today I am proud to introduce the Personalize Your Care Act of 2010.
Advances in healthcare have led to increasingly complex health care decisions and more treatment options than we have ever had the benefit, or the burden, of choosing between. Both Democrats and Republicans agree that individuals should be fully involved in decisions related to their health care, making informed decisions that reflect their values and their needs. We also agree that when people have expressed their wishes, those wishes should be known and respected.
While there is widespread agreement in these principles, too often this is not the reality. Most adults have not completed an advance directive; if documents are completed, they are not regularly revisited and can be difficult to locate. Because these issues are difficult to discuss, surrogates can feel ill-prepared to interpret their loved ones' written wishes.
These shortcomings often leave families and health care proxies faced with the burden of determining their loved ones' wishes in the midst of crisis, sometimes with little or no information about how best to direct care. This adds not only stress and anxiety to an already difficult situation, but studies show that lack of advance care planning actually prolongs the grieving process after losing a loved one.
One of the greatest misconceptions about advance care planning is that it is a one-time event. Attempting to plan for all possibilities in a single document or within a single conversation is both overwhelming and impossible. Early advance care planning is important because a person's ability to make decisions may diminish over time and he or she may suddenly lose the capability to participate in his or her health care decisions. Ongoing conversations are also necessary.
For advance care planning to be successful, it must become less about legal documentation and more about facilitating ongoing communication about future care wishes among individuals, their health care providers, and surrogates. This approach recognizes that advance care documents like advance directives are not the ``ends'', but the ``means''--the tools for documenting care preferences based on informed decisions that incorporate an individual's values, personal goals, and current circumstances.
This process not only provides higher quality care, but personalized care.
The Personalize Your Care Act aims to support advance care planning by providing Medicare and Medicaid coverage for voluntary consultations about advance care planning every 5 years or in the event of a change in health status. This periodic revisiting of advance care documents and goals of care recognizes that individual's preference may change over time. More so, should an individual develop a serious or chronic illness, additional curative and palliative treatment options may be available and the advance care plan should be updated to reflect the individual's current circumstances and preferences.
Honoring the expressed wishes of individuals must also be a priority and for this to occur, advance care planning documents must be accessible where care is provided. To this end, the bill would ensure that an individual's electronic health record is able to display his or her current advance directive and/or physician orders for life sustaining treatment (POLST), so that his or her wishes would be more easily accessible and respected. Furthermore, advance directives would be more portable to help individuals ensure that advance directives completed in one state are honored in another state in which the individual needs care.
And lastly, the bill provides grants to states to establish or expand physician orders for life sustaining treatment programs. These programs have a track record of promoting patient autonomy through documenting and coordinating a person's treatment preferences, clarifying treatment intentions and minimizing confusion, reducing repetitive activities in complying with the Patient Self Determination Act, and facilitating appropriate treatment by emergency personnel.
These investments in advance care planning will reinforce patient- centered care--engaging individuals in planning and decision-making about their future care and ensuring that those preferences are documented, accessible, and can be honored in any state and care setting.
I am proud to introduce the Personalize Your Care Act with the support of patient advocates, physicians, nurses, and the faith community who see everyday how advance care planning improves individuals' and families' peace of mind and the quality of their care.
I would like to submit for the Record letters of support from the AARP, Supportive Care Coalition, National Hospice and Palliative Care Organization, and American Hospital Association.
American Association of
Retired Persons,
July 19, 2010.
Hon. Earl Blumenauer,
House of Representatives,
Washington, DC.
Dear Representative Blumenauer: AARP is pleased to endorse
the Personalize Your Care Act of 2010. Your bill ensures that
more Americans have the opportunity to better plan and
prepare for their future health care needs. Early advance
care planning informs physicians, other health care
providers, and family members of an individual's treatment
preferences should he or she become unable to direct their
own care. This planning and informed decision-making between
patients,
families, and their health care providers aligns treatment
with patients' wishes.
To help encourage advance care planning, the Personalize
Your Care Act would provide Medicare and Medicaid coverage of
voluntary advance care planning consultations between
individuals and their doctor, nurse practitioner, or
physician assistant. Such consultations would occur no more
often than every five years unless there is a significant
change in the health, health-related condition or care
setting of the individual.
Honoring the expressed wishes of individuals must be a
priority regardless of where the care is provided. To this
end, the bill would ensure that an individual's electronic
health record would include their current advance directive
and/or physician orders for life sustaining treatment
(POLST), so that their wishes would be more easily accessible
and respected. Furthermore, advance directives would be more
portable to help individuals ensure that advance directives
executed in one state are honored in another state in which
the individual needs care.
Finally, the bill would also authorize grants to establish
statewide programs for physician orders for life sustaining
treatment or to expand or enhance existing POLST programs.
POLST translates the wishes of patients with advanced chronic
progressive illness into medical orders that health care
systems understand.
AARP supports your bill to help give Americans peace of
mind knowing their wishes for care are understood and
respected. If you have any further questions, please feel
free to call me or have your staff contact Rhonda Richards on
our Government Relations staff at (202) 434-3770.
Sincerely,
David P. Sloane,
Senior Vice President, Government Relations and Advocacy.