New Measure Aims to Strengthen Patient Access to Palliative Care in NJ

Lilo H. Stainton | August 12, 2019 | Health Care
The law is also designed to improve access to hospice care; program expected to be in effect within three months

New Jersey officials have three months to establish a statewide program to boost understanding of and participation in palliative and hospice care services. Under a new law, the officials will be expected to achieve that by working with stakeholders and an advisory council.

Gov. Phil Murphy signed the law Friday to set up the program under the state Department of Health. The aim is to improve access to existing palliative and hospice care programs. Such programs have proven benefits for patients facing difficult medical treatments or the end of life.

The law tasks state officials with ensuring that hospitals, nursing homes and rehabilitation facilities give accurate and comprehensive information about these services to patients with serious illnesses. The services are available in hospitals, outpatient facilities and sometimes in homes. An 11-member panel, appointed by Murphy and legislative leaders, will oversee the program.

Both palliative and hospice care are designed to reduce pain and suffering and improve comfort — not extend life. Palliative care can start at any time, including when a patient is first diagnosed, and can proceed in conjunction with treatment, to ease symptoms of the disease or side effects of medication. Hospice care is typically reserved for when treatment is suspended and the patient is at the end of their life, often within an estimated six months of death.

Assemblyman Herb Conaway Jr. (D-Burlington)
“Palliative care optimizes a patient’s quality of life by anticipating, preventing, and treating suffering caused by serious illness,” said Assemblyman Herb Conaway (D-Burlington), a doctor and lead sponsor of the bill, which had unanimous support in both houses when it passed in June. “It’s a compassionate approach to treatment that we should be promoting for the benefit of New Jersey families.”

The measure — which dates back nearly five years and amassed dozens of sponsors — also had the backing of diverse advocates, including the American Cancer Society. The organization faulted New Jersey for not having a program dedicated to palliative care in a recent report on cancer-related policy; but ACS leaders also said that the state would receive a better grade on this metric in the future if Murphy signed the bill into law.

Easing pain and anxiety

Samantha DeAlmeida, New Jersey government relations director of ACS’ Cancer Action Network, said palliative care treatments can ease pain and anxiety for cancer patients; an estimated 50,000-plus people are diagnosed with cancer annually in New Jersey. The palliative protocol involves a team of doctors, nurses and other specialists focused on comfort, who work across other disciplines to coordinate care, ensuring that those involved weigh the patient’s suffering carefully in all the decisions they make.

“Palliative care can actually lead to a longer, more satisfying life for cancer patients and those with other major health conditions,” DeAlmeida said, praising Murphy for taking action. “It treats the whole person and not only the cancer.”

New Jersey already has an established advisory council on end-of-life care; it was convened in 2016 and issued a report last fall with more than two dozen recommendations on how the state can improve care for elderly and terminally-ill residents. But DeAlmeida and others said that, given the public need, there is ample room for a more detailed examination of aspects of this process, like palliative and hospice care.

The Garden State is home to more than 1.35 million senior citizens, and this demographic is expected to grow by two-thirds through 2030 as the baby boom generation ages.

Older population, greater incidence of cancer

“Given that the state’s population is aging, with greater incidence of cancer and a higher prevalence of chronic conditions, the demand for high quality hospice and palliative care services will undoubtedly increase,” said Assemblywoman Nancy Pinkin (D-Middlesex), another lead sponsor of the bill. Senate health committee chairman Joe Vitale (D-Middlesex) and Sen. Ron Rice (D-Essex) championed the bill in their house.

Assemblywoman Nancy Pinkin, (D-Middlesex)
Cancer rates have been falling in recent years across the country, and in New Jersey, but the state has a slightly higher incidence of these diseases than the nation overall — nearly 478 cases per 100,000 residents, versus 441, according to federal data from 2011 through 2015.

The law gives the governor, senate president and assembly speaker a month to appoint members to the advisory council — which will include nine public members and two legislators — with input from a variety of professional organizations and state licensing agencies. In addition to a senator and assembly member, the panel is required to include a doctor, several nurses, a social worker, a pediatric oncologist, a chaplain and a hospital administrator; these public members must be certified in palliative or hospice care.

The group must work with the Cancer Institute of New Jersey to create and build the program within DOH in the months to follow, including developing public materials about hospice and palliative care programs. The department will then determine which facilities must distribute the information and work with them to ensure they have a plan in place to get it to those in need.