Evolution of the palliative care field in recent decades has increased access to this specialized medical care for patients and families facing serious illness. Guided by a commitment to ensuring equal access for low-income and underserved patients, the California Health Care Foundation (CHCF) has supported initiatives to develop sustainable inpatient and community-based palliative care (CBPC) programs in California’s public hospital system.

Accelerating Change: Community-Based Palliative Care in Public Hospitals (PDF) describes CHCF’s efforts to implement and expand CBPC services in California’s public hospitals for health care systems, providers, and other stakeholders interested in expanding palliative care’s reach to vulnerable and underserved communities.

Key points include:

• CBPC services in public hospitals allow more people with serious illness to get the support they need earlier than inpatient palliative care services alone, and provide important continuity of care for people who are at risk for repeat hospitalizations and emergency department visits.
• The resource constraints of most public hospitals and the complex economic and social challenges facing many of their patients present unique challenges to CBPC programs in these settings — creativity, adaptability, and persistence are hallmarks of program success.
• While challenges abound, seed funding to help services get off the ground (from foundations, health plans, or health systems themselves) can enable new services to take root or existing services to grow. Opportunities to learn from others doing similar work are highly valued.