Literature Review

RFK Jr. continues pioid Crisis PHE into its eighth year Inside Health Policy; by Dorothy Mills-Gregg; 3/19/25 HHS Secretary Robert F. Kennedy Jr. recently renewed the department’s longest ongoing public health emergency (PHE) first declared under the first Trump administration: the opioid abuse crisis. While the Centers for Disease Control and Prevention found a 25.5% decrease in overdose deaths in 2024 compared to the previous year, HHS says the opioid PHE needs to be renewed for another 90 days so federal coordination efforts can continue and key flexibilities for HHS will be preserved.Editor's note: How recently have you reviewed your Policies & Procedures for destroying drugs in the patient's home, upon death--in accordance with state laws? For staff education and accountability? For communicating this with family? For assessing possible drug diversion of opioids, with appropriate follow-up actions? Additionally, numerous hospice bereavement programs have been flooded with grief needs of bereaved family members from opioid deaths. Click here for the U.S. Department of Justice's Drug Enforcement Administration - Diversion Control Divsion; more focused, scroll down to their "Home Disposal Methods."

Social Media Watch

From heroes to burnout: How we failed our frontline health workers MedPage Today's KevinMD.com, and excerpt from Health Care Nation; by Tom Lawry; 3/15/25 Of all the lessons learned from fighting a pandemic, none was more frightening or important than discovering how dependent the system is on how we treat our doctors, nurses, and frontline caregivers.  They were already in short supply, with burnout on the rise, when the pandemic hit. As multiple waves of COVID-19 variants washed over us, frontline health workers stepped in at great risk and personal sacrifice to care for highly infectious patients. ... Some witnessed more deaths on a double shift than they did in a normal year. They delivered the bad news to families and managed end-of-life care. They were often the last face and warm voice a COVID-19 victim saw and heard. In the end, they not only saved lives but saved the system from total collapse. ... We called them heroes. And we promised to do better in how we treated them once the COVID-19 crisis passed. Promises made should be promises kept. While we continue to talk about workforce burnout using polite terms with concern in our voices, let us be clear: A system with a mission of healing continues to harm in record numbers the very people in short supply who are there to take care of the rest of us. ... [Click on the title's link for more.]

The Stanford Letter Project helps you discuss your end-of-life wishesKALW 91.7 FM - Your Call, Bay Area, CA; by Rose Aguilar and Nina Kissinger; 3/18/25 On this edition of Your Call, we discuss the importance of conversations, letters, and advance directives in communicating your end-of-life care wishes to loved ones and doctors. Although 92 percent of US adults say it's important to discuss their end-of-life care wishes, only 32 percent have had this conversation, and less than one-third have advanced-care directives in place. ... The Stanford Letter Project was designed to give you the tools you need to start the process. Dr. VJ Periyakoil, the founder and director of the project, shares her insights into making end-of-life care plans and resources to help guide you through the process. ... Resources [with links to the content]:

Santa Maria investment advisor pleads guilty to defrauding elderly clients out of more than $2 million Office of Inspector General - Federal Deposit Insurance Corporation, Los Angeles, CA; 3/4/25A Santa Barbara County investment advisor pleaded guilty today to stealing approximately $2.25 million from elderly clients of her investment advisory business – some of whom were receiving end-of-life care.  Julie Anne Darrah, 52, of Santa Maria, pleaded guilty to one count of wire fraud. She remains free on $50,000 bond. ... During the scheme, Darrah stole approximately $2.25 million from her firm’s clients. She did so by obtaining control of her victims’ assets, and then – without the victims’ knowledge or consent – she liquidated their security holdings and transferred the proceeds to accounts she controlled. ... 

AI scribes: Can technology do more than free doctors from data entry? Penn LDI - Leonard Davis Institute of Health Economics; by Hoag Levins; 3/17/25 Since the widespread adoption of electronic health record (EHR) systems in the 1990s, the health care industry has been on a relentless quest to digitally optimize the doctor-patient interaction. Today, many predict this pursuit will be dramatically changed by the integration of artificial intelligence (AI) into nearly all aspects of EHR systems, transforming patient care and clinical workflows in ever more revolutionary ways. AI-powered EHRs are now theoretically capable of automating administrative tasks, providing real-time clinical insights, personalizing treatment plans, and allowing health care providers to focus more on patient care and less on data entry.

Impacting end-of-life care with new healthcare legislation: Patient-Directed Medical Orders (PDMO) in advance care planningAmerican Nurse - State Nurses Associations - Florida News Journal; by Meredith Fischer, BSN, RN, CHPN; 3/19/25 Over the summer, a friend’s elderly father underwent resuscitation and intubation because his nursing facility could not locate his Do Not Resuscitate Order (DNRO) or Advanced Directive (AD). ... New legislation is being filed for a Patient-Directed Medical Order (PDMO) document designed to address the shortcomings of the ADs and DNRO forms—currently the primary tools for addressing end-of-life care preferences in Florida. The PDMO form originates from the POLST paradigm, which has been adopted by most states since its inception in Oregon in the early 1990s (National POLST, 2022). Healthcare professionals recognized that many individuals were not receiving the end-of-life care outlined in their ADs and DNROs due to accessibility, clarity, and practicality (National POLST, 2022).

Dr. Sean O’Mahony aims to expand UTMB’s Division of Palliative Care UTMB Health - The University of Texas Medical Branch at Galveston;  3/18/25 Palliative care should be more accessible, bridge gaps in health care environment. ... Dr. Sean O’Mahony, director of the Palliative Medicine division, came to UTMB in June, having served as professor and Director of Supportive Oncology and Section Chief at Rush University Medical Center in Chicago, and in key roles at Albert Einstein College of Medicine and Memorial Sloan-Kettering Cancer Center. ... O’Mahony said, “I was attracted to UTMB’s commitment to underserved patients, its prison health population, and its large population of underinsured patients. I’m also interested in the opportunity to develop palliative medicine from the ground up in the mainland hospitals.” ... 

More care doesn't equal happier patients in traditional Medicare American Journal of Managed Care (AJMC); by Maggie L. Shaw; 3/17/25 The extremes of health care contact days—having too few or more than average—among community-dwelling beneficiaries 65 years and older of traditional Medicare have been associated with unnecessary care, misdirected care coordination, and excessive care outside the home, according to new research published online today in JAMA Internal Medicine. Health care contact days are days spent receiving care outside of the home. ... “Clinicians, researchers, and policymakers could use contact days to evaluate interventions and reduce excess contact days for patients,” the authors conclude, “by avoiding unnecessary care, improving care coordination, and shifting care to the home.”

The challenges ahead with Jeanne Chiricohallenges ahead with Jeanne Chirico, HPCANYS President/CEO

Congress extends telehealth flexibilities: 5 notes Becker's Health IT; by Naomi Diaz; 3/17/25 Congress has passed a federal spending bill that extends telehealth provisions through Sept. 30, 2025. ... Here are five key telehealth-related elements of the bill:

Alliance Statement on MACPAC Report National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 3/18/25 On Thursday, March 13th, the Medicaid and CHIP Payment and Access Commission (MACPAC) released its semi-annual report, which included three chapters and five recommendations. (See analysis from the National Alliance for Care at Home HERE and HERE.) Two recommendations in the MACPAC report concern home and community-based services (HCBS):

Slush is frozen over. People say that winter lasts forever, but it’s because they obsess over the thermometer. North in the mountains, the maple syrup is trickling. Brave geese punch through the thin ice left on the lake. Underground, pale seeds roll over in their sleep. Starting to get restless. Starting to dream green. ~ Laurie Halse AndersonGoodbye Winter! We welcome tomorrow's first day of Spring 2025.