The Future of State Workforce Policy in Palliative Care

• Published in: Journal of pain and symptom management 2024-05, Vol.67 (5), p.e701-e702
• Main Authors: Sinclair, Stacie, Feder, Shelli, Rusyn, Eugene
• Format: Article
• Language: English
• ISSN: 0885-3924
• DOI: 10.1016/j.jpainsymman.2024.02.175

1. Participants will be able to describe the importance of state-level policies in growing the palliative care workforce. 2. Participants will be able to analyze different types of state-level health care workforce-related policies and determine which may be feasible for replication in their own states. There is an urgent need to bolster the palliative care workforce. After surveying over a decade of state-level initiatives in and beyond palliative care, we identify potentially impactful policies for future workforce development. These include loan forgiveness and facilitating workers practicing at the top of their licenses. While state policymakers are increasingly interested in palliative care, there has been limited exploration of state-level strategies to address clinician shortages. As states expand palliative care payment, they must also ensure that there are sufficient specialists and clinicians trained in core palliative care principles and practices to deliver this care. We sought to identify state policies that can grow the palliative care workforce by (1) surveying over a decade of existing state legislation using an innovative database (the Palliative Care Law and Policy GPS, “GPS”) and (2) reviewing state-level workforce policies in related fields. The GPS is an online public-facing, searchable database of palliative care policies grouped into topic categories. Using this, we reviewed palliative care policies from 2010 - 2022, categorizing them into two groups: building the palliative care workforce and clinical skill-building. Following this, we conducted a literature review using PubMed and Health Affairs to identify policy exemplars that addressed workforce concerns in primary care, oral health, and behavioral health and developed a system to categorize the policies by type. GPS review yielded 15 bills in 8 states directed towards building the specialty palliative care workforce and 50 bills in 11 states that included provisions to grow broader clinician skill building in palliative care. Reviews of state-level policies and programs in other health fields yielded additional policies in several categories. These included provider loan forgiveness and policies that support healthcare professionals in practicing at the top of their license. State action over the past decade to grow the palliative care workforce is limited. Adopting successful state-level initiatives from other fields can accelerate progress in bolstering the palliative care wo