Using the Palliative Care Law and Policy GPS Tracker to Evaluate and Shape State Policy (GP749)

Outcomes. 1. Explain the main trends in current state policymaking regarding palliative care 2. Identify the main opportunities for future reform in state policymaking regarding palliative care Importance. In the United States, state policies to advance palliative care (PC) access and quality have increased. The Palliative Care GPS Tracker, a collaboration between Yale Law School and the Center to Advance Palliative Care, was created to track and evaluate state legislative policy trends, inform PC policy research, encourage policy innovation to ameliorate disparities in access, and help reform PC quality and education. Objective(s). We examined states' PC legislation and analyzed trends to inform PC policymaking. Method(s). We compiled counts of legislation in each state and the District of Columbia from 2019 to 2021, grouping pieces of legislation by year into seven categories: workforce, payment, quality and standards, clinical skill building, public awareness, telemedicine, and pediatric palliative care. We calculated descriptive statistics and performed bivariate regression to identify potential associations. Results. 2019 was the most active year for PC legislation, with 170 pieces of legislation considered by legislatures across states. From 2019 to 2021, the most legislation nationally pertained to quality and standards (34%), followed by payment policies (21%). Pediatric PC policy was least common (3%). Telemedicine PC policies increased significantly, from 4% of all legislation in 2019 to 19% in 2021 (p < 0.001). States with the most pieces of PC legislation introduced were Hawaii (n = 13) in 2019, New Jersey (n = 12) in 2020, and Georgia (n = 5) in 2021. No PC legislation developments were introduced in 4 states in 2019, 14 states in 2020, and in 24 states in 2021. Conclusion(s). Data provide an overview of which states are adopting PC policies over time and how. Telemedicine policies have seen the most growth, probably in response to the COVID-19 pandemic. Continued development of the Tracker to include all years of PC legislation will enable more in-depth monitoring of PC policies. Impact. Better understanding trends in policymaking can improve effective advocacy and expand access to PC throughout the country.