The Greater Washington Partnership is excited to announce a research initiative exploring the topic of equality in access to pain medication.

The Partnership is actively carrying on discussions with local hospice organizations, pharmacists, government health fellows, and pharmaceutical intermediaries to uncover any challenges that may hinder lower income DC communities from filling opioid prescriptions.

The goal of these conversations and research is not only to shed light on hurdles to equal opioid access in DC, but to also take action to improve the quality of life in D.C.'s underserved neighborhoods.

If you would like to be interviewed or otherwise have any comments, questions, and/or information you wish to share regarding this initiative, please email Megan Clayton, GWP Public Policy Intern, at meganc@gwpartnership.org.

To participate in the coordination and steering of this research, please click here to join the Partnership's Public Policy Committee.

Beginning this summer, the Partnership will coordinate presentations on palliative care for seniors at community organizations around the DC area. The goal of the presentations will be to help seniors take control of their own health care and understand all of their health care options, including how palliative care can help improve their quality of life, as well as the quality of life of their loved ones.

Some presentations at area senior centers will be offered in conjunction with the Palliative Care Program at Potomac Valley Nursing and Wellness Center -- winner of the Partnership's 2008 New Palliative Care Award. Upcoming presentations will occur at Miriam's House and the Washington Seniors Wellness Center. The Partnership will also be participating in "Senior Day" on May 18 during EMS Week to offer information on palliative care.

The presentation will be interactive and include Q&A and some roleplaying following a thirty-minute power-point presentation and lecture. Each presentation will be conducted by an expert in palliative care. Information covered will include advance directives and Comfort Care Orders, how to talk to your doctor and your family members, and how to ensure that your health care treatment corresponds to your individaul values and priorities. The Partnership is willing to tailor the content and format of the presentation to the individual specifications of facilities and organizations interested in hosting a presentation. We will work closely with you to ensure that we are meeting your unique needs.

Although the presentation is directed towards seniors, it is also appropriate for anyone interested in learning more about palliative care. Some facilities which will be hosting upcoming presentations have expressed interest in inviting seniors' friends and family to attend the presentation with them, or in having their staff join in to learn more about palliative care.

For more information or to schedule a presentation, please contact the Partnership at info@gwpartnership.org or 202-895-9489.

The Partnership encourages you to take action to ensure that the needs of patients and families facing serious illnesses be prioritized by the DC government in planning future initiatives, including the allocation of the economic stimulus funds that DC will receive and/or apply for under the American Recovery & Reinvestment Act.

We urge you to contact or participate in the health workgroup and/or the health policy luncheon and advocate for improved palliative and end-of-life care, as well as find out about opportunities that you could use to advance your programs.

The Greater Washington Partnership will participate in "Senior Day" of Emergency Medical Services Week on Monday, May 18 from 10:00 am to noon at Freedom Plaza to help inform senior citizens about how palliative care may help them improve their quality of life.

DC FEMS is sponsoring a week's worth of events from May 16 - May 22 to celebrate and honor providers of emergency medical care in our community -- as well as help DC residents learn more about how to take care of their health, whether by detecting and working to avert potential indicators of a future medical emergency or how to help oneself or another during an emergency.

EMS Week events include parties and celebrations, health education sessions, and a series of health screenings and CPR demonstrations throughout the District of Columbia.

Last month, the FDA issued a ban on the manufacture of unapproved opioid analgesics. After the health care community, especially providers of hospice and palliative care, expressed dismay with the FDA's decision and informed the FDA that certain unapproved opioids, such as 20 mg/ml morphine sulfate solution, are needed to care for seriously ill patients, the FDA reversed its decision and has resolved to consult more with key stakeholders prior to making comparable decisions.

The FDA has also promised to redress any drug shortages related to last month's ban. They have asked providers to inform them of any shortages of pain management medications as they occur. Please email the FDA at drugshortages@fda.gov to notify them of any drug shortages in the Greater Washington region; in your email, please include your professional credentials, your location, the name of the particular drug, and the wholesaler (if applicable).

Health Care in the Media:

Barack Obama Discusses End-of-Life Care in the NYT

(from the New York Times, 4/28/09 and 4/30/09)

President Barack Obama discusses end-of-life care in an interview with the New York Times Magazine in which he identifies reform of end-of-life care as one of the greatest challenges facing the American health care system. He poignantly discusses how his views on health care reform are shaped by his personal experience of his grandmother's health care decision-making towards the end of her life.

Read the interview...

Read an analysis of the interview...

Quality of Death: End of Life Care in America Inside Out

(from WBUR, 4/27/09)

This radio documentary explores the obstacles in America to proper end-of-life planning and a "respectful death," including well-intentioned but possibly unwarranted medical interventions, pressure from family members, and the difficult decisions that doctors - who are trained to extend survival - have to make when treating elderly patients. Several terminal patients in their last months, as well as their family members, are interviewed about their decisions to pursue aggressive and sometimes painful medical treatments and/or focus on how to maintain the best quality of life. Listen online...

(from Emaxhealth, 4/27/09)

"Most teams treating heart failure are medically focused,/ said David Bekelman, M.D., M.P.H., lead author of the study and assistant professor of medicine at the University of Colorado Denver School of Medicine. 'There is little guidance on the emotional, financial, spiritual and social impact of heart failure. This study helps define a role for palliative care in addressing the needs of heart failure patients and their caregivers.'" Read more...

"In the Asian culture, where many people live beyond life expectancy, decision-making regarding end-of-life care differs from Western society. Analysis of Asian beliefs and values reveal that medicine has very little influence on end-of-life decisions. Promoting cultural understanding of these viewpoints is an important step in evolving with regards to end-of-life issues." Read more...


	Volume I Issue 4. May 13, 2009.	Greetings Laura,
	In This Issue Partnership Updates: Partnership's ELNEC Program Debuts at VA Medical Center Partnership Researches Opioid Access in DC Neighborhoods Partnership Offers Presentations for Seniors on Palliative Care News and Announcements: Opportunities to Learn About DC's Economic Stimulus Funds DC EMS Week: May 16-22, 2009 FDA Requests to Hear About Shortages of Pain Management Medications National Healthcare Decisions Day Encourages Advance Care Planning Health Care in the Media: Barack Obama Discusses End-of-Life Care in the NYT Quality of Death: End-of-Life Care in America Inside Out CMS Proposes FY 2010 Hospice Wage Index for Medicare Heart Failure Patients, Caregivers Have Unmet Needs for Palliative Care Eastern Mindsets and Final Decisions For many additional recent articles, please visit the "News" section of the Partnership website. Sign Up for the Speakers Bureau The Partnership is coordinating a directory of experts in palliative care who are willing to share their knowledge at speaking engagements. Boost your CV while helping to spread the word about palliative care by joining our Speakers Bureau today! Please click here to download the sign-up form and email it to us at info@gwpartnership.org. *New Listservs* The Partnership has launched new listservs on palliative care and professional education where health care professionals and community members can connect to one another by email to discuss topics of importance to them. Please click here to sign up for the new listservs and add your voice to the conversation! Help Improve the Comfort Care Order Help us make the DC Comfort Care Order easier for patients and families! The DC Department of Health has asked the Partnership to provide recommendations on how the Comfort Care Order program might be improved, which they will take into consideration in updating the Protocol for the program this year. There are three ways that you could submit your feedback to us: Email us your suggestions to info@gwpartnership.org. Schedule to be interviewed in person or by telephone by contacting us at 202-895-9489 or info@gwpartnership.org. Send us your feedback over our online feedback form for health care professionals or our online feedback form for patients and families. **Professional Education Committee The Partnership's Professional Education Committee has just finished coordinating an ELNEC training at the VA Medical Center this past April. The response to the highly attended training has been enthusiastic. The Committee will repeat the ELNEC training program at Howard University Hospital this October, as well as begin several new educational initiatives, including training for long-term care facilities on the Comfort Care Order and palliative care. The ELNEC program is coordinated by a partnership of six local health care organizations. If you or your organization would like to become involved in organizing local ELNEC trainings, please join us for the next meeting of the Professional Education Committee, which will take place on June 15 at 4:30 pm. To join the Committee or for more details about the meeting, please email info@gwpartnership.org. Public Education Committee The Public Education Committee is coordinating a series of interactive presentations for senior citizens on palliative and end-of-life care, including advance care planning and the DC Comfort Care Order. Please contact us if you'd like for the Public Education Committee to present at your facility. In addition, the Committee is developing brochures describing the CCO program that will be translated into the languages most frequently spoken in the District. The next meeting of the Public Education Committee will take place on June 17th at 4 pm. To join the Committee or for more details about the meeting, please email info@gwpartnership.org. Public Policy Committee The Public Policy Committee is currently working to ensure that legislation and policy on the DC Comfort Care Order optimally serves patients and families in DC. The Committee is conducting interviews with health care professionals and community members about the efficiency and accessibility about the Comfort Care Order. If you or your organization would like to be interviewed, please contact us at info@gwpartnership.org. The Committee is also researching possible strategies to improve access to pain management medications in low-income neighborhoods in DC. Representatives from hospices, pharmacies, government agencies, and professional pharmacy associations have been interviewed. If you or your organization would like to be interviewed or surveyed, please contact us at info@gwpartnership.org. The next meeting of the Public Policy Committee will take place on Tuesday, May 26 at 3 pm. To join the Committee or for more details about the meeting, please contact the Partnership at info@gwpartnership.org. Join the Partnership The Partnership needs the support of dedicated professionals and community members like you to make real changes in palliative and end-of-life care in Greater Washington. Please click here to read about volunteer opportunities with the Partnership. About this E-Newsletter** The Greater Washington Partnership has created "The Partnership Perspective" to help keep you apprised of news and announcements on palliative and end-of-life care in our community. Sign up to receive the e-newsletter. Forward this message to a friend View archives of the e-newsletter online. Would you like to promote your events or issues of interest in our e-newsletter? Please contact us.	Partnership Updates: Partnership's ELNEC Program Successfully Debuts at VA Medical Center Left: Beverly Lunsford, Chair of the Partnership's Professional Education Committee, presents ELNEC Module 5; Right: Students gather in the VA Medical Center Auditorium for ELNEC Training Highly Attended and Highly Rated by Participants Next Training at Howard University Hospital in October The Partnership hosted its first ELNEC training at the VA Medical Center on April 16 and 23. The ELNEC (End-of-Life Nursing Education Consortium) curriculum provides instruction in the specialized knowledge and skills required to provide the highest quality of care to patients and families facing the end of life. The training was greeted with an enthusiastic response. Registration filled early, and a waiting list had to be created for additional persons interested in attending. We were joined by over ninety health care professionals, including nurses in hospice, palliative care, critical care, oncology, and geriatrics; chaplains; social workers; a hospice community liaison; a care coordinator; and even one consumer -- Fred Gersh, Regional Director of US TOO: Prostate Cancer Education & Support. Mr. Gersh commented that the training was very helpful for him as a patient and cancer survivor, and has asked the Partnership to offer similar educational presentations for cancer support groups. Dr. Beverly Lunsford, Chair of the Partnership's Professional Education which oversaw the training, said that ELNEC "was truly a great partnership of people and organizations to improve the quality of palliative and end of life care. The audience was a culturally, ethnically, and professionally diverse group of people. This diversity enriched the dialogue when speakers engaged the audience in case studies and discussion. It also contributed to excellent opportunities for networking during lunch and the breaks." The Partnership will be conducting ELNEC trainings at local health care facilities twice a year. The next training will take place at Howard University Hospital in October. We encourage anyone interested in the training to register early. A registration form and flier will be distributed in August. Read more... Please contact the Partnership at info@gwpartnership.org or (202) 895-9489 to join the mailing list to receive registration forms for upcoming trainings. If you'd like to help coordinate ELNEC trainings or other educational programs, please join the Partnership's Professional Education Committee. Please click here for more information about the April ELNEC training, including photos, a schedule of events, testimonials, and a list of partners and sponsors. Partnership Researches Opioid Access in DC Neighborhoods The Greater Washington Partnership is excited to announce a research initiative exploring the topic of equality in access to pain medication. The Partnership is actively carrying on discussions with local hospice organizations, pharmacists, government health fellows, and pharmaceutical intermediaries to uncover any challenges that may hinder lower income DC communities from filling opioid prescriptions. The goal of these conversations and research is not only to shed light on hurdles to equal opioid access in DC, but to also take action to improve the quality of life in D.C.'s underserved neighborhoods. If you would like to be interviewed or otherwise have any comments, questions, and/or information you wish to share regarding this initiative, please email Megan Clayton, GWP Public Policy Intern, at meganc@gwpartnership.org. To participate in the coordination and steering of this research, please click here to join the Partnership's Public Policy Committee. Partnership Offers Presentations for Seniors on Palliative Care Find Out How Your Organization Can Host A Presentation Beginning this summer, the Partnership will coordinate presentations on palliative care for seniors at community organizations around the DC area. The goal of the presentations will be to help seniors take control of their own health care and understand all of their health care options, including how palliative care can help improve their quality of life, as well as the quality of life of their loved ones. Some presentations at area senior centers will be offered in conjunction with the Palliative Care Program at Potomac Valley Nursing and Wellness Center -- winner of the Partnership's 2008 New Palliative Care Award. Upcoming presentations will occur at Miriam's House and the Washington Seniors Wellness Center. The Partnership will also be participating in "Senior Day" on May 18 during EMS Week to offer information on palliative care. The presentation will be interactive and include Q&A and some roleplaying following a thirty-minute power-point presentation and lecture. Each presentation will be conducted by an expert in palliative care. Information covered will include advance directives and Comfort Care Orders, how to talk to your doctor and your family members, and how to ensure that your health care treatment corresponds to your individaul values and priorities. The Partnership is willing to tailor the content and format of the presentation to the individual specifications of facilities and organizations interested in hosting a presentation. We will work closely with you to ensure that we are meeting your unique needs. Although the presentation is directed towards seniors, it is also appropriate for anyone interested in learning more about palliative care. Some facilities which will be hosting upcoming presentations have expressed interest in inviting seniors' friends and family to attend the presentation with them, or in having their staff join in to learn more about palliative care. For more information or to schedule a presentation, please contact the Partnership at info@gwpartnership.org or 202-895-9489. News and Announcements: Opportunities to Learn About DC's Economic Stimulus Funds The Partnership encourages you to take action to ensure that the needs of patients and families facing serious illnesses be prioritized by the DC government in planning future initiatives, including the allocation of the economic stimulus funds that DC will receive and/or apply for under the American Recovery & Reinvestment Act. The DC government has established workgroups -- including a workgroup on health -- to strategize about how to apply for and spend stimulus funds. To submit feedback or suggestions to the health workgroup, or to get involved, please email health.recovery@dc.gov. For more information, please visit recovery.dc.gov. The DC Department of Health is also coordinating brownbag health policy luncheons the third Thursday of every month from 12:00-1:30 pm at 825 N. Capitol Street NE. The luncheons have recently addressed upcoming Request For Information meetings and preparation for Request For Proposals. For more information or to RSVP, please contact Pierre Vigilance, MD, MPH, Director of the DC Department of Health, at pierre.vigilance@dc.gov. We urge you to contact or participate in the health workgroup and/or the health policy luncheon and advocate for improved palliative and end-of-life care, as well as find out about opportunities that you could use to advance your programs. DC Emergency Medical Services Week: May 16 - 22, 2009 The Greater Washington Partnership will participate in "Senior Day" of Emergency Medical Services Week on Monday, May 18 from 10:00 am to noon at Freedom Plaza to help inform senior citizens about how palliative care may help them improve their quality of life. DC FEMS is sponsoring a week's worth of events from May 16 - May 22 to celebrate and honor providers of emergency medical care in our community -- as well as help DC residents learn more about how to take care of their health, whether by detecting and working to avert potential indicators of a future medical emergency or how to help oneself or another during an emergency. EMS Week events include parties and celebrations, health education sessions, and a series of health screenings and CPR demonstrations throughout the District of Columbia. Please click here to view a full schedule of EMS Week events. FDA Requests to Hear About Shortages of Pain Medications Last month, the FDA issued a ban on the manufacture of unapproved opioid analgesics. After the health care community, especially providers of hospice and palliative care, expressed dismay with the FDA's decision and informed the FDA that certain unapproved opioids, such as 20 mg/ml morphine sulfate solution, are needed to care for seriously ill patients, the FDA reversed its decision and has resolved to consult more with key stakeholders prior to making comparable decisions. The FDA has also promised to redress any drug shortages related to last month's ban. They have asked providers to inform them of any shortages of pain management medications as they occur. Please email the FDA at drugshortages@fda.gov to notify them of any drug shortages in the Greater Washington region; in your email, please include your professional credentials, your location, the name of the particular drug, and the wholesaler (if applicable). National Health Care Decisions Day Encourages Advance Care Planning Partnership Launches New Web Page on Advance Care Planning Resources National Health Care Decisions Day (NHDD) took place this year on April 16, 2009. Organizations around the country -- including the Partnership -- encouraged patients and families around the country to plan in advance for their future health care needs. • 28,948 people were confirmed to have received advance directive information as part of NHDD. • 81,000 facility staff members or organizational staff members received information via email or internal newsletters, etc. • 1,310 people are known to have executed an advance directive as a result of NHDD activities In observance of National Health Care Decisions Day, the Partnership launched a new web page on local and national resources on advance directives and advance care planning, which is available at: http://www.gwpartnership.org/AdvanceCarePlanning.html. In 2010, the Partnership will plan to host a community event on advance care planning in conjunction with other local health care organizations. Health Care in the Media: Barack Obama Discusses End-of-Life Care in the NYT (from the New York Times, 4/28/09 and 4/30/09) President Barack Obama discusses end-of-life care in an interview with the New York Times Magazine in which he identifies reform of end-of-life care as one of the greatest challenges facing the American health care system. He poignantly discusses how his views on health care reform are shaped by his personal experience of his grandmother's health care decision-making towards the end of her life. Read the interview... Read an analysis of the interview... Quality of Death: End of Life Care in America Inside Out (from WBUR, 4/27/09) This radio documentary explores the obstacles in America to proper end-of-life planning and a "respectful death," including well-intentioned but possibly unwarranted medical interventions, pressure from family members, and the difficult decisions that doctors - who are trained to extend survival - have to make when treating elderly patients. Several terminal patients in their last months, as well as their family members, are interviewed about their decisions to pursue aggressive and sometimes painful medical treatments and/or focus on how to maintain the best quality of life. Listen online... CMS Proposes FY 2010 Hospice Wage Index for Medicare (from CCH Medicare, 5/07/09) CMS published its proposed rule amending the hospice wage index for fiscal year (FY) 2010, which begins October 1, 2009. The proposed rule includes changes to the budget neutrality adjustment factor, the certification process for terminal illnesses, and services covered. Read more... Heart Failure Patients, Caregivers Have Unmet Needs for Palliative Care (from Emaxhealth, 4/27/09) "Most teams treating heart failure are medically focused,/ said David Bekelman, M.D., M.P.H., lead author of the study and assistant professor of medicine at the University of Colorado Denver School of Medicine. 'There is little guidance on the emotional, financial, spiritual and social impact of heart failure. This study helps define a role for palliative care in addressing the needs of heart failure patients and their caregivers.'" Read more... Eastern Mindsets and Final Decisions (from Advance for Nurses, 4/15/09) "In the Asian culture, where many people live beyond life expectancy, decision-making regarding end-of-life care differs from Western society. Analysis of Asian beliefs and values reveal that medicine has very little influence on end-of-life decisions. Promoting cultural understanding of these viewpoints is an important step in evolving with regards to end-of-life issues." Read more... (Would you like to learn more about providing culturally-specific end-of-life care, as described in this article? Then please contact the Partnership's Professional Education Committee).
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