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Better Together Forging a New Path to Palliative Care 10TH ANNUAL PALLIATIVE CARE SUMMIT APRIL 10-11, 2018 ANAHEIM, CA CCCCSUMMIT.ORG

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Page 1: Forging a New Path to Palliative Care - ccccsummit.orgccccsummit.org/wp-content/uploads/2018/03/Summit-Brochure-final.pdf · Elisabeth Kübler-Ross Foundation Dianne Gray is an author,

Better TogetherForging a New Path to Palliative Care

10TH ANNUAL PALLIATIVE

CARE SUMMITAPRIL 10-11, 2018

ANAHEIM, CA

CCCCSUMMIT.ORG

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REGISTER EARLY― SAVE UP TO 22%!

Early Registration available through January 28, 2018

Special room rates available through March 15, 2018

CCCCSUMMIT.ORG

Tell us how you are forging a new path! Tweet using #CCCC18 Forging a new path for pal l ia t ive care.

Coalition for Compassionate Care of California promotes high-quality, compassionate care for all who are seriously ill or nearing the end of life. Our goal is to transform healthcare so that medical care is aligned with individual patient preferences—that people get the care they need and no less, and the care they want and no more. COALITIONCCC.ORG

INTENDED AUDIENCEThe 2018 Summit is designed for EVERYONE who wants to learn more about palliative care, share innovative practices, and be a part of a growing movement to improve the care of seriously ill people of all ages, including pediatrics, adolescents, young adults, adults, and geriatrics. In particular, the Summit brings together people from a variety of backgrounds who want to work together to advance palliative care, including:

• Physicians• Nurses • Social workers• Chaplains• Administrators• Long-term supports and services providers• Healthcare leaders• Faith leaders• Educators• Academics• Caregivers• Patients• Consumers• Policymakers• Government employees or staff• Media• Entrepreneurs • Innovators• Businesses and investors • Technologists • Designers • And more!

JOIN US FOR OUR 10TH ANNUAL SUMMITFor the past decade, the Coalition for Compassionate Care of Califor-nia has provided leadership and a place for members of California’s palliative care community to learn, collaborate, and grow. We proudly invite you and your colleagues to join us in Anaheim this April as we celebrate our 10th Annual Summit and explore exciting new frontiers in palliative care.

Now is the time—prominent healthcare leaders and policy makers are calling for increased access to palliative care as part of healthcare re-form. The media and the public are increasingly asking for information about death, dying, and serious illness. Never before has there been so much interest in palliative care.

Our Summit purposefully brings together a variety of individuals with a vested interest in palliative care, including patients, professionals, and policy makers. We create a space for anyone interested in palliative care at any level to collaborate with us, share ideas, and work in tan-dem to develop strategies, tools, and resources to ensure that all people have access to the care they need and no less, and the care they want and no more. Register today!

Children’s Hospice & Palliative Care Coalition, a division of the Coalition for Compassionate Care of California, is dedicated to improving children’s access to community-based palliative and hospice care services through advocacy, program development and education. COALITIONCCC.ORG/CHPCC

≈12 CMEs/CEsApplication for CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending.

Applications for CE credit have been filed with the California Board of Registered Nursing, the California Board of Behavioral Sciences, California Association of Marriage and Family Therapists, and the California Nursing Home Administration. This program may be used for continuing education credit for chaplains certified with the Board of Chaplaincy Certification, Inc.

OBJECTIVESThe participant will be able to:

• Describe how palliative care can improve quality and reduce the cost of care for people with advanced illness.

• Discuss ways that hospice has been demonstrated to be one of the best ways to care for people at the end of life.

• Identify successes over the past 50 years to integrate palliative care into mainstream health care.

• Define the stages of the geriatric life cycle.• Develop skills to prognosticate risk of patient-centered quality metrics.• Identify risks for hospital induced delirium.• Describe California’s experience legalizing physician aid-in-dying – highlighting best practic-

es and areas for improvement.• Reflect on the role of hospice and palliative care in responding to the End of Life Option Act.• Discuss areas for further research or policy development to improve care for patients at the

end of life.

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Register online: CCCCSUMMIT.ORG/REGISTRATION 3BETTER TOGETHER.

TUESDAY, APRIL 10Charles F. von Gunten, MD, PhD OhioHealth Kobacker House,Journal of Palliative MedicineDr. Charles von Gunten is widely known as a pioneer in hospice and palliative medicine. He is the Founding Chairman, Test Committee, Hospice and Palliative Medicine, American Board of Medical Specialties. He is Editor-in-Chief of the Journal of Palliative Medicine. Dr. von Gunten has received numerous awards including a lifetime achievement award from the American Academy for Hospice and Palliative Medicine (AAHPM) and the American Cancer Soci-ety’s prestigious Pathfinder in Palliative Care Award. He has been recognized by AAHPM as one of 30 pioneers in palliative medicine and was named a top cancer doctor in Newsweek Health. He has published and spoken widely on the subjects of hospice, palliative medicine, and pain and symptom control. Dr. von Gunten earned a PhD in Biochemistry and an MD with honors from the University of Colorado Health Sciences Center in Denver, Colorado in 1988. Prior to joining OhioHealth, he led the development of education and research programs in the Institute for Palliative Medicine at San Diego Hospice as Provost and the University of California, San Diego as Clinical Professor of Medicine.

Daniel R. Hoefer, MDSharp HospiceCareDr. Daniel Hoefer is a board-certified family practice physician, board certified in palliative medicine and is part of Sharp Rees Stealy Medical Group in San Diego. He has spent over 25 years working in nursing homes and with geriatric patients. Dr. Hoefer is an EPEC-trained physician who has been the visionary for the development of an evidence-based disease management care model for late-stage illness. He frequently presents to physicians and other healthcare providers on local, state and national levels including the World Congress of Geriatrics and Gerontology in Kaohsuing, Taiwan. Dr. Hoefer received his undergraduate degree from UCLA and his MD from Eastern Virginia Medical School, and completed his residency at Northridge Family Practice.

WEDNESDAY, APRIL 11Dianne GrayHospice and Healthcare Communications, Elisabeth Kübler-Ross FoundationDianne Gray is an author, advocate, and force of nature as a grief and end-of-life care expert with a degree that focused on sports management/sports medicine in college and the school of life afterward. She’s a global keynote speaker, author of hundreds of articles and textbook chapters, TV/radio host and guest, and President of the Elisabeth Kübler-Ross Foundation. She’s also been the single parent/caregiver for a child diagnosed at age 5 with a neurodegenerative disorder and parent of a healthy young daughter. Since her son died she has dedicated her life to improving care for all adults and children facing serious illness. Most recently, Dianne worked with Olivia Newton-John, Beth Neilsen Chapman and Amy Sky as a writer/partner “builder for good” for the LIV On project.

Ira Byock, MD, FAAHPMInstitute for Human Caring Providence Health and ServicesIra Byock is a leading palliative care physician, author and public advocate for improving care through the end of life. He is founder and chief medical officer of the Institute for Human Caring of Providence Health and Services based in Torrance, California. Dr. Byock is Active Emeritus Professor of Medicine and Community and Family Medicine at the Geisel School of Medi-cine at Dartmouth. He has been involved in hospice and palliative care since 1978, and is a past president of the American Academy of Hospice and Palliative Medicine (AAHPM). Dr. Byock has written extensively about the ethics and practice of care. He has received numerous awards for academic achievement and community services and was recognized as a Visionary by AAHPM in 2014. Dr. Byock has been a featured guest on national television and radio programs.

See bios for all 35+ presenters at ccccsummit.org/speakers

FEATURED SPEAKERS

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4 Tell us how you are forging a new path! Tweet using #CCCC18 Forging a new path for pal l ia t ive care.

PROGRAM: TUESDAY, APRIL 10, 2018

MORNINGkeynoteTaking Palliative Care Mainstream: A Glimpse of the Future CHARLES F. VON GUNTEN, MD, PHDVP, Medical Affairs, Hospice and Palliative Medicine OhioHealth Kobacker House; Edi-tor-in-Chief, Journal of Palliative Medicine Dr. von Gunten describes the path that other health care systems will follow by illustrating the path of a typical, Midwestern health care system in response to two facts. First, hospice care has been proven to be the best way to care for people in the last months of life. Second, palliative care has been proven to improve quality and reduce cost for the care of people with advanced illness. This represents success of the efforts of the past 50 years to change mainstream health care. However, success requires us to change, too.

general sessionWhat the Heck Happened in 2017? The New “Normal” and What It Means for Palliative CareJUDY THOMAS, JD, Coalition for Compassionate Care of California2017 was marked by natural disasters, mass shootings and political turmoil. What does that mean for palliative care? How do we take the high level of stress, chaos and trauma that seems to be our “new normal” and turn it into an asset for the palliative care movement? Find out what the Coalition for Compassion-ate Care is working on, has in store, and how you can participate in this great societal change.

Patient Stories: Are We Really “Hearing” What Our Patients Say?Better maternity care, seat belt laws, AIDS care, organ donation…. Every major improve-ment in public health has been advanced by an accompanying social movement. How can we work with patients to create a successful social movement around palliative care? We can start by listening. In these short, MedX style presentations, engaged patients and caregivers will share their personal stories and perspectives on life and serious illness.

AFTERNOONbreakoutsThe Road Ahead in San Diego: Application of the CCCC ModelKARL STEINBERG, MD AND JOHN TASTAD, SCC, San Diego Coalition for Compassion-ate CareIn 2016, CCCC hosted a statewide conven-ing of palliative care leaders and represen-tatives of diverse communities serving the needs of people challenged by serious illness. The goal was to provide an opportunity for participants to discuss progress, gaps and opportunities related to serious illness care in California, and from that discussion develop an agenda for progress toward a shared vision. CCCC has since made a toolkit for The Road Ahead events available to local coalitions. In November 2017, the San Diego Coalition for Compassionate Care hosted The Road Ahead to engage community leaders, identify local progress, gaps and opportuni-ties, and respond to local needs. This session will report on the event, share lessons learned and the final results.

Cultivating Our Capacity for CompassionANN ALLEGRE, MD, FACP, FAAHPM, Spiritual Care ProgrammeCaring for those who are suffering or dying can lead caregivers to feel depleted, a problem which is exacerbated by the stresses of working in the current health care envi-ronment. Empathy, or feeling the suffering of others, is essential to providing compas-sionate patient-centered care, but empathy alone leads to risk of burnout. Compassion is a way of being, a feeling that arises when witnessing the suffering of others and a desire to help. This session will help participants to understand the differences between empathy and compassion, consider the impact of these practices in their work and to learn a compassion practice that they can use in their own lives and work setting.

Starting From Scratch: Engaging Communities Using a Strengths-Based ApproachMARY MATTHIESON AND LISA DEAL, Mission Hospice and Home CareHospices have significant experience around end-of-life issues, yet can find themselves isolated as “just” end-of-life care providers in a community. Using an asset-based approach to community engagement around end-of-life issues delivered first in the UK and published in the BMJ Supportive and Palliative Care Journal, Mission Hospice launched a pilot in two communities to learn how and if we could begin a partnership and participatory approach to wider awareness, education and compassionate community initiatives in our region. This session will engage participants in the background, process and steps used, and share the key themes identified by each as essential to reach a wider community.

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Register online: CCCCSUMMIT.ORG/REGISTRATION 5BETTER TOGETHER.

Oil Blending for Pain and Symptom Management: The Use of Medical Cannabis in Palliative CareDAVID SINE, MD, Trilliam Kids/Bio-Life; DON ANDERSON, Bio-Life; SEAN HUNT, Bio-Life; LEE THAI, Bio-Life In 2016, Dr. Sine presented a session examin-ing recent clinical data and family testaments regarding the use of various alternative treatments and their increasing potential in pe-diatric palliative care. This session will update the progress made in the last two years on the project which has increased from about 40-50 patients to now over 450 patients – adults and children utilizing medical Cannabis for pain and symptom management. The session will present from the perspectives of physician, nurse practitioner and compound pharmacist.

Holding Onto Hope: Parental Beliefs and Emotions in Pediatric Palliative CareREV. SUSAN A COSIO, Sutter Medical CenterParents of children with advanced, life-threat-ening illness may face excruciating decisions

about their child’s medical care. Thinking about a child’s mortality is something most parents – and many healthcare professionals

– do not feel prepared to do. This workshop will explore the role and impact of parental perceptions, beliefs and emotions in pediatric palliative care, and identify ways that the palliative care team can better understand and respond to parents’ ways of thinking. We will identify the powerful role of hope, belief and expectation, and identify ways to com-municate honestly and effectively with parents, patients and families, while supporting their emotional, spiritual and cultural needs. We will also explore opportunities to maintain and/or transition the hopes of parents and providers throughout the continuum of care.

general sessionIf Only Someone Had Warned Us DANIEL R. HOEFER, MD, Sharp HospiceCareUsing a variety of patient scenarios, Dr. Hoefer will highlight the unintended conse-quences of continuing traditional interventions for pre-terminal geriatric patients. Honing our palliative prognostication skills is necessary if we are to provide interventions that support patient-centered outcomes.

afternoon networking events*This year, you’ll have multiple opportunities to get into smaller groups and explore game demonstrations, Q&As, and other fun stuff.

PROGRAM: TUESDAY, APRIL 10, 2018

AFTERNOON CONTINUED

EVENINGreception & poster sessionJoin us for cocktails, hors d’oeuvres, and a poster session featuring a showcase of the best community- based palliative care programs and projects from around the state.

Explore Anaheim!

Our first day at the Summit will end with the reception and poster session to allow you a night of fun and exploration in Anaheim. From restaurants

near the conference location, to Downtown Disney® and more, you’ll have plenty of time Tuesday night to get out of the hotel and enjoy what

Anaheim and Orange County have to offer.

*Get Interactive

Among the hallmarks of CCCC’s annual Summit are the variety of opportunities for participants to be interactive with the speakers, sessions and activities. We want you to get up, speak out and take advantage of all the Summit has to offer. You’ll find even more opportunities to become fully engaged in this year’s Summit through:

• Small group discussions• Large group discussions• Meet-ups with speakers• Q&As with presenters• Game demonstrations• And more!

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6 Tell us how you are forging a new path! Tweet using #CCCC18 Forging a new path for pal l ia t ive care.

local coalitions breakfastWatch your email for an invitation to the special networking opportunity for our local coalitions. This chance to meet with other coalition leaders and CCCC staff is a great place to see what other coalitions are doing and learn from each other.

panelThe Healing Power of Now: Using Presence as a Therapeutic ToolModerated by: JIM MCGREGOR, MD, Sutter Care at Home This panel session will explore what it means to be truly present with a seriously-ill person. Using a case-based approach, this inter-disciplinary panel will explore the practical application of Eckhart Tolle’s teachings on presence to the practice of palliative care.

panelUpping our Game: Understanding the Needs and Concerns of Those with Disabilities GRETCHEN ALKEMA, SCAN Foundation (Invited Moderator)Just as cancer used to be a topic we avoid, so is disability. How does that avoidance impact the care we provide and the conver-sations we have? Is it possible that by being more inclusive in our thinking that we can improve care for everyone?

morning networking events*This year, you’ll have multiple opportunities to get into smaller groups and explore game demonstrations, Q&As, and other events. See page 5 for more information.

awards luncheonCompassionate Care Leadership Awards

Celebrate the accomplishments of California’s leaders in palliative and end-of-life care during the Compassionate Care Leadership Award luncheon.

See Page 11 to learn how you can nominate an individual and organization for a Compassionate Care Leadership Award.

PROGRAM: WEDNESDAY, APRIL 11, 2018

MORNING

AFTERNOON

Taking Psychedelics Seriously: Responding to Persistent SufferingIRA BYOCK, MD, Providence Institute for Human Caring; CHARLES GROB, MD, Har-bor-UCLA Medical CenterSevere psychological and existential suffering robs people of meaningful quality of life and brings some to desire to end their lives. Currently available treatments for depression, anxiety, and spiritual distress often fail to alleviate suffering among people who are seriously ill. Renewed research involving psilocybin, MDMA and similar psychedel-ic compounds suggests that this class of drugs has important therapeutic potential in treatments for persistent, non-physical suffering. Psychedelic properties of specific plants have been used for centuries by indigenous cultures to induce expanded states of consciousness and spiritual experiences. In this session, we will review the pharmacology, clinical trials, and neurobiology of psychedelics, including evidence from functional imaging and discuss the clinical indications, contraindications, and side-effects of these medications as well as

the socio-political, legal and regulatory chal-lenges of prescribing and using psychedelics in carefully monitored ways.

Patients with Disabilities: Avoiding Unconscious Bias When Discussing Goals of Care CLARISSA KRIPKE, MD, UCSF Medical CenterPeople with terminal diagnoses sometimes fear loss of function, dependence on others for help, and loss of autonomy more than they fear death. Also, people with complex disabil-ities, cognitive or communication challenges, or who use personal support are frequently presumed to be terminally ill, or to have a low quality of life. These fears and beliefs can lead to premature withdrawal of life-sustaining care, poor advanced care planning, and unnecessary existential distress. This session will examine the ways in which healthcare providers can recognize and re-frame false narratives about disability and terminal illness to improve the lives of elders, people with

progressive medical conditions, and people with disabilities. It will review best practices for goals of care conversations and discharge planning to ensure that people can continue to participate and live well in their own homes and communities regardless of their functional limitations and support needs.

Bridging the Gap: An Advanced Illness Program to Connect the Community with Health ServicesCYNTHIA CARTER PERRILLIAT, MPA, Alameda County Care Alliance; VALERIA STEINMETZ, Alameda County Care Alliance; JANICE BELL, MN, MPH, PHD, Betty Irene Moore School of Nursing; JILL JOSEPH, MD, PHD, Betty Irene Moore School of NursingThe Alameda County Care Alliance (ACCA) Advanced Illness Care Program™ (AICP) is a faith-based, person-centered program operated through a consortium of 12 churches in Alameda and Contra Costa counties that provides navigation support to persons need-ing advanced illness care and their families/

breakout sessions

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Register online: CCCCSUMMIT.ORG/REGISTRATION 7BETTER TOGETHER.

PROGRAM: WEDNESDAY, APRIL 11, 2018

AFTERNOON (CONT.)caregivers to meet spiritual, advanced care planning, health (physical and psychosocial), social and caregiving needs. This session will explore how to reach vulnerable populations with advanced illness care needs beyond the healthcare delivery system through the training and deployment of community care naviga-tors in the faith-based community.

Targeting Strategies to Improve Advance Directives in Major Cancer HospitalsFINLY ZACHARIAH, MD and LINDSAY EMANUAL, City of Hope National Medical CenterThis session will present the efforts at City of Hope National Medical Center to increase completed advance directives through the development of a culturally sensitive ACP campaign; the successful integration of ACP patient navigators; and successful collabora-tive strategies to work with the hematology transplant population. We will share how a series of targeted interventions allowed for the increase of advance directive rates from 29 percent to 70 percent in just two years.

Care Concordance and the Evolution of End-of-Life WishesJENNIFER HOPPING-WINN, LCSW and MELISSA STERN, Kaiser Permanente North-ern CaliforniaHealth systems across the United States are engaging in efforts to elicit, document and honor the care preferences of patients as they near the end of life. However, little is known about how the wishes of patients evolve and whether those wishes are respected. To better understand the issue, Kaiser Permanente conducted a comprehensive review of care concordance between patients’ documented wishes and their final care encounter. In this session, we will share how this method can be replicated in other health systems and implications for any organization using POLST forms. While advance care planning and the POLST form provide invaluable tools for recording patients’ wishes, this study highlights the challenge in tracking patients’ wishes as they evolve over time and the need for ongo-ing conversations about goals of care.

It’s Different with Kids: A Conversation About Ethics and EmotionsMARTA FIEDMAN, LCSW, AHSW, JD and CHRISTY TORKILDSON, UCSF Benioff Chil-dren’s HospitalIn this session, we will look at the challenging situations faced in working with seriously-ill children in light of our own histories, narratives, feelings and judgments which often involve loss, cumulative grief, trauma, family dysfunc-tion and fracture, cultural/spiritual/religious differences, and so much more that we all bring. Working with children often leads to additional loss, grief, and trauma for providers as well as families. One of the hallmarks of palliative care is to gain an understanding of our patients and families, and how they make the difficult decisions we so often ask them to make. The goal of this session is to build upon intermediate and advanced ethical principles, and clinical skills and practice. As a group, we will look at case studies and share strate-gies that can be implemented in the very real situations that we often face.

Who Decides When Adoles-cents and Adults Don’t AgreeILANIT BROOK, MD, LINDA RADBILL, PHD, and MARI RADZIK, MA, PHD, Children’s Hospital of Los AngelesOne of the more difficult scenarios in medicine is navigating a medical plan when the patient and family do not agree. This becomes even more complex when the patient is not of legal age but seemingly has capacity to make medical decisions. We will explore how the palliative care team can help to navigate to a unified, agreed-upon medical plan when there is dissent between an adolescent patient and their family. Using current understanding of both the legal and neuro-developmental aspects of capacity and cases we’ll highlight a potential path to com-promise and discuss tools that are available to support the case that an adolescent may have capacity to make their own decisions.

panelAfter the Act: Lessons Learned and Benefits for the Broader Population after the End of Life Option Act ImplementationModerated by: LAEL DUNCAN, MD, Coalition for Compas-sionate Care of CaliforniaHas implementation of the End of Life Option act moved the dial on how we die? What did we learn from the development of policy and processes for the End of Life Option Act that we can use to better inform the care and conversations we offer everyone with terminal illness? Does the work we’ve done around the Act affect how we think about creating a better end-of-life experience for all patients? Have we learned what it might take to ensure universal patient access to informed deci-sion-making in the last phase of life?

closing sessionTogether We Can Do Any-thing: Leveraging Communities of Care to Spread Palliative CareDIANNE GRAY, Hospice and Healthcare Communications and Elisabeth Kübler-Ross FoundationDianne Gray would like you to think differ-ently about your tribe — those who make up your overall palliative care community. Why? Because as she puts it, “the need for palli-ative care will soon out-pace the resources available. Simply put, we don’t need to ask palliative care teams to work harder. We need to help them work smarter… and one way to do this is through creating enhanced communities of care.” Listen in as Dianne, a former 12-year caregiver who now is a 25-year hospice and palliative care journalist, researcher and global advocate, shares the most up-to-date outside the box resources, research and technology that will help not only patients and family members but you too, as you strive to meet the needs inherent in the provision of quality palliative care. Together we do anything, especially if we expand our scope of vision as to what constitutes our inter-nal and external tribe, as well as our palliative care community.

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8 Tell us how you are forging a new path! Tweet using #CCCC18 Forging a new path for pal l ia t ive care.

HOTEL & TRAVEL

Hotel WYNDHAM ANAHEIM GARDEN GROVE 12021 Harbor Blvd, Garden Grove, CA 92840

Special Room Rate: $165 Single/DoubleSpecial Rate Cutoff Date: March 15, 2018Reservations: https://aws.passkey.com/go/CoalitionforCompas-sionateCarePhone: (800) 996-3426Booking and canceling hotel reservations are the responsibility of Summit attendees.

PARKINGThe Wyndham Anaheim offers overnight and day parking. Overnight self-parking is included in hotel registration, overnight valet is available for $16/night.

Day self-parking is complimentary, and day-use valet is available for Summit attendees for $13/day.

TRANSPORTATIONThe Wyndham Anaheim Garden Grove is located off of Interstate 5, and is convenient to the Long Beach, John Wayne-Orange County, LAX, and Ontario airports. Additionally, the hotel offers a courtesy shuttle to and from Disney-land® as well as a Disneyland® Resort Desk for admission purchases.

MEETING LOCATIONWyndham Anaheim Garden Grove is an Orange County oasis, nestled between the scenic cities of Anaheim and Garden Grove, just ten minutes away from legendary attractions like Disney California Adventure Park® and Downtown Disney®. Discover bright, modern California-style décor and a wealth of amenities that will enrich your stay.

ANAHEIMFrom world-famous theme parks and nearby beaches to pro sports and foodie hotspots, sun-splashed Anaheim has it all. Find yourself here – and leave ordinary behind.

Southern California is home to many of the world’s best theme parks, from the original Disneyland® Park in Anaheim to SeaWorld® in San Diego to Universal Studios Hollywood. You’ll also find Aquarium of the Pacific, the Richard Nixon Presidential Library and Museum, as well as a number of history and art museums and golf courses nearby.

Make the best of your visit to Anaheim. Check out VisitAnaheim.org.

WELCOME TO ANAHEIMAlways a good time in Anaheim!

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Register online: CCCCSUMMIT.ORG/REGISTRATION 9BETTER TOGETHER.

Summit Registration RatesPricing Deadline Member Non-Member

January 28, 2018 $399 $599

February 28, 2018 $499 $699

Late & Onsite $599 $799

Online RegistrationPay online at http://ccccsummit.org/registration

Register by MailTo register by mail, complete the form on Page 10 and mail it along with payment (credit card or check) to:

Coalition for Compassionate Care of California Attn: Keeta Scholl 1331 Garden Highway, Suite 100 Sacramento, CA 95833

SPECIAL NEEDSTo address a grievance or request special accommodations pursuant to the Americans with Disabilities Act, call (916) 489-2222.

SCHOLARSHIPSA limited number of scholarships are available for students and pallia-tive care patient advocates. All scholarship recipients are expected to attend the Summit in full. Visit the scholarships page to learn more and apply at http://ccccsummit.org/scholarships.

SUMMIT CANCELLATION POLICYRegistration substitutions are allowed and encouraged. If you must cancel your registration, send written cancellation requests via fax to (888) 789-9475 or via email to [email protected]. Cancellations received prior to February 27, 2018, are subject to a $25 adminis-trative fee. Cancellations received on or after February 27, but prior to March 20, 2018, are subject to a $100 administrative fee. No refunds will be issued for cancellations received on or after March 20, 2018.

CONTINUING EDUCATIONFull attendance, in its entirety, is required at all education sessions in order to receive professional continuing education credits (CMEs/CEs). Continuing education is provided for full-day attendance. Partial day credit is not available. All attendees must sign in with their professional license numbers in the morning of each day of the Summit. In order to receive credit, participants must complete an online survey within 30 days following the Summit in order to receive a CME/CE certificate. Continuing education certificates will be sent via email. Certificates of at-tendance will be available at the end of the Summit in the afternoon of Wednesday, April 11, 2018. Note: A 50-minute minimum of uninterrupted time is required to qualify for one hour of CME/CE credit. Continuing education excludes lunch and break periods.

PHYSICIANS & PHYSICIAN ASSISTANTS

Application for CME credit has been filed with the American Academy of Family Physicians. Determina-tion of credit is pending. CME credits are sponsored by Partnership HealthPlan of California.

NURSES This course meets the qualifications for approximately 12 contact hours. This provider is approved by the California Board of Registered Nursing, Provider #CEP 15403.

SOCIAL WORKERS

This course meets the qualifications for an estimated 12 hours of continuing education credit for LMFTs, LCSWs, LPCCs and/or LEPs as required by the California Board of Behavioral Sciences. CCCC is ap-proved by the California Association of Marriage and Family Therapists to sponsor continuing education for LCSWs and LMFTs, Provider #91987.

NURSING HOME ADMINISTRATORS

An application has been made to the California Nursing Home Administration program (NHAP# CEP 1735) for an estimated 12 NHAP/P credits. Determination is pending.

CHAPLAINS This program may be used for continuing education credit for chaplains certified with the Board of Chap-laincy Certification, Inc.

A CONFIRMATION EMAIL WILL BE SENT TO ALL REGISTRANTS AT LEAST ONE WEEK BEFORE THE SUMMIT.

REGISTRATION INFORMATION

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SUMMIT REGISTRATION

ONLINE @ http://ccccsummit.org/registrationFAX (888) 789-9475 / PHONE (916) 489-2222CCCC SUMMIT, 1331 GARDEN HIGHWAY, SUITE 100, SACRAMENTO, CA 95833MORE INFORMATION: [email protected]

NAME SUFFIX

TITLE ORGANIZATION

ADDRESS

@

EMAIL PHONE TWITTER HANDLE

CONTINUING EDUCATION ARE YOU INTERESTED IN ATTENDING PEDIATRIC BREAKOUT SESSIONS?

{ Physician { Nursing { Social Work { Nursing Home Administrator { Yes { No { Maybe

{ Certificate of Completion License No. (required):

CCCC ANNUAL SUMMIT REGISTRATIONRegistration includes summit materials, and continental breakfast and lunch on both days. Limited partial scholarships are available. Contact CCCC for more information at (916) 489-2222 or [email protected].

EARLY (Postmarked by January 28, 2018) { CCCC Member ...............................................................$399 { Non-Member .................................................................$599

ADVANCE (Postmarked between January 28 and February 28, 2018) { CCCC Member ...............................................................$499 { Non-Member .................................................................$699

LATE (Postmarked on or after February 28, 2018) { CCCC Member ............................................................... $599 { Non-Member ................................................................. $799

CCCC MEMBERSHIP / I would like to become a member of CCCC { Individual .......................................................................$50

All staff of organizational members can attend at the member rate. For more information, visit CoalitionCCC.org/membership

You must have paid CCCC dues for the current year to qualify for the membership rate. To verify, contact CCCC at (916) 489-2222 or [email protected].

If registering as a member, specify membership type: { Organization { Community Coalition { Individual

Indicate the name of the organization or coalition that is a current CCCC member: _____________________________________________________

CCCC DONATION Keep up the good work!AMOUNT $___________________________________________________

TOTAL $_____________________________________________________

I give CCCC my permission to include my contact information in the roster of attendees:

{ Yes { No

PAYMENT METHODAll registrations must be pre-paid:

{ Check enclosed payable to Coalition for Compassionate Care of California { Credit Card (Visa, Mastercard or Discover)

Name (as it appears on card)

Billing Address

City State Zip

- - -

Credit Card Number

Expiration Date (dd/yy) 3 or 4 digit security code

Signature

Faxed registration with signed purchase order is also accepted. Fax to (888) 789-9475.

Indicate below if you wish to receive one of the following meals:

{ Vegetarian { Vegan

Indicate below if you require special accommodations pursuant to the ADA:

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Register online: CCCCSUMMIT.ORG/REGISTRATION 11BETTER TOGETHER.

OTHER INFORMATION

Nominate a Leader

& HONOR THE EXTRAORDINARY

Do you know of a leader, researcher, practitioner or

organization making a positive impact on the way Californians are cared for during serious ill-

ness or at the end of life?

Nominate them for a Compassionate Care Leadership Award!

Categories include individuals and organizations, companies or facilities. Honorees are cel-

ebrated at a Summit luncheon on Wednesday, April 11.

Deadline for nominations:5pm PT, Wednesday, Feb. 7,

2018

Learn more at:ccccsummit.org/awards

Susan Keller, MA, MLIS2017 Compassionate Care Leadership Award recipient

Early Registration

Our registration desk will be open on Monday evening from 4:00 - 7:00pm. Swing by, grab your badge and program, and be ready to hit the Summit run-ning on Tuesday morning.

schedule-at-a-glance

Sponsor the Summit

Your gift of sponsorship will help us bring together more than 400 health care professionals—including healthcare administrators, doctors, nurses, phy-sician assistants, social workers, educators, chaplains, and thought leaders from around the state—who are dedicated to taking palliative care main-stream and making it a standard in care for people with serious illness or life-threatening conditions.

Join us as a sponsor and make possible the discussion, learning, and inno-vation in how we can improve care for the seriously ill—from helping families make informed decisions to providing quality end-of-life and palliative care for under-served populations.

Sponsorships start at $1,500 and include your logo printed on Summit mate-rials and promotion before and during the event. Contact us today to learn more!

Purchase your sponsorship at www.ccccsummit.org/sponsor, and contact us at (916) 993-7712 or [email protected].

MONDAY,APRIL 94:00pm–7:00pmEarly Registration Open

TUESDAY,APRIL 10

7:30am–6:00pmExhibitor Tables Open

7:30am–4:30pmRegistration

8:30am–4:30pm Sessions

4:30–6pmReception & Poster Session

WEDNESDAY,APRIL 11

7:30–8:30amRegistration

8:30am-4:00pmSessions

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REGISTER EARLY &

SAVE UP TO 22%

Forging a New Path to Palliative Care10th Annual Palliative Care Summit

APRIL 10-11, 2018 ANAHEIM, CA

10TH ANNUAL PALLIATIVE CARE SUMMITRegister by January 28, 2018 and save!

1331 Garden Highway, Suite 100Sacramento, California 95833

CCCCSUMMIT.ORG

PRESORTFIRST CLASSU.S. POSTAGE

PAIDPERMIT NO. 1841

SACRAMENTO, CA