PART – 1

Use this document to complete Part 1 of the Module 2 Assessment Legislation Comparison Grid
and Testimony/Advocacy Statement

Health-related H.R. 647: Palliative Care and Hospice Education and

Bill Name Training Act

Description This bill was introduced on January 17, 2019 and sponsored by Rep.
Eliot, L. Engel The description of the introduced bill is as follows –
“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”.
Proponents of the The original sponsors of this Bill are – Rep. Tom Reed, Rep. Yvette D.
Bill Clarke, Rep. Earl L. ‘Buddy’ Carter, Rep. Frank, Jr. Pallone and Rep.
Greg Walden. There are 278 other cosponsors of this bill as well. Of the
283 total sponsors (including 5 originals), 191 are Democrats and 92
Republicans.
Federal or State? Federal Law
Legislative Intent The intent of the bill is to establish a framework across all the healthcare
system where there are palliative care units as permanent discipline. It
is also intended that all the medical, nursing, social work schools and
other similar institutions have the permanent faculty that imparts such
course that helps in building the palliative work force.
This bill is important as the number of aged persons in United States
are increasing and they are suffering from some of the life threatening
and painful diseases like cancer; heart, kidney, liver, lung, and
infectious diseases; as well as neurodegenerative diseases such as
dementia, Parkinson’s disease, or amyotrophic lateral sclerosis. It is
thus required that the quality of care and treatment is provided that
helps them believe in themselves and they are able to cope up with the
stress of being in the illness and loneliness.
Target Population All the students who are enrolled for the graduate medical education
and similar fields.
As per the proposed bill, the eligible individuals are – “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”.
Status of the bill The aforesaid bill was introduced and referred to House Committee on
(Is it in hearings or Energy and Commerce dated January 17, 2019. The above couple of
committees? Is it actions were taken in the House of Representatives
receiving press
The Committee on Energy and Commerce has referred the same to
coverage?)
Subcommittee on Health dated January 25, 2019.
General The coverage of this bill will extend to the various medical schools,
Notes/Comments nursing schools, of where programs like psychology, pharmacy, nursing,
social work, physician assistant education, chaplaincy, or other health
disciplines is taught, duly approved by the Secretary. Right now, the
program will be only available to the present faculties and they would be
given a chance to upgrade their skills in Palliative Care and their term of
appointment would be for 5 years.

References  https://www.govtrack.us/congress/bills/116/hr647/text
 https://www.congress.gov/bill/116th-congress/house-bill/647/text

PART – 2
 The medical science is changing constantly and there are some of the bitter pills that
go along with it as well. Palliative care is also one of them. With the increment in the quality
of life and advancement of medical sciences, the length of life span is also increasing which
also mean that we have more elderly among us than ever before. Along with that, some life
threatening and chronic diseases are also part of the elderly and other categories of
population. It is a known fact that death is inevitable and it is uniquely personal experience
both for the patient as well as their family. When it is certain that a person is suffering from
the life threatening or life limiting disease and the same cannot be cured, then the focus
shifts from curing to ensure that the patient gets the good care and pleasant experience
before nature does its part. The focus of the palliative care is to make the patient
independent, limiting the symptoms, emotional and physical support and planning for the
future and their family members.
Palliative care should be an integral part of the overall healthcare system but
unfortunately, it is not the case across the United States and though the percentage of the
same has increased from 25% in 2000 to 75% in 2015, the quality and focus of such care is
not sufficient. There is a need to have an independent interdisciplinary team that can provide
the high-quality palliative care. Palliative care is relatively new branch in medical science and
is yet to gain acceptance and understanding, both by the healthcare professionals and the
general public. In order to ensure that, a bill has been proposed in with the name of Palliative
Care and Hospice Education and Training Act and the same is pending for approval and be
converted into law. The proposed bill aims to provide the following:

 The bills propose to improve training of the palliative and hospice education wherever
required.
 It also aims at providing the training to the all the registered physicians and they
would be appointed as full-time health professional committed for palliative care and
hospice education and training.
 There is also the provision for workforce development as there is huge shortage of
palliative and hospice care professionals, especially for patients of chronic diseases.
 The main of the proposed bill is to prepare a workforce of palliative specialist so that
they can fill the required gap in the healthcare centers and medical establishments.
 One of the aims of the bill is to create the special preferences in nursing education as
well.
 This bill also aims at providing the education and initiate awareness programs so that
families and health professionals are motivated to recognize the benefits of palliative
care.
The bill is essential and required as the number of palliative care professionals is very low
and is not been able to catch up with the growing needs of the patients who are suffering
from life threatening or terminal illness. The graveness of the situation can be understood
with the fact there is only 1 palliative care physician on a population of 1,700 patients with
life threatening diseases. Moreover, there are 35 medical organizations are supporting the
bill like American Cancer Society's Cancer Action Network, the Alzheimers Association, and
the American Heart Association/American Stroke Association, AGS, HPNA, SWHPN,
NHPCO, CAPC and so many others. Those who are opposing the bill must understand that
dying should also be a dignified process and patient should embrace death with peace and
due respect.
One Amendment – The palliative and hospice care should be compulsory part of the nursing
education curriculum as they are the nearest to the patient and understand them more than
just a patient body. There are chances that they would serve as better palliative professional
than any other health care professional as service is central to nursing profession and it
would be an extension to the same.