Rochester Health Feature Profile: CompassionAndSupport.org

Individuals facing serious life-threatening illness and approaching death deserve to be treated with dignity, respect and compassion and to receive care that is focused on the individual’s goals for care. Families need and deserve to receive support. To achieve their goals, individuals need to plan ahead, know their choices, make sound decisions and share their wishes with their loved ones and health care professionals. This Web site aims to educate and empower patients, families, health care and other professionals to accomplish this goal.

With the input of more than 150 community volunteers, the Community-wide End-of-life/Palliative Care Initiative developed the CompassionAndSupport.org Web site in 2002 to educate the community on advance care planning, MOLST, palliative care, pain management and hospice care and related topics. Through the generous funding of the Medical Society of the State of New York and Excellus BlueCross BlueShield, the Web site was enhanced in 2007. A new section for Professionals was added and the section for Patients and Families was improved.

Advance Care Planning:
Conversations Change Lives. Start Your Conversation.

What would happen if you experienced a sudden illness that prevented you from making your own medical decisions? How would you assure that you receive the kind of care that you wanted? Would your family or loved ones know enough about what you value and believe to feel comfortable about making decisions about your care?

According to the End-of-Life Care Survey of Upstate New Yorkers: Advance Care Planning Values and Actions, Summary Report, 2008, nearly nine of ten local adults said it is important to have someone close to them making medical decisions for them if they were to have an irreversible terminal condition and were unable to make decisions. Yet, less than half had designated a health care agent to ensure their wishes are carried out.

Advance Care Planning is a process of planning for future medical care in case you are unable to make your own decisions. Each state has its own laws governing Advance Care Planning and the use of Health Care Proxy forms and Living Wills. Advance Care Directives from each state can be found at your state’s Department of Health Web site or caringinfo.org. While advance directive documents differ in each state, the Advance Care Planning process remains the same.

The Community-wide End-of-life/Palliative Care Initiative has developed a successful two-step approach to advance care planning with two award-winning programs to help individuals Know Your Choices and Share Your Wishes.

Community Conversations on Compassionate Care (CCCC) Program
Medical Orders for Life-Sustaining Treatment (MOLST) Program

Community Conversations on Compassionate Care (CCCC) Program

Community Conversations on Compassionate Care (CCCC) Program is an award-winning program that combines storytelling with Five Easy Steps to promote conversations that help you complete your Health Care Proxy and Living Will.

Learn why healthy individuals should complete their advance directive through using a collection of Advance Care Planning resources on-line, reading the Advance Care Planning booklet, or viewing an array of Community Conversations on Compassionate Care videos that illustrates stories from real patients and families and explains the Advance Care Planning process using the Five Easy Steps:

Learn about Advance Directives
Remove Barriers
Motivate Yourself
Complete Your Health Care Proxy and Living Will
- Have Conversations with Your Family and Health Care Provider
- Choose the Right Health Care Agent
- Discuss Your Values, Beliefs and What is Important to You
- Understand Life-Sustaining Treatment
- Share Copies of Your Completed Advance Directives
Review and Update

The Advance Care Planning booklet is an easy-to-use manual that will guide you through the Advance Care Planning process using the Five Easy Steps. The booklet provides a Health Care Proxy and Living Will form as well as the information necessary to ensure that your wishes will be carried out based on your previously discussed values and beliefs.

Community education to reach a diverse population is illustrated in the Community Partners in Advance Care Planning Education video that features the collaboration with Chi Eta Phi Sorority, Beta Chi Chi Chapter, and Rochester ministers.

Visit the Compassion And Support Video Library at CompassionAndSupport.org.

Medical Orders for Life-Sustaining Treatment (MOLST) Program

The Medical Orders for Life-Sustaining Treatment (MOLST) Program is designed to improve the quality of care seriously ill people receive at the end of life. It is based on effective communication of patient wishes, documentation of medical orders on a brightly colored pink form and a promise by health care professionals to honor these wishes.

The MOLST form does not replace the Health Care Proxy or Living Will. MOLST is for the seriously ill, applies right now and contains medical orders set by the patient.

Learn how this new program for seriously ill patients improves care at the end-of-life; view the Writing Your Final Chapter: Know your Choices...Share Your Wishes MOLST video.

MOLST is New York State’s Physicians Orders for Life-Sustaining Treatment (POLST) Paradigm Program. Visit www.ohsu.edu/polst/ to see if your state has a POLST Paradigm program.

For further information on the Medical Orders for Life-Sustaining Treatment (MOLST) Program, visit CompassionAndSupport.org. Have a question after viewing the MOLST? Click "Contact" found in the top tool bar or call toll free at (877) 718-6709.

National Health Care Reform

Take this Opportunity to Learn the True Intent of HR3200 Section 1233 Advance Care Planning Consultation. Read the facts and personal stories in the most recent edition of the Bomba Letter, written by Dr. Patricia Bomba, M.D., F.A.C.P., a national expert in end-of-life care and advance care planning. Simply click on the link MedAmerica’s Elder Abuse Awareness and Prevention Initiative and Bomba Letter and select the August-September issue of The Bomba Letter or click here to read the letter.

Did you know?

New York State is one of only two states that prohibit family members from making health care decisions for incapacitated loved ones. The Senate has passed the Family Health Care Decisions Act 2009 bill.

Take Action! Encourage the Assembly to pass this important bill. Make a difference and advocate for the Family Health Care Decisions Act 2009 bill.

National health care reform recognizes the value of informed discussions between patients and their health provider that focus on the patient’s goals for care and guide the patient’s treatment preferences for their last months and years of life. Currently, physicians do not receive adequate reimbursement for having thoughtful conversations on advance care planning.

Rochester Takes Action! With the input of more than 150 community volunteers, the Community-wide End-of-life/Palliative Care Initiative developed the Medical Orders for Life-Sustaining Treatment (MOLST) Program, New York State’s Physician Orders for Life-Sustaining Treatment (POLST) Paradigm Program. The MOLST can be used in the community in lieu of the NYS Nonhospital Do Not Resuscitate (DNR) as a result of a successful MOLST Pilot Project.

On July 9, 2008, Gov. David A. Paterson signed into law a bill that helps to ensure a person’s end-of-life wishes are followed whether the person is at home, in a nursing home or in any other non-hospital setting. The new law amends NYS public health law and permanently permits use of the MOLST form in the community throughout New York State.

The MOLST can be used in the community in lieu of the NYS Nonhospital Do Not Resuscitate (DNR). In signing the legislation, Gov. Paterson said, "People should be allowed as much say in their end-of-life care as they would have at any other time. This bill will allow many people who are critically ill to make enduring decisions on the care they will receive. These will be difficult decisions for every person to make, but they should have the freedom to make them."

Rochester Takes Action! Key physician leaders are attending the Beyond the Health Care Proxy: Advance Care Planning for Patients with Serious Illness conference in November to learn how to get it right and get paid for having thoughtful advance care planning conversations with their patients with serious illness. This conference is presented and developed by the Unwarranted Clinical Variations in End-of-life Care Workgroup jointly led by the University of Rochester Medical Center and Excellus BlueCross BlueShield.

Nationally there is a lack of consumer education, tools and resources provided or made available to patients and families on advance care planning.

Rochester Takes Action! With the input of more than 150 community volunteers, the Community-wide End-of-life/Palliative Care Initiative developed the CompassionAndSupport.org Web site.

View reliable information about:

Have a question after viewing CompassionAndSupport.org? Click Contact found in the top tool bar or call toll free at (877) 718-6709.

Information presented by: Patricia A. Bomba, M.D., F.A.C.P.

Patricia Bomba, MD, FACP, Vice President and Medical Director, Geriatrics, Excellus BlueCross BlueShield leads the Community-wide End-of-Life/Palliative Care Initiative and implementation of Community Conversations on Compassionate Care, Medical Orders for Life-Sustaining Treatment program, a community website, CompassionAndSupport.org, Community Principles of Pain Management and Guidelines for Long Term Feeding Tube Placement. Her collaborative work with NYSDOH on health policy and legislative advocacy established MOLST as a statewide program. Currently, she chairs the MOLST Statewide Implementation Team and the National Healthcare Decisions Day New York State Coalition, is New York State’s representative on the National POLST Paradigm Task Force, and is a member of the Medical Society of the State of New York Ethics Committee. In addition to serving as a New York State Delegate to the White House Conference on Aging, she served as a member of the Review Committee of the National Quality Forum’s Framework and Preferred Practices for a Palliative and Hospice Care Quality project. She has practiced Internal Medicine and Geriatrics in the Rochester community since 1979. Dr. Bomba is passionately focused on educating the medical community, and the public at large with a goal of improving the quality of life for seniors and their families. She has spoken extensively regionally, statewide and nationally to professionals, community groups and professional organizations on issues related to Advance Care Planning, MOLST, Palliative Care, Pain Management, and End-of-Life Care. Dr. Bomba is author of several articles on issues related to palliative care, and end-of-life concerns.

Feature Profile Creation Date: September 1, 2009. The profile information is current as of the profile creation date.