This is a large section, I'll try to fit it on one page. . .
PG 425 Lines 4-12 Government mandates Advance Care Planning Consult. Think Senior Citizens end of life.
‘‘Advance Care Planning Consultation
21 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the
22 term ‘advance care planning consultation’ means a con
23sultation between the individual and a practitioner de
24scribed in paragraph (2) regarding advance care planning,
25 if, subject to paragraph (3), the individual involved has
1 not had such a consultation within the last 5 years. Such
2 consultation shall include the following:
3 ‘‘(A) An explanation by the practitioner of ad
4vance care planning, including key questions and
5 considerations, important steps, and suggested peo
6ple to talk to.
7 ‘‘(B) An explanation by the practitioner of ad
8vance directives, including living wills and durable
9 powers of attorney, and their uses.
10 ‘‘(C) An explanation by the practitioner of the
11 role and responsibilities of a health care proxy.
Possibly true. Much has been read into this. Will explore further. . .
PG 425 Lines 17-19 Government will instruct & consult regarding living wills, durable powers of atty. Mandatory!
‘‘(E) An explanation by the practitioner of the
20 continuum of end-of-life services and supports avail
21able, including palliative care and hospice, and bene
22fits for such services and supports that are available
23 under this title.
I haven't seen manditory. False. So far. Correction, when the government makes the 5 year visit manditory, then it is.
PG 425 Lines 22-25, 426 Lines 1-3 Government provides approved list of end of life resources, guiding you in death.
‘‘(F)(i) Subject to clause (ii), an explanation of
2 orders regarding life sustaining treatment or similar
3 orders, which shall include—
4 ‘‘(I) the reasons why the development of
5 such an order is beneficial to the individual and
6 the individual’s family and the reasons why
7 such an order should be updated periodically as
8 the health of the individual changes;
Dark claim, but true.
PG 427 Lines 15-24 Government mandates program for orders for end of life. The Government has a say in how your life ends.
‘‘(II) distributes or makes accessible such
14 orders to physicians and other health profes
15sionals that (acting within the scope of the pro
16fessional’s authority under State law) may sign
17 orders for life sustaining treatment;
18 ‘‘(III) provides training for health care
19 professionals across the continuum of care
20 about the goals and use of orders for life sus
21taining treatment; and
22 ‘‘(IV) is guided by a coalition of stake
23holders includes representatives from emergency
24 medical services, emergency department physi
25cians or nurses, state long-term care associa-
1 tion, state medical association, state surveyors,
2 agency responsible for senior services, state de
3partment of health, state hospital association,
4 home health association, state bar association,
5 and state hospice association.
True.
PG 429 Lines 1-9 An “advance care planning consultant” will be used frequently as patients health deteriorates.
‘‘(4) A consultation under this subsection may in
2clude the formulation of an order regarding life sustaining
3 treatment or a similar order.
4 ‘‘(5)(A) For purposes of this section, the term ‘order
5 regarding life sustaining treatment’ means, with respect
6 to an individual, an actionable medical order relating to
7 the treatment of that individual that—
8 ‘‘(i) is signed and dated by a physician (as de
9fined in subsection (r)(1)) or another health care
10 professional (as specified by the Secretary and who
11 is acting within the scope of the professional’s au
12thority under State law in signing such an order, in
13cluding a nurse practitioner or physician assistant)
14 and is in a form that permits it to stay with the in
15dividual and be followed by health care professionals
16 and providers across the continuum of care;
17 ‘‘(ii) effectively communicates the individual’s
18 preferences regarding life sustaining treatment, in
19cluding an indication of the treatment and care de
20sired by the individual;
21 ‘‘(iii) is uniquely identifiable and standardized
22 within a given locality, region, or State (as identified
23 by the Secretary); and
1 ‘‘(iv) may incorporate any advance directive (as
2 defined in section 1866(f)(3)) if executed by the in
3dividual.
True.
PG 429 Lines 10-12 “advance care consultation” may include an ORDER for end of life plans. AN ORDER from Government.
(as specified by the Secretary and who
11 is acting within the scope of the professional’s au
12thority under State law in signing such an order, in
13cluding a nurse practitioner or physician assistant)
14 and is in a form that permits it to stay with the in
15dividual and be followed by health care professionals
16 and providers across the continuum of care;
True, in that IT MAY INCLUDE. Not mandated.
PG 429 Lines 13-25 The Government will specify which Doctors can write an end of life order. Logan’s Run anyone?
(as specified by the Secretary and who
11 is acting within the scope of the professional’s au
12thority under State law in signing such an order, in
13cluding a nurse practitioner or physician assistant)
14 and is in a form that permits it to stay with the in
15dividual and be followed by health care professionals
16 and providers across the continuum of care;
True. See bolded section.
PG 430 Lines 11-15 The Government will decide what level of treatment you will have at end of life.
‘‘(B) The level of treatment indicated under subpara
5graph (A)(ii) may range from an indication for full treat
6ment to an indication to limit some or all or specified
7 interventions. Such indicated levels of treatment may in
8clude indications respecting, among other items—
9 ‘‘(i) the intensity of medical intervention if the
10 patient is pulse less, apneic, or has serious cardiac
11 or pulmonary problems;
12 ‘‘(ii) the individual’s desire regarding transfer
13 to a hospital or remaining at the current care set
14ting;
15 ‘‘(iii) the use of antibiotics; and
16 ‘‘(iv) the use of artificially administered nutri
17tion and hydration.’’.
True.
PG 432 Lines 18-21 The Government will publish “quality measures” for individual’s end of life in Federal Register.
‘‘(B) PROPOSED SET OF MEASURES.—The
11 Secretary shall publish in the Federal Register
12 proposed quality measures on end of life care
13 and advanced care planning that the Secretary
14 determines are described in subparagraph (A)
15 and would be appropriate for eligible profes
16sionals to use to submit data to the Secretary.
17 The Secretary shall provide for a period of pub
18lic comment on such set of measures before fi
19nalizing such proposed measures.’’.
True, but the public will be able to comment, if desired.
This was a huge section, I hope I got it all right, if there are any issues/corrections/mistakes please let me know.
Mike
[edit on 9-8-2009 by mikerussellus]