Palliative Care Access Act (PHL Section 2997-d): Palliative Care Requirements for Hospitals, Nursing Homes, Home Care and Assisted Living Residences (Enhanced and Special Needs)


On April 1, 2011, Governor Cuomo signed into law Chapter 59 of the Laws of 2011, which added Section 2997-d to the Public Health Law, now commonly known as the Palliative Care Access Act ("PCAA"). It imposes certain requirements on hospitals, nursing homes, home care agencies and two types of assisted living residences (enhanced and special needs) regarding palliative care. It becomes effective on September 27, 2011.

The PCAA expands upon the requirements of the Palliative Care Information Act ("PCIA") which took effect on February 1, 2011. The PCIA requires physicians and nurse practitioners to offer information and counseling about palliative care to patients with a terminal illness.

The "PCAA" builds upon the "PCIA" in the following ways:

  1. It applies directly to health care facilities, home care agencies, and assisted living residences, as well as individual practitioners;
  2. It applies to patients/residents with "advanced life limiting conditions or illnesses who might benefit from palliative care" and not just those who are terminally ill;
  3. It requires, not only an offer of information and counseling, but also that the covered health care provider or residence "facilitate access to appropriate palliative care consultation and services, including associated pain management consultations and services."

Like the PCIA, the PCAA is intended to ensure that patients are fully informed of the options available to them when they are faced with a serious illness or condition, so that they are empowered to make choices consistent with their goals for care, and wishes and beliefs, and to optimize their quality of life. The law is not intended to limit the options available to patients. Nor is it intended to discourage conversations about palliative care with patients who have distressing symptoms and serious conditions, but do not technically fall within the law's requirements. Patients and providers should recognize that palliative care and disease-modifying therapies are not mutually exclusive. Patients may opt to pursue palliative care while also pursuing aggressive treatment. Palliative care may be provided together with life-prolonging or curative care or as the main focus of care.

Summary of the Law

Public Health Law section 2997-d requires that hospitals, nursing homes, home care agencies, special needs assisted living residences, and enhanced assisted living residences, provide access to information and counseling regarding options for palliative care appropriate to patients with advanced life limiting conditions and illnesses. These providers and residences must also facilitate access to appropriate palliative care consultation and services, including associated pain management consultation and services, consistent with the patient needs and preferences.

When the patient or resident lacks capacity to make medical decisions, the provider or residence must have policies so that access to such information and counseling will be provided to the persons who are legally authorized to make medical decisions on behalf of such patients or residents.

Statutory Definitions

means consistent with applicable legal, health and professional standards; the patient's clinical and other circumstances; and the patient's reasonably known wishes and beliefs.
"Palliative care"
means health care treatment, including interdisciplinary end-of-life care, and consultation with patients and family members, to prevent or relieve pain and suffering and to enhance the patient's quality of life, including hospice care under article forty of [the Public Health Law].

For More Information:

The Department will be publishing questions and answers about the PCAA here. While they are under development, many of the questions and answers and resources developed for the PCIA can help providers and residences to prepare to implement the PCAA which you can find here.