Palliative Care Services Benefit

  • Hawaiʻi is the first state to comprehensively cover palliative care services for its Medicaid beneficiaries, by adding community palliative care as a preventive service in its Medicaid state plan.
  • This novel SPA (State Plan Amendment) is the result of multi-stakeholder collaboration over many years. It serves as a road map for other states exploring new ways to pay for interdisciplinary, community-based palliative care.

In 2022, a statewide assessment of the state of Hawai’i’s capacity, capability, and competency to provide high-quality palliative care to members of our communities with serious illness was conducted. More

2024 Timeline: CMS Approves Hawai’i MedQuest Palliative Care Program

May 7, 2024:
The Centers for Medicare and Medicaid Services (CMS) approved a new State Plan Amendment (SPA) in Hawaiʻi to cover community-based palliative care. Hawaiʻi is the first state in the nation to do so!

It defines palliative care and the required services and details the composition of the palliative care team – including scope and minimum qualifications, as well as relevance to adult and/or pediatric palliative care.

The approved policy document (PDF 10 pages) adds community-based palliative care as a preventive service, a first!

“What we are trying to do is forge the pathway with CMS to have home-based palliative care defined as a regular Medicaid benefit just like we would for any other Medicaid service” 

In talking with CMS, they agreed, and we all agreed, that preventive services can be defined quite broadly including preventing worst outcomes, and palliative care is definitely designed to help individuals and their families lead a better quality of life and approach their care so they have more coordination and collaboration so that they can help manage the serious illness now facing them and their families.” Judy Mohr Peterson, Med-QUEST Administrator, Hawaiʻi Department of Human Services.

Congratulations, to everyone involved who has put in so many years of work especially to the leadership of Judy Mohr Peterson, Joy Soares and Torrie Fields

This exciting new opportunity is very fast developing and shaping up. We will share more information on this webpage once it becomes available.

And now to the future!! We hope you will be involved in this groundbreaking work.

Explanatory Webinars with Kōkua Mau

In collaboration with MedQuest, Kōkua Mau will be conducting a series of webinars to explain the benefit to providers as well as a webinar for the public. 

Please let us know what questions you have on the benefit. This will help us to structure and plan the webinars to meet our community’s needs. Send your questions to Hope and Jeannette.

Palliative Care Awareness Committee

For the last 3 years, Kōkua Mau’s Palliative Care Awareness Committee has been working to better understand palliative care in Hawaiʻi and how to educate both providers and the public. 

It was a good decision to start the group in January 2021, despite everything going on at the time. We since developed materials and messaging for both providers and the public as we see there continues to be a lot of confusion about what palliative care is and the opportunity it presents. 

Materials for providers include the Referral Toolkit (see below).  For the public we have updated our webpages, including videos, FAQs and other interactive activities. Visit:  Palliative Care for Patients and Families

Especially as we move forward with the new groundbreaking benefit, it will be important that we use messaging that works to reach both providers and the MedQuest population.

We will be sharing the lessons learned, principles to adopt and messages to try (and things to avoid!!) in a webinar in the near future. And let us know if you would like to learn more and be involved with our efforts. 

Resources: To promote palliative care referrals for providers

Goal: To increase patient referrals to palliative care. The Palliative Care Awareness Committee has compiled resources to facilitate patient referrals to Palliative Care

Webinars and other resources focusing on the Palliative Care Service Benefit:

(8/5/24) Adding community palliative care as a preventive service in its Medicaid state plan, Hawaiʻi is the first state to be able to comprehensively cover these palliative care services for its Medicaid beneficiaries. Watch the webinar recording (link coming soon) to learn from those who lead this important work in Hawaiʻi and the plans for implementation.

Speakers:

  • Scott Bane, JD, MPA, Senior Program Officer, The John A. Hartford Foundation
  • Torrie Fields, Founder and CEO, TFA Analytics
  • Wendy Fox-Grage (Moderator), Senior Director, NASHP
  • Judy Mohr Peterson, PhD, Med-QUEST Administrator, Hawaii Department of Human Services
  • Joy Soares, Policy Analyst, Med-QUEST Division, Hawaii Department of Human Services

(8/24/24) Watch a recent national webinar with Judy Mohr Peterson, Med-QUEST Administrator, Hawaiʻi Department of Human Services in the series “State Palliative Care Policies and Emerging Innovations”.


(07/22/24) Hawaii Receives First Medicaid State Plan Amendment for Community Palliative Care Services, Blog