- Email: [email protected]
The Angola Hospice Experiment: 16 Years of Better End-of-Life Care Within Corrections (P20)
Vol. 45 No. 2 February 2013
Journal of Pain and Symptom Management 317
The Annual Assembly of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association: Education Schedule With Abstracts March 13e16, 2013 New Orleans Wednesday, March 13 8 ame5 pm
AAHPM & Workshops
HPNA
Preconference
Regulatory Boot Camp for Hospice Physicians (P1) Kate Faulkner, MD FAAHPM, Evercare Hospice & Palliative Care, Dover, MA. Heather Wilson, PhD, Weatherbee Resources, Hyannis, MA. Stephanie Patel, MD, Hospice of the North Shore and Greater Boston, Danvers, MA. Joy Barry, MEd RN CLNC, Weatherbee Resources, Hyannis, MA. (All authors listed above had no relevant financial relationships to disclose.) Objectives 1. Describe the differences between hospice conditions of coverage and conditions of participation and the types of payment and regulatory scrutiny associated with each. 2. Name three ‘‘minimum necessary’’ areas of regulatory competency for all hospice physicians. 3. Name three common regulatory issues/challenges hospice physicians face and detail a framework for ‘‘regulatory decisionmaking.’’ Hospice medical directors bear ultimate responsibility for the medical component of their hospice patient care program. A related responsibility, one that has grown significantly in importance, is ensuring that the hospice interdisciplinary team functions and documents in a way congruent with hospice regulations. Hospice physicians can play a major role in proactively helping their hospice avoid scrutiny from Medicare and Medicaid contractors, the Office of the Inspector General, and other regulatory or investigative agencies but only if they have a good
understanding of pertinent hospice regulations and the evolving regulatory landscape. This full-day workshop is designed to increase the regulatory competence of hospice physicians by focusing on the areas of the hospice regulations most relevant to them. Using interactive case studies and examples, the physician presenters will pose regulatory dilemmas, challenges, gray areas, and questions they face daily in their work as hospice medical directors. In response, a framework is offered for efficiently and effectively defining the issues as well as strategies for locating relevant regulatory or other information to assist in finding answers. Grappling with issues such as determining eligibility, prognosticating, making related versus not related to the terminal illness determinations, helping the team develop individualized care plans that incorporate patient goals, conducting effective face-to-face encounters with patients, billing and coding for hospice physician visits, writing cogent physician narratives, and managing changes in levels of caredespecially general inpatient and continuous caredare some of the regulatory requirements and challenges explored in this workshop. Ample time will be allowed for questions and discussion.
The Angola Hospice Experiment: 16 Years of Better End-of-Life Care Within Corrections (P20) Jamey Boudreaux, MSW MDiv, The LouisianaMississippi Hospice and Palliative Care Organization, New Orleans, LA. (Boudreaux had no relevant financial relationships to disclose.) Objectives 1. Describe the history and current status of hospice and palliative care in prisons and jails across the country. 2. Describe the unique characteristics of providing hospice and palliative care in a correctional setting.
318
Schedule With Abstracts
3. Experience the correctional environment through a tour of the Angola facility, exposure to the infirmary and hospice setting, meeting with the inmate volunteers who assist in the provision of care to dying inmates, and discussion with correctional staff involved in the program 4. Explore resources to assist prisons and jails in the start-up process. 5. Discuss program models in use around the country. 6. Experience a ‘‘round the bus’’ facilitated discussion and debriefing to maximize learning from the tour of Angola. Join a 9-hour preconference road trip to experience end-of-life care in a maximum security correctional facility. Have lunch, hosted by Warden Burl Cain, and see the miracle at Angola: Louisiana State Penitentiary’s award-winning hospice program. Hear from prison officials and inmates involved in this innovative initiative in end-of-life care and learn how hospice is changing life for the prison’s entire inmate population and correctional staff. Dialogue with those involved in formulating models for prison hospice programs and working to develop end-of-life programs and policy within corrections across the country. This intensive session will begin with a 2-hour ‘‘classroom on wheels’’ introducing participants to end-of-life care experiments in correctional facilities across the country. Participants will tour the 18,000-acre maximum-security facility at Angola, LA, and have lunch with prison officials responsible for the Angola hospice program. Participants will also tour the hospice facility and meet with the hospice volunteer inmates directly responsible for the care of terminally ill inmates at Angola. Following the tour of Angola, participants will continue their learning experience on board the ‘‘multimedia classroom on wheels’’ as they return to the conference site in New Orleans. This preconference is limited to 53 attendees. Lunch and transportation will be provided. HPNA sponsored
8 ameNoon Neurodegenerative Diseases: Palliative Care From Day One (P2) Elizabeth Lindenberger, MD, Mount Sinai School of Medicine, New York, NY. Mara Lugassy, MD, Metropolitan Jewish Hospice, New York, NY. Elizabeth Clark, MD, Geriatric
Vol. 45 No. 2 February 2013
Research, Education, and Clinical Center, James J. Peters VA Medical Center, Bronx, NY. Kathleen Bixby, MSN RN CHPN, Department of Veterans Affairs, Washington, DC. Natalie Sutcliffe, MS, James J. Peters VA Medical Center, Bronx, NY. Ruchir Shah, MD, VA Palo Alto Health Care System, Palo Alto, CA. (All authors listed above had no relevant financial relationships to disclose.) Objectives 1. Describe the common physical, cognitive, neuropsychiatric, and speech/swallow symptoms associated with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease (PD) as well as effective management approaches for each. 2. Discuss disease-specific advance care planning challenges in ALS and PD. 3. Identify community resources available to help alleviate the numerous caregiver and financial burdens associated with neurodegenerative diseases. Neurodegenerative diseases affect adults of all ages and are associated with complex physical and neuropsychiatric symptoms, progressive functional impairments, and profound personal and caregiver suffering. Although amyotrophic lateral sclerosis (ALS) and Parkinson’s disease (PD) are distinct disease entities varying in prevalence and disease trajectories, they share numerous characteristics and care needs. Both are associated with multiple domains of loss and severe disruptions of patients’ roles and relationships. Core palliative care tasks begin at the time of diagnosis and include communication with patients and families, management of symptoms and progressive disability, psychosocial support, and coordination of medical and social services. These tasks may take place over a short time for a rapidly progressive disease such as ALS or over many years for PD. Optimal advance care planning starts early and includes attention to common disease-specific challenges including dementia in PD and respiratory failure in ALS. In this interactive workshop, we offer hospice and palliative care providers practical tools to care for patients with ALS and PD. Through interactive discussions using unfolding cases, interdisciplinary presentations, and video, learners will (a) identify disease trajectories, principles of prognosis, and hospice criteria for neurodegenerative diseases; (b) assess and manage the complex respiratory, pain, motor, speech
Journal of Pain and Symptom Management 317
The Annual Assembly of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association: Education Schedule With Abstracts March 13e16, 2013 New Orleans Wednesday, March 13 8 ame5 pm
AAHPM & Workshops
HPNA
Preconference
Regulatory Boot Camp for Hospice Physicians (P1) Kate Faulkner, MD FAAHPM, Evercare Hospice & Palliative Care, Dover, MA. Heather Wilson, PhD, Weatherbee Resources, Hyannis, MA. Stephanie Patel, MD, Hospice of the North Shore and Greater Boston, Danvers, MA. Joy Barry, MEd RN CLNC, Weatherbee Resources, Hyannis, MA. (All authors listed above had no relevant financial relationships to disclose.) Objectives 1. Describe the differences between hospice conditions of coverage and conditions of participation and the types of payment and regulatory scrutiny associated with each. 2. Name three ‘‘minimum necessary’’ areas of regulatory competency for all hospice physicians. 3. Name three common regulatory issues/challenges hospice physicians face and detail a framework for ‘‘regulatory decisionmaking.’’ Hospice medical directors bear ultimate responsibility for the medical component of their hospice patient care program. A related responsibility, one that has grown significantly in importance, is ensuring that the hospice interdisciplinary team functions and documents in a way congruent with hospice regulations. Hospice physicians can play a major role in proactively helping their hospice avoid scrutiny from Medicare and Medicaid contractors, the Office of the Inspector General, and other regulatory or investigative agencies but only if they have a good
understanding of pertinent hospice regulations and the evolving regulatory landscape. This full-day workshop is designed to increase the regulatory competence of hospice physicians by focusing on the areas of the hospice regulations most relevant to them. Using interactive case studies and examples, the physician presenters will pose regulatory dilemmas, challenges, gray areas, and questions they face daily in their work as hospice medical directors. In response, a framework is offered for efficiently and effectively defining the issues as well as strategies for locating relevant regulatory or other information to assist in finding answers. Grappling with issues such as determining eligibility, prognosticating, making related versus not related to the terminal illness determinations, helping the team develop individualized care plans that incorporate patient goals, conducting effective face-to-face encounters with patients, billing and coding for hospice physician visits, writing cogent physician narratives, and managing changes in levels of caredespecially general inpatient and continuous caredare some of the regulatory requirements and challenges explored in this workshop. Ample time will be allowed for questions and discussion.
The Angola Hospice Experiment: 16 Years of Better End-of-Life Care Within Corrections (P20) Jamey Boudreaux, MSW MDiv, The LouisianaMississippi Hospice and Palliative Care Organization, New Orleans, LA. (Boudreaux had no relevant financial relationships to disclose.) Objectives 1. Describe the history and current status of hospice and palliative care in prisons and jails across the country. 2. Describe the unique characteristics of providing hospice and palliative care in a correctional setting.
318
Schedule With Abstracts
3. Experience the correctional environment through a tour of the Angola facility, exposure to the infirmary and hospice setting, meeting with the inmate volunteers who assist in the provision of care to dying inmates, and discussion with correctional staff involved in the program 4. Explore resources to assist prisons and jails in the start-up process. 5. Discuss program models in use around the country. 6. Experience a ‘‘round the bus’’ facilitated discussion and debriefing to maximize learning from the tour of Angola. Join a 9-hour preconference road trip to experience end-of-life care in a maximum security correctional facility. Have lunch, hosted by Warden Burl Cain, and see the miracle at Angola: Louisiana State Penitentiary’s award-winning hospice program. Hear from prison officials and inmates involved in this innovative initiative in end-of-life care and learn how hospice is changing life for the prison’s entire inmate population and correctional staff. Dialogue with those involved in formulating models for prison hospice programs and working to develop end-of-life programs and policy within corrections across the country. This intensive session will begin with a 2-hour ‘‘classroom on wheels’’ introducing participants to end-of-life care experiments in correctional facilities across the country. Participants will tour the 18,000-acre maximum-security facility at Angola, LA, and have lunch with prison officials responsible for the Angola hospice program. Participants will also tour the hospice facility and meet with the hospice volunteer inmates directly responsible for the care of terminally ill inmates at Angola. Following the tour of Angola, participants will continue their learning experience on board the ‘‘multimedia classroom on wheels’’ as they return to the conference site in New Orleans. This preconference is limited to 53 attendees. Lunch and transportation will be provided. HPNA sponsored
8 ameNoon Neurodegenerative Diseases: Palliative Care From Day One (P2) Elizabeth Lindenberger, MD, Mount Sinai School of Medicine, New York, NY. Mara Lugassy, MD, Metropolitan Jewish Hospice, New York, NY. Elizabeth Clark, MD, Geriatric
Vol. 45 No. 2 February 2013
Research, Education, and Clinical Center, James J. Peters VA Medical Center, Bronx, NY. Kathleen Bixby, MSN RN CHPN, Department of Veterans Affairs, Washington, DC. Natalie Sutcliffe, MS, James J. Peters VA Medical Center, Bronx, NY. Ruchir Shah, MD, VA Palo Alto Health Care System, Palo Alto, CA. (All authors listed above had no relevant financial relationships to disclose.) Objectives 1. Describe the common physical, cognitive, neuropsychiatric, and speech/swallow symptoms associated with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease (PD) as well as effective management approaches for each. 2. Discuss disease-specific advance care planning challenges in ALS and PD. 3. Identify community resources available to help alleviate the numerous caregiver and financial burdens associated with neurodegenerative diseases. Neurodegenerative diseases affect adults of all ages and are associated with complex physical and neuropsychiatric symptoms, progressive functional impairments, and profound personal and caregiver suffering. Although amyotrophic lateral sclerosis (ALS) and Parkinson’s disease (PD) are distinct disease entities varying in prevalence and disease trajectories, they share numerous characteristics and care needs. Both are associated with multiple domains of loss and severe disruptions of patients’ roles and relationships. Core palliative care tasks begin at the time of diagnosis and include communication with patients and families, management of symptoms and progressive disability, psychosocial support, and coordination of medical and social services. These tasks may take place over a short time for a rapidly progressive disease such as ALS or over many years for PD. Optimal advance care planning starts early and includes attention to common disease-specific challenges including dementia in PD and respiratory failure in ALS. In this interactive workshop, we offer hospice and palliative care providers practical tools to care for patients with ALS and PD. Through interactive discussions using unfolding cases, interdisciplinary presentations, and video, learners will (a) identify disease trajectories, principles of prognosis, and hospice criteria for neurodegenerative diseases; (b) assess and manage the complex respiratory, pain, motor, speech