Summit Schedule

  • Day One
    Monday, April 8, 2019
    7:30 a.m. - 8:30 a.m.
    Registration & Breakfast
    8:00 am - 5:00 pm
    Tabletop Exhibits
    Stop by our tabletop exhibits throughout the day to gather information and learn more about a variety of products and services which support palliative care, advance care planning and end-of-life care.
    Judy Thomas, JD
    8:30 - 8:50 a.m.
    Welcome and opening inspiration. Presenter: Judy Thomas, JD.
    Katy Butler
    8:50 a.m. - 10:05 a.m.
    KEYNOTE | The Art of Dying Well: Empowering Patients to Shape Their Destiny
    Your patients want more than pain control and a clean bed. They want to live and die as full human beings, not a bundle of diagnoses. Our keynoter Katy Butler is an expert at translating the concerns of lay people into the language of medicine. She will give you a groundbreaking set of conceptual tools and new language to help your patients imagine what lies ahead, plan and prepare, express what matters to them, and remain the authors of their own futures. Presented by Katy Butler.
    Judy Thomas, JD
    10:05 a.m. - 11:05 a.m.
    GENERAL SESSION | The History of the Palliative Care Movement and Our Next Steps
    A brief look at how far we've come in the palliative care movement and where our next steps may lead us. Presented by Judy Thomas, JD.
    11:20 a.m. - Noon
    GENERAL SESSION | A Personal Reflection of the Benefits of Palliative Care
    Julie thought her life was over until she was introduced to home-based palliative care. Join us as Julie and her palliative care physician Dr. Jeffrey Yee reflect on Julie’s experience and how the introduction of palliative care support has improved her quality of life as she continues to live with advanced illness. Presenters: Julie Grimes and Dr. Jeff Yee.
    12:00 p.m. - 1:00 p.m.
    Networking Lunch
    1:00 p.m. - 2:15 p.m.
    PEDIATRICS BREAKOUT | Changing the Culture of Pediatric Palliative Care at the Bedside
    Johns Hopkins All Children’s Hospital provides palliative care as an inpatient, multidisciplinary consult service. As the consults increased, bedside palliative care was provided by hospital staff, many of which admitted a lack of comfort and confidence in providing these critical concepts when a patient is diagnosed with a life-limiting illness or at the end-of-life. A Palliative care champions program was designed to identify and train palliative care experts at the bedside. This Champions Program increased staff comfort & confidence in providing quality palliative care, allowing the palliative team to maximize resources to meet the needs of a growing patient population and can be adapted for use in a variety of settings. Presenter: Susan Shields
    Tab Cooney
    PEDIATRICS BREAKOUT | Building Bridges: Providing Optimal Pediatric Palliative Care Between Hospice and Home
    This session will use a case-based presentation to demonstrate how multiple care providers from both hospital and home-base agencies can come together to coordinate care for terminally ill children and their families. We will explore how care can be respectful supportive, honest and therapeutic even in the reality of non-disclosure - a challenge faced often in pediatrics. We’ll discuss how mutual pretense and family wishes play a significant role in the family narrative, how this might be navigated in an ethical and compassionate manner, all while keeping in mind the basic tenets of palliative care including family-centered care and meeting the family where they are as we identify challenges that led to changes in our own approaches and interventions. Presenters: Anita Sharma, Christy Torkildson, Hania Thomas-Adams, and Tab Cooney
    1:00 pm - 2:15 pm
    BREAKOUT | Let’s Talk: Advance Care Planning 101
    This interactive workshop is for people who want to engage the public in advance care planning. Learn how to get the conversation started, the nuts and bolts of advance directives and how to navigate discussion on the topic. The workshop will also review key aspects of California's new End of Life Option Act law and learn how it could impact providers and organizations. Attendees will have the opportunity to practice conversation skills for engaging your patients to explore and discuss their end-of-life concerns and preferences. Presenter: Lael Duncan, MD
    BREAKOUT | Incorporating Doulas in Caring for the Dying
    This session will introduce a comprehensive overview of an emerging role in end of life care that provides an option for addressing challenges faced by palliative care and hospice organizations in delivering meaningful and supportive care to the dying and their families by utilizing volunteers with special training. These challenges include: increasing costs, declining reimbursement, and limitation in staffing. We will be discussing anecdotal evidence of incorporating End of Life Doulas effectively in both palliative care and hospice settings along with examples of logistics and structure that have been effective in both inpatient and community-based models. Presenters: Kris Kington-Barker and Henry Fersko-Weiss
    J. Redwing Keyssar, RNMichael D. Fratkin, MD
    BREAKOUT | Start with a Poem: Using Poetry to Facilitate Connection, Self-Expression and Resiliency
    Poetry is way of connecting to the unspoken in our minds and hearts. In this workshop, we will examine our emotional and psychological responses to our relationships with patients, colleagues, and ourselves, through simple practices of "poem making." This practice can offer a means to express the metaphors and meaning of the suffering we experience in ourselves and bear witness to in others. By asking people what they wish to invite into their lives and their clinical practice, we create a space to hold what has been hidden or perhaps neglected in the busy pace of life in the field of palliative care. Presented by: Michael D. Fratkin and Michael W. Rabow.
    BREAKOUT | A Model Of Collaboration Between Hospice and Aid in Dying Programs
    This presentation will demonstrate an optimized partnership between hospice and aid in dying services and introduce a Kaiser Permanente Best Practice Toolkit for hospice departments working with co-enrolled EOLOA patients. The Toolkit is the result of ongoing collaboration between several high-volume KP hospice programs and regional KP ELOA programs. It includes best-practices that outline how to build a successful, neutral, and sustainable partnership between Hospice and the ELO Program. We aim to share learnings that support quality care experience for patients and families while supporting hospice staff regardless of their views on medical-aid-in-dying. Presenters: Ann Gordon and Stephanie Marquet
    2:20 p.m. - 3:05 p.m.
    INTERACTIVE SESSIONS | Engaging the Public
    Small group discussions and game demonstrations focused on sharing innovative opportunities for engaging the public. Sessions/Topics include: ReImagine led by Brad Wolfe; CSUSM's What Gives Your Life Meaning program, led by Sharon B. Hamill, Ph.D.; ACP in Senior Housing, led by Doris Hawks; Go Wish game demo, led by Gary Lee; Hello demo, lead by Jennifer Lui; Before I Die Boards, led by Liz Romero; Hear to Heart demo, led by Sandy Stokes; and Health Hats, led by Danny van Leeuwen.
    3:10 p.m. - 4:30 p.m.
    GENERAL SESSION | Cracking the Nut on POLST Registries (Panel)
    Two groups of panelists with experience in POLST registry operations and technologies will share their insights on current POLST registry trends and technologies, commonalities and unique features of some of the various registry implementations, and how providers can prepare themselves for future Registry connectivity.
    5:15 p.m. - 7:00 p.m.
    Reception & Poster Session
    Join us for cocktails, hors d’oeuvres, and a poster session featuring a showcase of the best community- based palliative care programs and projects from around the state.
    6:30 p.m. - 8:30 p.m.
    Pediatric Palliative Care Meet & Greet
    Anyone with an interest in pediatrics is invited to gather in the hotel bar area for this informal, no-host Pediatric Palliative Care Meet and Greet.
  • Day Two
    Tuesday, April 9, 2019
    7:00 a.m. - 8:15 a.m.
    BY INVITATION | Local Coalition Breakfast
    An invitation-only gathering of leaders from local POLST and ACP coalitions to share ideas and network.
    7:30 a.m. - 8:30 a.m.
    Registration & Breakfast
    Judy Thomas, JD
    8:30 a.m. - 8:40 a.m.
    GENERAL SESSION | Welcome & Morning Inspiration
    Welcome & Morning Inspiration
    Bob Horowitz
    8:40 a.m. - 9:40 a.m.
    GENERAL SESSION | Self Compassion: Taking Care of You
    Self-compassion is simply giving ourselves the same kindness that we would give to others, especially when you're stressed or upset. Being hard on yourself may seem necessary to succeed in life, but the research suggests just the opposite: self-compassion is a productive and healthier way to relate to ourselves than harsh self-criticism. Self-compassion has been linked to many benefits, including happiness, resilience, and satisfying relationships, while experiencing less anxiety and depression. In this presentation, we’ll explore self-compassion and learn about it first hand through writing and experiential exercises. Presenter: Robert Horowitz, MD
    Devon DabbsJudy Thomas, JDKathleen Kerr
    9:55 a.m. - 10:55 a.m.
    GENERAL SESSION | Delivering Community Based Palliative Care – Where Are We Now? (Panel)
    The hard part is over – or is it? It began as a proof of concept. We wrestled with developing clinical guidelines; we justified services via evidence of positive outcomes; we rallied to encourage change in the payment processes, and ultimately we influenced policy changes. The reward for those successes is that many more seriously ill Californians have access to community-based palliative care, even as a new wave of challenges related to scaling, standardizing and sustaining services have come to the fore. In this session we will review the current state of CBPC in California by reviewing three initiatives that are aimed at addressing some of those second wave challenges. We’ll take a look back to see how these initiatives came about, learn how they all are connected, and look forward to where we are heading. Moderator: Kate Meyers. Presenters: Devon Dabbs, Kathleen Kerr, and Judy Thomas
    11;00 a.m. - 11:45 a.m.
    Choose between a variety of small group discussions focused on current hot topics. Topics include Vulnerable Patients, led by Anne Kinderman; Telehealth, led by Michael Fratkin; Engaging the Mental Health Community, led by Susan Keller; PTSD, led by MarlaJan Wexler; Self Compassion, led by Robert Horowitz; and the End of Life Option Act, led by Jennifer Ballentine.
    11:45 a.m. - 12:50 p.m.
    Lunch & Leadership Awards
    Celebrate the accomplishments of California’s leaders in palliative and end-of-life care during the Compassionate Care Leadership Award luncheon.
    1:00 p.m. - 2:15 p.m.
    PEDIATRICS BREAKOUT | Ethical Dilemmas in Pediatric Palliative Care at End-of-Life in an Adolescent Patient
    A 13-year-old girl was admitted to our inpatient palliative care unit at end of life. She had a rare, pediatric tumor and was actively bleeding into her abdominal cavity. Her pain was difficult to manage due to sporadic, acute bleeds. Her father had died of cancer and her mother was being treated for stage IV breast cancer at the time this child entered our care. The parents were divorced and she had many questions about her own faith and her fear of dying. We will address how the team worked with the patient and the family to navigate some of these issues and how spiritual, social and physical needs of the whole group were negotiated in the end. Presenters: Joan Fisher, Kathy Hull, Patti Maloney, and Salina Patel.
    1:00 p.m. - 2:15 p.m.
    PEDIATRICS BREAKOUT | Pediatric Pearls: Working in Pediatric Hospice/Palliative Care with Confidence
    This workshop will address the challenges of adult cross coverage in the pediatric hospice/palliative care home based setting. Offering a multidisciplinary perspective we will explore providers fears when asked to care for children with life threatening and life limiting illness and their families. We will address the similarities and identify what makes pediatrics different and possibly intimidating. This includes a discussion of the unique developmental needs of children, adolescents, and young adults, suggestions for working with parents/guardians and including them in the development and implementation of care plans, and pecific recommendations for nursing and social work interventions in hopes of increasing confidence among providers. Presenters: Heather Jolly, Richard Sheehy, and Cheryl Welch.
    1:00 p.m. - 2:15 p.m.
    BREAKOUT | Caring for Personality Disorders in a Clinical Setting
    Patients with Personality Disorders are some of the most difficult as there is often chaos, making it difficult for the provider to not be pulled into a conflict. Frequently caregivers become exhausted and overwhelmed while attempting to provide care and sometimes we regret our behaviors. This presentation will review a few theories of PD and present concrete interventions to provide quality, neutral care to patients with PD. We’ll review the difficulties that PD patients have when facing terminal illness and specific case examples will inform participants in ways to provide care. Presenter: Tom Grothe
    Anne Kinderman, MDKathleen Kerr
    1:00 p.m. - 2:15 p.m.
    BREAKOUT | Overcoming Challenges to Implementing SB 1004 in California
    California's SB 1004, which mandates access to palliative care services for patients enrolled in managed Medi-Cal plans, was implemented statewide in January 2018. In this session, we will describe the objectives, structure, and content of the technical assistance series, and present data describing MCPs and PCOs experiences in planning and implementing SB 1004 services. We will highlight three common implementation challenges: identifying and engaging eligible patients, engaging referring providers, and optimizing MCP / PCO collaboration and share lessons learned and best practices, as identified by the MCPs and PCOs who participated in the technical assistance series. Presenters: Kathleen Kerr and Anne Kinderman.
    1:00 p.m. - 2:15 p.m.
    BREAKOUT | SUFFERING, Not Indignity, Can Answer the Living Will 'When' Question
    By 2050, an estimated one of twelve people over 65 will live with advanced dementia. We will address the previous attempts to overcome the challenges of ACP for advanced dementia; paradigm shifts that expand the concept of SUFFERING to answer the “When Question”; and living will requests that can translate into physician orders and POLST forms to answer the “What Question”. The importance of early dementia patients to fully engage family members in ACP planning, and technology options that that can integrate living wills into healthcare institutions’ electronic medical record systems will also be discussed. Presenters: Nate Hinerman, Catherine Madison, Karl Steinberg, and Stanley Terman.
    1:00 p.m. - 2:15 p.m.
    BREAKOUT | San Quentin Project - Prisoners as Compassionate End of Life Volunteers
    In 2016, California spent $13 billion dollars caring for prisoners. For the 18,400 prisoners age 55+, costs sky rocket yet is inadequate to care for dying prisoners. Most prisoners will die in their cell or in the hospital unit, isolated from the rest of the prison population. This session will inform participants about this invisible population, what local hospices can do to support these men and women, and how Mission Hospice & Home Care, the Brother’s Keepers and the Humane Hospice Prison Project partnered to bring a Compassionate End of Life training to a group of prisoners in San Quentin. Presenters: Susan Barber, Ladybird Morgan, and Marvin Mutch.
    Michael D. Fratkin, MD
    2:20 p.m. - 3:20 p.m.
    GENERAL SESSION | Opioids: Separating the Fact from the Fear (Panel)
    In this panel discussion, we will look at the history of opioids and how this history ties in to both the current opioid epidemic and the future of pain management for both physicians and their patients. The laws surrounding prescribing opioid will be discussed, followed by a case study and discussion of best practices. Moderator: Michael Fratkin, MD.
    Frank Ostaseki
    3:20 p.m. - 4:20 p.m.
    KEYNOTE | Don't Wait: A Pathway to Fulfillment and an Antidote to Regret
    Keynote Frank Ostaseki, internationally respected Buddhist teacher, visionary founder of the Metta Institute and co-founder of the Zen Hospice Project, shares his perspective on what death has to teach the living. Death is the secret teacher hiding in plain sight. She helps us to discover what matters most. And the good news is we don’t have to wait until the end of our lives to realize the wisdom that death has to offer. Embracing the truth that all things inevitably must end encourages us not to wait in order to begin living each moment in a manner that is deeply engaged. We learn to not hold our opinions, our desires, and even our own identities so tightly. We become kinder, more compassionate, and more forgiving. Don’t Wait is a pathway to fulfillment and an antidote to regret.
    4:20 p.m. - 4:30 p.m.
    CLOSING | Celebrating Our Journey
    Celebrating Our Journey