II 

115TH CONGRESS 

1ST SESSION S. 693 

To amend the Public Health Service Act to increase the number of permanent 

faculty in palliative care at accredited allopathic and osteopathic medical 

schools, nursing schools, social work schools, and other programs, including 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. 

IN THE SENATE OF THE UNITED STATES 

MARCH 22, 2017 

Ms. BALDWIN (for herself and Mrs. CAPITO) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to increase the 

number of permanent faculty in palliative care at accredited allopathic and osteopathic medical schools, nursing 

schools, social work schools, and other programs, including 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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Palliative Care and 

3 Hospice Education and Training Act’’. 

4 SEC. 2. FINDINGS. 

5 Congress makes the following findings: 

6 (1) Palliative care is interdisciplinary, patient7 and family-centered health care for people with seri8 ous illnesses. This type of care is focused on pro9 viding patients with relief from the symptoms, pain, 

10 and stress of a serious illness, whatever the diag11 nosis. The goal of palliative care is to relieve suf12 fering and improve quality of life for both patients 

13 and their families. Palliative care is provided by a 

14 team of doctors, nurses, social workers, physician as15 sistants, chaplains, and other specialists who work 

16 with a patient’s other health care providers to pro17 vide an extra layer of support, including assistance 

18 with difficult medical decisionmaking and coordina19 tion of care among specialists. Palliative care is ap20 propriate at any age and at any stage in a serious 

21 illness, and can be provided together with curative 

22 treatment. Palliative care is not dependent on a life23 limiting prognosis and may actually help an indi24 vidual recover from illness by relieving symptoms, 

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1 dergoing sometimes difficult medical treatments or 

2 procedures, such as surgery or chemotherapy. 

3 (2) Hospice is palliative care for patients in 

4 their last year of life. Considered the model for qual5 ity compassionate care for individuals facing a life6 limiting illness, hospice provides expert medical care, 

7 pain management, and emotional and spiritual sup8 port expressly tailored to the patient’s needs and 

9 wishes. In most cases, care is provided in the pa10 tient’s home but may also be provided in free11 standing hospice centers, hospitals, nursing homes, 

12 and other long-term care facilities. In 2014, an esti13 mated 1,600,000 to 1,700,000 patients received 

14 services from hospice, including non-Medicare bene15 ficiaries. Nearly 48 percent of all Medicare dece16 dents in 2014 received care from a hospice program. 

17 Hospice is a covered benefit under the Medicare pro18 gram. There were 4,025 Medicare-certified hospices 

19 serving more than 1,300,000 Medicare beneficiaries 

20 in 2014. 

21 (3) Despite a high intensity of medical treat22 ment, many seriously ill patients experience trou23 bling symptoms, unmet psychological and personal 

24 care needs, and high caregiver burden. Numerous 

25 studies have shown that adding palliative care can 


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1 improve pain and symptom control, quality of life, 

2 and family satisfaction with care. 

3 (4) Health care providers need better education 

4 about pain management and palliative care. Stu5 dents graduating from medical, nursing and other 

6 health professional schools today have very little, if 

7 any, training in the core precepts of pain and symp8 tom management, advance care planning, commu9 nication skills, and care coordination for patients 

10 with serious or life-threatening illness. Even for spe11 cialists, training is lacking. For example, the Accred12 itation Council for Graduate Medical Education re13 quires oncology fellowship programs to integrate 

14 competence in palliative care into their curriculum 

15 and the American Society of Clinical Oncology has 

16 recommended the integration of palliative care serv17 ices into standard oncology practice at the time a 

18 person is diagnosed with metastatic or advanced 

19 cancer. Yet a 2015 national survey found that hema20 tology/oncology fellows were ‘‘inadequately prepared’’ 

21 to provide palliative care to their patients. Less than 

22 half had a rotation in palliative care and 25 percent 

23 of fellows reported no explicit teaching on key skills 

24 such as assessing prognosis, conducting a family 


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1 meeting to discuss treatment options, and referral to 

2 palliative care. 

3 (5) The American Board of Medical Specialties 

4 and the Accreditation Council for Graduate Medical 

5 Education provided formal subspecialty status for 

6 hospice and palliative medicine in 2006, and the 

7 Centers for Medicare & Medicaid Services recognized 

8 hospice and palliative medicine as a medical sub9 specialty in October of 2008. 

10 (6) As of February 2017, there were a total of 

11 127 hospice and palliative medicine training pro12 grams accredited by the Accreditation Council for 

13 Graduate Medical Education. For the 2016–2017 

14 academic year, these programs were training 327 

15 physicians in hospice and palliative medicine. Some 

16 programs include an additional track in pediatrics, 

17 geriatrics, research, or public health. Fewer than a 

18 dozen of these ACGME-accredited training programs 

19 focus solely on pediatric palliative medicine though 

20 data show an increasing prevalence of children with 

21 complex chronic conditions who could benefit from 

22 such specialized care. 

23 (7) There is a large gap between the number of 

24 healthcare professionals with palliative care training 

25 and the number required to meet the needs of the 


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1 growing population of individuals with serious or 

2 life-threatening illness. In 2015, 75 percent of 

3 United States hospitals with 50 or more beds had a 

4 palliative care program though not all these pro5 grams have in place the interdisciplinary team nec6 essary to provide comprehensive, high-quality pallia7 tive care. Hospital data reported to the National 

8 Palliative Care Registry show that in 2015 only 44 

9 percent of programs met national staffing standards 

10 set by the Joint Commission, even when including 

11 unfunded positions. Among the 56 percent of pro12 grams without complete interdisciplinary teams, 30 

13 percent have no physician, 10 percent have no ad14 vanced practice registered nurse or RN, 54 percent 

15 have no social worker, and 70 percent have no chap16 lain. Looking at just physician specialists, 2017 pro17 jections by the George Washington University 

18 Health Workforce Institute show that current train19 ing capacity for hospice and palliative medicine is 

20 not sufficient to provide hospital-based care and 

21 keep pace with growth in the population of adults 

22 over 65 years old. The shortages are exacerbated 

23 when considering the current rapid expansion of 

24 community-based palliative care, such as in out25 patient and home-based settings. A separate survey 


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1 of physicians in the field found that, if the rate of 

2 those entering and leaving hospice and palliative 

3 medicine maintains, there will be no more than 1 

4 percent absolute growth in this physician workforce 

5 in 20 years, during which time the number of per6 sons eligible for palliative care will grow by over 20 

7 percent. The study’s authors project this will result 

8 in a ratio of one palliative medicine physician for 

9 every 26,000 seriously ill patients by 2030. 

10 (8) According to the National Academy of Med11 icine, there is a ‘‘need for better understanding of 

12 the role of palliative care among both the public and 

13 professionals across the continuum of care so that 

14 hospice and palliative care can achieve their full po15 tential for patients and their families’’. 

16 SEC. 3. PALLIATIVE CARE AND HOSPICE EDUCATION AND 

17 TRAINING. 

18 (a) IN GENERAL.—Part D of title VII of the Public 

19 Health Service Act (42 U.S.C. 294 et seq.) is amended 

20 by inserting after section 759 the following: 

21 ‘‘SEC. 759A. PALLIATIVE CARE AND HOSPICE EDUCATION 

22 AND TRAINING. 

23 ‘‘(a) PALLIATIVE CARE AND HOSPICE EDUCATION

24 CENTERS.— 


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1 ‘‘(1) IN GENERAL.—The Secretary shall award 

2 grants or contracts under this section to entities de3 scribed in paragraph (1), (3), or (4) of section 

4 799B, and section 801(2), for the establishment or 

5 operation of Palliative Care and Hospice Education 

6 Centers that meet the requirements of paragraph 

7 (2). 

8 ‘‘(2) REQUIREMENTS.—A Palliative Care and 

9 Hospice Education Center meets the requirements of 

10 this paragraph if such Center— 

11 ‘‘(A) improves the training of health pro12 fessionals in palliative care, including 

13 residencies, traineeships, or fellowships; 

14 ‘‘(B) develops and disseminates curricula 

15 relating to the palliative treatment of the com16 plex health problems of individuals with serious 

17 or life-threatening illnesses; 

18 ‘‘(C) supports the training and retraining 

19 of faculty to provide instruction in palliative 

20 care; 

21 ‘‘(D) supports continuing education of 

22 health professionals who provide palliative care 

23 to patients with serious or life-threatening ill24 ness; 


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1 ‘‘(E) provides students (including resi2 dents, trainees, and fellows) with clinical train3 ing in palliative care in long-term care facilities, 

4 home care, hospices, chronic and acute disease 

5 hospitals, and ambulatory care centers; 

6 ‘‘(F) establishes traineeships for individ7 uals who are preparing for advanced education 

8 nursing degrees, social work degrees, or ad9 vanced degrees in physician assistant studies, 

10 with a focus in palliative care in long-term care 

11 facilities, home care, hospices, chronic and 

12 acute disease hospitals, and ambulatory care 

13 centers; and 

14 ‘‘(G) does not duplicate the activities of ex15 isting education centers funded under this sec16 tion or under section 753 or 865. 

17 ‘‘(3) EXPANSION OF EXISTING CENTERS.— 

18 Nothing in this section shall be construed to— 

19 ‘‘(A) prevent the Secretary from providing 

20 grants to expand existing education centers, in21 cluding geriatric education centers established 

22 under section 753 or 865, to provide for edu23 cation and training focused specifically on pal24 liative care, including for non-geriatric popu25 lations; or 


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1 ‘‘(B) limit the number of education centers 

2 that may be funded in a community. 

3 ‘‘(b) PALLIATIVE MEDICINE PHYSICIAN TRAINING.— 

4 ‘‘(1) IN GENERAL.—The Secretary may make 

5 grants to, and enter into contracts with, schools of 

6 medicine, schools of osteopathic medicine, teaching 

7 hospitals, and graduate medical education programs, 

8 for the purpose of providing support for projects 

9 that fund the training of physicians (including resi10 dents, trainees, and fellows) who plan to teach pal11 liative medicine. 

12 ‘‘(2) REQUIREMENTS.—Each project for which 

13 a grant or contract is made under this subsection 

14 shall— 

15 ‘‘(A) be staffed by full-time teaching physi16 cians who have experience or training in pallia17 tive medicine; 

18 ‘‘(B) be based in a hospice and palliative 

19 medicine fellowship program accredited by the 

20 Accreditation Council for Graduate Medical 

21 Education; 

22 ‘‘(C) provide training in palliative medicine 

23 through a variety of service rotations, such as 

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1 prehensive evaluation units, hospice, home 

2 health, and community care programs; 

3 ‘‘(D) develop specific performance-based 

4 measures to evaluate the competency of train5 ees; and 

6 ‘‘(E) provide training in palliative medicine 

7 through one or both of the training options de8 scribed in subparagraphs (A) and (B) of para9 graph (3). 

10 ‘‘(3) TRAINING OPTIONS.—The training options 

11 referred to in subparagraph (E) of paragraph (2) 

12 are as follows: 

13 ‘‘(A) 1-year retraining programs in hospice 

14 and palliative medicine for physicians who are 

15 faculty at schools of medicine and osteopathic 

16 medicine, or others determined appropriate by 

17 the Secretary. 

18 ‘‘(B) 1- or 2-year training programs that 

19 are designed to provide training in hospice and 

20 palliative medicine for physicians who have 

21 completed graduate medical education programs 

22 in any medical specialty leading to board eligi23 bility in hospice and palliative medicine pursu24 ant to the American Board of Medical Special25 ties. 


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1 ‘‘(4) DEFINITIONS.—For purposes of this sub2 section the term ‘graduate medical education’ means 

3 a program sponsored by a school of medicine, a 

4 school of osteopathic medicine, a hospital, or a pub5 lic or private institution that— 

6 ‘‘(A) offers postgraduate medical training 

7 in the specialties and subspecialties of medicine; 

8 and 

9 ‘‘(B) has been accredited by the Accredita10 tion Council for Graduate Medical Education or 

11 the American Osteopathic Association through 

12 its Committee on Postdoctoral Training. 

13 ‘‘(c) PALLIATIVE MEDICINE AND HOSPICE ACA14 DEMIC CAREER AWARDS.— 

15 ‘‘(1) ESTABLISHMENT OF PROGRAM.—The Sec16 retary shall establish a program to provide awards, 

17 to be known as the ‘Palliative Medicine and Hospice 

18 Academic Career Awards’, to eligible individuals to 

19 promote the career development of such individuals 

20 as academic hospice and palliative care physicians. 

21 ‘‘(2) ELIGIBLE INDIVIDUALS.—To be eligible to 

22 receive an award under paragraph (1), an individual 

23 shall— 

24 ‘‘(A) be board certified or board eligible in 

25 hospice and palliative medicine; and 


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1 ‘‘(B) have a junior (non-tenured) faculty 

2 appointment at an accredited (as determined by 

3 the Secretary) school of medicine or osteopathic 

4 medicine. 

5 ‘‘(3) LIMITATIONS.—No award under para6 graph (1) may be made to an eligible individual un7 less the individual— 

8 ‘‘(A) has submitted to the Secretary an ap9 plication, at such time, in such manner, and 

10 containing such information as the Secretary 

11 may require, and the Secretary has approved 

12 such application; 

13 ‘‘(B) provides, in such form and manner as 

14 the Secretary may require, assurances that the 

15 individual will meet the service requirement de16 scribed in paragraph (6); and 

17 ‘‘(C) provides, in such form and manner as 

18 the Secretary may require, assurances that the 

19 individual has a full-time faculty appointment 

20 in a health professions institution and docu21 mented commitment from such institution to 

22 spend a majority of the total funded time of 

23 such individual on teaching and developing 

24 skills in interdisciplinary education in palliative 

25 care. 


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1 ‘‘(4) MAINTENANCE OF EFFORT.—An eligible 

2 individual who receives an award under paragraph 

3 (1) shall provide assurances to the Secretary that 

4 funds provided to the eligible individual under this 

5 subsection will be used only to supplement, not to 

6 supplant, the amount of Federal, State, and local 

7 funds otherwise expended by the eligible individual. 

8 ‘‘(5) AMOUNT AND TERM.— 

9 ‘‘(A) AMOUNT.—The amount of an award 

10 under this subsection shall be equal to the 

11 award amount provided for under section 

12 753(c)(5)(A) for the fiscal year involved. 

13 ‘‘(B) TERM.—The term of an award made 

14 under this subsection shall not exceed 5 years. 

15 ‘‘(C) PAYMENT TO INSTITUTION.—The 

16 Secretary shall make payments for awards 

17 under this subsection to institutions, including 

18 schools of medicine and osteopathic medicine. 

19 ‘‘(6) SERVICE REQUIREMENT.—An individual 

20 who receives an award under this subsection shall 

21 provide training in palliative care and hospice, in22 cluding the training of interdisciplinary teams of 

23 health care professionals. The provision of such 

24 training shall constitute a majority of the total fund25 ed obligations of such individual under the award. 


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1 ‘‘(d) PALLIATIVE CARE WORKFORCE DEVELOP2 MENT.— 

3 ‘‘(1) IN GENERAL.—The Secretary shall award 

4 grants or contracts under this subsection to entities 

5 that operate a Palliative Care and Hospice Edu6 cation Center pursuant to subsection (a)(1). 

7 ‘‘(2) APPLICATION.—To be eligible for an 

8 award under paragraph (1), an entity described in 

9 such paragraph shall submit to the Secretary an ap10 plication at such time, in such manner, and con11 taining such information as the Secretary may re12 quire. 

13 ‘‘(3) USE OF FUNDS.—Amounts awarded under 

14 a grant or contract under paragraph (1) shall be 

15 used to carry out the fellowship program described 

16 in paragraph (4). 

17 ‘‘(4) FELLOWSHIP PROGRAM.— 

18 ‘‘(A) IN GENERAL.—Pursuant to para19 graph (3), a Palliative Care and Hospice Edu20 cation Center that receives an award under this 

21 subsection shall use such funds to offer short22 term intensive courses (referred to in this sub23 section as a ‘fellowship’) that focus on palliative 

24 care that provide supplemental training for fac25 ulty members in medical schools and other 


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1 health professions schools with programs in 

2 psychology, pharmacy, nursing, social work, 

3 physician assistant education, chaplaincy, or 

4 other health disciplines, as approved by the Sec5 retary. Such a fellowship shall be open to cur6 rent faculty, and appropriately credentialed vol7 unteer faculty and practitioners, who do not 

8 have formal training in palliative care, to up9 grade their knowledge and clinical skills for the 

10 care of individuals with serious or life-threat11 ening illness and to enhance their interdiscipli12 nary and interprofessional teaching skills. 

13 ‘‘(B) LOCATION.—A fellowship under this 

14 paragraph shall be offered either at the Pallia15 tive Care and Hospice Education Center that is 

16 sponsoring the course, in collaboration with 

17 other Palliative Care and Hospice Education 

18 Centers, or at medical schools, schools of nurs19 ing, schools of pharmacy, schools of social work, 

20 schools of chaplaincy or pastoral care education, 

21 graduate programs in psychology, physician as22 sistant education programs, or other health pro23 fessions schools approved by the Secretary with 

24 which the Centers are affiliated. 


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1 ‘‘(C) CONTINUING EDUCATION CREDIT.— 

2 Participation in a fellowship under this para3 graph shall be accepted with respect to com4 plying with continuing health profession edu5 cation requirements. As a condition of such ac6 ceptance, the recipient shall subsequently pro7 vide a minimum of 18 hours of voluntary in8 struction in palliative care content (that has 

9 been approved by a palliative care and hospice 

10 education center) to students or trainees in 

11 health-related educational, home, hospice, or 

12 long-term care settings. 

13 ‘‘(5) TARGETS.—A Palliative Care and Hospice 

14 Education Center that receives an award under this 

15 subsection shall meet targets approved by the Sec16 retary for providing palliative care training to a cer17 tain number of faculty or practitioners during the 

18 term of the award, as well as other parameters es19 tablished by the Secretary. 

20 ‘‘(6) AMOUNT OF AWARD.—Each award under 

21 this subsection shall be in the amount of $150,000. 

22 Not more than 24 Palliative Care and Hospice Edu23 cation Centers may receive an award under this sub24 section. 


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1 ‘‘(7) MAINTENANCE OF EFFORT.—A Palliative 

2 Care and Hospice Education Center that receives an 

3 award under this subsection shall provide assurances 

4 to the Secretary that funds provided to the Center 

5 under the award will be used only to supplement, 

6 not to supplant, the amount of Federal, State, and 

7 local funds otherwise expended by such Center. 

8 ‘‘(e) PALLIATIVE CARE AND HOSPICE CAREER IN9 CENTIVE AWARDS.— 

10 ‘‘(1) IN GENERAL.—The Secretary shall award 

11 grants or contracts under this subsection to individ12 uals described in paragraph (2) to foster greater in13 terest among a variety of health professionals in en14 tering the field of palliative care. 

15 ‘‘(2) ELIGIBLE INDIVIDUALS.—To be eligible to 

16 receive an award under paragraph (1), an individual 

17 shall— 

18 ‘‘(A) be an advanced practice nurse, a so19 cial worker, physician assistant, pharmacist, 

20 chaplain, or student of psychology who is pur21 suing a doctorate, masters, or other advanced 

22 degree with a focus in palliative care or related 

23 fields in an accredited health professions school; 

24 and 


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1 ‘‘(B) submit to the Secretary an applica2 tion at such time, in such manner, and con3 taining such information as the Secretary may 

4 require. 

5 ‘‘(3) CONDITIONS OF AWARD.—As a condition 

6 of receiving an award under this subsection, an indi7 vidual shall agree that, following completion of the 

8 award period, the individual will teach or practice 

9 palliative care in health-related educational, home, 

10 hospice, or long-term care settings for a minimum of 

11 5 years under guidelines established by the Sec12 retary. 

13 ‘‘(4) PAYMENT TO INSTITUTION.—The Sec14 retary shall make payments for awards under this 

15 subsection to institutions which include schools of 

16 medicine, osteopathic medicine, nursing, social work, 

17 psychology, chaplaincy or pastoral care education, 

18 dentistry, and pharmacy, or other allied health dis19 cipline in an accredited health professions school or 

20 program (such as a physician assistant education 

21 program) that is approved by the Secretary. 

22 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

23 are authorized to be appropriated to carry out this section, 

24 $44,100,000 for each of the fiscal years 2018 through 

25 2022.’’. 


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1 (b) EFFECTIVE DATE.—The amendment made by 

2 this section shall be effective beginning on the date that 

3 is 90 days after the date of enactment of this Act. 

4 SEC. 4. HOSPICE AND PALLIATIVE NURSING. 

5 (a) PREFERENCE FOR GRANTS OR AWARDS FOR

6 NURSING WORKFORCE DEVELOPMENT PROJECTS.—Sec7 tion 805 of the Public Health Service Act (42 U.S.C. 

8 296d) is amended— 

9 (1) by striking ‘‘or help’’ and inserting ‘‘help’’; 

10 and 

11 (2) by inserting the following before the period 

12 at the end: ‘‘, or for education and training in hos13 pice and palliative nursing’’. 

14 (b) ADVANCED EDUCATION NURSING GRANTS.—Sec15 tion 811 of the Public Health Service Act (42 U.S.C. 

16 296j) is amended— 

17 (1) in subsection (a)— 

18 (A) in paragraph (1), by striking ‘‘and’’ at 

19 the end; 

20 (B) by redesignating paragraph (2) as 

21 paragraph (3); and 

22 (C) by inserting after paragraph (1), the 

23 following new paragraph: 

24 ‘‘(2) palliative care and hospice career incentive 

25 awards under section 759A(e); and’’; and 


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1 (2) in subsection (g)(2), by inserting ‘‘or for 

2 education and training in hospice and palliative 

3 nursing’’ after ‘‘section 332’’. 

4 (c) NURSE EDUCATION, PRACTICE, AND QUALITY

5 GRANTS.—Section 831 of the Public Health Service Act 

6 (42 U.S.C. 296p) is amended— 

7 (1) in subsection (a)— 

8 (A) by striking ‘‘or’’ at the end of para9 graph (1); 

10 (B) by striking the period at the end of 

11 paragraph (2) and inserting ‘‘; or’’; and 

12 (C) by adding at the end the following new 

13 paragraph: 

14 ‘‘(3) education and training in hospice and pal15 liative nursing.’’; and 

16 (2) in subsection (b)(3), by inserting ‘‘hospice 

17 and palliative nursing,’’ after ‘‘coordinated care,’’. 

18 (d) NURSE RETENTION GRANTS.—Section 831A of 

19 the Public Health Service Act (42 U.S.C. 296p–1) is 

20 amended— 

21 (1) in subsection (c)(2), by inserting ‘‘, and to 

22 applicants with programs that include initiatives to 

23 train nurses in hospice and palliative nursing’’ be24 fore the period; and 


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1 (2) in subsection (d), by inserting ‘‘, and to 

2 train nurses in hospice and palliative nursing’’ be3 fore the period. 

4 (e) ADDITIONAL PALLIATIVE CARE AND HOSPICE

5 EDUCATION AND TRAINING PROGRAMS.—Part D of title 

6 VIII of the Public Health Service Act (42 U.S.C. 296p 

7 et seq.) is amended by adding at the end the following: 

8 ‘‘SEC. 832. PALLIATIVE CARE AND HOSPICE EDUCATION 

9 AND TRAINING. 

10 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary shall 

11 award grants to eligible entities to develop and implement, 

12 in coordination with programs under section 759A, pro13 grams and initiatives to train and educate individuals in 

14 providing palliative care in health-related educational, hos15 pice, home, or long-term care settings. 

16 ‘‘(b) USE OF FUNDS.—An eligible entity that receives 

17 a grant under subsection (a) shall use funds under such 

18 grant to— 

19 ‘‘(1) provide training to individuals who will 

20 provide palliative care in health-related educational, 

21 home, hospice, or long-term care settings; 

22 ‘‘(2) develop and disseminate curricula relating 

23 to palliative care in health-related educational, home, 

24 hospice, or long-term care settings; 


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1 ‘‘(3) train faculty members in palliative care in 

2 health-related educational, home, hospice, or long3 term care settings; or 

4 ‘‘(4) provide continuing education to individuals 

5 who provide palliative care in health-related edu6 cational, home, hospice, or long-term care settings. 

7 ‘‘(c) APPLICATION.—An eligible entity desiring a 

8 grant under subsection (a) shall submit an application to 

9 the Secretary at such time, in such manner, and con10 taining such information as the Secretary may reasonably 

11 require. 

12 ‘‘(d) ELIGIBLE ENTITY.—For purposes of this sec13 tion, the term ‘eligible entity’ shall include a school of 

14 nursing, a health care facility, a program leading to cer15 tification as a certified nurse assistant, a partnership of 

16 such a school and facility, or a partnership of such a pro17 gram and facility. 

18 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

19 are authorized to be appropriated to carry out this section 

20 $5,000,000 for each of fiscal years 2018 through 2022.’’. 

21 SEC. 5. NATIONAL PALLIATIVE CARE EDUCATION AND 

22 AWARENESS CAMPAIGN. 

23 Part A of title IX of the Public Health Service Act 

24 (42 U.S.C. 299 et seq.) is amended by adding at the end 

25 the following new section: 


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1 ‘‘SEC. 904. NATIONAL PALLIATIVE CARE EDUCATION AND 

2 AWARENESS CAMPAIGN. 

3 ‘‘(a) IN GENERAL.—Under the authority under sec4 tion 902(a) to disseminate information on health care and 

5 on systems for the delivery of such care, the Director shall 

6 provide for the planning and implementation of a national 

7 education and awareness campaign to inform patients, 

8 families, and health professionals about the benefits of 

9 palliative care throughout the continuum of care for pa10 tients with serious or life-threatening illness. 

11 ‘‘(b) INFORMATION DISSEMINATED.— 

12 ‘‘(1) MANDATORY INFORMATION.—The cam13 paign under subsection (a) shall include dissemina14 tion of the following: 

15 ‘‘(A) PALLIATIVE CARE.—Information, re16 sources, and communication materials about 

17 palliative care as an essential part of the con18 tinuum of quality care for patients and families 

19 facing serious or life-threatening illness (includ20 ing cancer; heart, kidney, liver, lung, and infec21 tious diseases; as well as neurodegenerative dis22 ease such as dementia, Parkinson’s disease, or 

23 amyotrophic lateral sclerosis). 

24 ‘‘(B) PALLIATIVE CARE SERVICES.—Spe25 cific information regarding the services provided 

26 to patients by professionals trained in hospice 


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1 and palliative care, including pain and symptom 

2 management, support for shared decision3 making, care coordination, psychosocial care, 

4 and spiritual care, explaining that such services 

5 may be provided starting at the point of diag6 nosis and alongside curative treatment and are 

7 intended to— 

8 ‘‘(i) provide patient-centered and fam9 ily-centered support throughout the con10 tinuum of care for serious and life-threat11 ening illness; 

12 ‘‘(ii) anticipate, prevent, and treat 

13 physical, emotional, social, and spiritual 

14 suffering; 

15 ‘‘(iii) optimize quality of life; and 

16 ‘‘(iv) facilitate and support the goals 

17 and values of patients and families. 

18 ‘‘(C) PALLIATIVE CARE PROFESSIONALS.— 

19 Specific materials that explain the role of pro20 fessionals trained in hospice and palliative care 

21 in providing team-based care (including pain 

22 and symptom management, support for shared 

23 decisionmaking, care coordination, psychosocial 

24 care, and spiritual care) for patients and famiVerDate Sep 11 2014 04:29 Mar 24, 2017 Jkt 069200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\S693.IS S693

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1 lies throughout the continuum of care for seri2 ous or life-threatening illness. 

3 ‘‘(D) RESEARCH.—Evidence-based re4 search demonstrating the benefits of patient ac5 cess to palliative care throughout the continuum 

6 of care for serious or life-threatening illness. 

7 ‘‘(E) POPULATION-SPECIFIC MATERIALS.— 

8 Materials shall be developed that target specific 

9 populations, including patients with serious or 

10 life-threatening illness who are among medically 

11 underserved populations (as defined in section 

12 330(b)(3)) and families of such patients or 

13 health professionals serving medically under14 served populations. Such populations shall in15 clude pediatric patients, young adult and ado16 lescent patients, racial and ethnic minority pop17 ulations, and other priority populations speci18 fied by the Director. 

19 ‘‘(2) OTHER INFORMATION.—In addition to the 

20 information described in paragraph (1), such cam21 paign may include dissemination of such other infor22 mation as the Director determines to be relevant. 

23 ‘‘(3) INFORMATION FORMAT.—The information 

24 and materials required to be disseminated under 

25 paragraph (1) and any information disseminated 


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1 under paragraph (2) shall be presented in a variety 

2 of formats (such as posted online, in print, and 

3 through public service announcements). 

4 ‘‘(4) REQUIRED PUBLICATION.—The informa5 tion and materials required to be disseminated under 

6 paragraph (1) and any information disseminated 

7 under paragraph (2) shall be posted on the Internet 

8 websites of relevant Federal agencies and Depart9 ments, including the Agency for Healthcare Re10 search and Quality, the Centers for Medicare & 

11 Medicaid Services, the Administration on Aging, the 

12 Centers for Disease Control and Prevention, and the 

13 Department of Veterans Affairs. 

14 ‘‘(c) CONSULTATION.—The Director shall consult 

15 with appropriate professional societies, hospice and pallia16 tive care stakeholders, and relevant patient advocate orga17 nizations with respect to palliative care, psychosocial care, 

18 and complex chronic illness with respect to the following: 

19 ‘‘(1) The planning and implementation of the 

20 national palliative care education and awareness 

21 campaign under this section. 

22 ‘‘(2) The development of information to be dis23 seminated under this section. 

24 ‘‘(3) A definition of the term ‘serious or life25 threatening illness’ for purposes of this section.’’. 


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1 SEC. 6. CLARIFICATION. 

2 None of the funds made available under this Act (or 

3 an amendment made by this Act) may be used to provide, 

4 promote, or provide training with regard to any item or 

5 service for which Federal funding is unavailable under sec6 tion 3 of Public Law 105–12 (42 U.S.C. 14402). 

7 SEC. 7. ENHANCING NIH RESEARCH IN PALLIATIVE CARE. 

8 (a) IN GENERAL.—Part B of title IV of the Public 

9 Health Service Act (42 U.S.C. 284 et seq.) is amended 

10 by adding at the end the following new section: 

11 ‘‘SEC. 409K. ENHANCING RESEARCH IN PALLIATIVE CARE. 

12 ‘‘(a) IN GENERAL.—The Secretary, acting through 

13 the Director of the National Institutes of Health, shall de14 velop and implement a strategy to be applied across the 

15 institutes and centers of the National Institutes of Health 

16 to expand national research programs in palliative care. 

17 ‘‘(b) RESEARCH PROGRAMS.—The Director of the 

18 National Institutes of Health shall expand and intensify 

19 research programs in palliative care to address the quality 

20 of care and quality of life for the rapidly growing popu21 lation of patients in the United States with serious or life22 threatening illnesses, including cancer; heart, kidney, liver, 

23 lung, and infectious diseases; as well as neurodegenerative 

24 disease such as dementia, Parkinson’s disease, or 

25 amyotrophic lateral sclerosis.’’. 


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1 (b) EXPANDING TRANS-NIH RESEARCH REPORTING

2 TO INCLUDE PALLIATIVE CARE RESEARCH.—Section 

3 402A(c)(2)(B) of the Public Health Service Act (42 

4 U.S.C. 282a(c)(2)(B)) is amended by inserting ‘‘and, be5 ginning January 1, 2018, for conducting or supporting re6 search with respect to palliative care’’ after ‘‘or national 

7 centers’’. 

Æ 


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