Call for COVID Bereavement Strategy

For Immediate Release:
January 21, 2021

The Need to Grieve: How Grief and Bereavement Care in the U.S. Needs to be Retooled

NHPCO and SWHPN Applaud the COVID Memorial Ceremony that Gave America an Opportunity to Grieve as a Nation but Ongoing Support will be Critical for National Healing

(Alexandria, Va) – The nation’s attention turned to healing on the evening of January 19, 2021 at the Memorial and Nationwide Tribute to Remember and Honor the Lives Lost to COVID-19 at the Lincoln Memorial Reflecting Pool. The National Hospice and Palliative Care Organization (NHPCO) and the Social Work Hospice and Palliative Care Network (SWHPN) applaud this powerful event that allowed the nation to publicly grieve together. By lighting candles around the Reflecting Pool, this first-ever event highlighted the need to honor the memories of Americans who have died from COVID, and help their families and friends grieve these losses.

NHPCO and SWHPN offer insight regarding the way bereavement support in the U.S. can be made more accessible to those struggling with loss and grief and issue a call for organizations to join the list of organizations in support of a National Grief Strategy.

“One of the most profound lasting effects from the coronavirus pandemic will be its impact on how we experience grief,” said NHPCO President and CEO Edo Banach. “The significance of loss in our lives is something hospice and palliative care professionals know well.”

The magnitude of the losses feels even greater now during the pandemic for several reasons. For those who have lost a family member, friend, or colleague to COVID-19, in addition to grieving the actual death, there may also be the loss of not being able to be physically present during the dying process. Many people who know someone is dying have anticipatory grief. For others, there has been the loss of financial stability, or loss of the feeling of physical safety. People are missing the normalcy of human contact. Rituals and milestones like funerals, graduations, and weddings have been postponed or eliminated altogether. We are grieving the loss of the life we knew before the virus.

For frontline health care workers, these changes are compounded by some of the most challenging work of their lives. In addition to dealing with limited access to necessary medical and personal protective equipment, and vaccine access, health care workers are managing massive volumes of sick patients, many who are seriously ill, and are learning how to use technology that connects families to those that are isolated and dying, when they would typically be trying to offer a more human connection.

Saying goodbye to someone who is dying can be challenging and has been made measurably worse by the pandemic. Travel restrictions and facility lockdowns have forced people to remain physically separated. Comfort is now provided through facemasks or technology. COVID-19 has denied family members of those in intensive care, nursing homes, and other congregate care facilities the ability to sit at the bedside, stripping away these cherished final moments. Being present in this manner and completing rituals around death are important to the grieving process. Complicated grief and unresolved issues at death can cast a long shadow over those who survive.

“With over 400,000 dead in the United States alone from COVID-19, we are all grieving together, but we are grieving in a country that doesn’t often talk about death or grief,” said SWHPN Executive Director Jessica Strong. “It is time we change that, time we talk about and build a better understanding of grief, so we can all help each other through this difficult time.”

Grief literacy encompasses the idea that if individuals know more about what grief looks and feels like, we can support each other through the most difficult aspects of grief.  By creating a culture of awareness and support around grief, Americans can help each other prevent many of the negative long-term health outcomes associated with grief that goes unaddressed.

Humans are inherently drawn to community. We are not meant to face difficult times alone; we need the support of others who understand. This is why hospices frequently offer bereavement support within their communities beyond people with family members who have received hospice care. We are well positioned to provide this kind of support as we move through this pandemic together. We can work together to create a National Grief Strategy, building compassionate communities that support each other.

Call for National Grief Strategy

Additionally, health care leaders and policy makers must engage in a national conversation toward addressing the new and compounded forms of grief that are emerging because of the COVID-19 pandemic.  We have an opportunity to address this crisis by mobilizing resources and education to assist people in navigating the grief that lies ahead, and in studying the effects of such a collective experience. Please add your name to the growing list of people and organizations that support a National Grief Strategy.

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Edo Banach, JD is President and CEO of the National Hospice and Palliative Care Organization (NHPCO) based in Alexandria, Virginia.

Jessica Strong is Executive Director of the Social Work Hospice and Palliative Care Network (SWHPN) based in Pittsburgh, Pennsylvania.

Contact:
Jon Radulovic
NHPCO Communications
Ph: 571-412-3973

NHPCO Outlines 2021 Policy Priorities for President-Elect Biden and the Incoming Administration

For Immediate Release:
January 19, 2020

Priorities include prioritizing COVID-19 relief, innovating on how serious-illness care is provided and improving access to high-quality hospice and palliative care.

(Alexandria, Va) – The National Hospice and Palliative Care Organization (NHPCO) sent a letter to President-elect Joseph Biden, highlighting the hospice and palliative care priorities NHPCO wishes the new Administration to address. The letter outlines a set of priority recommendations that NHPCO urges the Biden Administration to implement during their first 100 days in office as they require immediate attention:

      1. Protect Patients and Families
        Hospice providers are front line health care workers who are increasingly being exposed to COVID-19. Hospice workers, hospice patients and their caregivers should be prioritized for receiving COVID-19 vaccinations as soon as they are available, and providers should be a priority in FEMA PPE distribution and testing. NHPCO also calls for extended regulatory flexibilities, paused audits, and expanded economic support and funding for bereavement care to ensure hospice providers can continue offering high quality care during the pandemic.
      2. Innovate How Serious Illness Care is Provided
        COVID-19 has shined a spotlight on the “holes” in care for seriously ill individuals and their families. Innovative approaches are needed to provide the “right care at the right time” for patients with serious illness and their families.To that end, NHPCO supports concurrent care with hospice, the creation of a community-based palliative care benefit, and expansion of advance care planning. NHPCO also asked that the Biden Administration halt implementation of the Medicare Advantage Value-Based Insurance Design (MA VBID) Model by at least one year to allow technical and operational issues to be addressed.  Hospice patients and their families deserve a demonstration that improves access to high quality care at the end of life.
      3. Improve Access to Hospice and Palliative Care
        To help more Americans access the person-centered care offered by hospice, NHPCO is working to reduce racial disparities in access and strengthen the hospice and palliative care workforce. NHPCO also encourages the removal of the six-month prognosis barrier to hospice and increasing hospice access in rural and underserved areas.

“The incoming Biden Administration has a golden opportunity to impact in the lives of the most vulnerable Americans. Hospice and palliative care providers, patients, and their caregivers deserve now more than ever the attention of federal policy makers to support people on the front lines of this global pandemic. We look forward to partnering with this administration on day one to move important policy changes from powerful ideas into immediate and effective actions,” said NHPCO President and CEO Edo Banach.

Download NHPCO’s Letter and NHPCO’s 2021 Policy Priorities.

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Media Contact:
Jon Radulovic
NHPCO Communications
Ph: 571-412-3973

MedPAC Votes to Modify Hospice Aggregate Cap

For Immediate Release:
January 14, 2021

MedPAC Votes in Favor of Modifications to the Hospice Aggregate Cap

NHPCO concerned about unintended consequences to access and quality

(Alexandria, Va) – The National Hospice and Palliative Care Organization (NHPCO) was present at today’s virtual public meeting when the Medicare Payment Advisory Commission (MedPAC) voted on recommendations that were introduced at the December 2020 public meeting. Commissioners voted unanimously in favor of eliminating the update to the fiscal year 2021 Medicare base payment rates for hospice for fiscal year 2022 and to wage adjust and reduce the hospice aggregate cap by 20 percent.

NHPCO firmly believes that the recommended modifications to the hospice aggregate cap will negatively impact access to care and potentially drive people to more expensive care settings. NHPCO is especially concerned for people living in rural and underserved areas, as hospice providers have noted that these dramatic cuts could result in unintended hospice closures, particularly in low wage index and underserved areas.

“NHPCO does not support MedPAC’s recommendation to modify the hospice aggregate cap because this approach is overly broad and careless, especially in light of the strain put on providers by the COVID-19 pandemic. If the recommendation is adopted by Congress, it could lead to a decrease in hospice access for patients and families, especially in rural and underserved areas. In the short term, we urge MedPAC to use a targeted approach that will have a higher likelihood of rewarding high quality and improving access,” said NHPCO President and CEO Edo Banach.

“MedPAC’s role is very important but I have serious reservations with the recommendation to cut the hospice program in the midst of a global pandemic.  It is unsafe and potentially harmful to our most vulnerable citizens. Given the unprecedented challenges hospice organizations are already facing while providing care to individuals in the safety of their own home, the policy recommendations could ultimately limit access to high-quality hospice and palliative care services. I would hope for the sake of seriously ill Kentuckians that MedPAC instead focus on minimizing the hardship hospice organizations are experiencing during this incredibly difficult time to ensure that our most vulnerable will have access to the care they deserve. The sweeping recommendations lack nuance and could have very real consequences that limit the ability of hospice organizations to effectively respond to the needs of dying Medicare beneficiaries,” said Liz Fowler, CEO of Kentucky-based hospice provider Bluegrass Care Navigators.

“We urge MedPAC to reconsider recommendations that cut the hospice program. The last year has shown how important high-quality hospice and palliative care services are to vulnerable patients and their families, and we would not want to do anything that would limit access. For the sake of New Yorkers in need of these critical services during this time of unprecedented challenges, we encourage MedPAC to share their insights into ensuring access to the care New Yorkers deserve,” said Rosemary Baughn, Senior Vice President of Visiting Nurse Service of New York Hospice and Palliative Care.

“We do not support MedPAC’s recommendation to wage index and reduce the hospice aggregate cap by 20 percent. Absent reliable data and analysis, it is unclear how such reductions would lead to Medicare savings, increase access to care, or lead to higher quality of care for Californians,” said Cortland Young, Chief Clinical Officer, Central Coast VNA and Hospice.

“We strongly urge MedPAC to reassess their recommendations that make unnecessary cuts to the hospice program. Floridians are in need of these critical hospice services and additional cuts will only compound a host of issues the community is already struggling with, including reimbursement issues related to increased PPE costs and increased staffing costs. Cutting reimbursement at this difficult time would present even more challenges to the hospice community,” said Samira Beckwith, President and CEO of Hope Healthcare.

NHPCO will continue its dialog with MedPAC and is ready to offer assistance to MedPAC to determine current savings to the system when hospice is chosen as an alternative to costlier services, as this analysis is necessary in informing any proposals to change the hospice reimbursement rate or the aggregate cap.

Providers should remember that MedPAC is an advisory body that makes recommendations to Congress. Even with a unanimous vote in favor of the modifications to the hospice aggregate cap, Congress must adopt the necessary legislative changes to put these recommendations into effect. For more detailed information on the recommendations, NHPCO members should see the 12/03/20 Policy Alert on the Regulatory Alerts and Updates page of the NHPCO website.

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Contact:
Jon Radulovic
Communications Team
Ph: 571-412-3973

Learn more about hospice on NHPCO’s CaringInfo.org

Message from Edo Banach

Thoughts on Events in D.C.

January 7, 2021

I want to share a message with you all following the events of yesterday in Washington, DC.  NHPCO’s offices are only a few miles from the grounds of the Capitol building, a global symbol of our nation’s democracy. First, we are all safe.  Some of our staff live within the shadow of the U.S. Capitol, and yesterday’s events hit close to home.  Many of us watched with incredulity the events unfold in real time on television and via social media.

This should not be a partisan time, as much as a time that cuts to the core of what it means to be a democratic republic. What it means to be America.  Our democracy is integral to the fabric of this great nation. We have wide-ranging differences, but we are able to discuss and debate civilly as one nation. Free speech and the ability to gather in peaceful protest is afforded to us by the U.S. Constitution. Many nations across the globe do not have that freedom. We should celebrate that.  However, what happened yesterday in Washington, DC was not a peaceful protest but violence directed at the heart of our nation. It is important that we call it what it is.

Every year, many of our members – you and your colleagues – gather in the nation’s capital to walk the halls of Congress and meet with our legislators to advocate for the work that we as hospice and palliative care providers do to bring compassion and dignity to many people in communities of every kind. And many of us actively engage with our elected officials from our homes and offices to make our voices heard. The opportunity to be an integral part of America’s democracy is a privilege that we do not take for granted.

It was reassuring to see our elected officials gather back into the chambers of the U.S. Capitol yesterday evening to continue their work. It is also reassuring, and a good reminder of what the U.S. stands for, to go back to our founding document.  Let me share the preamble to the Constitution with you:

“We the people of the United States, in order to form a more perfect union, establish justice, ensure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this constitution for the United States of America.”

Some might question why yesterday’s actions are important to us. Yes, I know that we are hospice and palliative care professionals and advocates, but we are also people first.  As we continue to recover from so many challenges that presented themselves in 2020, we must continue to explore the ways that we can work together to improve and care for our nation using the skills at which we excel. As the nation’s best example of person-centered, interdisciplinary care, I think we can help show how we can work together with people that have different beliefs or backgrounds. We have lots of healing to do as a nation. We know something about that as well.

So onward, hospice and palliative care community.  Let’s keep leading, let’s not lose hope, and let’s move forward, together, for the good of the people we serve. I continue to be proud of the work you are doing every day and I feel honored to be working on your behalf.

Regards,
Edo Banach

2021 Board

For Immediate Release:
January 4, 2021

NHPCO Welcomes New Board Members in 2021

New Chair and Vice-Chair Lead the Executive Committee

(Alexandria, Va) – The National Hospice and Palliative Care Organization (NHPCO) is proud to welcome five new members to the organization’s board of directors and two individuals  returning for a second term. The full NHPCO board will meet for its first meeting of the year on January 27, 2021.

Joining the NHPCO board of directors for three-year terms are:

      • Philip Chuang – Kaiser Permanente, Oakland, CA
      • Honey Goodman – Treasure Valley Hospice, Nampa, ID
      • Corina Tracy – Compassus, Brentwood, TN
      • Terri Warren – Providence St. Joseph Health, Tukwila, WA
      • Tracy Wood – Hospice of Chattanooga, Chattanooga, TN

Returning for a second term are:

      • Samira Beckwith – Hope Healthcare, Fort Myers, FL
      • Balu Natarajan – Seasons Hospice and Palliative Care, Rosemont, IL

Executive Committee
The NHPCO board of directors 2021 executive committee is comprised of:

      • Norman McRae, Chair – Caris HealthCare, Knoxville, TN
      • Melinda Gruber, Vice-Chair – Caring Circle, St. Joseph, MI
      • Edo Banach, President and CEO – NHPCO, Alexandria, VA
      • Elizabeth Fowler, Secretary – Bluegrass Care Navigators, Lexington, KY
      • Brian Jones, Treasurer – SHARE Foundation, El Dorado, AR
      • Balu Natarajan, At-large – Seasons Hospice and Palliative Care, Rosemont, IL
      • Tarrah Lowry, At-large – Sangre De Cristo Hospice & Palliative Care, Pueblo, CO
      • David Totaro, HAN Representative – BAYADA Home Health Care, Philadelphia, PA

Greg Wood, of Hospice of the Ozarks, will serve in an ex officio capacity as immediate past-chair.

Appreciation goes out to Reggie Bodnar of Carroll Hospice and Sandy Kuhlman of Hospice Care, Inc. who both concluded their terms on the NHPCO board at the end of 2020.

“NHPCO thanks all the new and existing board members for their dedicated service on behalf of our nation’s hospice and palliative care provider community as well as the millions of patients and family caregivers that benefit from the care that our diverse membership provides,” said NHPCO President and CEO Edo Banach. “Our board members come from programs that vary in size, structure, and service area and represent that wide range of organizations across the country that share our common goal of leading person- and family-centered care.”

A full list of NHPCO’s board of directors is available in the “About NHPCO” section of the organization’s website.

To learn more about hospice and palliative care, visit NHPCO’s CaringInfo.org website.

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Contact:
Jon Radulovic
NHPCO Communications
Ph: 571-412-3973