Overview
Title
To improve end-of-life care.
ELI5 AI
H.R. 9237 is a bill that wants to make sure people get good care when they are very sick and near the end of their life, by helping doctors learn more and using computers to talk to sick people, like video calls.
Summary AI
H.R. 9237, also known as the "Compassionate Care Act," aims to enhance end-of-life care in the United States. It establishes guidelines and educational campaigns for advance care planning, ensuring individuals understand their rights to make health care decisions. The bill includes measures to improve provider education on end-of-life care, encourages the integration of telehealth services for hospice care, and mandates various studies and reports to evaluate and improve the implementation of advance directives across healthcare settings. The act underscores the importance of personalizing care to match patients' preferences and enhancing the quality of life at the end of life.
Published
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AnalysisAI
Summary of the Bill
The Compassionate Care Act aims to enhance end-of-life care in the United States by focusing on consumer and provider education, Medicare amendments, and various studies and reports. It seeks to inform the public about their healthcare decision rights, improve training for healthcare providers, and expand the use of telehealth for hospice care. The bill also attempts to develop uniform policies and better quality measures for end-of-life care. It puts an emphasis on advance care planning, which involves preparing for healthcare decisions in case individuals are unable to make those decisions themselves.
Significant Issues
Several issues have been identified with this bill. Firstly, some sections lack clear financial guidelines, with phrases like "such sums as may be necessary" in Section 102 potentially leading to unchecked spending. Additionally, there are concerns over the implementation and accountability of the proposed measures. For instance, Section 101 lacks concrete guidelines, leading to potential inconsistencies in practice. Moreover, the phrase "to the extent practicable" is vague, risking varied interpretation and enforcement. There is also a concern about a possible lack of transparency regarding who will be involved in developing end-of-life care measures under Section 113.
Furthermore, the repeal of a section from the Omnibus Budget Reconciliation Act of 1990 is mentioned but not explained, creating uncertainty about the effects on existing policies. Lastly, the ambitious timeline for developing a public provider website by January 1, 2025, raises questions about feasibility and preparedness.
Impact on the Public
The public is likely to experience a mixed impact from this bill. On a positive note, the increased emphasis on education and awareness around advance care planning could better equip individuals to make informed decisions about their healthcare preferences. This initiative could empower families and patients, leading to care that better aligns with their wishes and potentially improves the quality of their end-of-life experiences.
However, without clear benchmarks for success or well-defined financial policies, the public may bear the burden of potential inefficiencies or misuse of funds. Moreover, the complex language and lack of clear explanations in some sections might result in misunderstandings among non-experts, possibly diluting the intended benefits.
Impact on Specific Stakeholders
Healthcare providers might benefit from improved training and resources, facilitating more informed discussions with patients regarding advance care planning. Yet, the lack of specific guidelines regarding provider qualifications and responsibilities can lead to ambiguities, potentially affecting care delivery.
Telehealth providers may experience a positive impact from the removal of geographic restrictions, potentially expanding their reach and service delivery. However, this could also lead to an uneven playing field, as not all providers may have equal access to resources and infrastructure.
Government agencies and policymakers might face challenges in assessing the effectiveness and fiscal responsibility of the proposals without clear success metrics or oversight mechanisms. Ambitious timelines and vague language in the bill may necessitate additional resources and attention to detail in implementation.
Overall, while the Compassionate Care Act has the potential to significantly enhance end-of-life care in the United States, careful consideration and possible revisions are needed to address financial ambiguities, improve clarity, and ensure accountability.
Issues
The authorization of appropriations in Section 102 is vague, using the phrase 'such sums as may be necessary', which could lead to unregulated or excessive spending without clear budget limits. This raises concerns about fiscal responsibility and transparency for taxpayers.
The lack of concrete measures and accountability in Section 101 for 'advance care planning' could lead to inconsistent application or enforcement, impacting the effectiveness of the intended care improvements.
The section 113 dealing with the 'Development of core end-of-life care quality measures' lacks specific detail on criteria and involved organizations, potentially leading to favoritism, inconsistent implementation, and public concern over transparency and equity.
The proposal for a national public education campaign in Section 102 does not include specific benchmarks or success metrics, making it difficult to assess its impact, justify funding, and ensure efficient taxpayer use.
The use of the phrase 'to the extent practicable' in Section 101 is vague, potentially leading to varied interpretation and inconsistent application, which could undermine the bill's objectives.
Section 121, 'Permanent extension of authorization for use of telehealth', could imply long-term financial commitments without a clear outline of the costs involved, raising concerns about fiscal impact and budgetary responsibility.
The language in Section 122 regarding advances in telehealth is legally complex, which may be unclear to non-expert readers and could create ambiguities in public understanding and implementation.
Section 114 does not specify how continuing education curricula will be evaluated for effectiveness, which raises concerns about accountability and the potential for wasteful spending if the programs do not produce demonstrable benefits.
Repealing Section 4751(d) of the Omnibus Budget Reconciliation Act of 1990 in Section 102 is mentioned but not explained, creating uncertainty about its implications on existing regulations or programs.
The amendment in Section 122 regarding telehealth services could potentially favor certain telehealth providers by removing geographic restrictions without stating it explicitly, leading to concerns about market fairness and potential bias.
The timeline for the development of the public provider advance care planning website by January 1, 2025, in Section 111 could be overly ambitious, given potential infrastructure and content challenges, which may impact service delivery expectations.
Sections
Sections are presented as they are annotated in the original legislative text. Any missing headers, numbers, or non-consecutive order is due to the original text.
1. Short title Read Opens in new tab
Summary AI
The Compassionate Care Act is introduced in this document, highlighting its short title and table of contents. The Act includes provisions for consumer and provider education on advance care planning, amendments to Medicare for improved telehealth services related to hospice care, and various reports and studies on national policies for advance directives.
2. Definitions Read Opens in new tab
Summary AI
The section provides definitions for key terms related to health care planning and services, such as "advance care planning," "Medicaid," and "Medicare." It explains concepts like advance directives, living wills, and the roles of different health care agents and providers, ensuring clarity on how these processes and programs function within the framework of health care legislation.
101. Advance care planning guidelines Read Opens in new tab
Summary AI
The Senate believes that advance care planning should ideally involve the patient's health care agent, primary clinician, or a decision-making team, be regularly updated, and remain adaptable to the patient’s medical needs while following best practice guidelines.
102. National public education campaign Read Opens in new tab
Summary AI
The bill mandates the Secretary of Health to launch a national education campaign to inform the public about advance care planning and the right to make health care decisions, using various media and culturally appropriate content, with a focus on legal documents and end-of-life care discussions. The campaign is to run for at least five years, and its effectiveness must be reported to Congress by July 1, 2026, with funding authorized as necessary and a repeal of a previous statute.
111. Public provider advance care planning website Read Opens in new tab
Summary AI
The bill requires the development of a website by January 1, 2025, to inform health care providers and chaplains about advance care planning under Medicare, Medicaid, and other programs. The site will provide resources and education on integrating advance care planning into healthcare, continuing education, and discussing end-of-life care with patients.
112. Advance care curricula pilot program Read Opens in new tab
Summary AI
The bill outlines a pilot program where grants are given to medical schools and related entities to develop end-of-life care training. Eligible programs must have trained staff, offer practical experience, and ensure faculty retrain in palliative medicine, covering topics like patient communication, children’s care, palliative and hospice services, legal aspects, and cultural competence.
113. Development of core end-of-life care quality measures across each relevant provider setting Read Opens in new tab
Summary AI
The section describes a plan by the Secretary, through the Director of the Agency for Healthcare Research and Quality, to create new quality measures for end-of-life care across various health care settings. It outlines requirements for these measures, including being patient-oriented and considering factors like race and age, and sets deadlines for disseminating reporting requirements by January 1, 2024, and for initial reporting to begin by January 1, 2026.
114. Continuing education for qualified health care providers Read Opens in new tab
Summary AI
The bill section outlines that by January 1, 2024, the Secretary will work through the Administrator of the Health Resources and Services Administration to develop or improve education programs focused on advance care planning and end-of-life care for health care providers. This education will cover topics such as advance care planning documents, counseling skills, palliative care principles, and the importance of early hospice introduction to enhance the quality of life.
121. Permanent extension of authorization for use of telehealth to conduct face-to-face encounter prior to recertification of eligibility for hospice care Read Opens in new tab
Summary AI
The section modifies the Social Security Act to permanently allow the use of telehealth for face-to-face encounters required before recertifying a patient's eligibility for hospice care, continuing this option beyond the previously set expiration date of December 31, 2024.
122. Improvements to advance care planning through telehealth Read Opens in new tab
Summary AI
The bill proposes changes to the Social Security Act to make it easier for people to receive advance care planning services through telehealth, starting January 1, 2024, by removing certain geographic restrictions.
201. Study and report by the Secretary regarding the establishment and implementation of a national uniform policy on advance directives Read Opens in new tab
Summary AI
The section requires the Secretary, through the Office of the Assistant Secretary for Planning and Evaluation, to conduct a study on creating a national policy for advance directives, addressing issues like family satisfaction with carrying out a patient's wishes, the usability of such directives, and state law differences. Within two years, the Secretary must report to Congress with the study's findings and recommendations, while also consulting with relevant stakeholders.
202. Gao study and report on establishment of national advance directive registry; other studies Read Opens in new tab
Summary AI
The section discusses several studies and projects related to advance directives. It includes a study by the Comptroller General on establishing a national registry for advance directives, a study by the National Coordinator for Health Information Technology on incorporating advance care planning into electronic health records, and two demonstration programs to improve the use of electronic advance directives. Additionally, there is a study on healthcare services provided that might not reflect the patient's preferences.