Group Endorses Sen. Blumenthal’s New Bill to Improve End-of-Life Care during...and after...Covid-19 Crisis

Bill would modernize advance care planning, expand use of advance directives, extend use of telehealth

Compassion & Choices, the nation’s largest end-of-life care advocacy organization, today endorsed new legislation introduced by U.S. Senator Richard Blumenthal (D-Conn.) to improve end-of-life care, an especially challenging goal during the COVID-19 crisis. A dozen other healthcare groups also endorsed the bill (see list of other healthcare organizations that have endorsed the bill in Sen. Blumenthal’s news release).

“This bill will help Americans have the difficult but necessary conversations about end-of-life care,” said Blumenthal. “The COVID-19 pandemic has reminded Americans of all ages of the importance to have a plan in place in case of severe illness or death. By promoting end-of-life care through public awareness, expanding telehealth services, and working with physicians, we can ensure that not one more person is robbed of making critical life or death decisions for themselves during this pandemic and beyond.”

“The coronavirus pandemic underscores the need to improve our advance care planning policies so that doctors and families are not put in the devastating position of having to make uninformed life-altering care decisions,” said Kim Callinan, president & CEO of Compassion & Choices, the nation’s largest and oldest end-of-life care advocacy organization. “We will work with Senator Blumenthal to secure congressional support to pass this crucial legislation, which would increase the likelihood that patient preferences, not provider bias, determine the care one receives at life’s end.”

“Passing this bill is important because many people nearing the end-of-life are not physically, mentally, or cognitively able to make their own decisions about care,” said Callinan. “Only about one in three of the nation’s adults have completed an advance directive, leaving too many physicians and family members in the midst of this pandemic to make last-minute, agonizing, life-and-death decisions for an individual.”

The legislation would improve end-of-life care in three ways:

  • By modernizing advance care planning;
  • Expanding the usage of advance directives; and
  • Extending the use of telehealth.

Modernize Advance Care Planning

Advance care planning helps ensure future medical treatment conforms with an individual's beliefs and values, mitigates bias to ensure people get the full breadth of care they want, and protects against excessive, unwanted treatment. Unfortunately, we live in a highly fragmented healthcare system, where clinicians providing medical care often have no knowledge or ability to access a patient’s advance directive. As a result, clinicians are put into the unfathomable position of having to make life-altering end-of-life care decisions without knowing the patient’s preference. COVID-19 has exposed this devastating and pervasive problem. The Compassionate Care Act begins to address these challenges by calling for national guidelines, methods for educating providers, and the evaluation of ways to improve the usability portability of, and compliance with, advance directives.

Expand Use of Advance Directives

COVID-19 has shined a spotlight on an unfortunate reality that too few Americans have completed an advance directive. This problem is even more pervasive among communities of color, who face barriers to accessing information about end-of-life care and therefore, are far less likely than their white counterparts to have the necessary tools to talk about end-of-life care and planning, have documented their end-of-life wishes, or enrolled in hospice care. Through the creation of a national public awareness campaign, we have the potential to increase the number of Americans who document their end-of-life preferences and begin to close the end-of-life care disparities gap that exists across racially and ethnically diverse communities.

Extend Use of Telehealth

Telehealth has become a lifeline for people seeking care this year, particularly for those at high risk for COVID-19, including older adults, people who are medically vulnerable, or those challenged with mobility issues. Indeed, telehealth has rightfully become a norm. Our experience during the pandemic has demonstrated that telehealth can be conducted safely, efficiently, and with medical efficacy, justifying its continued widespread utilization, especially for patients who need it most, including those who are facing the end of their lives. The Act extends authorization for the use of telehealth for advance care planning and for the process of recertification of eligibility for hospice.

The full text of the legislation can be found here and the summary can be found here.