This morning, U.S. Senator Sheldon Whitehouse hosted a panel discussion with Bill Novelli, co-chair of the Coalition to Transform Advanced Care (C-TAC), to discuss the organization's work to improve advanced illness care. Advanced illness occurs when chronic conditions, such as end-stage cancer and heart disease, progress to the point that general functioning declines and medical treatment begins to lose its effect.
During the meeting, Senator Whitehouse and Rhode Island health care stakeholders highlighted initiatives already underway in the state to ensure that patients' wishes are honored. They also discussed possible areas for collaboration between Rhode Island and C-TAC. The meeting marks the first step in what Senator Whitehouse and state health leaders hope will be an ongoing discussion about how to make Rhode Island a national model for care planning and the delivery of patient-centered advanced illness care.
"Nearly all of us will, at some point in our lives, be forced to confront the difficult choices that come with advanced illness or end-of-life situations. These are uncomfortable discussions to have, but we need to have them and I thank C-TAC for joining me today," said U.S. Senator Sheldon Whitehouse. "There is so much we can do to improve care and empower patients to express their wishes and goals for treatment. I hope today's discussion is the beginning of a productive partnership between Rhode Island and C-TAC."
"We must strive to support our neighbors, our friends and our families, when they make some of the most challenging decisions of their lives, by ensuring that our care system puts patients and their families first and at the center of advanced illness and end-of-life care," said Lieutenant Governor Elizabeth Roberts.
"With Americans aging and older people needing more care, now is the time to transform our health system so that seriously ill people receive care that meets their needs and is consistent with their values," said Bill Novelli, co-chair of C-TAC.
A National Journal poll found that 93% of Americans say advance care planning should be a priority of the health care system. Unfortunately, the majority of Americans do not have an advance directive or some form of legal document discussing their decision-making for medical treatment. According to a 2008 report by the Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services, only 18 to 36 percent of Americans have completed an advance directive. Addressing advanced care issues is increasingly important as the baby-boomer generation ages, and the percentage of the population age 65 and older grows to almost one fifth of the entire population by 2030. Care in the last year of life represents 30 percent of the total cost of Medicare in the United States, according to a 2011 Dartmouth Institute study.
In addition to Mr. Novelli, meeting speakers included Lieutenant Governor Elizabeth Roberts; Dr. Joan Teno, Professor of Health Services Policy and Practice at Brown University and member of the Institute of Medicine's Committee on Transforming End of Life Care in America; Dr. Edward Martin, Chief Medical Officer at Home and Hospice Care of RI and Clinical Associate Professor of Medicine at Brown University's Warren Alpert Medical School; Gail Paltry, RN, Chief Program Officer from Healthcentric Advisors; Maureen Glynn, co-founder of the Improving the End of Life Care Coalition; Dr. Kate Lally, Medical Director of Palliative Care at Kent Hospital and the VNA of Care New England; and Reverend Don Anderson, Executive Minister of the RI Council of Churches.
Panelists discussed a wide range of topics, including the need for transparency and accountability in advanced illness care delivery, the new fellowship program run by Brown University and Home and Hospice Care of RI to train medical students and residents in hospice and palliative care, and state initiatives to increase consumer participation in patient-directed advanced care planning. The meeting was hosted at the Warren Alpert Medical School at Brown University.
C-TAC is a diverse alliance of 80+ national patient and consumer advocacy groups, health care professionals and providers, private sector stakeholders, faith-based organizations, and health care payers. These stakeholders have a shared mission to provide all Americans, especially the sickest and most vulnerable, with comprehensive, high quality, person- and family- centered care that is consistent with patient goals and honors patient dignity.