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Council reviews infusion and compounding plans, long-term care education, MOLST digital rollout and a skilled-nursing virtual palliative pilot
Summary
Connecticut hospice and health systems described plans to build outpatient compounding capacity and expand palliative services; the council discussed training for residential and long-term care providers and a planned electronic MOLST form expected in 3–4 months. A procedural motion to approve December minutes passed.
Dr. Sacco said Connecticut Hospice is building a new compounding pharmacy at its Branford facility that will perform sterile compounding and is expected to be outward-facing; she estimated it will not be operational for at least six months. “We will be compounding and we will be outward facing,” Dr. Sacco said, and she said the compounding service will likely serve inpatient, home-care and community-based patients.
Council members discussed barriers to infusion services for palliative and hospice patients. Billy reported that he and Chair Karen planned outreach to Rod Marriott at the Department of Public Health to clarify regulatory questions about infusion services.
Karen and other members discussed education and training for long-term care and residential care providers. Council staff said Connecticut has about 88 residential care homes; members noted that staff turnover and limited palliative training are persistent obstacles and suggested using statewide provider events and the Long Term Care Ombudsman program to deliver training.
Joe, speaking for Connecticut Hospice, described an outpatient palliative care program launched in October 2013 with a current census of about 65 patients and said the program is expanding telehealth and clinic services to increase access. Jen Capo and others described models at Yale New Haven and other systems that focus palliative services within cancer centers and, in some cases, home-based care.
Council members described a pilot to deliver virtual palliative consults to skilled nursing facility (SNF) patients discharged from hospital with advanced cancer. Jen said the SNF pilot will begin in about a month and will use virtual visits facilitated by the SNF provider or bedside nurse and that initial referral criteria are limited to advanced solid tumors (stage 4) and specific stage 3 cancers (pancreatic or lung) where discharge intent is to pursue further therapies.
Barb reported that the council is revising the Medical Orders for Life-Sustaining Treatment (MOLST) form following recent legislative changes that removed a witness signature requirement. The council is pursuing a “digital-first” approach and aims to have an electronic MOLST ready for commissioner review and potential deployment in about three to four months; staff are also discussing registries used by other states such as Oregon, Massachusetts, Washington and California.
On council business, members moved and seconded a motion to approve the December meeting minutes. A motion to approve was made and seconded by Toni Anne; members present voted to approve the minutes. No roll-call vote or tally was read into the record.
No formal policy votes beyond the minutes were taken. Members agreed to continue outreach to the Department of Public Health, to collaborate with Yale Law School and other academic partners on training and white papers, and to track timelines for the compounding pharmacy and MOLST electronic changes.
