To the editor:

Twenty-seven million Americans may be unable to access hospice in rural and underserved communities thanks to a quirk in current law.

Specifically, patients of Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) are unable to keep their physician when they elect to begin hospice services. As a BSN RN/VP of Clinical Services in Van Wert, Ohio, I think this is unfair.

All other hospice patients are entitled to the attending physician of their choice, as the system recognizes the unique needs of those facing serious illness and the end of life. It's not right that patients of FQHCs and RHCs are excluded and at their most vulnerable time they are cut loose from their trusted physician. 

FQHCs are generally considered "safety net" providers who provide healthcare access to underserved communities. RHCs similarly provide care in rural and frontier areas and are frequently the only provider for miles. Both of these providers play critical roles in ensuring access to healthcare for all Americans, regardless of their demographics or geography. Therefore, it is imperative that these clinics, which reach some of our most vulnerable neighbors, be able to continue serving their patients when they elect hospice.

Thankfully, Sens. Jeanne Shaheen (D-New Hampshire) and Shelley Moore Capito (R-West Virginia) and Congressman Ron Kind (D-Wisconsin) and Congresswoman Jackie Walorski (R-Indiana) have worked together to introduce the Rural Access to Hospice Act (HR 2594, S.1190), which would fix this oversight. This non-controversial, bi-partisan legislation will help ensure that terminally ill beneficiaries in rural communities can access the hospice benefit and the physician of their choice

I hope our members of Congress will recognize the burden this problem causes to vulnerable patients and families and act quickly to enact the Rural Access to Hospice Act.

No American should be prevented from accessing quality end-of-life care due to their demographics or zip code.


Peggy Carnahan

Van Wert, Ohio