Honoring Those Who Fought for Our Freedom

My first honor flight experience was one I will never forget. One hundred and ten Veterans from the Korean and Vietnam Wars arrived in Washington, D.C. on a gloomy, overcast morning. However, the weather could not dampen their spirits as they proudly exited the plane to a mass of cheers and welcome. As I stood there clapping, smiling, and welcoming the Veterans off the flight, I took a moment to consider how things had changed since the last time they were welcomed off a plane in such a manner. I wondered if all of them had been so deservingly honored with a welcoming home from their service. The smiles on their faces and tears in their eyes – most of them would only admit to allergies or “sweaty eyes” – told me that this moment was unlike any other for the honored guests of the capital.

For most of the Veterans, it was their first time in Washington, D.C. and the guided bus tour provided their first glimpse at the Washington Monument, Lincoln Memorial, and more. Having lived in D.C. for only a month, the monuments became just objects disrupting the D.C. horizon to me instead of the wonderful testaments to American freedom. The Veterans’ marveling and appreciation for the monuments and memorials provided me a renewed significance of the grounds. 

The honor flight experience added context to the importance of my work with the We Honor Veterans program this summer. After learning of the many challenges that Veterans face in terms of health and mobility, the opportunity for the Veterans to visit the nation’s Capitol that they sacrificed and fought so valiantly for became much more significant. In fact, many of the Veterans that required wheelchairs to get off the plane chose to stand and walk through the memorials instead of being assisted. Their perseverance and respect for their fallen brothers in arms was admirable and inspiring.

 It was an honor to help the Veterans locate a friend’s name on the Vietnam Memorial wall or even just listen to their stories. I had the fortune of being present for the reunion of two Veterans who had not fought in the war together, but worked at the same gas station in the years after the war. The two talked about the feeling of significance that they felt in their work during the war and the lost sense of purpose upon returning. Hearing the conversation reaffirmed the need to honor and respect Veterans regardless of one’s position on war. 

Welcoming and walking alongside the Veterans from the honor flight renewed my respect for Washington, D.C. and its symbol of freedom. Additionally, the experience helped me understand the need to continue to show respect to our Veterans of all wars for their service and dedication to protecting the independence of our country that we just celebrated on the Fourth of July. I cannot express my sincere gratitude enough for the National Hospice and Palliative Care Organization and the Honor Flight Network for the amazing opportunity.

By Kevin Curwick
Kevin is an intern working with NHPCO’s Access Team and We Honor Veterans program. He recently graduated from St. John’s University in Minnesota with a Bachelor of Arts in Integrative Health Science.  Kevin has done a lot of work at the Mayo Clinic, both as an undergraduate research assistant in their Pain Rehabilitation Center and as an undergraduate research fellow in their Department of Critical Care.

Every summer, NHPCO welcomes student interns who are involved in a wide range of projects for the organization and its affiliates. This summer, our three interns participated in an Honor Flight event in DC and we asked them to share their experience. This is the third of three blogs that will run this week.  See blog the previous blogs: "Some Wounds Never Heal"  and "Honoring American's Heroes."
 

Thoughts on OIG Report on Hospice Inpatient Care

The HHS Office of Inspector General report on the use and misuse of hospice inpatient care in the Medicare Hospice Benefit, that was released on March 31, 2016, was undertaken as part of an ongoing effort at OIG to prevent inappropriate claims for hospice general inpatient care (GIP), including care being billed but not provided and beneficiaries receiving care they do not need.

As the oldest and largest leadership organization representing hospice and palliative care providers and professionals, NHPCO continues to welcome appropriate oversight of the field and works continually with its members to ensure their awareness of and compliance with all hospice related rules and regulations. NHPCO has also worked closely with Congress and CMS to promote policy changes that stem the abuses referenced in the report, and ensure a high quality hospice experience for consumers. Specifically, NHPCO recommends that hospices:

• Have a process and procedure for determining eligibility for the GIP level of care, that they document the reasons that GIP is appropriate for each patient, and evaluate continued eligibility for GIP EVERY DAY with documentation in the medical record that can be easily reviewed.
• Obtain a written physician order for a change in level of care. 
• Review use of GIP and the length of stay for each patient at the GIP level of care on a monthly basis, with documentation about the review in each patient’s medical record. 
• Review the development of plans of care for patients admitted to and continuing in the GIP level of care.
•  Develop a process for reviewing all medications, check and double check how medications are paid for and ensure that contract providers are billing appropriately.
• Review and update your processes at inpatient facilities to ensure daily evaluation of eligibility, detailed documentation to prove continued eligibility and accurate and complete care plans. 

NHPCO will continue to work with member organizations, policymakers, and other stakeholders to ensure that hospice claims are billed appropriately, and that beneficiaries experience high quality, compassionate care at the end-of-life.

See NHPCO's Regulatory Alert on the new OIG report.

Call to Action: Contact legislators to support hospice

All supporters of hospice care in the U.S. are encouraged to contact their legislators July 14 through 16, 2015, as part of the hospice community's annual legislative event on Capitol Hill.

On July 14, nearly 300 Hospice Advocates, representing 48 states and districts, and every discipline in the Interdisciplinary Team, are in Washington, DC, visiting more than 400 Congressional offices to call for support of hospice.

Individuals across the country also can make a tangible difference for hospices by participating from their homes across the nation. Hospice Action Network and NHPCO are encouraging all hospice supporters to call their Members of Congress and take specific actions that will not only benefit the hospice community but allow hospices to better serve the people for which they care.   

Advocates will be asking their Senators to support The Care Planning Act of 2015 (S 1549) designed to give people with serious illness the freedom to make more informed choices about their card, and the power to have those choices honored. Additionally, Senators will be asked to join the Sign-on Letter written by Senators Roberts and Warner that calls for CMS to test hospice payment changes that were included in the FY2016 Notice of Proposed Rulemaking.

Members of the House of Representatives will be asked to co-sponsor The Hospice Care Access Improvement Act of 2015 (HR 3037) that was just introduced yesterday, July 13, 2015. This legislation calls for a one year testing period to ensure any payment methodology reforms proposed by CMS will be implemented with minimal unintended complications or consequences. The opportunity to test any system changes and conduct the necessary education and training would benefit CMS and the hospice provider community. The legislation also contains a number of program integrity provisions long-supported by the hospice community.

The Hospice Action Network has created an easy to use online "Click to Call" Campaign that will help people understand the issue and then connect them to their Congressional representatives. The whole process should take no longer than 30 minutes, start to finish- that’s all it takes for you to make a difference.

My first observation

I'm touched by the way the lovely Latino woman at the donut store calls me "Honey" and tells me to have a nice day when she hands me my iced coffee. It's completely authentic and caring and it touches me.  So as today starts, that's one thing I'm thanking for - not just the kind woman but the warmth she gives me with my iced coffee.