In 2008, a California HealthCare Foundation (CHCF) report on California hospital-based palliative care programs found that although 43% of all hospitals in the state had palliative care programs, only 22% of public hospitals (4 of 17) had palliative care programs. Due to the state's fiscal crisis, many public hospitals lacked the funds to establish or expand palliative care services.
Recognizing that a lack of palliative care services in public hospitals was a barrier to providing appropriate care for their underserved populations, in 2008 CHCF launched a partnership with the California Safety Net Institute (SNI) and the University of California, San Francisco, Palliative Care Leadership Center (PCLC). The goal of this five-year initiative, Spreading Palliative Care in Public Hospitals (SPCPH), was to develop new, sustainable in-patient palliative care programs in California's public hospital system and to support expansion and enhancement of existing public hospital palliative care programs, with an emphasis on reaching diverse communities.
This reports chroincles the work of the SPCPH initiative, including three projects that were created along the way to respond to challenging situations faced by participating palliative care teams. Teh report highlights the initiative's success and challenes and describes the elemejnts that paved the way for the establishment of sustainable palliative care programs in all of California's public hospitals.