Hospice providers discuss legislative priorities

Hospice providers from central and western Kansas discussed their services and legislative priorities Friday with Rep. Roger Marshall, (R-Great Bend) during a roundtable discussion in Salina.

Hospice care provides patients in the final phase of a terminal illness with comfort and support to improve their quality of life, rather than trying to find a cure for their condition. Hospice is a form of palliative care, which focuses on relieving pain and other symptoms of a serious illness.

Marshall, who represents the Kansas First Congressional District, is familiar with the experiences of healthcare providers. He served as a physician before being elected to Congress in 2016.

Sandy Kuhlman, Executive Director of Hospice Services of Northwest Kansas, which is based in Phillipsburg, said hospice provides patients with quality and compassionate end-of-life care.

“It involves a team approach, expert medical care, pain management, and emotional and spiritual support, specially tailored to the person’s wishes,” she said. “Emotional and spiritual support is also extended to the family and loved ones. Generally, the care is provided in the patient’s home or a home-like setting operated by a hospice.”

Services

Julie Pinkerton, Executive Director of Hospice of the Prairie, which is based in Dodge City, said her organization provides access to grief support services to the public at no cost. Pinkerton said her agency provides programs and counseling to students at schools in Dodge City and throughout their service area.

“Area mental health providers are very important, but we know they are extraordinarily overwhelmed," she said. "Hospices get to supplement what our communities need with mental health regarding grief.”

Tara Dahlstrom, Business Development Director for Hospice and HomeCare of Reno County, said her agency sent chaplains to Newton Medical Center to serve patients following a 2016 mass shooting in Hesston. Her organization also helped provide a memorial service on the one-year anniversary of the incident.

Congressional District Director Katie Sawyer, a member of Marshall's staff, recommended that providers contact federal case worker Nikki Meagher if they or their patients have any difficulties working with the Medicare program.

“Please use her as someone who can help advocate for you and your patients,” Sawyer said.

Access to Opioids

Hospice providers are worried that the recent rise in the number of Americans addicted to opioids, such as OxyContin, heroin, and fentanyl, could lead policy makers to adopt new regulations that would prevent them from having access to medications they need to relieve the pain of terminally ill patients.

Jenny Niblock, a nurse at Hospice Services of Northwest Kansas, said access to these medications is important for the people she serves.

“None of us will deny the opioid crisis,” she said. “We need it controlled and want it controlled in our rural communities. We are very concerned about our patients. For us, the pharmacy will close on Friday night and we won’t see a pharmacist again until Monday morning. We need to make sure we have good supplies, and we are afraid that some of the legislation that needs to happen will limit us. We would just ask for exceptions so our patients don’t do without.”

Doctor Joe Barnes, who works at Hospice Services of Northwest Kansas, said some prescribers are becoming uncomfortable writing prescriptions for opioids.

“The last thing you want is Congress members deciding how many days of opioids you should be giving patients,” Marshall said.

Legislation

Kuhlman discussed two proposed bills in Congress that would help hospice providers. The “Rural Access to Hospice Act” would change how Medicare bills for hospice care. According to the Hospice Action Network, the current billing system prevents some patients from choosing their primary care physician as their hospice attending physician. The bill seeks to fix this problem.

Marshall expressed support for the legislation.

“This is a slam dunk policy,” he said. “We would be hard-pressed to find another congress member to say this is crazy. The number one challenge before me is to have enough oxygen left in the room to get something like this done. As long as we are going to keep fighting about Mueller, Russia, and all the other things, there seems to be little oxygen left.”

Meanwhile, the “Palliative Care and Hospice Education and Training Act” would provide physicians, nurses, social workers, chaplains, pharmacists, and other professionals with improved training at palliative care and hospice education centers. The act would also expand palliative care research. Marshall is a co-sponsor of the bill.

Representatives from Hospice of Salina, Meadowlark Hospice, and Hospice of Dickinson County also participated in the roundtable discussion.