Health and Human Services (HHS) Policy Committee

A RESOLUTION ON IMPROVING OUTCOMES FOR MOTHERS AND CHILDREN DURING PREGNANCY

WHEREAS, National Black Caucus of State Legislators (NBCSL) supports the need to improve maternal health outcomes in the United States by advocating for public policy that will ensure all women have access to local, equitable, comprehensive and quality affordable health care;

WHEREAS, maternal mortality is defined by the Centers for Disease Control (CDC) as the death of a woman while pregnant or within 1 year of the end of a pregnancy regardless of the outcome, duration or site of the pregnancy from any cause related to or aggravated by the pregnancy or its management;

WHEREAS, severe maternal morbidity is defined as unexpected outcomes of labor and delivery that result in significant short or long-term consequences to a woman’s health;

WHEREAS, maternal mortality and morbidity have become a crisis in the United States, there was a 26 percent increase in maternal deaths between 2000 and 2014, and at least 50,000 women in the United States suffered from severe maternal morbidity in 2014;

WHEREAS, the United States is the only advanced economy, and one of only eight nations globally, to have experienced an increase in maternal deaths in recent years while maternal mortality rates in other developed countries are decreasing;

WHEREAS, women of all races and cultures in the U.S. are at risk for pregnancy-related complications, but maternal death rates are disproportionately higher for African American and other traditionally marginalized women, low-income women, and women living in rural areas;

WHEREAS, according to the CDC Black and American Indian/Alaska Native women are about three times more likely to die from a pregnancy-related cause than white women, implicit bias and systemic inequality are key contributing factors;

WHEREAS, reports have indicated that a lack of access to quality of care are leading factors, particularly among women in lower socioeconomic levels;

WHEREAS, maternal deaths are significantly underestimated and inadequately documented, preventing efforts to identity and reduce or eliminate the causes of death;

WHEREAS, African American women are 4 times more likely to die in childbirth than white women, and the racial discrepancies in maternal death rates persist even when controlling for socioeconomic status and education;

WHEREAS, low income and rural women can have challenges accessing comprehensive high-quality maternal care, a study by Georgetown University found that states that expanded Medicaid were able to see significant improvements in maternal health and a reduction in maternal and infant mortality; and

WHEREAS, 60 percent of pregnancy-related deaths in the U.S. could have been prevented with the tools that exist today, major pregnancy related ailments that negatively impact the health outcomes of women after giving birth include, but are not limited to, obstetric hemorrhage, preeclampsia, and post-partum depression (PPD).

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) urges federal, state and county legislators and officials to enact policies to enhance the quality of and access to equitable maternal health care;

BE IT FURTHER RESOLVED, that the NBSCL calls on state legislatures and Congress to improve maternal health by investing in connected data systems that allow states and the federal government to coordinate on the collection and reporting of aligned data and metrics;

BE IT FURTHER RESOLVED, that the NBSCL urges states to support the funding and full implementation of Maternal Mortality Review Committees, as they study data on the underlying causes of maternal death and identify strategies to help combat it, and share learnings and best practices across states;

BE IT FURTHER RESOLVED, that the NBSCL calls on states to evaluate and enhance medical education and training to ensure that all healthcare providers who care for women have the tools and support they need to provide quality care, including education on implicit bias, racial disparities, and culturally appropriate approaches to addressing maternal deaths and morbidity;

BE IT FURTHER RESOLVED, that the NBSCL calls on states to review and enhance standards and practices for hospitals and birthing centers by offering maternal care bundles, such as the Alliance for Innovation on Maternal Health (AIM)’s patient safety bundle, to reduce mortality and morbidity;

BE IT FURTHER RESOLVED, that the NBSCL calls on states to increase access to quality health care through the support of rural hospitals and treatment centers, and by ensuring that low-income women have access to quality pre-natal, perinatal care, and post-natal care;

BE IT FURTHER RESOLVED, that the NBSCL calls on states to extend Medicaid coverage to pregnant women for a year after giving birth to the child to protect their health as they are still vulnerable after the pregnancy;

BE IT FURTHER RESOLVED, that the NBSCL calls on those states that have not expanded Medicaid coverage under the Affordable Care Act to do so;

BE IT FURTHER RESOLVED, that the NBCSL calls on states and the Congress to strengthen workforce programs and policies, such as Paid Family Leave, that support women in caring for themselves and their children after giving birth;

BE IT FURTHER RESOLVED, that the NBCSL will work with our legislators to help create policies and action items that legislators can work on in their respective states to improve maternal and infant health, and focus on closing the gap in outcomes for African Americans and other minorities;

BE IT FURTHER RESOLVED, that the NBCSL strongly urges all states and federal legislators to recognize this crisis, develop new solutions, increase the available resources, and share best practices to improve maternal and infant health, to end the racial divide in patient outcomes in the United States;

BE IT FURTHER RESOLVED, that the NBSCL urges states to invest in and use innovative care models to address social determinants of health that impact the wellness of birthing persons; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the Unites States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials and agencies as appropriate.

• SPONSOR(S): Representative Laura Hall (AL), Representative Karen Camper (TN), and Senator Brenda Gilmore (TN)
  Committee of Jurisdiction: Health and Human Services Policy Committee
  Certified by Committee Co-Chair: Representative David J. Mack, III (SC)
  Ratified in Plenary Session: Ratification Date is December 6, 2019
  Ratification is certified by: Representative Gilda Cobb-Hunter (SC), President

A RESOLUTION ON COMBATING THE OPIOD CRISIS

WHEREAS, the National Black Caucus of State Legislators (NBCSL) recognizes the scourge of an opioid epidemic that takes the life of one American every 11 minutes;

WHEREAS, there are more than 192 Americans dying every day from drug overdoses, 130 of these daily deaths result from opioids;

WHEREAS, the President’s Commission on Combating Drug Addiction and the Opioid Crisis concluded that new research and development is needed for alternatives to opioids for pain management;

WHEREAS, the National Institutes of Health (NIH) has concluded that the end of the opioid crisis will not be successful until we can provide patients with better options for pain management, particularly non-addictive therapies;

WHEREAS, the CDC estimates that the economic burden of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement;

WHEREAS, the National Institute on Drug Abuse estimates that between 21% and 29% of patients prescribed opioids misuse them, and about 5% of that population transitions to heroine;

WHEREAS, the U.S. House Appropriations Committee noted that little research has been done to date on natural products that are used by many to treat pain in place of opioids, and that it is imperative to know more about potential risks or benefits, and whether or not they can have a role in finding new and effective non-opioid methods to treat pain; and

WHEREAS, U.S. House Appropriations Committee recommended an additional $3,000,000 for this research for new natural products to replace opioids and directs AHRQ to make center-based grants to address research which will lead to clinical trials in geographic regions which are among the hardest hit by the opioid crisis.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) supports full funding from Congress for the research and development of safe alternatives to currently available opioids, and NBCSL further supports increasing the overall authorization level for such research and development;

BE IT FURTHER RESOLVED, that the NBCSL calls upon the U.S. Congress to enact legislation that deals with addiction and develop a long term strategy toward not only handling the opioid crisis, but all addiction including preparing for future chemical addictions to prevent future crises, and such a new policy should provide additional resources to our states with added flexibility to fight the problems in our communities;

BE IT FURTHER RESOLVED, that the NBCSL calls upon the U.S. Congress to improve coordination at the Federal level by giving the Office of National Drug Control Policy a greater role in coordinating all federal partners to fight addition; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials as appropriate.

• SPONSOR(S): Representative Billy Mitchell (GA) and Representative Vernon Jones (GA)
  
• Committee of Jurisdiction: Health and Human Services Policy Committee
  
• Certified by Committee Co-Chair: Representative David J. Mack, III (SC)
  
• Ratified in Plenary Session: Ratification Date is December 6, 2019
  
• Ratification is certified by: Representative Gilda Cobb-Hunter (SC), President

A RESOLUTION ON ACCESS TO LIFESAVING TREATMENTS FOR SPINAL MUSCULAR ATROPHY (SMA) BABIES

WHEREAS, the National Black Caucus of State Legislators (NBCSL) has consistently supported the expansion of statewide screening of newborns;

WHEREAS, the NBCSL supports granting access to treatment to babies diagnosed with Spinal Muscular Atrophy (SMA), a rare genetic disorder that afflicts 1 in 11,000 children;

WHEREAS, the identification of the SMA disorder at birth and subsequent treatment administered immediately after the diagnosis is essential to saving the lives of the majority of these babies born with this disorder;

WHEREAS, SMA babies require diagnosis at birth as part of the approved newborn screening test, and Type 1, the most severe and most common type of SMA, typically leads to death of the infant early in life unless the infant is diagnosed at birth and then immediately treated;

WHEREAS, the NBCSL supports providing safe and effective treatment options to babies who otherwise will suffer irreversible loss of motor nerve cells that rob infants of the ability to walk, eat, or breathe, and for Type I SMA babies the ability to survive beyond the first two-years of life;

WHEREAS, the NBCSL recognizes that new breakthrough SMA treatments for this rare genetic disorder are expensive, and that many families with SMA babies face impossible economic barriers to care, and where many will be forced to become Medicaid eligible;

WHEREAS, states have discretion on which disorder screenings to include in their newborn screening panels;

WHEREAS, only two states currently test for all 35 disorders in the Recommended Uniform Screening Panel (RUSP) as approved by the HHS Advisory Committee on Heritable Disorders;

WHEREAS, the U.S. Congress has incentivized the development of new rare disease therapies, including gene replacement therapies that may save the lives of SMA babies;

WHEREAS, there are not currently adequate cost-sharing financing mechanism to ensure the required immediate treatment of SMA babies is administered, and that imposes an impossible financial burden on state Medicaid programs who are responsible for care of these eligible SMA babies;

WHEREAS, state Medicaid programs are financially stressed and are forced to conduct often lengthy reviews of high-cost treatment for high-cost rare disease patients, and those delays will doom SMA Type 1 babies to a lifetime of profound disabilities or possible death; and

WHEREAS, the U.S. Congress should develop and enact a rare disease cost-sharing program or other innovative financing model for high cost treatments such as SMA treatments to remove financial barriers to needed SMA treatment, including Medicaid program reimbursement.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) calls upon the U.S. Congress to develop and pass a rare disease cost-sharing program or other innovative financing models with state Medicaid programs to ensure SMA babies receive timely treatment and that this situation does not happen for future treatments;

BE IT FURTHER RESOLVED, that the NBCSL calls upon every state to expedite on the addition of the SMA screen to its newborn screening panel by legislative or administrative means as soon as practical;

BE IT FURTHER RESOLVED, that states should expedite the passage of any needed statutory or regulatory policies that allows for safe and effective treatments for babies where the SMA gene defect is identified; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the Unites States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials and agencies as appropriate.

• SPONSOR(S): Representative Billy Mitchell (GA) and Representative Vernon Jones (GA)
  
• Committee of Jurisdiction: Health and Human Services Policy Committee
  
• Certified by Committee Co-Chair: Representative David J. Mack, III (SC)
  
• Ratified in Plenary Session: Ratification Date is December 6, 2019
  
• Ratification is certified by: Representative Gilda Cobb-Hunter (SC), President

A RESOLUTION ON IMPROVING ADOLESCENT MENTAL HEALTH

WHEREAS, suicide is the third leading cause of death among all African American children ages ten to nineteen;

WHEREAS, between 2001 and 2017, suicide rates doubled among African American girls aged 13-19, and for African American boys of the same age it rose by 60%;

WHEREAS, the rate of suicides for African American children between the ages of five and twelve has exceeded that of all other ethnic groups and more than a third of elementary school-aged suicides involved African American children;

WHEREAS, the Congressional Black Caucus (CBC) has established an Emergency Taskforce on Black Youth Suicide and Mental Health to raise awareness and identify solutions to this growing problem;

WHEREAS, adolescent well-care examinations are visits that include physical, developmental, behavioral and psychosocial screening and assessment;

WHEREAS, after the age of 12 years old, unless they need immunizations, get sick, or need a school or sports physical, children are no longer required to see a medical provider;

WHEREAS, American Academy of Pediatrics’ Bright Futures Guidelines recommends annual well-care visits during adolescence;

WHEREAS, annual well-care visits during adolescence promote healthy behaviors, prevent risky ones, and detect conditions that can interfere with physical, social, and emotional development;

WHEREAS, a key component of this visit for teens is the universal administration of the PHQ-9, a depression screening tool that begins at age 12;

WHEREAS, Pediatricians and family physicians can possibly diagnose depression and/or other mental and physical health problems early, and save lives; and

WHEREAS, including Pediatricians to be involved along with law enforcement, teachers, students and parents in the mental health discussion can increase the chances of spotting and helping a child dealing with mental health issues.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) recognizes the importance of annual well-care visits during adolescence;

BE IT FURTHER RESOLVED, that the NBCSL urges all states to consider options like mandating annual adolescence well-care visits for youth ages 12-19 and ensuring they are affordable to all students, increasing access to mental health services overall, and increasing mental health services in schools in order for more youth to be screened for mental health issues;

BE IT FURTHER RESOLVED, that the NBCSL supports schools and school districts ensuring that school counselors and mental health counselors be available to all students at the commonly accepted appropriate ratios to the relative student population, to ensure that students have reliable access to mental health counselling; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the Unites States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials and agencies as appropriate.

• SPONSOR: Representative Bobby DuBose (FL)
  
• Committee of Jurisdiction: Health and Human Services Policy Committee
  
• Certified by Committee Co-Chair: Representative David J. Mack, III (SC)
  
• Ratified in Plenary Session: Ratification Date is December 6, 2019
  
• Ratification is certified by: Representative Gilda Cobb-Hunter (SC), President

A RESOLUTION ON REDUCING PATIENT OUT OF POCKET COST ON PRESCRIPTION MEDICATION

WHEREAS, some people with chronic conditions such as diabetes or asthma continue to face challenges affording their medication and overall health care;

WHEREAS, there are now insurance plans with a $7,000 deductible for individuals and $15,000 for families, and 1 in 5 have deductibles of more than $3,000 for individuals and $5,000 for families;

WHEREAS, in a recent survey by Kaiser Family Foundation, they found that half of all Americans with coverage either delayed or skipped medical or dental care because of the cost;

WHEREAS, for people under age 65 with commercial insurance, enrollment in high deductible health plans (HDHPs) has increased from 22.4% in 2009 to 46% in 2018;

WHEREAS, HDHPs require patients to incur the full cost of some prescription medications before their plan deductible is met, meaning they often pay the full retail price out-of-pocket (OOP) before they meet their deductible and the health plan starts helping them pay for certain medicines;

WHEREAS, patients are not guaranteed to directly benefit from the rebates and discounts drug manufacturers provide to health plans and Pharmacy Benefit Managers (PBM) in the form of lower OOP costs at the pharmacy counter;

WHEREAS, when a health plan exempts a health care services for certain services from the deductible, known as first dollar coverage, many OOP expenses for patients are eliminated or limited to a copay or coinsurance;

WHEREAS, first dollar coverage is an effective way for health plans to help people with chronic diseases such as diabetes manage their health and their OOP costs – especially people enrolled in HDHPs;

WHEREAS, when a patient’s OOP costs are lower and health care expenses are more consistent throughout the year, medicine adherence rates increase, resulting in better patient health outcomes; and

WHEREAS, the Internal Revenue Service (IRS) issued guidance in July of 2019 that includes medicines that HDHPs with a health savings account (HSA-HDHPs) may consider as preventive and exempt from the deductible (provide first dollar coverage for), which enables states to legislate or regulate certain aspects of HSA-HDHPs.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) encourages state legislators to explore legislation that will help patients who are struggling to afford their medication;

BE IT FURTHER RESOLVED, that the NBCSL legislators to research the fiscal impact of state regulated health plans providing first dollar coverage for medicines to treat chronic diseases, such as diabetes; requiring state-regulated health plans and/or PBMs to pass through a majority of manufacturer rebates and discounts to patients at the pharmacy counter, and; ensuring that health plans do not charge patients more OOP for insulin than the net cost of the drug to the health plan;

BE IT FURTHER RESOLVED, that the NBCSL believes that high deductible plans should be limited, so that healthcare can truly be affordable for Americans; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the Unites States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials and agencies as appropriate.

• SPONSOR: Representative David Mack, III (SC)
  
• Committee of Jurisdiction: Health and Human Services Policy Committee
  
• Certified by Committee Co-Chair: Representative David J. Mack, III (SC)
  
• Ratified in Plenary Session: Ratification Date is December 6, 2019
  
• Ratification is certified by: Representative Gilda Cobb-Hunter (SC), President

A RESOLUTION ON EDUCATING COMMUNITIES ABOUT PHARMACEUTICAL PATIENT ASSISTANCE PROGRAMS

WHEREAS, more than 30 million children and adults in the United States have diabetes, and 1 in 4 of it is undiagnosed;

WHEREAS, diabetes is the 7^th leading cause of death in the United States;

WHEREAS, in the last 20 years, the number of adults diagnosed with diabetes has more than doubled as the American population has aged and become more overweight or obese;

WHEREAS, people with diabetes are twice as likely to have heart disease or a stroke as people without diabetes—and at an earlier age;

WHEREAS, diabetes is the leading cause of Chronic Kidney Disease in the United States, 2019, lower-limb amputations, and adult-onset blindness;

WHEREAS, African Americans and other minority communities are at higher risk for prediabetes and type 2 diabetes;

WHEREAS, during their lifetime, half of all Hispanic men and women and non-Hispanic black women are predicted to develop diabetes;

WHEREAS, a patient who cannot access or take all the insulin they need can result in poorer health outcomes and significant financial costs for the individual and the health care system;

WHEREAS, there are numerous medical conditions that people struggle with the high cost of their medication, and where non-profit, government, and business community help patients with the high out-of-pocket costs of these medications;

WHEREAS, 3,400 drugs have increased in price, a 17 percent increase compared with the nearly 2,900 drug price hikes at the same time in 2018;

WHEREAS, when a patient’s out-of-pocket costs are lower and health care expenses are more consistent throughout the year, adherence rates to medicine increase resulting in better patient health outcomes; and

WHEREAS, many diabetes care organizations currently offer immediate assistance to patients in the United States who are struggling to afford their insulin other medicines, or supplies.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) encourages state policymakers and their membership to increase states’ efforts to inform citizens about all manufacturer-offered, non-profit, state programs, and other existing assistance programs currently available, particularly for people with diabetes;

BE IT FURTHER RESOLVED, that the NBCSL believes that states should inform pharmacies, pharmacists, and providers about pharmaceutical assistance programs and encourage them to share information about these assistance programs to ensure they have access to affordable medication, including insulin;

BE IT FURTHER RESOLVED, that the NBCSL applauds the actions of non-profits, government, and businesses that provide these type of assistance programs to those struggling with the cost of their medication; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the Unites States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials and agencies as appropriate.

• SPONSOR: Representative David Mack, III (SC)
  
• Committee of Jurisdiction: Health and Human Services Policy Committee
  
• Certified by Committee Co-Chair: Representative David J. Mack, III (SC)
  
• Ratified in Plenary Session: Ratification Date is December 6, 2019
  
• Ratification is certified by: Representative Gilda Cobb-Hunter (SC), President

A RESOLUTION ON A NEW COMPREHENSIVE APPROACH TO HEALTHY COMMUNITIES

WHEREAS, African Americans, Hispanic-Americans, and other minority groups experience debilitating health conditions that are brought on by a lack of wholesome resources and result in quantifiable health disparities;

WHEREAS, health, both individual and community health, consists of more than physical health, other important measures including spiritual, emotional, social, economic and environmental health, and these various measures can be seen clearly to affect each other;

WHEREAS, the World Health Organization’s definition of health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”;

WHEREAS, the National Black Caucus of State Legislators’ (NBCSL) fifteen (15) policy committees focus on improving the health and well-being of African American communities by identifying the lack of resources and encouraging public policy change;

WHEREAS, African Americans encounter disproportionately higher mortality and morbidity from Heart Disease, Cancer, Stroke, Diabetes, Asthma, Infant Mortality, and Mental Illness, among many other conditions;

WHEREAS, African Americans have significantly higher rates of poverty, hazardous environmental exposure, inadequate educational resources, insufficient financial service options, fewer employment options, and a lack of financial stability and economic development;

WHEREAS, African American farmers experience higher financial turmoil due to state and federal policies, combined with insufficient private and public sector support;

WHEREAS, the lasting legacy of racial enslavement, discrimination, and bias are contributing factors to the unhealthy outcomes in African American communities;

WHEREAS, while there is no homogeneous neighborhood or clear definition of a healthy community, communities should be better defined based on comparing available resources in different areas;

WHEREAS, empirical evidence must be used to measure access to vitally needed health services, fresh fruits and vegetables, spiritual and communal support, educational services, and high-quality financial services to help distinguish a healthy community from its less healthy contemporary;

WHEREAS, this comprehensive series of studies will help define healthy communities better and propose the allocation of resources to more effectively improve the well-being of citizens that reside in every neighborhood; and

WHEREAS, these measurements and the appropriate allocation of resources in less healthy areas can help reduce the rates of morbidity, mortality, poverty, and crime.

BE IT THEREFORE RESOLVED, that the National Black Caucus of State Legislators (NBCSL) will work with its partners to define “Healthy Communities” based on our fifteen (15) policy committees established under the NBCSL;

BE IT FURTHER RESOLVED, that the NBCSL will work with our legislators, government, and various partners to identify and inform our legislators of how various areas are “Healthy Communities” and are less healthy than their contemporaries;

BE IT FURTHER RESOLVED, that the NBCSL will work with our legislators, government, other partners to find resources necessary to inform our legislators of an inventory of grocery stores, hospitals, places of worship, educational resources, and various financial service organizations initially to compare neighborhoods;

BE IT FURTHER RESOLVED, that the NBCSL will continually reassess and help members, policymakers, governmental agencies, and the private sector identify areas that lack healthy resources;

BE IT FURTHER RESOLVED, that the NBCSL will work with communities to identify incentives like Opportunity Zones and others to encourage investment and resource allocation in less healthy communities;

BE IT FURTHER RESOLVED, that the NBCSL urges the development and implementation of state- and community-based programs to support “Healthy Community” initiatives, to bring healthier options into underserved communities across America; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials as appropriate.

• SPONSOR: Representative Gilda Cobb-Hunter (SC)
  
• Committee of Jurisdiction: Health and Human Services Policy Committee
  
• Certified by Committee Co-Chair: Representative David J. Mack, III (SC)
  
• Ratified in Plenary Session: Ratification Date is December 6, 2019
  
• Ratification is certified by: Representative Gilda Cobb-Hunter (SC), President

A RESOLUTION TO EDUCATE, EMPOWER, AND ADVOCATE AROUND END-OF-LIFE CARE

WHEREAS, the National Black Caucus of State Legislators (NBCSL.) is the foremost organization serving and representing the interests of current and former Black state legislators from all states, commonwealths and territories of the United States and the Western Hemisphere and serves as a catalyst for joint action on issues of common concern to all segments of the community; and we are committed to educating our communities to make informed end-of-life decisions;

WHEREAS, the NBCSL recognizes that African American disparities extend to the end-of-life process, and recommends that individuals and families educate themselves on all aspects of  end-of-life planning including advance healthcare directives, healthcare proxies, wills, trusts, powers of attorney, and end-of-life options;

WHEREAS, Duke Divinity School survey found that only 50% of African Americans have talked with family members about their end-of-life care and 20% have never discussed end-of-life wishes with anyone;

WHEREAS, it is imperative to empower our community with information to better make informed decisions when planning for the end of life and have candid conversations with friends, family, faith leaders and medical providers about end-of-life care before a time of crisis;

WHEREAS, a 2016 study in the Journal of Palliative Medicine reported that only 24% of African Americans were likely to have completed advance directives compared with 44% of their white peers;

WHEREAS, advance healthcare directives are state-specific free legal documents to choose medical treatment options in case one is unable to make decisions because of illness or infirmity and to appoint a healthcare proxy to speak on one’s behalf;

WHEREAS, according to the National Hospice and Palliative Care Association, only 8%

of hospice users are African American, and hospice care is a health service that provides comfort care to patients, in-home or at a facility, in their final phase of illness or within six months of death;

WHEREAS, hospice care should be accessed as early as possible as there is an emphasis on patient support and the entire spectrum of improved quality of life, and hospice staff and caregivers provide holistic care rather than a curative emphasis;

WHEREAS, palliative care is a compassionate interdisciplinary approach (doctors, nurses, faith leaders, other medical professionals) to specialized medical and nursing care for people with chronic and terminal illnesses, the ultimate goal is improving the quality of life for the patient and their support network by focusing on providing pain relief, and physical and mental stress support at any stage of illness;

WHEREAS, according to a 2016 from the University of Iowa and University of California, African Americans are significantly less likely to be prescribed opioids for back pain and abdominal pain compared to white peers, and African American patients are more likely to have their pain underestimated and undertreated;

WHEREAS, according to the National Center for Health, just 13% of African Americans have a living will in place compared with 32% of whites, and African Americans are less likely to purchase long-term care insurance, term life insurance, whole life insurance, disability insurance, homeowners’ insurance, or to complete estate planning;

WHEREAS, wills and trusts are vital components of estate planning and should be considered in end-of-life discussions;

WHEREAS, having an understanding of the entire spectrum of care options is critical in order to make informed healthcare decisions, from the refusal of treatment to aggressive treatment options; and

WHEREAS, being equipped with treatment-option information and illness-specific questions for medical professionals during appointments can empower our community to advocate for ourselves.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL)  must be proactive in educating, empowering and advocating for our community at the end of life, and we will work with and encourage our legislators to share resources with our constituents;

BE IT FURTHER RESOLVED, that the NBCSL encourages charting one’s end of life journey. consistent with one’s own wishes and values and having those very important discussions with loved ones;

BE IT FURTHER RESOLVED, that the NBCSL urges Congress to enact legislation that would encourage Medicare and Medicaid to take meaningful steps toward identifying and educating vulnerable populations that are nearing the end of their life; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the Unites States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials and agencies as appropriate.

• SPONSOR: Representative Laura Hall (AL)
  
• Committee of Jurisdiction: Health and Human Services Policy Committee
  
• Certified by Committee Co-Chair: Representative David J. Mack, III (SC)
  
• Ratified in Plenary Session: Ratification Date is December 6, 2019
  
• Ratification is certified by: Representative Gilda Cobb-Hunter (SC), President