End-of-Life Choice, Death with Dignity, Palliative Care and Counseling

Compassion & Choices

CMS Allows Reimbursement for Advance Planning

Compassion & Choices received some very encouraging news on the heels of our federal policy briefing- one of our policy agenda items has already been implemented. The Centers for Medicare & Medicaid Services (CMS) released a rule that allows the agency to reimburse doctors starting Jan. 1, 2016, for communicating with patients about whether and how they would want to be kept alive if they become too sick to speak for themselves.

“This new rule removes a barrier for doctors to initiate and engage in conversations, a key step to ensure healthcare providers honor patients’ treatment goals, preferences and values,” said Kim Callinan, Chief Program Officer for Compassion & Choices, which advocated for this proposal as a provision in the Affordable Care Act. “The complimentary step to achieve this goal is for CMS to formulate a proposal to ensure that healthcare providers are not reimbursed for unwanted medical treatment, which polling data suggests about 25 million American have experienced.” CMS has also added Advanced Care Planning as an optional element (at the beneficiary’s discretion) to the Annual Wellness Visits.

Click here to download and read our federal policy agenda, and click here to learn more about our Capitol Hill briefing.

Compassion & Choices Capitol Hill Briefing

By Khalid Pagan

C&C’s Chief Program Officer Kim Callinan

At our federal briefing last week, Compassion & Choices staff presented our federal policy agenda and our work on the state level to Congressional staff, Beltway thought-leaders and Washington-area supporters. The briefing was a huge success! If you couldn’t make it, click here to watch the full video of the briefing.

Kim Callinan, our Chief Program Officer, was the briefing moderator and she presented C&C’s federal policy agenda. Our speakers included Dan Diaz, Brittany Maynard’s husband, who has testified in favor of death-with-dignity laws in California, Washington D.C., and Massachusetts since Brittany passed last year. Charmaine Manansala, Compassion & Choices’ California Political Director, outlined the provisions in the California law, which was based on 17 years of success in Oregon. Dr. David Grube shared his experience as a family physician working in Oregon during the implementation of Oregon’s Death with Dignity Act, and C&C board member Rev. Dr. Ignacio Castuera shared his experience with outreach to the medical and faith communities.

Dr. David Grube and Charmaine Manansala

Our Federal Policy Agenda

You already know about our advocacy for state aid-in-dying laws, and now you can take a look at our newly-updated federal policy agenda.

The federal policy agenda calls on policymakers to improve end-of-life care through actions in five major areas. When followed, our agenda lays out a roadmap for achieving patient-centered, family-oriented care that is responsive to personal choices.

Our federal priorities range from changing the ways that doctors interact with their patients to engaging the public and the medical community to amend best-practices and training programs. Some highlights of our policy agenda include:

  • Establishing payment for palliative care consultations and training so that we have a pool of providers with the experience necessary to ensure the patient’s values and choices are being met.
  • Encouraging Congress and/or CMS to end reimbursement for unwanted medical treatment. Studies indicate that more than 25 million Americans have received unwanted medical treatment.
  • Requiring electronic medical records to to include advance care planning information. Today, even if patients do have advanced directives, they are often undiscovered or even ignored by doctors.
  • Allowing patients admittance into hospice while continuing attempts to cure their illnesses. Patients shouldn’t have to choose between palliative care and a chance to live longer.

We received some very encouraging news on the heels of our briefing- one of our policy agenda items was implemented! The Centers for Medicare and Medicaid Services (CMS), the agency that regulates and coordinates Medicare and Medicaid payments, announced that it will allow reimbursement for doctors for advance end-of-life care planning conversation. CMS has also added Advanced Care Planning as an optional element (at the beneficiary’s discretion) to the Annual Wellness Visits. This new rule removes a barrier for doctors to initiate and engage in these conversations, a step in the right direction of normalizing end-of-life planning. But we still have a lot of work to do.

Dan Diaz and Dr. Ignacio Castuera
Dan Diaz and Dr. Ignacio Castuera

What You Can Do

Sens. Mark Warner (D-VA) and Johnny Isakson (R-GA) have introduced the Care Planning Act, legislation which is designed to give people with serious illness the freedom to make more informed choices about their care, and the power to have those choices honored. Their bipartisan legislation would further efforts to strengthen end-of-life care by developing quality measures, promoting public and provider education, addressing the decision-making for people with serious illness throughout the process, and including adherence and portability measures to ensure that patients’ choices are honored.

We need you to write your Senator and ask them to co-sponsor the Care Planning Act. In addition to Senators Warner and Isakson, the bill currently has 4 bipartisan cosponsors: Sens. Tammy Baldwin (D-WI), Susan Collins (R-ME), Amy Klobuchar (D-MN), and Shelley Moore Capito (R-WV).

Click here to write a letter to your senators and ask them to cosponsor The Care Planning Act of 2015. Make sure to include your personal story about your parents, grandparents, spouse, friend, or other loved one.

New Brittany Maynard Video Shows Impact of Death-With-Dignity Advocate’s Message

Compassion & Choices Video Released on Eve of Deadline for CA Gov. to Act on Bill Inspired by Maynard

(Washington, D.C. – Oct. 6, 2015) Compassion & Choices today released a new video featuring California death-with-dignity advocate Brittany Maynard to commemorate the first anniversary of the organization’s partnership with Maynard and her family.

The release of never-before-seen excerpts of Maynard’s original video, recorded in Aug. 2014, which launched this historic partnership one year ago today on Oct. 6, 2014, comes one day after California Gov. Jerry Brown signed a death-with-dignity bill inspired by her to become law.

“Brittany came on the scene and set in motion a chain of events leading to the passage of an aid-in-dying bill through the California legislature less than one year after her death. We had been trying to do that since 1991,” says Compassion & Choices President Barbara Coombs Lee, who coauthored the Oregon death-with-dignity law. “In 2014, there were aid-in-dying bills in four states. Immediately after Brittany’s emergence on the scene, lawmakers in 25 jurisdictions, plus the District of Columbia, introduced bills.”


Calif. Gov.’s Signing of Aid-in-Dying Bill Should Spur Action in Other States

Brittany Maynard’s Story, Victory in Nation’s Most Populous State Will Have Ripple Effect for Death-With-Dignity Movement

(Sacramento, Calif. – Oct. 5, 2015) Gov. Jerry Brown’s signing of California’s End of Life Option Act today should spur legislators in other states to advance bills to allow terminally ill adults the option of medical aid in dying to end unbearable suffering, advocates say.

The bill’s signing into law comes one year after Brittany Maynard and her family launched a partnership with Compassion & Choices on Oct. 6, 2014, to authorize this end-of-life option in California and other states nationwide. Maynard was a 29-year-old Californian who brought international attention to the issue when she had to move to Oregon to utilize its death-with-dignity law, which she utilized to end her suffering from terminal brain cancer on Nov. 1, 2014.

“This is the biggest victory for the death-with-dignity movement since Oregon passed the nation’s first law two decades ago,” said Compassion & Choices President Barbara Coombs Lee, a lawyer, former ER and ICU nurse and physician assistant, who coauthored the Oregon Death with Dignity Act.

“This victory is hugely significant in both substance and scope,” Coombs Lee observed. “Enactment of this law in California means we are providing this option to more than 1 in 10 Americans.” More

Medical Aid-in-Dying Bill Lands on CA Gov.’s Desk

Supporters Optimistic Gov. Brown Will Allow Bill to Become Law

CHP_6726(Sacramento, Calif. – Sept 25, 2015) The clock is ticking for California Gov. Jerry Brown to decide whether he will allow a bill to become law to give terminally ill adults the option of medical aid in dying. The bill would authorize adults with six months or less to live who are facing unbearable suffering to request a doctor’s prescription for medication that they could take to die painlessly and peacefully in their sleep.

Today Gov. Brown received the legislation, known as the End of Life Option Act (ABX2-15), authored by Assemblymember Susan Talamantes Eggman, and coauthored by Senate Majority Leader Bill Monning and Senate Majority Whip Lois Wolk. Brown has 12 days, until Oct. 7, to sign or veto the bill. If he takes no action by midnight on Oct. 7, the legislation automatically becomes law.

“We hope Gov. Brown honors the will of the majority of Californians of every faith and demographic group by allowing the End of Life Option Act to become law.” said Compassion & Choices Campaign Director Toni Broaddus. “Californians just want to know that if they become terminally ill and their suffering becomes unbearable, they have the option to take prescription medication so they can die gently in their sleep.”

Three out of four Californians support the End of Life Option Act (ABX2-15), according to a poll released last month by the Institute of Governmental Studies (IGS) at the University of California, Berkeley. Support levels included 82 percent of Democrats, 79 percent of independents, 67 percent of Republicans and at least 69 percent across all other demographic categories, from gender to educational, income and age levels.

“We urge Gov. Brown to look into his heart and make his decision based on what it tells him the people of California want and need,” said Christy O’Donnell, a 47-year-old single mom, attorney and former LAPD sergeant from Santa Clarita, who is dying from lung, brain, spine, rib and liver cancer. “Some terminally ill Californians like me are dying painfully because no hospice or palliative medication can relieve our suffering. We just want the option to die peacefully and end our suffering in our final days.”

The legislature passed the End of Life Option Act on Sept. 11, 10 months after the death of Brittany Maynard, a 29-year-old Californian with terminal brain cancer. She brought international attention to this issue when she had to move to Oregon to utilize its death-with-dignity law last November. In the final weeks of her life, Maynard and her family partnered with Compassion & Choices to launch a campaign on Oct. 6, 2014, to make aid in dying an open and accessible medical option.

The End of Life Option Act is closely modeled after the death-with-dignity law in Oregon. It has worked well for 17 years, without a single documented case of abuse or coercion. Currently, three other states authorize medical aid in dying: Washington, Montana and Vermont. In addition, A New Mexico appellate court recently overturned a district court ruling that aid in dying is a fundamental right under the state constitution. But the case will be heard by the New Mexico Supreme Court.

“No parent should have to watch his or her child suffer like I did,” said Dr. Robert Olvera, a Harvard-trained physician from Santa Ana, whose 25-year-old daughter, Emily Rose, suffered horribly for 17 years from leukemia in her brain before her death last year. “Gov. Brown, please give Californians the option to die peacefully instead of living their last days in excruciating, unbearable pain.”