Palliative care — with its whole-person approach to enhancing the quality of life for patients with advanced illness — has become increasingly available in California over the last decade, resulting in improved patient care and satisfaction, and reduced health care costs. However, most rural communities, which are often medically underserved, offer only limited or no palliative care. This is a significant problem because of the state’s immense rural geography, with widely dispersed communities. A 2014 survey found that 22 of the state’s 58 counties have no community-based palliative care (CBPC) services.

With narrow hospital access in many rural areas, community health centers and clinics form the cornerstone of ambulatory care, where palliative care integration efforts are increasingly focused on CBPC. This report looks at the current availability of CBPC in rural California, as well as barriers and opportunities for integrating these services more widely into rural health care in the state.

Highlights from the report:

• In setting up and maintaining palliative care in their communities, rural health systems face many challenges: economic issues, the training of sufficient numbers of providers, and community engagement.
• A number of innovations in the health care arena can serve as models for rural CBPC: a learning collaborative in Minnesota, use of telehealth, and community-academic partnerships.
• Experts stressed that efforts to increase access to palliative care in rural California will require three principal elements: time to develop programs and relationships with the community, funding for program planning, and quality measures to assess outcomes, program costs, and return on investment.

The full report is available as a Document Download.