Literature Review

What is water cremation and why did Pa. lawmakers just back a bill to legalize it? LeighValleyLive.com, Leigh Valley, PA; by Lehigh Valley Community News; 10/5/25 The Pennsylvania House of Representatives passed bipartisan legislation on Wednesday authorizing alkaline hydrolysis, commonly known as water cremation, as an approved cremation method in the state. The bill would give Pennsylvania families a more environmentally sustainable option for end-of-life services. Alkaline hydrolysis uses a mixture of water and alkali in a sealed pressurized steel chamber to reduce the body to bone, which is then processed into ash. The process consumes significantly less energy than traditional flame cremation, which requires temperatures exceeding 1,600 degrees Fahrenheit. According to the Mayo Clinic, alkaline hydrolysis uses only about one-quarter of the energy required for flame cremation. 

Commentary: New York must act now to protect quality hospice care Times Union; by Cara Pace, Liz Krueger and Amy Paulin; 9/30/25 When your loved one is entering the final stage of their life, who would you rather manage their care: a nonprofit solely dedicated to providing the highest quality care possible? Or a private entity seeking to maximize profits? ... However, for-profit hospices now account for 70% of the market, up from 5% 35 years ago. This comes despite studies showing that for-profit hospices provide fewer essential services, employ less skilled staff, receive a higher volume of complaints and contribute less to their communities than their nonprofit counterparts. ... That's why we introduced legislation (S.3437/A.565) to prohibit the state from approving new applications for the establishment, construction or increased capacity of for-profit hospice entities. The two existing for-profit providers would not be touched, though their capacity to expand would be limited. The legislation now awaits Gov. Kathy Hochul’s signature.Editor's Note: For-profit or non-profit status alone does not speak to the quality of care provided by the individual hospice. Some for-profits provide excellent care; some non-profits do not. This article speaks to evidence-based data, quality scores, patterns, trends, and cumulative results from CAHPS, HIS (which is being replaced by the HOPE Tool, effective today), and more. Examine quality scores in your services with the National Hospice Locator (ranked by scores), provided by National Hospice Analytics.

C-TAC announces reintroduction of the Improving Access to Advanced Care Planning Act The Coalition to Transform Advanced Care (C-TAC), Washington, DC; by Debra McCarron; 9/18/25 The Coalition to Transform Advanced Care (C-TAC) today announced the reintroduction of the Improving Access to Advanced Care Planning Act, a key bill designed to expand access to advanced care planning (ACP) services under Medicare. The announcement was made by Senator Warner (D-VA), a long-time champion of patient rights, during the National Partnership for Healthcare and Hospice Innovation Washington Leadership Meeting. The bill continues to enjoy bipartisan support and has been cosponsored by Senator Collins (R-ME).

Home health groups press for a piece of rural health funding Modern Healthcare; by Diane Eastabrook; 9/2/25 Key Takeaways

With time running out, advocates mount push for telehealth, hospital-at-home extensions McKnights Home Care; by Adam Healy; 8/15/25 With the Sept. 30 expiration date approaching for telehealth flexibilities implemented during the COVID-19 pandemic, industry advocates are urging lawmakers to pass a two-year extension. “We have only 48 days to avert a telehealth shutdown on October 1, and we’re relying on continued bipartisan, bicameral support to win the day,” Kyle Zebley, executive director of American Telemedicine Association Action and senior vice president of public policy for the ATA, said Thursday [8/14] in a statement.

Aveanna beefs up advocacy efforts, leans into preferred payer strategy Home Health Care News; by Joyce Famakinwa; 8/15/25 Amid an uncertain reimbursement environment and sea of recent policy updates, Aveanna Healthcare Holdings Inc. (Nasdaq: AVAH) remains focused on the strategies that have been helping the company achieve success. ... This means ramping up the company’s efforts around advocacy, as well as actively working with various state Medicaid programs. Home Health Care News caught up with Jim Melancon at last month’s National Alliance for Care at Home Financial Summit to learn more. Melancon serves as senior vice president of government affairs at Aveanna. ... The company has 327 locations across 34 states.

Bipartisan bill offers ‘meaningful’ immigration reform that could help address senior living workforce needs, leaders say McKnights Senior Living; by Kimberly Bonvissuto; 7/1/25 A bipartisan immigration reform bill proposing a pathway to legal resident status for certain undocumented immigrants — including direct care workers — is earning the support of the senior living and care industry. The recently re-introduced Dignity Act of 2025 “offers the solution to our immigration crisis: secure the border, stop illegal immigration and provide an earned opportunity for long-term immigrants to stay here and work,” sponsor Rep. Maria Elvira Salazar (R-FL) had said in introducing the bill. [Its co-sponsor is] Rep. Veronica Escobar (D-TX).

National Alliance CEO Dr. Steve Landers: Hospice reform should mean more care, not less Hospice News; by Jim Parker; 7/28/25 Hospice reform efforts should focus on allowing for “more care, not less,” according to National Alliance for Care at Home CEO Dr. Steve Landers. Key elements of this should include home-based respite care and a payment system for high-acuity palliative services that hospice patients often lose out on due to the costs. ... “It means innovation in care, home-based respite services, better payment models for people that need things like dialysis or palliative radiation,” Landers said at the Alliance’s Financial Summit in Chicago. “That is that reform we’re talking about.” ... Landers also said that attempts at hospice reform should not “carve-in” hospice into Medicare Advantage. Bringing hospice under Medicare Advantage would undermine patient choice, adversely impact timely access to care and leave providers with lower reimbursement rates, according to the Alliance, the National Partnership for Healthcare and Hospice Innovation (NPHI) and LeadingAge

Hochul weighs political risk of aid-in-dying bill Fingerlakes1.com, Seneca Falls, NY; by Staff Report; 7/18/25 Gov. Kathy Hochul is under pressure as she considers signing New York’s Medical Aid in Dying Act, a controversial bill allowing terminally ill patients access to life-ending medication, according to Politico. The bill has strong support from advocates and many voters, but faces fierce opposition from religious groups and conservatives. Hochul, a practicing Catholic eyeing reelection, must balance public opinion, personal beliefs, and political risk.

VA announces expanded burial benefits for those under VA-provided hospice care Tri-State Alert; by Staff Report; 7/11/25 The Department of Veterans Affairs announced today it has temporarily expanded burial benefits for certain Veterans, per the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. The new law specifies eligible Veterans are those who are discharged from VA-provided medical or nursing care to receive VA-provided hospice care at their home and who pass away between July 1, 2025, and Oct. 1, 2026. Previously, Veterans who died at home under VA hospice care after discharge from VA-provided medical or nursing care were not always eligible for a full VA burial allowance. The Dole Act addresses that gap.

Medicaid provisions threaten home and community-based services for millions of vulnerable Americans National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 7/3/25The National Alliance for Care at Home (the Alliance) issued the following statement today in response to the House’s passage of the “One Big Beautiful Bill Act,” also known as the Reconciliation bill, which now heads to President Trump’s desk for his signature. “The Alliance is deeply troubled by the Medicaid provisions within the One Big Beautiful Bill Act, which has passed both chambers of Congress and now awaits President Trump’s signature,” said Alliance CEO Dr. Steve Landers. “These provisions—including work requirements, reduced provider taxes, and new cost-sharing mandates—prioritize short-sighted budget savings over the health and wellbeing of our most vulnerable citizens who rely on home and community-based services (HCBS).” The home care community advocated throughout the legislative process for Congress to mitigate these harmful Medicaid provisions.

Trump administration to end 988 suicide prevention specialized service for LGBTQ+ youth in JulyCNN; by Jacqueline Howard; 6/18/25The 988 Suicide & Crisis Lifeline’s specialized services for LGBTQ+ youth will no longer be in operation starting July 17, according to a statement from the US Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA). ... According to the latest data from SAMHSA, more than 14.5 million people have called, texted or sent chats to the 988 Lifeline and have been transferred to a crisis contact center since July 2022. Nearly 1.3 million of those were routed to the LGBTQ+ specialized service.Editor's Note: This 988 LGBTQ+ specialized option was piloted in September 2020, expanded on March 6, 2025, and rolled out fully nationwide in July 2023. This data translates to approximately 1,250 LGBTQ calls per day; 52 calls per hour; 1 call per minute. Who--in your world of family and friends--might this ultimately affect? Research, data, and personal stories (sure to be in each of our circles of family and friends) tell us why this matters. A resource for you to use is The Handbook of LGBTQIA-inclusive Hospice and Palliative Care, 2nd edition by Kimberly D. Acquaviva. This handbook is the first place winner, 2024 American Journal of Nursing Book of the Year Award in Palliative Care and Hospice.