Minnesota Palliative Care

The Minnesota Palliative Care Partnership was originally organized in 1999 as the Minnesota Partnership to Improve End of Life Care. It was founded by Allina Health Systems, Blue Cross Blue Shield of Minnesota, Fairview Health Services, and HealthPartners, all of whom continue to be the partners today. The Minnesota Partnership to Improve End of Life Care was originally under the financial management of the Metro Area Agency on Aging.

In its early days, the Partnership received a significant national grant from the Robert Wood Johnson Foundation to establish the Minnesota Commission on End of Life Care. The Commission was a joint effort of the Partnership and the Minnesota State Department of Health. It was co-chaired by Barry Baines, M.D., then of HealthPartners, and Jan Malcolm, then State Commissioner of Health. It included a diverse group of people from service provider organizations, academia, rural health experts, bioethics, several professional organizations, the clergy, and several minority health groups.

The Minnesota Commission on End of Life examined information and statistics from multiple sources, conducted numerous interviews, particularly focused on minorities and immigrants, and held four community round table discussions outside the Twin Cities. It met for nearly two years, and issued its recommendations in a Final Report in early 2002.

The Commission’s Final Report, and its recommendations for improving the status and standards for end of life care in the state, have become the basis for subsequent action taken by numerous parties. For example, Hospice Minnesota has since offered extensive training for hospice staff and leadership in the cultural concerns surrounding death and dying in various minority communities. The Commission established Five Guiding Principles for compassionate end of life care. These principles have been widely disseminated to Minnesota health care providers and are posted and followed in numerous health care settings.

One of the Partnership’s priorities in 2003 and continuing is to explore the possibilities of restructuring health insurance to provide funding for palliative care at the end of life and earlier for those people who do not qualify for hospice or home care benefits. Palliative care is a broad term applying to care aimed at easing suffering of all types rather than at curing disease. It uses a bio/psycho/social/spiritual model of care and offers services in all those areas, not only to a patient, but also to his or her family or other caregivers. Hospice uses the same philosophy but is only available to people with a prognosis of six months or fewer to live. Home care is only available to adults who are completely, or nearly completely, homebound and to certain children who suffer from advanced diseases. It does not always include all the elements of palliative care. Many other people, not homebound, and their families, are suffering greatly in earlier stages of advanced, life-limiting illness. This latter group is who could benefit greatly from expanded palliative care.

In the fall of 2003, the Partnership published a white paper on palliative care and the case for including expanded palliative care in the menu of health benefits offered by employers. In January 2004, Allina Health Services, a Minnesota-based self-insured employer who is a member of the Partnership, began offering a palliative care benefit to their own employees and their dependents. On June 1, 2004, a second Twin Cities employer, a large hospital, began offering a very similar employee benefit. Two of the other Partnership partners are considering or planning to do the same.

In February 2004, the Partnership’s Board voted to change the name of the organization to the Minnesota Palliative Care Partnership. This change recognized the growing importance the Partnership places on state of the art palliative care, not just at the end of life, but throughout the course of a serious chronic illness.

The Partnership continues to work in several areas aimed at expanding access to excellent palliative care for any who may need it.

The Minnesota Commission on End of Life Care was created because significant gaps exist for people who are facing the end of life. The Commission identified and prioritized the issues that cause the most significant barriers to accessing the best care. After analyzing interviews conducted by staff, data about the number of Minnesotans who die and the particulars of their deaths, and the composition of the health care system, the Commission arrived at recommendations for improving end of life  care. The remainder of this document is a detailed listing of  these recommendations and strategies for their implementation.

Here’s some links to more in-depth information on the Commission finding and Minnesota statistics:

End-of-Life Care in Minnesota, Death Statistics and background