CARE & PREPARE ( formerly CQEC )

Our dream: Provide All Texans with Advance Care Planning (ACP) & ability to retrieve those decisions by clinicians; our beta site will start in the Spring of 2021 in Ft. Worth & grow statewide.

Our challenge: To revolutionize the process of ACP in Texas by creating a registry of all Texan’s ACP documents & make those medical wishes available so any physician with a web browser can know & honor those healthcare decisions. Few Texans have ACP documents; studies show our minority communities have even less.

The elderly, terminally ill & underserved populations are struggling the most with Covid. Ours is a unique effort to reach the terminally ill, the frail & our minority community by embedding into physician’s offices & other trusted partners.
This social intervention of providing ACP education, with documentation & storage is a radical change from the status quo. We seek for all Texans to benefit – especially our BIPOC neighbors, who may not have understood their health care rights & responsibilities. C&P participated in a study that was reported in JAMA Network May 2020. 1 The research question was: “Can a low-cost, easily scaled, end-of-life conversation game motivate underserved African American individuals to engage in advance care planning?” Currently, less than 25% of BIPOC have ACP planning. Hence, they are less likely to have their medical care wishes known & honored. This more informal approach to ACP yielded an increase in ACP document completion. If we want to increase concordant ACP wishes & care with BIPOC, then better methods of communication are in order to decrease the disparity.

Other states have brought multiple orgs together to accomplish ACP. C&P is fortunate to have a new Board President, Rev. Dr. Mike Johnston, who has helped build a coalition in South Carolina ($2.3 million project). C&P is collaborating with others to increase health literacy, health education & build a state registry. This is another example of how public & private funding can benefit marginalized people. Upfront we are utilizing gifts to develop the concept. Goal: Sustainable program. Initial education for partners will require philanthropic support; increase our development & create a revenue generating ACP Benefit service to assist the community at large & fund our program. We will start with part-time admin & facilitators to launch our efforts in Dr. Jerry Barker’s Oncology office.
Medicine is making a quantum leap from a paper & archaic system to shared decision making & digitization of consent & ACP documents are necessary steps for best outcomes.

1. We are simplifying the confusing technical language frequently used in ACP.
2. We are embedding our uniquely trained ACP facilitators into healthcare systems & trusted community partners.
3. We are collaborating with other nonprofits to fundraise for a statewide ACP registry.
4. We are partnering for a solution that empowers clinicians, patients, and caregivers to understand their healthcare rights & responsibilities, including documenting end-of-life care wishes.

1. Highly motivated, well trained volunteers & staff
2. Collaborating with influential clinicians
3. Developing a sustainable business model for ACP Consulting and reimbursement
4. Research studies that have shown improved Patient, Family & Physician satisfaction when ACP is involved with terminal patients.

"ACP for All." Beta Site in 2021 pulling together successful elements of our practice in a new way.

Thus far we have:
Identified pioneering partners: Texas Cancer Specialists, Area Agency on Aging, Care & Prepare, Texas Talks
Developing crucial data points needed to capture
Hammering out workflow of ACP for ALL in clinical setting
Contracting for initial key personnel
Goal Beta site to launch Spring 2021 in Ft. Worth, TX.

2022 = Beta site successful Results:
1. NIH Study conducted with Pioneering Partners in Como Community Center. Survey to study what language works best with underserved Population.
2. Proof of concept for ACP Consulting Practice: Patients want to have these conversations; they are a covered benefit 9 out of 10 ten times; & physicians are not trained in the value & intricacies of these dialogues.
3. Public Speaking engagements promoting ACP have been successful with more invitations at each venue.

Currently, we need:
1. Launchpad money to start our ACP for ALL Facilitators - will seek opportunities to reach BIPOC. This will become a sustainable consulting practice through building a volume of business. 40 physicians desire our Services already, but we don't have capacity to meet the current demand.
2. Funding for creation & dissemination of Advance Care Planning materials.
3. Funding of operational support.
4. Funding for technology to help us capture individual ACP Plans so they can be available to physicians to honor those healthcare wishes.