Michigan Commission on End of Life Care

report cover

 

Report to the Governor, July 2002

Report to the Governor, August 2001

Completing A Life CD

 

Purpose:

This document is intended to provide background information for Michigan citizens on the purpose and mission of the Michigan Commission on End of Life Care. The Commission began their work in January 2000 to deliberate and examine the issues facing citizens at the end of life in Michigan. The Commission then offered a comprehensive set of recommendations to the Governor with the purpose of positioning Michigan as a national leader in providing quality, humane, and dignified care to patients, families, and other loved ones at the end of life. Public comment related to the main areas of the charge (see page 2) was extremely helpful to the commission as it developed its final recommendations that appear in their August 2001 Report to the Governor.

 

Introduction:

Governor Engler created the Michigan Commission on End of Life Care so they would offer recommendations on how Michigan may improve the humane and dignified treatment for Michigan citizens at the end of life. The Michigan Commission on End of Life Care worked to evaluate and improve education and curricula for health care professionals and to develop resources for the public in the area of end of life care planning. The commission also examined state policies to remove barriers to effective pain management and improve access for citizens to end of life care. Governor Engler signed Executive Order 2000-2 to amend Executive Order 1999-4, signed in June 1999 to create the commission. The commission's final report was released on August 30, 2001.

 

Commission Membership:

  • Dorothy Deremo, MSN, of Farmington Hills, is president and CEO of Hospice of Michigan in Southfield.
  • Kay Felt, J.D., of Grosse Pointe Shores, is a member of the law firm of Dykema Gossett, PLLC, and has had local and national leadership positions in health care law for over 30 years.
  • Thomas George, M.D., of Kalamazoo, is an anesthesiologist for Kalamazoo Anesthesiology and medical director of Hospice of Greater Kalamazoo. During the course of the commission's work, he was elected to the Michigan House of Representatives.
  • Mary Anne Gorman, MSW of Muskegon, is executive director of Hospice of Muskegon-Oceana.
  • Kim Kuebler, M.N., of Clare, is the owner of and an adult nurse practitioner for Adjuvant Therapies, Inc.
  • Guadalupe Lara, M.S.W., of Allen Park, is manager of Supporting Children & Families at the Children's Hospital of Michigan and the co-founder of the Michigan Hispanic Mental Health Association.
  • Jeanne Lewandowski, M.D., of Grosse Pointe Park is medical director of pediatrics at Bon Secours Cottage Health Services. She provides pediatric palliative care services in hospitals and hospices in southeast Michigan, and serves on the board as ethics chair for the American Academy of Hospice and Palliative Medicine.
  • Sister Mary Giovanni Monge, M.A., of Livonia, is the founder of Angela Hospice Home Care in Livonia and the president and CEO of Angela Health Care.
  • Karen Ogle, M.D., Director of the Palliative Care Education and Research Program in the Cancer Center at Michigan State University, and professor of Family Practice at Michigan State University's College of Human Medicine.
  • Reverend Clayton Thomason, J.D., of Okemos, is assistant professor of spirituality and ethics in medicine in the College of Human Medicine at Michigan State University and is Chairperson of the Commission.
  • James K. Haveman, Jr., M.S.W. of Grand Rapids, is the director of the Department of Community Health.
  • Kathy Wilbur, of Lansing, is the director of the Department of Consumer and Industry Services.

 

Guiding Principles:

The Commission utilized the following guiding principles:

It is the goal of the Michigan Commission on End of Life Care that in all aspects of its work the commission will gain information about, affirm and be responsive to core issues that:

Reflect the interests and needs of the state's diverse population, including:

  • The interests and needs of underserved citizens in both rural and urban areas of the state
  • Ethnic and cultural diversity, and the interests and needs of diverse groups
  • The expanding definition of "family" as it applies to end of life issues

 

Affirm that end of life care is an integral part of a holistic approach to health care delivery, including:

  • The complementary points of view, interests and needs of the respective health care disciplines, and the needs for interdisciplinary approaches to end-of-life care
  • The inter-relationship of acute care and palliative care, and the need for a continuum of care
  • The inter-relationship of chronic illness and end of life care, and the need for a continuum of care
  • The importance of standardization in training and competency requirements of health care providers in end of life care
  • The unique age-related needs of children and adults along the age continuum as it applies to palliative and end of life care
  • The recognition of the "family" as recipients of end of life services that are as important as the "patient"
  • The importance of after care and bereavement services for the loved ones - family and friends of the deceased

 

Commission Charge(s):

The commission has a multifaceted charge:

  1. The commission shall, by whatever means the commission deems appropriate, identify, compile and consider recommendations for improving end of life care from the public and private organizations throughout Michigan.
  2. The commission shall recommend model state and institutional policies with respect to end of life care, including an examination and compilation of the best ideas of multiple groups currently engaged in examining end of life issues and shall consider these in the development of the commission's final report.
  3. The commission shall coordinate their efforts with other groups actively engaged in addressing end of life issues, including but not limited to, the Circle of Life Committee in the Michigan Department of Community Health and the Advisory Committee on Pain and Symptom Management in the Michigan Department of Consumer and Industry Services.
  4. The commission shall identify and evaluate any existing barriers that result in inadequate end of life care in Michigan and, where appropriate, make recommendations for elimination or mitigation of such barriers.
  5. The commission shall evaluate the adequacy of education associated with end of life care being provided in Michigan schools of medicine, Michigan schools of nursing and in other health professional education programs and, where appropriate, make recommendations to improve such education.
  6. The commission shall evaluate the adequacy of the level and degree of graduate medical education being provided in Michigan residency programs associated with end of life care and, where appropriate, make recommendations for changes to improve such graduate medical education training.
  7. The commission shall survey availability and cost of public and private insurance coverage for hospice, pain management, and palliative care.
  8. The commission shall recommend, where appropriate, state policies concerning end of life care related to continuing medical education for health professionals licensed in Michigan.
  9. The commission shall inventory existing resources available to citizens for end of life planning and produce a guide of these resources for the general public.

Commission Work Products from the Executive Orders:

  1. By February 1, 2001, the commission shall issue a final report to the Governor and the Legislature containing its recommended model state and institutional policies and the rationale of the commission supporting their adoption.
  2. The results of the commission's survey on the availability and cost of public and private insurance coverage for hospice, pain management, and palliative care.
  3. An inventory of existing resources available to Michigan citizens for end of life planning published in the form of a resource guide for distribution to the general public.

 

Commission Public Hearing Process:

The commission held five public hearings (in the fall of 2000) around the state covering the major regions for ease of public input. Public input to the commission was extremely valuable and touched on specific areas of the commission's charge.

The commission received comments on many of the following issues that are core to its charge:

  • Any barriers that discourage or prevent access to adequate end of life care.
  • Adequacy of undergraduate and graduate education associated with end of life care for each respective profession or discipline.
  • Adequacy of continuing education associated with end of life care for each respective profession or discipline.
  • Information on public and private third-party reimbursement coverage limitations that encourage or prevent access to adequate end of life care.
  • Information about specific existing resources for citizens planning for and seeking adequate end of life care or resources for families; this information will be compiled for a guide to be made available to the general public. It is expected that this information will include names, addresses, phone numbers, program descriptions.

Schedule of Public Hearings

The Michigan Commission on End of Life Care held five public hearings in the fall of 2000 around the state to gather input on issues relating to end of life care in Michigan. Attached is a document that outlines the purpose, charge, and membership of the commission to enhance the public's understanding of the commission. Below are the dates and locations of the public hearings.

Grayling
Wednesday, September 6, 2000
9:00 am to 12:00 noon
Ralph A. MacMullan Conference Center
104 Conservation Drive
Roscommon, Michigan 48653
Location Information: 517-821-6200
Detroit
Thursday, September 7, 2000
9:00 am to 12:00 noon
Wayne County Medical Society
1010 Antietam Road
Detroit, Michigan 48207
Location Information: 517-567-1640
Mt. Pleasant
Tuesday, September 12, 2000
9:00 am to 12:00 noon
Central Michigan University
Bovee Conference Center - Lake Michigan Room
Mt. Pleasant, Michigan 48859
Location Information: 517-774-7477
Grand Rapids
Wednesday, September 13, 2000
8:30 am to 11:30 am
Calvin College
Commons Lecture Hall
3201 Burton SE
Grand Rapids, Michigan 49546
Location Information: 616-957-6000
Marquette
Thursday, September 14, 2000
9:00 am to 12:00 noon
Northern Michigan University
University Center - Pioneer Rooms A & B
Marquette, Michigan 49855
Location Information: 906-227-2623