News Briefs – June 2025
by INELDA
Communication Key to Building EOL Trust Providers
In an effort to help open access to equitable, inclusive end-of-life care to underserved populations, the National Alliance for Care at Home has published a research report identifying pathways for achieving deathcare equity. Chief findings include that stronger relationships and trust between care providers and underserved populations, built via multiple communication channels, can better support vulnerable communities.
The study of 2,000 people includes insights on supporting LGBTQIA2S+ communities and rural patients, as well as Asian American, Black, and Hispanic populations. The alliance developed a framework of principles—communication, outcomes, network, nurture, engagement, collaboration, and transparency, or CONNECT— to help care providers bolster support.
The framework was built by identifying barriers to care experienced by specific populations. For instance, LGBTQIA2S+ participants indicated that mistrust was a leading barrier, with nearly one third indicating that they did not fully trust that hospice providers would respect their sexual orientation or gender identity. Having a more diverse care team could help address this lack of trust.
“It’s important for hospice providers to recognize that addressing disparities in care requires a multifaceted approach that goes beyond traditional outreach methods,” India Harris-Jones, manager of health equity and diversity at the alliance, told Hospice News. “Engaging with community and faith-based organizations, providing culturally sensitive education, and fostering active participation from patients and caregivers are important steps toward developing inclusive and comprehensive hospice care services that effectively meet the unique needs of all patients and their families.”
Kansas Lawsuit Challenges Pregnancy Exemption to Advance Care Directive Laws
Five women, including two physicians, have filed a Kansas lawsuit challenging a clause in the state’s advance directive laws. Kansas’ Natural Death Act gives people who are incapacitated or terminally ill the right to accept or refuse health care in advance of incapacitation—and it states that pregnant people are exempt from giving this consent.
One of the plaintiffs is currently pregnant. Her advance directive outlines her wishes to receive life-sustaining treatment only if there were “reasonable medical certainty” that her child would be born at full term and with a “meaningful prospect of sustained life,” The Hill reports.
She and other two women claim that excluding pregnant people from the Natural Death Act violates their liberty, personal autonomy, and right to privacy. The physician plaintiffs claim that excluding pregnant people from the Natural Death Act mandates that they give a lower standard of care to pregnant people. The defendants (the state’s attorney general, the president of the Kansas State Board of Healing Arts, and the district attorney of Douglas County) did not reply to press requests for comment.
All states have advance directive laws. Kansas is one of nine states whose advance directive laws exclude pregnant people, according to Compassion and Choices. The others are Alabama, Indiana, Michigan, Missouri, South Carolina, Texas, Utah, and Wisconsin.
Community Health Workers: Critical and Underpaid
With community health workers a known way to support palliative care teams, reduce hospital visits for patients with advanced cancer, and boost deathcare equity, communities could benefit from incorporating more of them into health programs. A recent report from the California Budget and Policy Center on the state of community health workers in the California health care system aims to do exactly that.
Community health workers are representatives of the health care system who work directly with community members to promote care. Their responsibilities are far-ranging: walking people through applying for government-supported health care, leading health education workshops, supporting navigation of behavioral health systems, and other methods of bridging community and care systems. In communities of color, which see a heightened distrust of the medical system, their services are particularly critical in helping connect people with services.
Still, community health workers are often not fully recognized and fail to meet fair compensation guidelines. In 2022, California allowed some services provided by community health workers to be reimbursed through the state’s Medi-Cal program, which serves low-income people. Despite this advance, the service remains underutilized—leading some community-based organizations to reevaluate the cost-effectiveness of their work.
Sometimes coupled with end-of-life doulas in regards to the assistive and direct care they provide, community health workers may consider their work a labor of love. Still, as the report points out, that doesn’t fuel program funding.
“People don’t do this work for the money—they do it because helping their community is who they are,” Diana Chung of the Asian Youth Center told the policy group. “But a better wage would mean not having to have a second job to make ends meet. Higher reimbursement rates would mean we could support a bigger team to deliver high-quality care to more patients.”
