An Advocate at Life’s End
Early in her career, Cheryl Kraus ’04 was litigating a domestic violence case. She thought the outcome was “incredibly unjust,” and articulated her concern to the judge. “The law,” he replied, was appropriately applied in this case. “If you don’t like the law, change it.”
Challenge accepted. “That was my wake-up call,” she says. “It was the epiphany I needed to focus on legislative and policy advocacy to challenge the status quo and make a substantive difference.”
Now with much legislative advocacy and impactful substantive change under her belt, as the first vice president of government affairs and director of policy for the Hospice & Palliative Care Association of New York State, Kraus advances the cause of compassionate and holistic serious illness care both statewide and nationally.
In an era when social services providers embrace holistic approaches—considering the totality of people’s lives, from food to housing to mental health, in addressing their immediate need—Kraus notes that hospice and palliative care was a pioneer on the health care continuum. “Hospice was the first model to address health care from a holistic point of view,” she says, with not only medical but social work and spiritual support for dying patients, including grief support for their loved ones and families. “Hospice isn’t about curing an illness, but it is very much about healing. It provides patient-centric care and support that people truly need. It’s an incredible model, and the rest of the health care system is catching up to its tangible and intangible value.
Much of her role, Kraus says, centers around educating legislators and the public that Medicare covers hospice care for terminally ill people for up to six months—crucial support that is often underused. The mean length of such care in New York, she says, is only 17 days; “how to increase hospice utilization is truly a driving force of our work."
Toward that end, she’s celebrating win after win in the state Legislature: a recently passed bill to mandate a statewide campaign to encourage advance planning, educating New Yorkers on all aspects of end-of-life care and the decisions that accompany it. The effort also aims to address misconceptions around hospice care in some populations that Kraus says can prevent people from getting the care they need.
“Some people are very mistrusting of the health system in general,” she says, “and there is a social stigma surrounding hospice that creates barriers for patients and their families.” A cultural bias toward dying at home, for example, can dissuade patients from seeking hospice care if they do not know that hospice can include both in-home and inpatient situations. “People do not understand that hospice is not a physical location but a philosophy of care,” she says. “There needs to be a cultural shift in outreach and awareness.”
Kraus built the government affairs practice of the Hospice & Palliative Care Association from the ground up; it now has two in-house lobbyists and two who work on contract. She says that it’s a privilege working with legislators. Most recognize the tangible and intangible value of hospice and palliative care.
It’s not just ethically and morally the right health policy path to pursue, she says, it’s not just the recognition that when appropriately funded and regulated, hospice is health care done right—when it’s used appropriately, there’s profound cost savings in avoiding expensive and more invasive emergency room and hospital care. That’s significant when health systems are facing bankruptcy and when we are facing a healthcare workforce shortage – all policy issues being studied and advocated for by Kraus.
On the national scale, Kraus was invited by Sen. Kirsten Gillibrand to join a working group developing a federal Master Plan for Aging, assembling a set of recommendations to support the nation’s rapidly growing older population and enable them to age in place. “People are living longer, and they’re living longer with chronic conditions. We are not prepared on the state or the federal level for the aging tsunami that’s about to hit,” Kraus says. She also worked on New York State’s Master Plan for Aging, which will begin implementation in 2025. Through her association’s advocacy, Governor Hochul directed the creation of the Office of Hospice and Palliative Care at the Department of Health, the first state in the nation to do so. Through the association’s work, New York State has emerged as a leader in the serious illness care space.
Kraus’ commitment to the cause extends to volunteer service through the state Bar Association, the Women’s Bar Association, the national Hospice Action Network, as a legislative advocate with the Alliance for Care in the Home, and as the legislative chair and bioethicist for the New York State Medical Orders for Life-Sustaining Treatment Program (the MOLST form documents a patient’s wishes for end-of-life medical care). She has negotiated language on a number of impactful healthcare-related bills ranging from gestational surrogacy, domestic violence, adoptee rights, Medical Aid in Dying, and access to the hospice benefit.
That impulse for advocacy and her perseverance runs deep. Kraus is a first-generation high school graduate and was the first in her family to graduate from college, and then law school. “I’ve always been an advocate who had to be resourceful, innovative, and strategic. I’ve always been driven by wanting to serve and support others to achieve what is right and just,” Kraus says. “And there aren’t many practitioners who know the complex care and the end-of-life care space from a holistic health law and policy practice perspective. There are many moving parts and it’s a complicated game at the chess board. At the end of the day, I do it because it needs to be done. It’s past time to get this right.”