The detection of the coronavirus in the U.S. in late February accelerated the roll-out of Compassion & Choices federal advocacy efforts to advance a policy agenda to modernize and advance equitable, high quality end of life care that is  patient-directed  and -centered. Compassion & Choices  identified essential healthcare options needed in order to safeguard continuing access for seriously and terminally ill individuals while deepening  relationships with legislators and stakeholders by providing strategic  recommendations to increase patient directed care across the country.

Congress

Compassion & Choices’ Advocacy & Outreach team has submitted four (4) letters to congressional leadership with policy recommendations to help patients at the end of life during COVID-19. Please see the four (4) letters below:

Working closely with other stakeholders and advocates, Compassion & Choices  secured critical provisions for seriously and terminally ill patients in the Coronavirus Aid, Relief and Economic Security (CARES) Act, which became law on March 27, 2020.  Five provisions we sought were included in the package including:

  • Authorizing to use telehealth in Medicare’s hospice program during the emergency period. 
  • Reauthorizing  a Health Resources and Services Administration (HRSA) grant programs that supports  the use of telehealth technologies for health care delivery, education, and health information services and expands grant funding for evidence-based telehealth networks and telehealth technologies.
  • Authorizing Employee Retirement Income Security Act (ERISA) health plans in private industry to waive the deductible for telehealth and other remote services.
  • Enhancing Medicare telehealth services for federally qualified health centers and rural health clinics during the emergency period.
  • Increasing Medicare telehealth flexibilities during the emergency period. Authorizes waivers for telehealth services which, if the Department of Health and Human Services (HHS) exercised this authority could include expanding the clinicians authorized to bill telehealth and waivers of other existing telehealth restrictions beyond geographic and originating site restrictions that Congress had recently provided the federal agency administering the program.

The Administration

Advance directives are an essential tool in protecting against excessive and unwanted treatment and mitigate against clinician and institutional bias by ensuring that individuals receive care reflecting their values, goals, and preferences. The coronavirus pandemic underscored the need for widespread completion, accessibility, and enforceability of advance directives, particularly among minorities so that individuals have the peace of mind that their advance directives will be enforced and their end-of-life wishes will be respected by healthcare providers.

As part of the Administration’s efforts to help alleviate the strain caused by the coronavirus on hospitals, the U.S. Department of Health & Human Services issued a waiver of the Patient Right to Self-Determination Act requirement that hospitals notify patients of the institution’s advance directive policies. Compassion & Choices was one of the first organizations aware this occurred and CEO/President Kim Callinan notified other national organizations. Compassion & Choices delivered a letter to Congress and a letter to the U.S. Department of Health & Human Services’ Secretary Alex Azar, respectively, strongly urging the rescission of this waiver. Further, Compassion & Choices  prepared a sign-on letter joined by 12 national organizations and 5,000 individuals urging rescission of the waiver.