Congratulations to the State of Washington. You are doing the right thing for your employees.

Planning for future health care needs just became much simpler. Through an online wellness program, State employees now have an easier time accessing and filling out advance directives, documents that the Bree Collaborative encourages everyone in Washington to complete. Our goal is that everyone:

– Be informed about their end-of-life options,
– Communicate their preferences in actionable terms, and
– Receive end-of-life care aligned with their goals and values.

SmartHealth, the digital wellness management platform for Washington State employees who get health insurance through the Public Employees Benefits Board now encourages employees to complete an advance directive to earn points that count toward a financial incentive. SmartHealth was developed by Limeade and directs eligible employees along with their spouses and domestic partners to advance directives from the Washington State Medical Association and Caring Connections, a program of the National Hospice and Palliative Care Organization.

When looking at health care areas needing improvement, our Bree Collaborative members saw that the kind of care people get at the end of their lives often doesn’t match what they actually want. We realized that we need to work across all our different organizations to make this care better. Due to our efforts and those of many community partners, talking about planning for end-of-life care is increasingly popular in our State.

The Bree Collaborative’s recommendations – adopted in late 2014 – encourage everyone to think through the kind of care they would want and to use an advance directive with three main parts (although others such as organ donation can be included too):

– Durable Power of Attorney for Health Care
– A Living Will or Health Care Directive and
– A Written Personal Statement

How does the State support this work?

Washington State employees have great advocates in our State’s leadership. Governor Inslee established a Health and Wellness Steering Committee that provides guidance to programs like SmartHealth. This Committee is co-chaired by Dorothy Teeter, the Director of the Health Care Authority and John Weisman, the Secretary of the Department of Health. The Health Care Authority’s Chief Medical Officer and chair of the Bree Collaborative Implementation Team, Dr. Dan Lessler suggested integrating advance directives into the SmartHealth program. As of May 2015, over 3,000 people have accessed information about advance directives through SmartHealth.

How do I do this for my own employees?

Wellness programs are one way to encourage employees to take steps to make sure the care they receive at the end of their life is the care they want. There are other ways to educate employees about how to have conversations regarding their personal goals of care and the type of care desired at the end of life with family members, friends, and health care providers and how to fill out an advance directive. Some of these great resources are:

– Conversation Ready Project: theconversationproject.org
– Death over Dinner: deathoverdinner.org
– Six Steps: 6stepslivingwill.org

We also encourage employers as health care purchasers to negotiate with health plans to provide comprehensive benefits that honor a patient’s choices at the end-of-life through providing reimbursement for advance care planning conversations with patients and their surrogate decision makers.

What if I am not a State employee?

We can all talk to our friends and family and fill out an advance directive that tells our loved ones about the type of care we want at the end of our lives. One program offering these important resources is Honoring Choices: Pacific Northwest – a program from the Washington State Medical Association and the Washington State Hospital Association – get started here: www.honoringchoicespnw.org/get-started/start-the-conversation/

We encourage everyone to have these important conversations and write down their wishes for end-of-life care.

Ginny Weir, MPH
Program Director, Bree Collaborative