Doctors ask for statewide approach to patient care

Kalispell doctors are keeping their eyes on a state legislative bill that would set goals for how health facilities provide care to patients with a chronic illness beyond filling their immediate medical needs.

House Bill 285 states that people facing complex, chronic health issues that affect their quality of life should be able to use palliative care, or supportive care, throughout their treatment.

Dr. Leah Carlburg, the medical director for the Geriatrics and Supportive Care Program at Kalispell Regional Medical Center, said palliative care is “about the human side of illness.”

“You have a specialist for your surgery, your chemotherapy, but palliative care is intended to be the specialty that’s about your everyday life,” Carlburg said. “Your pain, your nausea, your stress, your decision-making, how to talk about it with everyone in your life.”

But, she said health facilities around the state currently don’t have a way of communicating how — or if — they administer palliative care.

If passed, House Bill 285 would require Montana’s Department of Public Health and Human Services to establish a palliative care access initiative. The department would appoint and operate an advisory council created to survey palliative care services in Montana and improve people’s access to that type of treatment.

The bill would also develop an education program for patients and health providers to understand what palliative care is and how to tap into resources across the state.

“We can’t know what gaps are out there, or what needs have to be filled, without that statewide collaboration,” Carlburg said. “This is a new way people are thinking about making choices in medical care.”

BILL sponsor Rep. Wendy McKamey, R-Great Falls, said 13 states have passed laws creating palliative care advisory councils.

She said the treatment helps patients find relief from pain and stress — whether they have been given two weeks to live or expect a full recovery.

During the bill’s public hearing before the Montana House Human Services Committee on Feb. 1, McKamey told legislators about her son, who was diagnosed with cancer at 13. He was given between three weeks and three years to live. It was the 1990s in rural Cascade County.

McKamey said they found out-of-state treatment and were connected with a palliative care program. They talked with doctors about the type of treatment suited for her son and found ways for him to experience life as a teenager throughout his treatment.

McKamey said the week before he died at 16, he drove a car, won a gold medal at a crops contest and played music with an old friend — him on the piano and his friend on the saxophone.

“He lived all the days of his life,” McKamey said. “I credit that to good medical care, and palliative care was part of that.”

For nearly an hour, health officials and former patients spoke in favor of House Bill 285 during the public hearing. No one testified against the bill.

ACCORDING to the governor’s office, the bill would cost $25,000 in its first year. That estimation was shaped around the council’s expected travel costs.

From 2019 through 2021, the office estimated it would cost more than $11,000 annually.

McKamey said the bill’s language would be edited to eliminate the state’s costs by prohibiting the department from paying for travel expenses. She also said the council would use online materials to avoid racking up printing costs.

Dr. Kerry Eby, a physician with the Geriatrics and Supportive Care Program, said the bill has the potential to help save the state money.

“That’s not the first goal, but when you’re working with a patient to hear how they define their quality of care, to tailor a patient’s treatment and pain management to their preferences, it tends to prevent hospitalizations which saves money,” Eby said.

Carlburg said hospitals need to work with private insurers, Medicaid specialists, social workers and pharmacies for the holistic approach of palliative care. She said that process will become easier if the legislators pass the bill to set a standard for meeting patients’ needs across the state.

“The bottom line with the bill is how do we all cooperate with each other, and how do we make care for people in Montana the absolute best it can be,” she said.

As of Feb. 6, the Human Services Committee had not set a time for executive action on the bill.

Reporter Katheryn Houghton may be reached at 758-4436 or by email at khoughton@dailyinterlake.com.