Squeaky, Squeaky Wheels

Both Lauren and I have been combing through the conference feedback forms from the Advocacy Intensive and we’ve both had this weird bit of cognitive dissonance. Our conference evaluation form is fairly standard. It uses 1-5 scales to rate various parts of the event, but then it also provides room for comments below each section.

It’s been interesting seeing the feedback come in. I’m happy to report that what we’re seeing so far is that folks generally really liked the Advocacy Intensive and have felt like they made a difference. We’re very thankful for this feedback because above all we want to empower people to take part in the process. We want folks to feel like coming to Washington was worth their time and effort. Most of the ‘scores’ and comments are positive, and that really pumps us up!

But still…

We do get some comments on the things we can do better. Most are very constructive and helpful, and we will absolutely use them when we are planning #HAN16. We welcome all feedback and we really do want to make each event better than the one before. On the other hand, we also get comments that, well, maybe aren’t the nicest or constructive.

The HAN team takes comments like those with a grain of salt of course, and as I said our aggregated responses were overwhelmingly positive. Still, it got me to thinking. The negative comments we get pale in comparison to some of the vitriol that Members of Congress routinely face. If you’re on Facebook, try this out- search for your Members of Congress and look at the comments sections of some of their facebook posts. I bet you know what you’ll see there (ONCE YOU WEED OUT THE RESPONSES IN ALL CAPS!!!). Folks can be pretty passionate in those posts and comments, right?

Now before I go any further, please don’t mistake the point of this post to be that:

  1. We’re going to change everything about the Advocacy Intensive to accommodate the comments of a small section of the attendees or:
  2. You should post mean things to your Member of Congress’ website or facebook accounts.

FullSizeRenderInstead, think of it this way: what we listen to the most is the constructive feedback, and I can guarantee that that’s who your Members of Congress strive to listen to also. Imagine if they heard it from a large number of their constituents! There’s data from the Congressional Management Foundation that we’ve seen that says the number of articulate and polite comments it takes to get the attention of a Congressional Communications Staffer can be as low as 10. Think about that for a second- if you and 9 of your friends all took 5-10 minutes to reach out to your Congressmen, each in your own words, and explain how you felt about an issue, it’s conceivable you’d get on their radar! Maybe it’s better to think of yourself not as a squeaky (ALL CAPS) wheel, but rather as the dashboard light on your car- the one that says ‘check engine’. It’s helpful, it points out a problem, and gives you some indication of what the solution might be.

That may seem counterintuitive, that as few as just 10 passionate advocates can make a difference on an issue, but it’s the truth! Now, commenting on facebook and twitter are great, but there are better and longer lasting ways to make your voice heard- keep following our blog to stay up to speed on all the latest tips and tricks!

What is #HPM?

Every Wednesday night at 9pm EST, there is an online tweet-chat in the hospice and palliative medicine (hpm) community. There is a rotating moderator and topic, and people tweet in using #hpm. As most discussions go, there is typically a core of active participants, and I am sure several more people who just ‘lurk’ in the background. Last night’s topic was hospice and palliative overlap and the MCCM. Some of the concerns presented would be address by the Care Planning Act, so hopefully we continue to see momentum on that bill.


Karen and I were hanging out in #hpm chat last night, and I typically pop in most Wednesday evenings. It would be great to see more of you there! (Shout out to @TheGilb84, who I see there frequently) You may find that you enjoy the casual, friendly atmosphere with other people familiar with our industry.

Similarly, make sure to tune in to the debate tonight on twitter and facebook if you want to see how other people use social media for advocacy and policy. I am sure you will see MANY people doing it badly, but hopefully you can also pick out some people doing it well. Feel free to link to the good, the bad, and the ugly in the comments below!




Reflections on Working at HAN

It is with a heavy heart that we announce the departure of our coworker and friend, Caitlin Reicks. While we are thrilled for her new opportunity, we will miss her around the office. I offered her this space today to say some parting words:

Reflections on Working at HAN

Hello! Some of you may know me, but for those who do not, my name is Caitlin and I am/was the Program Assistant for the Office of Health Policy at NHPCO.  I am writing today because, I am sad to say, today is my last day at NHPCO.  I wanted to share some reflections on my experience working for HAN, hospice, and the amazing individuals I have met and worked with along the way.

CaitlinIt has been an honor and a privilege to work for NHPCO these past two years.  This experience has been especially special because I grew up volunteering for hospice with my mother. I have fond memories from my childhood not only spending that time with my mother, but also recognizing and experiencing the profound impact and significant difference hospice has on patients and families.

When I was hired, I knew that I would be working with in the Quality/Research, Regulatory/Compliance, and Public Policy/HAN departments.   I was comfortable with Quality, Regulatory, and Public Policy – I had an idea and experience with the work involved, but did not know what to expect with HAN.  After my first week on the job, I attended the Advocacy Intensive. I was blown away, not just because it was an absolute blast, but because I was amazed to be surrounded by such compassionate, caring people who were here to share their hospice stories. And their stories made a difference.  This was my first experience with advocacy and I was SOLD!

Though my work with HAN, I have had countless experiences with Hospice Advocates who are passionate about providing the best care possible for the patient (and family) at the end of his/her life.  I am proud to have met and worked with these Hospice Advocates, and while my employment with NHPCO is ending my involvement with hospice will not!  Thank you for all that you do, hospice is truly special.

– Caitlin Reicks

Guest Post: Seth Wyatt, High School Junior and Hospice Advocate

At the 2015 Advocacy Intensive, I had the pleasure of spending some extended time with one of our youngest hospice advocates, Seth Wyatt. Seth accompanied his father, Arkansas Hospice Physician Neal Wyatt, from their home in Arkansas to Washington DC. When I first heard he would be joining us, I was amused and pleased that a high school junior would be interested in joining our cause. When I met Seth in person, I realized I wasn’t dealing with a typical high school junior.

As you will see from his post, Seth is a passionate and stunningly aware student of political science and philosophy. He maintains his own blog where he discusses all manner of current events, and his knowledge of the congressional process was very helpful to the Arkansas delegation at the Intensive. Did I mention that the second day of the Intensive, July 14, was Seth’s 17th Birthday? Impressed by his dedication, I invited him to share a few thoughts with us about his experience:

A few weeks ago, I had the incredible opportunity to journey to Washington DC with my Dad. It was no normal vacation or venture. It was a trip for the purpose of lobbying on behalf of Hospices and Hospice patients all over the United States. Organized by the National Hospice and Palliative Care Organization and its advocacy arm, the Hospice Action Network, I and hundreds of other Hospice-affiliated citizens from around the country gathered in DC to advocate for Hospice inside the United States Congress.

The Care Planning Act and a Sign-On letter in the Senate, and the Hospice Care Access Improvement Act in the House were the subjects of our advocacy. We dispersed amongst the great halls of our legislatures and spoke with staff members and legislators alike.

Prior to our day on the Hill and our day in training, my Dad and I experienced another adventure entirely when we spent almost 3 days traversing the Capitol Mall. In one afternoon, we walked over twenty-five thousand steps and covered a distance close to 40 miles of walking over the course of the week. Needless to say, we got our workout for the week. We visited as many monuments as we could: the Washington Monument, the Lincoln Memorial, the World War II Memorial, the Air and Space Museum, the National Archives, the White House, and the Jefferson Memorial. One night we even got tickets to go to the very top of the Washington Monument. The experience was incredible. To see DC from that view was truly breathtaking. The most impactful of the monuments and memorials was, in our opinion, the least discussed of them all – the Jefferson Memorial. A statue of Jefferson stands gazing out towards the Washington Monument, surrounded by pillars and texts of his own writing. It draws the question, how can corruption exist with monuments such as this within walking distance?

During our day advocating on the Hill, my group met with Senator John Boozman and his staff, Congressman Bruce Westerman and his staff, Congressman Rick Crawford and his staff, and the offices of Congressman French Hill, Congressman Steve Womack, and Senator Tom Cotton. The experience of getting to meet and talk with these Members of Congress and their staff humanized Washington for me in a way it never had been before. The men and women who operate our government are nothing more or less than that, men and women. The advocates from the Hospice Action Network were kinder and more gracious than I could have ever imagined. Some who came from our state with us even bought me some surprise birthday presents! (The day we spent advocating on the Hill was my 17th birthday.)

My trip to Washington was one of the most inspiring and impactful trips of my life. I am absolutely honored to have been able to take part in such an amazing adventure, and such a noble cause.

We were honored to have Dr. Wyatt and Seth join us for the 2015 Advocacy Intensive, and we hope to be seeing them both again! See more of Seth’s writing at his blog, and feel free to leave him any comments below!


Seth also had on appropriate socks for working the Hill

BREAKING: CMS Publishes FY2016 Final Rule for Hospice

UPDATE: August 3, 2:45pm

View NHPCO’s Press Release on the Final Rule.
NHPCO Members: Check out the complete Regulatory Alert!

“The National Hospice and Palliative Care Organization supports the implementation of the two-tiered payment model,” says Senior Vice President of Health Policy, Jonathan Keyserling. “We look forward to working with CMS, state Medicaid agencies, and hospice providers to ensure that implementation goes smoothly and hospices have clear instructions about the changes.”


Original Post:

There’s a rule around Washington, DC: CMS will never publish a proposed of final rule when you expect it. And when they do, it will be no earlier than 4pm. And usually on a Friday.

But I digress. At 4:15pm this afternoon, CMS posted the FY2016 Final Rule for Hospice (formally, “FY 2016 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements”).

The NHPCO Regulatory team and counsel are reviewing the Final Rule as we speak. We’ll direct you to their full analysis when it is available. But we do have one quick takeaway:

The new payment model will come into effect on January 1, 2016.
This is a delay from the proposed October 1, 2015 start date.