CANCER LEGAL SERVICES PROGRAM NEWSLETTER FUNDED BY A GRANT FROM THE NYS DEPARTMENT OF HEALTH, DIVISION OF CHRONIC DISEASE PREVENTION

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1 NEIGHBORHOOD LEGAL SERVICES, INC. CANCER LEGAL SERVICES PROGRAM NEWSLETTER FUNDED BY A GRANT FROM THE NYS DEPARTMENT OF HEALTH, DIVISION OF CHRONIC DISEASE PREVENTION How Neighborhood Legal Services, Inc. can help: Public Benefits: Public Assistance Food Stamps Medicaid Family Law: Divorce Child support Domestic violence Disability Law: Benefits counseling Special education SSI/SSDI denials & terminations Housing: Evictions Section 8 issues Other public & subsidized housing issue Miscellaneous: Preparation of advanced directives Permanency planning WELCOME! The purpose of this newsletter is to provide information to the public on various legal topics affecting individuals with cancer and their families. It is not intended to be legal advice. Copies of this newsletter may be reprinted and distributed without the written permission of Neighborhood Legal Services, Inc.. Suggestions for future legal topics can be submitted to either Eileen J. Katz, Esq. (ekatz@nls.org) or Dawn M. Myszka, Esq. (dmyszka@nls.org). This volume s topic: The Palliative Care Information Act What is the Palliative Care Information Act (PCIA)? The PCIA became effective in NYS on February 9, Under the PCIA, physicians and nurse practitioners are required to offer terminally-ill patients information and counseling concerning palliative care and end-of-life options such as: A) prognosis; B) range of options appropriate to the patient; April, 2014 Volume 44, Page 1 C) risks and benefits of various options; D) patient s legal rights to comprehensive pain and symptom management at the end of life. The law places the responsibility to start the conversation on the doctor or other health care provider with the patient. The law is intended to ensure that patients are fully informed of the options available to them when they are faced with a terminal illness or condition, so that they are empowered to make choices consistent with their goals for care, wishes and beliefs, and optimize their quality of life. It is not intended to limit the options available to terminally-ill patients. The information or counseling can be orally or in writing. Neighborhood Legal Services, Inc. * 237 Main Street, Suite 400, Buffalo, NY * phone (716) fax (716) * TDD (716) * website:

2 VOLUME 44, PAGE 2 Which patients would be subject to the PCIA? The PCIA focuses on patients with a medical condition that is expected to cause death within six months. What is palliative care? Palliative care, as defined under the PCIA, is health treatment, including interdisciplinary endof-life care, and consultation with patients and family members, to prevent or relieve pain and suffering and to enhance the patient s quality of life, including hospice care. Is palliative care the same as hospice? Hospice care is a type of palliative care for people who are likely to have six months or less to live. When medical treatments cannot offer a cure, hospice provides care, comfort and support for persons with life-threatening illnesses and their families. Palliative care is appropriate at any stage of a serious illness, whether that illness is potentially curable, chronic or life-threatening. Palliative care is appropriate for a much broader group of patients than hospice. Both hospice and palliative care offer a personalized plan of care, delivered by an interdisciplinary team that incorporates what is important to the patient and his or her caregivers in order to achieve the best possible quality of life for patients and their families. What if the patient lacks decision-making capacity? If the patient lacks decision-making capacity, the information and counseling must be provided to the person who has authority to make health care decisions for the patient. What types of medical providers are subject to this law? Physicians and nurse practitioners who are serving as a terminally-ill patient s attending health care practitioner are subject to the requirements of this law. Physician assistants and other health care professionals may also, consistent with their scope of practice, provide information and counseling about palliative care and end-of-life options, but are not required to do so under the law. Are there circumstances in which information and counseling about palliative care and endof-life options need not be provided? The information and counseling must be offered, but it need not be provided if the patient or his/ her authorized decision-maker, declines the offer. What if my doctor is not willing to provide this information and counseling to me? Your doctor must then arrange for another physician or practitioner to do so or refer or transfer you to another physician or nurse practitioner. If a patient receives care from several health care providers, are all of them required to offer palliative care and end-of-life information and counseling? All physicians and nurse practitioners who have primary responsibility for care and treatment of a patient are subject to the law s requirement to offer palliative care and end-of-life information and counseling. However, when there is more than one health care provider primarily responsible for a patient, the law allows them to agree to assign that responsibility to one of them. The assignment should then be reflected in the patient s medical record.

3 VOLUME 44, PAGE 3 When should the offer of palliative care information and counseling be made? It must be offered at the point in time that the physician or nurse practitioner reasonably expects the patient s condition to cause death within six months, whether or not treatment is given. Given the uncertainty inherent in an individual s prognosis, it is often appropriate to discuss palliative care options with seriously ill patients earlier in the disease progression, when the patient s life expectancy is expected to exceed six months. In certain cultures, discussions about end-of-life are considered taboo. Is there a cultural exemption from this requirement? No. The law does not provide an exemption from its requirement based on cultural considerations. ###########

4 VOLUME 44, PAGE 4 COMMUNITY RESOURCES The Visiting Nursing Association of WNY, Inc. located at 2100 Wehrle Drive, Williamsville, NY For more information call : (716) Website: The Cancer Wellness Center, located at Gateway Center, 84 Sweeney Street, Suite C9, North Tonawanda, NY, provides support, education and empowerment to cancer patients and their loved ones through services and programs such as the Cancer Coach Program, all free of charge. For more information call: (716) Website: The Cancer Services Program of Niagara County, located at HSBC Center, inside the Heart Center, Niagara Falls Memorial Medical Center, 571 Tenth Street, Niagara Falls, New York, provides breast, cervical and colorectal cancer screenings to eligible men ages and women ages at no cost. For more information call : (716) Website: National Cancer Legal Services Network is a coalition of attorneys, legal service programs, cancer support organizations and health care providers that provide services to individuals with cancer. Website: Breast Cancer Support Group 2U ABC-Changing lives 1 meeting at a time. Group meets 2 nd Monday at HSBC Center, inside the Heart Center, adjacent to Niagara Falls Memorial Medical Center, 571 Tenth Street, Niagara Falls, New York. Doors open at 5:30 p.m. This peer ran support group was established to help support the needs of women who are learning to live with or survived breast cancer. This group will provide a warm, empathetic atmosphere where women can share their experiences and victories in an environment with women that share a common bond. Cancer Services Program of Erie County, located at 95 Franklin Street, Room 950, Buffalo, NY 14202, provides free breast and cervical cancer screening and education to uninsured women. The Partnership also provides free colon cancer screening to all men and women over 50. For more information call: (716) Website: Hospice Buffalo (Bereavement Services), located at 150 Bennett Road, Cheektowaga, NY 14227, provides individual, children and family counseling and monthly support groups. These services are free of charge to those whose loved one received Hospice Care. For more information call: (716) Life Transitions Center, City Campus, located at 1140 Delaware Avenue (corner of West Ferry), Buffalo, New York 14209, provides emotional and social support for individuals and families coping with a serious illness, caregiver responsibilities, and/or bereavement. Our services include support groups, wellness programs, social networking activities and educational presentations. For more information call: (716) American Cancer Society For more information call toll free (800) This number is available 24 hrs/day, 7 days/week. Website:

5 VOLUME 44, PAGE 5 Organization NEIGHBORHOOD LEGAL SERVICES, INC. 237 Main Street, Suite 400 Buffalo, New York Phone: (716) Fax: (716) TDD: (716) Website: Neighborhood Legal Services, Inc. is a private, non-profit civil legal services agency, funded primarily by the Legal Services Corporation and the Interest on Lawyer Account Fund of the State of New York (IOLA). Financial support is also provided by the New York State Commission on Quality of Care, the United Way of Buffalo and Erie County, the City of Buffalo, and the State of New York. Neighborhood Legal Services, Inc. is governed by a Board of Directors made up of representatives from area Bar Associations and other public service organizations. Eligibility Services are provided free to financially eligible persons who reside in Erie, Niagara, Wyoming, Orleans and Genesee counties. In some matters, clients are required to pay court costs. Federal poverty guidelines are used to determine financial eligibility based on the number of persons in the household. For more information, please contact our Cancer Services hotline at (716) and ask for extension 420. Language interpretation available for non-english speaking clients. CASE EXAMPLE: Angelica, a breast cancer survivor, was physically abused by her husband. Finally, he moved out of the marital home, leaving her with no money and cancelling her health insurance. Neighborhood Legal Services, Inc. represented Angelica in obtaining a temporary order of protection from Family Court, as well as a temporary order directing her husband to pay her $1000 per month spousal support and reinstate her health insurance.