State Advisory Council on Palliative Care and Quality of Life: Advancing Palliative Care in Alabama

According to the Center for Advancing Palliative Care State by State Report Card (2015) the national average for hospital-based palliative care access was a B. However, a few states, including Alabama, had near failing grades. Many barriers exist which limit palliative care access in the state. Some of the barriers limiting quality palliative care include the lack of a specialized workforce and poor communication skill sets for leading difficult end of life discussions. Additional barriers to policy, research and educational preparation persist.

The changing landscape surrounding palliative care continues to evolve. Some of the contributing factors in the evolution of palliative care incudes new delivery care models, an aging population, and improved reimbursement mechanisms. Additionally, best evidence supports that patients who receive early palliative care access not only have improved outcomes and satisfaction, but also improved life expectancy. In 2015, in an effort to provide consumer awareness of patient centered and family focused palliative care, the Alabama Legislature passed an Act establishing the first interdisciplinary advisory council for advancing palliative care. Appointed by the State Health Officer, members of council were directed to include medical, nursing (mandatory APRN), social work, pharmacy, consumer, and spiritual expertise.

The Alabama State Council on Palliative Care and Quality of Life defined their purpose for maximizing the effectiveness of palliative care initiatives in the state by first ensuring comprehensive and accurate information and education about palliative care be available to the public, health care providers, and health care facilities. A recent amendment to the State’s Natural Death Act was passed, allowing for the adoption of a Portable Do Not Attempt Resuscitate document. The development of this important form, which was guided by the council, allows for patient end of life preferences to be accessed and honored across multiple health care settings. Several ongoing initiatives concerning pallaitive care are in development.