Health Plan of SJ launches pilot palliative care program aimed at easing pain, suffering

August 27, 2018

FRENCH CAMP — Health Plan of San Joaquin has initiated a pilot program called Palliative Care Options for members diagnosed with one of four critical diseases. Key elements include home visits from nurses and 24-hour access via telephone to a care provider.

It follows an earlier initiative started last year when Health Plan partnered with San Joaquin General Hospital to open the Palliative Care Clinic. Both programs fill a large gap in the care provided for seriously ill low-income patients on Medi-Cal and are funded by grants from the California Health Care Foundation.

Health Plan began its palliative care program for its 350,000 members in San Joaquin and Stanislaus counties early in anticipation of the new Medi-Cal benefit scheduled to start statewide in 2018.

What is palliative care?

Palliative care is introduced before end-of-life care, or hospice, and is used to anticipate, prevent and treat pain and suffering. It also addresses physical, intellectual, emotional, social and spiritual needs. Palliative care can be provided at the same time as curative care — practices with the intent of curing an ailment.

Who is eligible?

Health Plan of San Joaquin Medi-Cal beneficiaries who have been diagnosed with one of the following four conditions are eligible for the Palliative Care Options program. There is no cost to participate. The disease conditions include:

  • End-stage liver disease.
  • Advanced cancer.
  • End-stage congestive heart failure.
  • End-stage chronic pulmonary disease.

What the patient receives

Health Plan’s medical management team serves as a support to its partner organizations in providing the following care options for patients:

  • Home visits from certified nurses.
  • Hospital outpatient clinic visits.
  • 24/7 telephone care program with a certified social worker.

In addition to two dedicated palliative care physician specialists and experienced nurses, the patient care team consists of social services, pharmacy services, social services and behavioral health services (as needed).

How it helps

“There are folks with chronic illnesses. We provide care for them in different ways, but there comes a point where they are heading toward the end stage of the illness, and it could be because of a heart condition like heart failure. It could be chronic lung disease such as COPD — chronic obstructive pulmonary disease. It could be liver disease. And what most people know about most is cancer,” Dr. Lakshmi Dhanvanthari, Health Plan’s chief medical officer, explained.

“Basically, it is to provide — along with aggressive interventions they are receiving — comfort care and symptom management with a specialized team of folks, folks that really know how to provide compassionate care along with chaplain services, social services and behavioral health services, because they may be having extreme depression, difficulty coping with the situation, and all of that.”

Dhanvanthari said this should help make the transition to hospice from palliative care easier for a patient.

Who provides palliative care to Health Plan members?

Health Plan’s Palliative Care Options partners include:

  • Palliative Care Clinic at San Joaquin General Hospital, French Camp.
  • Transitions Palliative Care service provided by Hospice of San Joaquin for San Joaquin County members.
  • Community Care Choices service provided by Community Hospice for Stanislaus County members.