Solomon Center’s Groundbreaking Palliative Care Law and Policy Initiative Drives Nationwide Reforms

The Solomon Center for Health Law and Policy at Yale Law School has established the country’s first comprehensive interdisciplinary initiative dedicated to palliative medical care, law, and policy — a pathbreaking effort that is already shaping reforms for patients of all ages.

The fast growth of the palliative care field — which aims to reduce the symptoms and stress of serious illness — has created a pressing demand for policy guidance. More than 80% of hospitals with 50+ beds now have a palliative care team, and palliative care is spreading into community settings. Little regulation exists at the federal level, leaving a complex array of state and local laws and policies.

Drawing from its deep well of health law and policy expertise, the Solomon Center is engaged with work in areas ranging from pediatric palliative care, to clinical workforce needs, to improving health outcomes for Native American communities, incarcerated patients, and other vulnerable populations. There is a clinical impact too, in the Center’s Palliative Care Medical-Legal Partnership, a unique collaboration with Yale New Haven Hospital.

The work is supported by a first-of-its kind open-access research platform for palliative care policy across the states, developed by the Center, and in collaboration with partners at Yale School of Medicine, Yale School of Public Health, Yale School of Nursing, and Mount Sinai’s nationally renowned Center to Advance Palliative Care.

“Palliative care is mostly not end-of-life care; it’s essential medical care for those living with chronic illness across the life spectrum,” said Alfred M. Rankin Professor of Law and Solomon Center Faculty Director Abbe R. Gluck ’00. “Our work is equipping state, local, and Native American lawmakers, medical professionals, and advocates with the legal and policy tools they need to rapidly adopt and assess impactful reforms.”

Transforming care for Connecticut’s most vulnerable children

The Center’s leadership is highly visible in Connecticut, where momentum is building to enhance care for children navigating life-threatening conditions.

For years, the state has lacked comprehensive pediatric palliative care services, leaving families to assemble support from a patchwork of insurers and clinics. To help fill this gap, the Connecticut General Assembly established a working group in 2024 tasked with recommending statewide reforms. Solomon Center Senior Academic Fellow Eugene Rusyn ’17 recognized an opportunity to support policymakers in addressing the needs of this critical population.

“Here you have children already shouldering the burden of a life-threatening illness who are not getting basic assistance,” he said. “This is despite evidence showing that palliative care can both improve patient outcomes and decrease health system costs.” Rusyn and his colleagues, Deputy Director Elle Rothermich and 2024–25 Research Fellow Wendy Jiang, launched an ambitious research effort to help reframe the state’s approach to pediatric palliative care.

Over the past year, the team has published a series of white papers and an op-ed outlining how Connecticut could expand pediatric palliative care coverage, bolster the state’s palliative care workforce, and strengthen data collection.

In March 2025, the Connecticut Children’s Health, Advocacy, Management and Palliative Care (CHAMP) Working Group highlighted the Center’s research in its interim report to the state legislature, which the General Assembly expressly acknowledged in legislation enacted in June 2025, incorporating the Center’s work into the research timeline laid out in the law.

Soon after, CHAMP awarded the Center a seat on its advisory committee, and Rusyn was invited to present findings to the advisory council of the Pediatric Palliative Care Coalition of Connecticut. The CHAMP Working Group’s aim is to have a bill brought before the General Assembly in the next legislative session.

This swift uptake of reform proposals is precisely the effect well-targeted policy research should have, according to Jeremy Pilaar ’18, executive director of the Solomon Center.

Laying a national foundation for access to high-quality care with a cutting-edge research platform

Last year, the Center officially launched the Palliative Care Law and Policy GPS, a first-of-its-kind, publicly accessible database of state and local proposed and enacted legislation related to palliative care. The Center has been working on the GPS with Mount Sinai’s Center to Advance Palliative Care since 2021. It currently holds 15 years of data covering all 50 states, and is open to any researcher. The Center is in the process of adding an AI element to the platform to make its contents even more efficient and accessible.

The GPS has aided a broad research agenda. Last November, Rusyn, Jiang, and colleagues published the first-ever study examining palliative care legislation across all 50 states and the District of Columbia over a 15-year period. The piece was published in JAMA Health Forum.

“Our analysis highlights that while overall state-level palliative care policymaking has increased, there remains significant regional and topic-level variation likely contributing to unequal access to palliative care nationwide,” said Dr. Shelli Feder, a Solomon Center affiliated faculty member and Yale School of Nursing associate professor.

“These findings offer an essential starting point — identifying gaps in current palliative care policymaking as well as states that may benefit from targeted outreach,” she stressed.

Since its launch, the GPS has become a field-defining resource, informing research on subjects ranging from palliative care workforce development, policy evaluation, data gathering, and policy innovation to improvements in palliative care for children and adolescents, residents of rural communities, and cancer patients.

“This is exactly the outcome we were hoping for,” Rusyn said, “to provide a platform that researchers and lawmakers can use to inform concrete policy change across the states.” 

Turning research into action

Solomon Center scholars are expanding their research to cover an even wider range of palliative care subfields. Much of this work is focused on improving health outcomes among marginalized groups. Current projects include expanding palliative care in Native American communities, evaluating state efforts to increase community-based palliative care, tracing the effects of high drug prices on low-income people with serious illness, and addressing spiritual distress among pediatric patients.

Rusyn also recently joined a new state policy workgroup convened by the Palliative Care Resource Center at the National Academy for State Health Policy (NASHP). The group — composed of state policymakers and a small number of national experts — will develop model legislation for a Medicaid community palliative care benefit, which would extend vital services to the lowest-income Americans.

Novel clinical interventions: The Yale/Yale New Haven Palliative Care Medical-Legal Partnership

The Center’s involvement with palliative care goes back to 2014, when Gluck and Dr. Andrew Putnam at Yale School of Medicine first conceived of a Palliative Care Medical-Legal Partnership (PMLP). Solomon Center students and faculty work closely with the Palliative Care team at Yale New Haven Hospital (YNHH) to address critical needs of patients toward the end of their lives, including housing, guardianship, and benefits. This was the third distinct patient population added to the Yale/Yale New Haven Medical Legal Partnership (MLP), a program founded in 2012 by Gluck that brings lawyers into medical settings to address the social and legal civil needs of medical patients to improve their quality of life and reduce systemic costs.

Today, the Yale/Yale New Haven MLP is a collaboration of the Solomon Center, the School of Medicine, and YNHH. The MLP serves approximately 600 patients across eight sites each year.

“The PMLP is so wonderfully synergistic with the philosophy of palliative care itself,” said Gluck, “namely, that addressing the stressors and pain of patients — whether clinical, legal, or social — improves quality of life, which, in turn, can have a dramatic effect on health and the management of disease.”

As for the next step in this already sprawling project, “we are just getting started,” Pilaar emphasized. “We will keep doing all we can to advance reforms and innovations that support patients and families when they need it most.”

About the Solomon Center

The Solomon Center for Health Law and Policy at Yale Law School is the first of its kind to focus on the intersection of law and the governance, practice, and business of health care. The Center brings together leading experts and practitioners from the public and private sectors to address cutting-edge questions of health law and policy, and to train the next generation of top health lawyers, industry leaders, policymakers, and academics.