Palliative Care and Hospice Education and Training Act

IIB 116TH CONGRESS 1ST SESSION H. R. 647 IN THE SENATE OF THE UNITED STATES OCTOBER 29, 2019 Received; read twice and referred to the Committee on Health, Education, Labor, and Pensions AN ACT To amend the Public Health Service Act to increase the number of permanent faculty in palliative care at accred- ited allopathic and osteopathic medical schools, nursing schools, social work schools, and other programs, includ- ing physician assistant education programs, to promote education and research in palliative care and hospice, and to support the development of faculty careers in academic palliative medicine. VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H647.RFS H647 pamtmann on DSKBC07HB2PROD with BILLS 2 HR 647 RFS Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Palliative Care and 4 Hospice Education and Training Act’’. 5 SEC. 2. PALLIATIVE CARE AND HOSPICE EDUCATION AND 6 TRAINING. 7 (a) IN GENERAL.—Part D of title VII of the Public 8 Health Service Act (42 U.S.C. 294 et seq.) is amended 9 by inserting after section 759 the following: 10 ‘‘SEC. 759A. PALLIATIVE CARE AND HOSPICE EDUCATION 11 AND TRAINING. 12 ‘‘(a) PALLIATIVE CARE AND HOSPICE EDUCATION 13 CENTERS.— 14 ‘‘(1) IN GENERAL.—The Secretary shall award 15 grants or contracts under this section to entities de- 16 scribed in paragraph (1), (3), or (4) of section 17 799B, and section 801(2), for the establishment or 18 operation of Palliative Care and Hospice Education 19 Centers that meet the requirements of paragraph 20 (2). 21 ‘‘(2) REQUIREMENTS.—A Palliative Care and 22 Hospice Education Center meets the requirements of 23 this paragraph if such Center— 24 VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H647.RFS H647 pamtmann on DSKBC07HB2PROD with BILLS 3 HR 647 RFS ‘‘(A) improves the interprofessional team- 1 based training of health professionals in pallia- 2 tive care, including residencies, traineeships, or 3 fellowships; 4 ‘‘(B) develops and disseminates inter- 5 professional team-based curricula relating to 6 the palliative treatment of the complex health 7 problems of individuals with serious or life- 8 threatening illnesses; 9 ‘‘(C) supports the training and retraining 10 of faculty to provide instruction in interprofes- 11 sional team-based palliative care; 12 ‘‘(D) supports interprofessional team-based 13 continuing education of health professionals 14 who provide palliative care to patients with seri- 15 ous or life-threatening illness; 16 ‘‘(E) provides students (including resi- 17 dents, trainees, and fellows) with clinical train- 18 ing in interprofessional team-based palliative 19 care in appropriate health settings, including 20 hospitals, hospices, home care, long-term care 21 facilities, and ambulatory care centers; 22 ‘‘(F) establishes traineeships for individ- 23 uals who are preparing for advanced education 24 nursing degrees, social work degrees, or ad- 25 VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H647.RFS H647 pamtmann on DSKBC07HB2PROD with BILLS 4 HR 647 RFS vanced degrees in physician assistant studies, 1 with a focus in interprofessional team-based 2 palliative care in appropriate health settings, in- 3 cluding hospitals, hospices, home care, long- 4 term care facilities, and ambulatory care cen- 5 ters; 6 ‘‘(G) supports collaboration between mul- 7 tiple specialty training programs (such as medi- 8 cine, nursing, social work, physician assistant, 9 chaplaincy, and pharmacy) and clinical training 10 sites to provide training in interprofessional 11 team-based palliative care; and 12 ‘‘(H) does not duplicate the activities of 13 existing education centers funded under this 14 section or under section 753 or 865. 15 ‘‘(3) EXPANSION OF EXISTING CENTERS.— 16 Nothing in this section shall be construed to— 17 ‘‘(A) prevent the Secretary from providing 18 grants to expand existing education centers, in- 19 cluding geriatric education centers established 20 under section 753 or 865, to provide for edu- 21 cation and training focused specifically on pal- 22 liative care, including for non-geriatric popu- 23 lations; or 24 VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H647.RFS H647 pamtmann on DSKBC07HB2PROD with BILLS 5 HR 647 RFS ‘‘(B) limit the number of education centers 1 that may be funded in a community. 2 ‘‘(b) PALLIATIVE MEDICINE PHYSICIAN TRAINING.— 3 ‘‘(1) IN GENERAL.—The Secretary may make 4 grants to, and enter into contracts with, schools of 5 medicine, schools of osteopathic medicine, teaching 6 hospitals, and graduate medical education programs 7 for the purpose of providing support for projects 8 that fund the training of physicians (including resi- 9 dents, trainees, and fellows) who plan to teach pal- 10 liative medicine. 11 ‘‘(2) REQUIREMENTS.—Each project for which 12 a grant or contract is made under this subsection 13 shall— 14 ‘‘(A) be staffed by full-time teaching physi- 15 cians who have experience or training in inter- 16 professional team-based palliative medicine; 17 ‘‘(B) be based in a hospice and palliative 18 medicine fellowship program accredited by the 19 Accreditation Council for Graduate Medical 20 Education; 21 ‘‘(C) provide training in interprofessional 22 team-based palliative medicine through a vari- 23 ety of service rotations, such as consultation 24 services, acute care services, extended care fa- 25 VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H647.RFS H647 pamtmann on DSKBC07HB2PROD with BILLS 6 HR 647 RFS cilities, ambulatory care and comprehensive 1 evaluation units, hospices, home care, and com- 2 munity care programs; 3 ‘‘(D) develop specific performance-based 4 measures to evaluate the competency of train- 5 ees; and 6 ‘‘(E) provide training in interprofessional 7 team-based palliative medicine through one or 8 both of the training options described in para- 9 graph (3). 10 ‘‘(3) TRAINING OPTIONS.—The training options 11 referred to in subparagraph (E) of paragraph (2) 12 are as follows: 13 ‘‘(A) One-year retraining programs in hos- 14 pice and palliative medicine for physicians who 15 are faculty at schools of medicine and osteo- 16 pathic medicine, or others determined appro- 17 priate by the Secretary. 18 ‘‘(B) One- or two-year training programs 19 that are designed to provide training in inter- 20 professional team-based hospice and palliative 21 medicine for physicians who have completed 22 graduate medical education programs in any 23 medical specialty leading to board eligibility in 24 VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H647.RFS H647 pamtmann on DSKBC07HB2PROD with BILLS 7 HR 647 RFS hospice and palliative medicine pursuant to the 1 American Board of Medical Specialties. 2 ‘‘(4) DEFINITIONS.—For purposes of this sub- 3 section, the term ‘graduate medical education’ 4 means a program sponsored by a school of medicine, 5 a school of osteopathic medicine, a hospital, or a 6 public or private institution that— 7 ‘‘(A) offers postgraduate medical training 8 in the specialties and subspecialties of medicine; 9 and 10 ‘‘(B) has been accredited by the Accredita- 11 tion Council for Graduate Medical Education or 12 the American Osteopathic Association through 13 its Committee on Postdoctoral Training. 14 ‘‘(c) PALLIATIVE MEDICINE AND HOSPICE ACA- 15 DEMIC CAREER AWARDS.— 16 ‘‘(1) ESTABLISHMENT OF PROGRAM.—The Sec- 17 retary shall establish a program to provide awards, 18 to be known as the ‘Palliative Medicine and Hospice 19 Academic Career Awards’, to eligible individuals to 20 promote the career development of such individuals 21 as academic hospice and palliative care physicians. 22 ‘‘(2) ELIGIBLE INDIVIDUALS.—To be eligible to 23 receive an award under paragraph (1), an individual 24 shall— 25 VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H647.RFS H647 pamtmann on DSKBC07HB2PROD with BILLS 8 HR 647 RFS ‘‘(A) be board certified or board eligible in 1 hospice and palliative medicine; and 2 ‘‘(B) have a junior (non-tenured) faculty 3 appointment at an accredited (as determined by 4 the Secretary) school of medicine or osteopathic 5 medicine. 6 ‘‘(3) LIMITATIONS.—No award under para- 7 graph (1) may be made to an eligible individual un- 8 less the individual— 9 ‘‘(A) has submitted to the Secretary an ap- 10 plication, at such time, in such manner, and 11 containing such information as the Secretary 12 may require, and the Secretary has approved 13 such application; 14 ‘‘(B) provides, in such form and manner as 15 the Secretary may require, assurances that the 16 individual will meet the service requirement de- 17 scribed in paragraph (6); and 18 ‘‘(C) provides, in such form and manner as 19 the Secretary may require, assurances that the 20 individual has a full-time faculty appointment 21 in a health professions institution and docu- 22 mented commitment from such institution to 23 spend a majority of the total funded time of 24 such individual on teaching and developing 25 VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H647.RFS H647 pamtmann on DSKBC07HB2PROD with BILLS 9 HR 647 RFS skills in education in interprofessional team- 1 based palliative care. 2 ‘‘(4) MAINTENANCE OF EFFORT.—An eligible 3 individual who receives an award under paragraph 4 (1) shall provide assurances to the Secretary that 5 funds provided to the eligible individual under this 6 subsection will be used only to supplement, not to 7 supplant, the amount of Federal, State, and local 8 funds otherwise expended by the eligible individual. 9 ‘‘(5) AMOUNT AND TERM.— 10 ‘‘(A) AMOUNT.—The amount of an award 11 under this subsection shall be equal to the 12 award amount provided for under section 13 753(c)(5)(A) for the fiscal year involved. 14 ‘‘(B) TERM.—The term of an award made 15 under this subsection shall not exceed 5 years. 16 ‘‘(C) PAYMENT TO INSTITUTION.—The 17 Secretary shall make payments for awards 18 under this subsection to institutions, including 19 schools of medicine and osteopathic medicine. 20 ‘‘(6) SERVICE REQUIREMENT.—An individual 21 who receives an award under this subsection shall 22 provide training in palliative care and hospice, in- 23 cluding the training of interprofessional teams of 24 health care professionals. The provision of such 25 VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H647.RFS H647 pamtmann on DSKBC07HB2PROD with BILLS 10 HR 647 RFS training shall constitute a majority of the total fund- 1 ed obligations of such individual under the award. 2 ‘‘(d) PALLIATIVE CARE WORKFORCE DEVELOP- 3 MENT.— 4 ‘‘(1) IN GENERAL.—The Secretary shall award 5 grants or contracts under this subsection to entities 6 that operate a Palliative Care and Hospice Edu- 7 cation Center pursuant to subsection (a)(1). 8 ‘‘(2) APPLICATION.—To be eligible for an 9 award under paragraph (1), an entity described in 10 such paragraph shall submit to the Secretary an ap- 11 plication at such time, in such manner, and con- 12 taining such information as the Secretary may re- 13 quire. 14 ‘‘(3) USE OF FUNDS.—Amounts awarded under 15 a grant or contract under paragraph (1) shall be 16 used to carry out the fellowship program described 17 in paragraph (4). 18 ‘‘(4) FELLOWSHIP PROGRAM.— 19 ‘‘(A) IN GENERAL.—Pursuant to para- 20 graph (3), a Palliative Care and Hospice Edu- 21 cation Center that receives an award under this 22 subsection shall use such funds to offer short- 23 term intensive courses (referred to in this sub- 24 section as a ‘fellowship’) that focus on inter- 25 VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H647.RFS H647 pamtmann on DSKBC07HB2PROD with BILLS 11 HR 647 RFS professional team-based palliative care that pro- 1 vide supplemental training for faculty members 2 in medical schools and other health professions 3 schools with programs in psychology, pharmacy, 4 nursing, social work, physician assistant edu- 5 cation, chaplaincy, or other health disciplines, 6 as approved by the Secretary. Such a fellowship 7 shall be open to current faculty, and appro- 8 priately credentialed volunteer faculty and prac- 9 titioners, who do not have formal training in 10 palliative care, to upgrade their knowledge and 11 clinical skills for the care of individuals with se- 12 rious or life-threatening illness and to enhance 13 their interdisciplinary and interprofessional 14 teaching skills. 15 ‘‘(B) LOCATION.—A fellowship under this 16 paragraph shall be offered either at the Pallia- 17 tive Care and Hospice Education Center that is 18 sponsoring the course, in collaboration with 19 other Palliative Care and Hospice Education 20 Centers, or at medical schools, schools of nurs- 21 ing, schools of pharmacy, schools of social work, 22 schools of chaplaincy or pastoral care education, 23 graduate programs in psychology, physician as- 24 sistant education programs, or other health pro- 25 VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H647.RFS H647 pamtmann on DSKBC07HB2PROD with BILLS 12 HR 647 RFS fessions schools approved by the Secretary with 1 which the Centers are affiliated. 2 ‘‘(C) CONTINUING EDUCATION CREDIT.— 3 Participation in a fellowship under this para- 4 graph shall be accepted with respect to com- 5 plying with continuing health profession edu- 6 cation requirements. As a condition of such ac- 7 ceptance, the recipient shall subsequently pro- 8 vide a minimum of 18 hours of voluntary in- 9 struction in palliative care content (that has 10 been approved by a palliative care and hospice 11 education center) to students or trainees in 12 health-related educational, home, hospice, or 13 long-term care settings. 14 ‘‘(5) TARGETS.—A Palliative Care and Hospice 15 Education Center that receives an award under 16 paragraph (1) shall meet targets approved by the 17 Secretary for providing training in interprofessional 18 team-based palliative care to a certain number of 19 faculty or practitioners during the term of the 20 award, as well as other parameters established by 21 the Secretary. 22 ‘‘(6) AMOUNT OF AWARD.—Each award under 23 paragraph (1) shall be in the amount of $150,000. 24 Not more than 24 Palliative Care and Hospice Edu- 25 VerDate Sep 11 2014 00:40 Oct 30, 2019 Jkt 099200 [Text truncated for display. Full text available on Congress.gov.]