Topic: Update on AG Advanced Directives Project

Discussion: Wendy Morgan updated the group:  the Attorney General will be holding a press conference to formally introduce the Advanced Directives legislation.    Wendy talked to the group about a possible project through the Attorney General’s office that would pair clinicians with attorneys to facilitate the use of Advanced Directive forms. (All attorneys are required to do 50 hours per year of pro bono work which is an issue for attorneys working for the state who have to be careful not to be presenting themselves as representing the state during that time.) Ray Walker, a retired psychiatrist from Brattleboro, who serves on the Ethics Committee there, goes to people’s homes and creates a document re: their philosophy of how they want their care to look during their last year’s of life. (He does this on a volunteer basis) Attorneys from the state are interested.  The idea would be to have the VEN Advanced Directive form on a laptop so that clients would be able to go home with the document completed.  By having both the clinician and attorney present participants would be able to ask both medical and legal questions.  Possible formats might include one-on-one sessions, small group meetings (look at the faith groups?), and kitchen meetings (neighborhood meetings).  It was suggested that the proposed agent should attend the meeting and have the opportunity to ask questions as well.  Question from Wendy:  are there protocols for referral to palliative care?  Do individual hospitals have these protocols?  Discussion focused on the need to take the 6 month time line out of the decision process.

Action: Attorney General’s Press Conference: January 31, 2005 at 11:00am at the Statehouse   This project will be piloted in four areas of the state during the upcoming months with reports back to the ExCEL steering committee at the March meeting:  Diana, Denise, Zail, and Sharon have volunteered to serve as clinicians.     VEN will serve has the contact for these pilots.         Do people know of protocols for palliative care referrals?

“Advanced Directives and The Changing Landscape of Medical Decisions”	John Campbell brought flyers for the conference.  Bob Swartz is working on getting CME’s for the event.  What are the networks currently in place that could be used to publicize the event? Home Health, CEO’s of hospitals	Bud Hammes Conference is scheduled for 8-3 at the Capital Plaza on February 7, 2005. Wendy: e-mail flyer to the EOL group Patty: e-mail flyer to ExCEL members
Topic: Discussion re: hospital advance directive survey	Discussion: John Campbell led a discussion regarding the use of Bob Orr’s survey tool to evaluate the number of patient’s during a one day hospital census that looked at:  Advanced directives?       DNR orders?       Where did the DNR order originate? Is this an internal quality improvement measure? Is there funding?  Who should own this project?  What would be hoping to accomplish by pursuing it? (Looking for baseline data)	Action: Patty:  Talk with Helen and Paul re: is this a project that is appropriate for VPQHC? VAHHS?
Update on Opportunity Award – Reports from sub-committees: Survey Subcommittee: Partnership Development Subcommittee: Grant Activities Subcommittee:	Currently have the death certificates, and the IVR equipment is in place.  Waiting for completion of the IRB process – meeting should take place the last Tuesday in January. No progress to date with increasing funding sources.	Patty:  follow-up at growthhouse.org re:  possible funding sources.
Ideas for agenda at the March meeting	Sharon attended the NIH State of the Science Conference and would like a chance to present to the group at the March meeting.	Next meeting:  Monday, March 7, 2005 5:30-7:00pm Preplanning Call:  January 25, 2005 12:00 (noon)

 Addendum:  Barb Segal was in touch via e-mail and reported that she has contacted Hank Dunn author of Hard Choices for loving people to find out about his availability for the Annual Meeting in June.  She will keep us updated and would like to give a report at our next meeting.  Also, she is open to any ideas that people might want her to pursue regarding speakers for the meeting.