Palliative and Supportive Services
for Individuals Who Have Not Elected Hospice
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BQA 03-003 (PDF, 20 KB)
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Date: February 17, 2003 DSL-BQA-03-003
To: Hospices HSPC 1
From: Jan Eakins, Chief, Provider Regulation and Quality Improvement Section
cc: Susan Schroeder, Director, Bureau of Quality Assurance
The Bureau of Quality Assurance (BQA) recognizes a national trend for
hospice agencies to offer palliative and supportive service programs to
individuals who are not terminally ill or who choose not to be admitted to
a hospice because they are pursuing treatment to cure a medical condition.
BQA has received requests from hospice agencies in Wisconsin to be allowed
to provide palliative and supportive services to these individuals.
Under sections 50.90 to 50.981, Wis. Statutes and chapter HFS 131,
Wisconsin Administrative Code, a hospice agency must be
"primarily" engaged in providing palliative and supportive care
to individuals with terminal illness, which is a life expectancy of less
than 12 months. Palliative care does not include treatment to cure a
medical condition or artificially prolong life.
Wisconsin law does not preclude a hospice agency from using its
expertise and multidisciplinary approach to provide palliative and
supportive services to other individuals who are not traditional hospice
patients. However, the primary activity of the hospice must be the
provision of palliative and supportive care to terminally ill individuals.
CMS’s recent transmittal, A-02-102, at http://cms.hhs.gov/manuals/
pm_trans/A02102.pdf [link no longer operable],
addresses this issue in regard to federal hospice requirements and also
reaches the conclusion that "primarily" does not mean
The Department of Health and Family Services is mindful of the health,
safety and welfare needs of individuals who are not terminally ill or
choose not to be admitted to a hospice, but want to obtain palliative and
supportive services. Accordingly, the Department will develop additional
rules in chapter
DHS 131 (exit DHFS) to clarify the role of a hospice agency in providing
palliative and supportive services to those individuals. BQA will actively
seek provider input in this process.
Questions related to this memo can be directed to the following
Jeanne Siroky, Nurse Consultant, Provider Regulation &
Quality Improvement Section (replaced by Marianne Missfeldt,
Jan Heimbruch, Supervisor, Health Services Section, Northern
Unit at firstname.lastname@example.org
or (608) 243-2086.
Cremear Mims, Supervisor, Health Services Section, Southern Unit
or (414) 227-4556.
Jane Walters, Health Services Section Chief at email@example.com
or (608) 243-2028 (replaced by Cremear Mims).
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