Edo Banach is president and CEO of the National Hospice and Palliative Care Organization.
More than six months into the COVID-19 public health emergency, the nation’s attention remains focused on death rates and new infections. However, in addition to death and infections, I am concerned about the dread and social isolation that faces our most vulnerable.
Beyond those diagnosed with COVID-19, those living with or supporting people with serious illness such as cancer, heart disease or chronic obstructive pulmonary disease still need our attention.
Hospice and palliative care providers are continuing to serve this vulnerable population, and their work has been greatly impacted by COVID-19. Providers are donning more personal protective equipment, hospice employees are regularly tested for the virus, patients are using telehealth and virtual visits when possible and families are facing restrictions when visiting their loved ones. As a result, caregivers are facing more burnout, greater burden and more isolation than ever before.
The Coronavirus Aid, Relief, and Economic Security Act provided some benefits to hospice providers, including funds from the provider relief fund and the additional flexibility for conducting the hospice face-to-face encounter by telehealth. We believe that the next COVID package should build on the CARES Act and allow hospice providers to provide bereavement support to caregivers in the community, fund additional personal protective equipment and testing and allow for more flexibility for caregivers.
On Aug. 4, Sen. Sherrod Brown, D-Ohio, and Sen. Shelley Moore Capito, R-W.V., introduced the COVID-19 Hospice Respite Care Relief Act of 2020 (S. 4423). This bill would give the secretary of HHS the flexibility to allow respite care to be provided outside of inpatient settings, potentially including in the home, and to allow hospice patients to receive up to 15 days of respite care.
Current law only allows for five consecutive days of respite care. This bill epitomizes policymakers’ ability to offer well thought-out legislative proposals that increase adaptability and flexibility for hospice patients, hospice providers and caregivers during a very uncertain time.
In some circumstances, patients are being kept in the hospital or hospice inpatient facility longer than usual because the patient has nowhere to go. It may not be safe for the patient to go home, because of a caregiver having COVID-19, being fearful of exposure to COVID-19 from the patient, or the patient cannot go back to the nursing home because there is no bed available. This legislation gives both patients and providers the flexibility they need to provide care and keep patients safe.
CMS has granted flexibility to other Medicare provider types who are facing challenges in caring for COVID patients. This is new legislation, but this request gives providers more flexibility in caring for patients and their loved ones as their needs are assessed. I am hopeful that Congress includes this policy in their next COVID-19 legislative package.
As we all do our part to thank the healthcare providers on the front lines of the pandemic by staying home and wearing a mask, we cannot forget those who have no choice but to navigate the healthcare system to get the care they need and deserve. Additional flexibilities for respite care provided in this bill are a way to support those most vulnerable during the public health emergency.