It's Health Care Decisions Week: Talk to your patients about their end-of-life wishes The California Medical Association (CMA) recognizes National Health Care Decisions week by encouraging physicians to speak with their patients about the importance of completing an advance directive to make sure their end-of-life wishes are known. Experts say only about 20-30 percent of Americans have completed an advance directive, even though all people age 18 and older should have one. In California, advance directives are the legally recognized format for “living wills.” An advance directive enables individuals to make sure that their health care wishes are known in advance and considered if for any reason they are unable to speak for themselves. Advance directives also allow patients to appoint a health care "agent" who will have legal authority to make health care decisions in the event that the patient is incapacitated, or immediately upon appointment if the patient expressly grants such authority. “While it is understandable that people would put off discussing the topic of serious illness and death, it’s essential to have this family conversation in advance,” says CMA President Ruth Haskins, M.D. “It’s a discussion that should take place in the living room, not in the hospital waiting room when it may be too late.” CMA encourages Californians to think and talk with loved ones about their wishes for end-of-life medical care before a serious illness or injury occurs. CMA has developed a number of guidelines, forms and other resources to assist providers, patients and loved ones with making important end-of-life decisions. The information, available in English and Spanish, includes legally recognized documents such as Advance Directives, Do-Not-Resuscitate forms and Physician Orders for Life-Sustaining Treatment (POLST). CMA's Advance Health Care Directive and POLST kits also include wallet identification cards and answer frequently asked questions from patients. You can find a complete list of CMA's end-of-life health care resources with summaries at www.cmanet.org/endoflife. April 19, 2017 General Advance Directive, Advanced Care Planning, End of Life Issues, POLST 0 0 Comment Read More »
Learn patient communication skills for the End of Life Option Act On October 13, 2016, the Coalition for Compassionate Care of California (CCCC) is hosting a one-day interactive workshop, “California End of Life Option Act: Key Concepts and Skills for Providers.” The workshop will take place at the San Diego County Medical Society (5575 Ruffin Road, Suite 250) from 8:30 a.m. to 4:30 p.m. Workshop attendees will have the chance to review key aspects of the law and learn how it could impact providers and organizations. Attendees will also have the opportunity to practice conversation skills for engaging patients to explore and discuss their end-of-life concerns and preferences. Registrations submitted before September 12 are $159 for CCCC members; $199 for nonmembers. Continuing education units are available for nurses and social workers. September 22, 2016 General Physician Aid in Dying, End of Life Issues 0 0 Comment Read More »
Pilot planned to develop electronic POLST registry in CA: ACCMA and SDCMS participate A $3 million pilot project to build an electronic database for Physician Orders for Life-Sustaining Treatment (POLST) has been approved by the board of directors of the California Health Care Foundation (CHCF). Participating in the project will be the Alameda-Contra Costa Medical Association (ACCMA) and San Diego County Medical Society (SDCMS). POLST is a legally recognized document that outlines a plan of care reflecting patients' wishes concerning medical treatment and interventions toward the end of their lives. Currently, in California most POLST information is maintained only as a pink piece of paper that stays with the patient or the medical record. “The POLST form is a powerful tool for helping patients specify the treatments they do and don’t want,” said Kate O’Malley, CHCF senior program officer. “But when the paper form is not immediately available, it can result in unwanted care for the patient. Building and testing an electronic database for POLST forms can improve access to this critical information.” The Coalition for Compassionate Care of California (CCCC) will serve as the operations center for the registry. Pilot partners will design, develop and test a secure, cloud-based web portal for electronic submission, storage and retrieval of POLST data. The registry pilot project was spurred by passage of SB 19 (Wolk) in 2015, which authorized an electronic POLST registry pilot and identified the California Emergency Medical Services Authority (EMSA) as lead agency for the pilot. CCCC and EMSA will work together to create a cloud-based registry where completed POLST forms can be securely submitted and retrieved. The pilot registry will be tested and evaluated in two locations: San Diego and Contra Costa counties. ACCMA, one of the California Medical Association's county medical societies, will coordinate the Contra Costa pilot. It is hoped that the pilot will help guide the expansion of the electronic registry statewide. For more information about the project, click here. August 25, 2016 General POLST, Advanced care Planning, End of Life Issues 0 0 Comment Read More »
Learn about physician engagement in the advance care planning process on July 19 call As part of its Advance Care Planning Initiative, the Coalition for Compassionate Care of California (CCCC) hosts a monthly forum to discuss successful advance care planning efforts and share ideas about what is working to improve conversations and processes in both health care and community settings. The next call will take place on Tuesday, July 19, from noon to 1 p.m. Facilitated by Lael Duncan, M.D., CCCC medical director of consulting services, the topic is Engaging Physicians in Advance Care Planning. During the call, Dr. Duncan and other guest physicians will discuss the barriers, strategies and lessons learned in engaging physicians in the advance care planning process. To join the call next Tuesday, click here or call (916) 900-6615. Advanced registration is not required, but attendees will be asked to sign in with a LinkedIn or Google account, or with an email address and password. Can’t make this call? Subscribe here to receive notifications of the next advance care planning forum topic and call-in information. July 14, 2016 General End of Life issues, Advanced Care Planning 0 0 Comment Read More »
The End of Life Option Act takes effect on June 9: What physicians and patients need to know On June 9, 2016, California will become the fifth state in the nation to allow physicians to prescribe terminally ill patients medication to end their lives. California's new "End of Life Option Act" permits terminally ill adult patients with the capacity to make medical decisions to be prescribed an aid-in-dying medication if certain conditions are met. Recognizing the complexity of this new law, the California Medical Association (CMA) has published legal guidance in a question-and-answer format intended to help physicians and patients understand and navigate the law's requirements. The 15-page document addresses straightforward questions and identifies issues that are not yet resolved. “As physicians, there are a lot of questions about requirements under the new law, required documentation and forms, requests for the drug, consulting physicians and so on,” said CMA President Steven E. Larson, M.D., MPH. “There certainly will be areas that evolve as we look to best practices in areas like which drugs to prescribe, but this is a resource to help us all navigate the new landscape.” This resource – On-Call document #3459, "The California End of Life Option Act” – is free through CMA’s online health law library at www.cmanet.org/cma-on-call. CMA is hosted a webinar, "The California End of Life Option Act: An Overview," on Wednesday, June 1, from 12:15 to 1:15 p.m. The webinar will review the requirements of the act, who qualifies to participate, what is required if a physician opts out, and what the documentation and reporting obligations are. This webinar will also discuss the importance of palliative and hospice care services as well as advance care planning, tools and resources. The webinar is free to all interested parties, regardless of their membership status. Click here to view this on demand webinar. CMA removed longstanding opposition to physician aid-in-dying last May and took a neutral position on the End of Life Option Act (ABX2 15). CMA encourages Californians to think and talk with loved ones about their wishes for end-of-life medical care before a serious illness or injury occurs. CMA has developed a number of guidelines, forms and other resources to assist providers, patients, and loved ones with making important end-of-life decisions. CMA's end-of-life resources can be found on CMA's website at www.cmanet.org/endoflife. Contact: CMA legal information line, (800) 786-4262 or legalinfo@cmanet.org. June 8, 2016 General Health Law Library, Physician Aid in Dying, End of Life Issues 0 0 Comment Read More »
CSU and palliative care coalition launch eduction programs on advance care planning and billing In response to the nation’s growing demand for physicians trained in advance care planning conversations, the California State University Institute for Palliative Care has partnered with the Coalition for Compassionate Care of California to co-design a comprehensive continuing education curriculum for health care professionals. New this year, Medicare providers can be reimbursed for advance care planning conversations with patients. The newly implemented reimbursement provides an impetus for clinicians to spend time exploring patient health care preferences and documenting goals of care. “Patients want to have these conversations with their providers, and providers need to be paid for the time a meaningful conversation requires,” said Helen McNeal, executive director of the CSU Institute for Palliative Care. “The problem is that clinicians haven’t learned how to talk about advance care planning with patients, and their billing departments don’t know how to use the new billing codes.” The new online curriculum, "Effective Advance Care Planning: Skills Building for the Entire Organization," provides detailed information about the critical components of advance care planning and billing in an accessible, cost-effective format. Due to their online format, health care professionals from around the country can take the courses at a time and place convenient to them. Starting this May, the following self-paced courses will be open for registration: Effective Advance Care Planning Fundamentals Facilitating an Advance Care Planning Conversation Building Engagement with Advance Care Planning Billing for Advance Care Planning Conversations “Reimbursement for advance care planning is a game changer,” said Judy Thomas, CEO of the Coalition for Compassionate Care of California. “Advance care planning is an essential component of patient-centered, quality health care. Professionals with advance care planning expertise are able to identify and clarify individuals’ choices regarding medical treatment.” For more information, click here. April 28, 2016 General Advance Health Care Directive, End of Life Issues, Medicare, Palliative Care, Advance Directive, CME 0 0 Comment Read More »
New POLST toolkits available online in English and Spanish Physicians across California are successfully using Physician Orders for Life-Sustaining Treatment (POLST) to improve patient care at the end of life. POLST is a legally recognized document, printed on bright pink paper, that outlines a plan of care reflecting patients' wishes concerning medical treatment and interventions toward the end of our lives. Under a new law that took effect January 1, 2016, nurse practitioners (NP) and physician assistants (PA) acting under the direction of a physician and within their scope of practice are now able to sign the POLST forms and make them actionable medical orders. Physicians and NP/PAs should only use the new version of the POLST form, though previous versions will continue to be honored. The California Medical Association’s (CMA) POLST kits include this newly updated form, and are available in both English and in Spanish. They also contain legal forms and wallet identification cards, and answer frequently asked questions about end-of-life issues. Physicians are encouraged to keep a supply of forms in their offices for use when having end-of-life discussions with patients. POLST kits can be purchased from CMA's online resource library. Single copies are $5 for members ($6 for nonmembers). Significant discounts are available on bulk purchases. For bulk purchase inquiries, please call (800) 882-1262. For more information on POLST, see CMA On-Call document #3451, "Decisions Regarding Life-Sustaining Treatment: Advance Directives and POLST." On-Call documents are free to members in CMA's online health law library at www.cmanet.org/cma-on-call. Nonmembers can purchase documents for $2 per page. For more end-of-life resources, see www.cmanet.org/endoflife. April 4, 2016 General Life Sustaining Treatment, Physician Orders for Life Sustaining Treatment, POLST, End of Life Issues 0 0 Comment Read More »
Learn about end-of-life care through a cultural lens on April 7 Physicians are invited to attend Building Bridges: End-of-Life Care Through a Cultural Lens, a one-day seminar hosted by the Coalition for Compassionate Care of California (CCCC). This event is a unique opportunity to learn about the “culture” of health care while investigating how your own cultural biases and behaviors may influence the care you provide. Participants will learn how to compare and contrast the culture of health care and end-of-life care; discuss the prominent cultural features of your work environment and how they relate to end-of-life care; define cultural competency, cultural humility and cultural dignity in the context of health care; and critique your own cultural biases. This event is scheduled for April 7 from 8 a.m. to 3:30 p.m. at the Nonprofit Innovation Center in Sacramento. The cost for CCCC members is $199; non-member registration is $249. For more information or to register, click here. March 31, 2016 General End of Life Issues, Cultural Competency 0 0 Comment Read More »
CMA publishes physician guidance for the End of Life Option Act The California Medical Association (CMA) has published new legal guidance intended to help physicians and patients understand the End of Life Option Act, which was passed in 2015 and makes physician aid-in-dying legal in California. The document is in a question-and-answer format, and is intended to help both physicians and patients navigate the complicated law. “As physicians, there are a lot of questions about requirements under the new law, required documentation and forms, requests for the drug, consulting physicians and so on,” said CMA President Steve Larson, M.D. “There certainly will be areas that evolve as we look to best practices in areas like which drugs to prescribe, but this is a resource to help us all navigate the new landscape.” Throughout the 15-page document, both straightforward questions as well as those without answers yet are included, and acknowledge that the resource will evolve as the law goes into effect. CMA's health law library is the most comprehensive health law and medical practice resource for California physicians and contains On-Call documents with up-to-date information including current laws, regulations and court decisions related to the practice of medicine. On-Call documents are generally a benefit for CMA members and are available for sale to the public; however, On-Call document #3459, "The California End of Life Option Act," is free through CMA’s website. “CMA was fielding calls from not only our members, but the general public about what the End of Life Option Act means and how it will impact care moving forward,” said CMA General Counsel Francisco Silva. “This is a complicated issue and both physicians and patients should have access to answers that help further the patient-physician relationship.” CMA removed longstanding opposition to physician aid-in-dying last May and took a neutral position on the End of Life Option Act, Senate Bill 128. Contact: CMA Legal Information Line, (800) 786-4262 or legalinfo@cmanet.org. January 25, 2016 General Physician Aid in Dying, End of Life Issues 0 0 Comment Read More »
NPs and PAs can sign POLST forms beginning in 2016 A new law (Assembly Bill 637) recently signed by Gov. Jerry Brown will allow nurse practitioners (NP) and physician assistants (PA), under the direction of a physician and within their scope of practice, to sign Physician Orders for Life-Sustaining Treatment (POLST) forms and make them actionable medical orders. The law goes into effect on January 1, 2016. The POLST form is a legally recognized document that outlines a plan of care reflecting patients’ wishes concerning medical treatment and interventions toward the end of their lives. The California Medical Association (CMA) co-sponsored AB 637, citing the importance of POLST as a tool for honoring end-of-life care preferences. The new law will result in increased use of POLST orders by allowing nurse practitioners and physician assistants the ability to sign the document so that it legally goes into effect immediately. Therefore, patients can exercise more control over the medical treatment they receive. End-of-life conversations are never simple, but POLST is a powerful tool for physicians to use to help patients consider the level of care they want and need at the end of life. Thoughtful end-of-life planning can make a patient’s last few weeks, months, or even years far more satisfying. CMA publishes a POLST Kit, which includes legal forms and wallet identification cards, and answers frequently asked questions about end-of-life issues. Physicians are encouraged to keep a supply of forms in their offices for use when having end-of-life discussions with patients. For more information on POLST, see CMA On-Call document #3451, "Decisions Regarding Life-Sustaining Treatment: Advance Directives and POLST," and visit CMA's website for more resources on end-of-life decisions at www.cmanet.org/endoflife. POLST Kits can be purchased from CMA's online resource library. Single copies are $5 for members ($6 for nonmembers). Significant discounts are available on bulk purchases. For bulk purchase inquiries, please call CMA Publications at (800) 882-1262. September 9, 2015 General Advocacy, Nurse Practitioners, Physician Assistants, End of Life Issues, POLST 0 0 Comment Read More »
