WHV Partners Give Thanks - National Hospice and Palliative Care

Transcription

The Monthly Membership Publication of the National Hospice and Palliative Care Organization
November 2012
WHV Partners Give Thanks
W
e Honor Veterans is a program that NHPCO and
the Department of Veterans Affairs launched
together in September 2010, with one simple
goal: To focus more attention on the needs of Veterans
and support hospices in meeting those needs.
The single most important way to meet this goal is by
encouraging all hospices to participate in WHV—by
signing on as a “Recruit” and moving up in status (e.g.,
Partner Level One, Two, Three and Four) by performing
specific Partner-level activities.
So how is the WHV program doing? What impact is it making
on the care provided to Veterans and their families?
There are now 1,500 hospices which participate in the
program and are recognizing Veterans in a variety of
creative and, often heartfelt, ways.
Inside
In this article, six WHV Partners discuss the
initiative they’re most proud of and how it
is succeeding in recognizing Veterans for
their service while also improving their
quality of life at life’s end.
ACOs: Are You Ready?
Accountable Care Organizations are one part of a national health care overhaul to cut costs and increase
quality—and their numbers are growing! This article reviews the basic structure of ACOs, but devotes
more discussion to the role your hospice can play and a suggested plan of action if that’s the path you
wish to pursue.
How a Veteran’s Experience Can Inform Bereavement Practice
continued on next page
Short Takes:
• Serving Veterans: A Tool to Help Evaluate Your Performance
Through the stories of George, Jim and Mike, Bereavement Services Director Beth McGuire shows us
how a Veteran’s military service can help the hospice clinician better assess and understand the grief
reactions that may need to be addressed as part of a plan of care.
A Message From Don
Hospice in the Continuum
Member News and Notes
Since 2003, Kansas City Hospice and Palliative Care has launched a range of specialized services that
were lacking in its service area, including Palliative Home Care and Palliative Medicine programs.
President/CEO Elaine McIntosh discusses the ambitious expansion as well as the fiscal challenges of
providing palliative care.
Compliance Tip of the Month
• Now Live—ehospice.com
Videos Worth Watching
News From FHSSA
continued from previous page
Pikes Peak Hospice
& Palliative Care
Colorado Springs, CO
A Small Gesture
That Opens Doors
By John Bauer, DMin
Several years ago, Pikes Peak Hospice &
Palliative Care (PPHPC) staff members
who are Veterans themselves, or had
served in the uniformed services,
initiated a special effort to formally
thank the distinguished Veterans
receiving our care.
Each Veteran patient is presented with an heirloom-quality coin, created in the
shape of a “dog tag,” and a certificate of appreciation that bears the seal of his or her
branch of service.
These heirloom-quality dog-tag coins are patterned after the “coins of excellence”
that nearly all service members have received while in uniform. While just a piece
of metal, the coins of excellence are treasured by all soldiers, sailors, Marines, or
airmen who had one pressed into their hands as a “thank you” for service rendered,
so it was fitting to model our small gift after them.
On March 1, 2007, I had the privilege of being part of PPHPC’s first presentation to 92
year-old Norman Brown (pictured above). Norman was a combat Veteran of World
War II—a gunner on one of the B-29s that flew over Japan. Modest as ever during
the presentation, Norman said “I’m no hero. People may think that I am, but that’s
just because there’s not many of us left.”
Initially, we didn’t know how this expression of gratitude would be received by
our Veteran patients—and we were both heartened and surprised. Heartened when
one of the first responses we received was a simple, “thank you for saying thank
you.” And surprised that many Veterans from all of our wars (including the War in
Afghanistan) appreciated that we were making the effort.
We were also grateful that so many family members have appreciated the simple
gesture as well. Many of these family members had endured the worry and
loneliness of having their loved ones far way from home in harm’s way, so the coin
and certificate have become heirlooms to them when their loved ones have died.
continued on page 4
2
NewsLine
November Means Many Things
It has been a particularly busy fall, not only for us here at NHPCO but
for everyone across the nation. As we go to press, we are two weeks
away from a presidential election. While it may occur every four years,
it is always significant. Regardless of the outcome, I think it’s safe to
say that the hospice palliative care community will be facing some
challenging times ahead. A big part of this involves the ever-increasing
regulatory and compliance scrutiny facing our field as well as ongoing
threats to reimbursement.
Please rest assured that NHPCO and our colleagues at the Hospice Action
Network are keeping a close eye on all the factors that might have an
effect on hospice and palliative care providers. A new Congress will
be coming to Washington in the months ahead and that always brings
the opportunity to cultivate new Congressional champions. You play an
important part in that critically important work and I encourage you to
make sure that you, your coworkers, and your organization’s supporters
are part of the Hospice Action Network. It’s free to register at www.
hospiceactionnetwork.org and this will connect you with the largest
hospice advocacy effort in the U.S.
And it would not be November without wishing you a happy National
Hospice and Palliative Care Month. I am always profoundly touched
when I read of the amazing outreach efforts and events that happen
every year during this time. To help shine the light on this work, we will
be encouraging hospice supporters to share photos and news of special
events on Twitter (using the hashtag: #hospicemonth). Throughout the
month, I encourage you to join NHPCO in filling the Twitter-scape with
positive messages about hospice!
We will also honor our nation’s Veterans on November 11. As we share
in this month’s cover story, there are now more than 1,500 hospices
registered with our unique We Honor Veterans campaign. If your program
is not one of them, please visit the We Honors Veterans website to join us.
As the month moves forward and we focus on the holiday season that so
often draws family and loved ones near, I encourage you to spend some
time thinking about the many things we have to be thankful for.
J. Donald Schumacher, PsyD
President/CEO
NewsLine
3
Those who served in World War II are now dying by the thousands. They have
been called “The Greatest Generation,” but they were also members of “The Silent
Generation.” They went off to serve their duty, often for the entire length of the
conflict. Then, when they came home, more often than not they said nothing,
keeping the horrors of war to themselves, much like Norman. “I make it a rule not
to talk about it,” he said. “There were too many guys who went through a lot worse
than I did.”
We have found that this simple act of gratitude opens the door for these Veterans’
untold stories. Our hospice care teams report again and again that when the coin
and certificate are presented, a pent-up dam of emotion bursts. I have personally
found it profoundly moving to look into the eyes of a Veteran whose buddies didn’t
come back or who has seen what the weapons of modern technology can do to a
human body, and see the light begin to shine again.
Norman Brown was our first recipient, and on August 31 of this year, we presented
our 1,400th coin and certificate.
John Bauer retired from the U.S. Army in 2003 and has served as a chaplain for Pikes
Peak Hospice and Palliative Care since 2004.
Hospice & Palliative
CareCenter
Winston-Salem, NC
Creating a
Lasting Tribute
By Tina Stearns
A very special event to honor Veterans
is taking place this month, in
celebration of Veterans Day. The staff,
volunteers, and patients and families of
Hospice & Palliative CareCenter will be
joined by invited guests to unveil our
Veterans Garden.
The dedication ceremony promises to be a memorable one, punctuated by the Oak
Ridge Military Academy’s Color Guard and the VFW Memorial Honor Guard, and
a three-volley rifle salute to honor all deceased military Veterans, followed by a
4
NewsLine
bugle performance of Taps. At the conclusion of the formal program,
“Amazing Grace” will be played on bagpipes while the Patriot Guard
Riders surround the Veterans Garden, each holding a flag.
The garden is situated in front of our Hospice House,
which is located on the CareCenter’s 14-acre wooded
campus. Its centerpiece is a flagpole that is embedded
in a large boulder, upon which the emblems of the five
branches of military service are engraved. The flagpole
is surrounded by a raised flower bed and four custom
benches, designed and handcrafted by sculptors from our
community under the guidance of local artist, Jan Detter.
The benches feature beautiful mosaic designs (Jan’s
specialty), some made from actual bullet casings.
The garden is designed for wheelchair accessibility, with the goal
of being a special place for reflection and respite while also being a
tangible expression of thanks to all Veterans who have served our
country.
Opposite: The Garden’s
centerpiece as it takes
shape. Above: The back of
one of the benches where
bullet casings were used to
create a starburst design.
Of special note was the overwhelming support we received from
the community. The fundraising efforts were swift and successful,
illustrating our community’s shared passion for this project. A
significant portion of the funds were raised by reaching out to local
Veteran organizations like the VFW, Patriot Guard Riders, Oak Ridge
Military Academy and the American Legion. I presented “Hospice 101”
sessions during their meetings and received donations for the garden
afterwards. We also reached out to the families of the patients we have
served. Additional donations were made by corporate donors, including
a major corporate grant from Wells Fargo.
As we look upon the finished garden, we see so many benefits that have
come from it. Our president/CEO, Brian Payne, wanted a way to openly
demonstrate our support of all Veterans, and it surely accomplishes that.
But it has also served as a way for many members of our community
to express their thanks through donations and has helped us, as an
organization, develop valuable relationships with the VA, the VFW,
Patriot Guard Riders and the Oak Ridge Military Academy.
Tina Stearns is the director of community outreach for the Hospice &
Palliative CareCenter, where she has worked since 2005.
NewsLine
5
Stein Hospice
Sandusky, OH
An Honorable Send-off
By Julie Yeager
During a brief ceremony at one of Ohio’s two Veterans Homes, a U.S. flag was
draped over the body of a Veteran who had just died as staff members gathered
around for a short but meaningful tribute. This ceremony took all of 15 minutes,
but the staff members of Stein Hospice, which has offices in both Veterans Homes,
were so moved by it that they decided to create a similar ceremony for Veteran
patients at Stein Hospice’s 18-bed Care Center in Sandusky.
Since March of 2011, we have conducted this “Escort Ceremony” for 36 Veteran
patients and it has become especially important to both the families and hospice staff.
When we launched the initiative, Rev. Charles Odums, a chaplain at one of the
Veterans Homes and a parent of a slain soldier, helped us conduct training on how
to properly fold the U.S. flag, and the training was taped for future hires. We then
created a formal policy, established procedures, and notified the area funeral home
directors. A Stein Hospice chaplain donated a U.S. flag (that had been flown over
the U.S. Capitol years ago) and a storage case was purchased.
When a Veteran patient dies, a “Code Stars and Stripes” intercom announcement is
made. During the day, as many as 25 staff members are able to gather outside the
patient’s room. In the middle of the night, only one or two staff might be available.
Regardless of the number of participants, the ceremony is essentially the same:
• After the funeral home director has moved the Veteran from the bed to a
gurney, a flag is placed over the body (stars over the head and to the left side,
and stripes at the feet).
• If a Veteran is available, he or she leads the procession, followed by a chaplain,
family members and Stein Hospice staff and volunteers. (At Stein, the Veteran
might be our senior medical director, Dr. William Inglis, a Veteran volunteer, a
family member of the deceased, or a family member of another patient.)
• The procession stops at our chapel, where the flag is folded.
• One of the participants offers words of appreciation for the Veteran’s service to
our country and condolences to the Veteran’s loved ones.
6
NewsLine
While the ceremony is simple, it is meaningful. Families often tell us,
with tears in their eyes, that it is just what their deceased loved one
would have wanted.
William “Bill” Brown was one of our first Veteran patients to be
honored with an Escort Ceremony. He was a gentle giving man who
joined the U.S. Army during World War II, had witnessed the liberation
of a German concentration camp, and had earned several ribbons and
medals. As Bill’s family waited for the funeral home director to arrive,
Stein Hospice staff members were notified that a Veteran had died and
by midnight the ceremony was conducted.
“It was brief but reverent, and fitting respect for a warrior, a loving
family man, and a wonderful citizen of the universe,” Bill’s son, Joe,
told us. “In a final simple act of unconditional love and respect, he was
escorted from the facility for his final ride home.”
[Since instituting this Escort Ceremony for Veterans, families of nonVeteran patients have asked that a similar service be conducted for their
loved ones, so Stein has created a generic policy and performs a nonmilitary ceremony on request. A copy of this policy is available on the
WHV website.]
Julie Yeager is the Veterans Service director for Stein Hospice, a role she
has served since 2010.
NewsLine
7
Mercy Care
Myrtle Beach, SC
Public Recognition
Through Community
Pinnings
By J. Michael Neal, MABC
“We Love Our Vets” read the sign at
the Inlet Square Mall in Myrtle Beach,
South Carolina. It was Valentine’s Day
2012, and Mercy Care had been asked
by the Mall promotion director, along
with other local businesses, to collaborate on a special event to honor and thank
the Veterans in our community for their service to the country. Our ambition was
to make this the largest pinning to take place in our county!
When Valentine’s Day arrived, so did our country’s finest. Flags representing
all branches of service were carried into the Mall’s central court where over 300
hundred family members and guests were seated and watched with pride as their
loved ones entered and took their seats. All the while, there were bands playing,
a barbershop quartet singing patriotic songs, and appearances by the JROTC drill
team, Rolling Thunder and the Patriot Guard.
Short speeches were made to express the community’s gratitude for their service,
with the highlight being a poem that was written and read by a Veteran of the
Korean War.
The Veterans from each branch were then asked to stand and, with the swiftness
of a well-trained military squad, 12 Mercy Care Veteran volunteers walked through
each aisle and carefully placed a specially designed “Mercy HONORS” pin on
the lapel of each Veteran standing at attention. After Veterans from each branch
received their pins, the Mercy Veteran volunteers stood at attention and saluted
each group, from the Army to the Merchant Marines.
Watching from the front of the room, I saw one Veteran after another smile with
appreciation while others had tears streaming down their cheeks. I was to learn
that for many, this was the first time anyone had thanked them for their service.
From personal experience, I knew there were only two items left to do before
the event concluded. Great care must always be taken to recognize our living
Veterans, but greater care must be provided to recognize families that have lost a
8
NewsLine
loved one in times of armed conflict. I have made it a practice to invite
these family members or close friends to stand and be recognized for
their sacrifice and loss. To those who stand, I will say “I am sorry for
your loss and I thank you for your family’s sacrifice to help protect our
freedoms.”
I also always invite all Vietnam Veterans to stand, and ask everyone
in the room to voice in unison, “welcome home.” There is usually a
standing ovation that follows. I encourage the Veterans to look around
and absorb the genuine appreciation that’s always palpable. It is then
that healing begins.
After this event concluded, we discovered that over 350 Veterans had
been recognized, from Word War II through our present conflicts in
Afghanistan and Iraq.
While this is not yet an annual event, we would gladly participate if
it were. As part of our commitment to honoring Veterans, Mercy Care
participates in dozens of community pinnings each year and finds them
to be a poignant way to express our gratitude and foster healing.
J. Michael Neal has served as director of counseling for Mercy Care since
2010.
NewsLine
9
Covenant Hospice
Pensacola, FL
The Gift of Veteran
Volunteers
By Brian Ranelli
Early last summer, Randy Barbour told
Jim Kirby, “All I want to do is go to the
Naval Aviation Museum. Then I’ll never
have to leave my home again.” Randy is
an Army Veteran and Covenant Hospice
patient and Jim is a Navy Veteran and
Covenant Hospice Volunteer. And voicing
that wish was all that was needed.
Within a month of that conversation, Randy was at the renowned museum and
received a special two-hour tour from Vice Admiral Gerald Hoewing. He was also
given a medallion commemorating the 2012 opening of the National Flight Academy
and a book detailing the history of the museum. It was a special day and as Randy’s
handwritten note later expressed, the tour was an experience he will cherish forever.
Jim was the catalyst that made it happen.
For John Christy, a Navy Veteran
and Covenant Hospice patient, it was
camaraderie that was missing from
his life. He had served his country as
a chaplain and, after his retirement,
was an active member of his church
and its choir. Covenant asked Veteran
volunteer, Ray Wann, to provide John
with the support he needed since Ray
was also a chaplain and the two had
attended the same church for years.
As time went on, Ray noticed how John had become more and more withdrawn, as
he was now largely confined to his home. To help support his friend, he planned
a special ceremony and invited several of John’s friends. Because music was so
important to John, Ray also invited Covenant’s music coordinator who played some
of John’s favorite patriotic music and spiritual hymns. It was a poignant way to
honor John for his many years of service as well as a time of fellowship.
10
NewsLine
Veterans have made many sacrifices that undeniably leave a lasting
impact on their lives years after they have taken off the uniform. While
Covenant Hospice’s staff are taught the special needs of Veterans through
trainings and our close work with the Department of Veterans Affairs and
local Veteran Service Organizations, our Veteran volunteers can be our
best teachers, and can make an invaluable contribution in the care we
provide to our nation’s finest at the end of life.
Brian Ranelli is the special projects manager for Covenant Hospice, a role
he has served for two years.
VITAS Innovative Hospice
Care of Atlanta Metro
Atlanta, GA
Advocating for the
Veteran and Family
By Paula Sanders
Jerry, a World War II Army Veteran
with heart disease and dementia,
loved to reminisce about his
military days, especially as his
health diminished toward the end of his life. His daughter, Debbie,
heartbroken as she watched her father’s deterioration, promised him at
least one thing would always be true: he would spend his final days at
home surrounded by his loved ones. Eventually, however, Jerry’s heart
condition worsened to the point where he needed professional care,
which Debbie simply could not afford.
Join Us!
There are now 1,500 hospices
which participate in We Honor
Veterans at Partner Levels
One, Two, Three or Four.
Many hospices which are not
yet partners may already be
doing work that would qualify
them for this distinction.
To learn more about joining
the initiative, visit the WHV
website—and see Enroll Your
Hospice.
That’s when the VITAS Veterans Program team came in. They helped
Debbie receive an eligible Veterans special monthly pension for her
dad and, in addition to providing medical care, provided Debbie with
emotional support during his illness and after his death.
In Atlanta’s metropolitan area, Larry Robert, the Veterans’ liaison for
VITAS, works closely with the Veterans Administration (VA), Medicare,
Medicaid and other local organizations to help ensure that Veterans and
their families receive the care and benefits they’re entitled to. When
admitting patients to the hospice program, Larry, who himself served
13 years as a Navy chaplain, conducts a special assessment for every
Veteran patient to determine the specific level of support they need.
NewsLine
11
Robert, who is also one of Georgia’s 15 accredited claims agents with the
Department of Veterans Affairs, files claims for Veterans directly. “Many veterans
aren’t aware that they’re eligible for benefits from the VA, and we work hard to
ensure they receive the specialized care they need,” he said.
As part of this commitment, Robert and his colleagues at VITAS work closely with
other Veterans’ organizations that VITAS supports. This includes:
• Sponsoring Keep the Spirit of ’45 Alive, the Tuskegee Airmen, and Honor Flight,
which all work to celebrate and honor Veterans
• Working with state and local Veterans’ groups and organizations to advocate
for Veterans and ensure they receive the support they need at the end of life
• Participating in the Veterans History Project, which seeks to record and
document a living legacy of Veterans’ stories that are archived at the Library of
Congress as living legacy.
These specialized programs and others are critically important for Veterans,
Robert said. “As they near the end of life, many become almost obsessed with their
military history, regardless of whether they spent one year or 60 in the military.”
For this reason, in addition to providing medical care and emotional support,
Robert and the Veterans Program
team also provide something very
important that veterans need:
recognition. “It may be difficult
for those who are not Veterans to
understand this because it might
not seem like much, but Veterans
really need to make peace with their
military experience,” Robert said.
“They just want someone to recognize
their service and sacrifices.”
Paula Sanders is the general manager
for VITAS Innovative Hospice Care of
Atlanta Metro.
12
NewsLine
Free Distance-learning Sessions
on Serving Veterans
NHPCO’s E-OL (End of Life Online)
offers a range of distance-learning
courses for staff and volunteers at all
levels. Among the offerings are six
short sessions on serving Veterans at
the end of life—available to NHPCO
members free of charge:
Understanding Veteran Benefits
30 minutes
Having knowledge of Veteran
benefits rates high on Veteran and
family hospice satisfaction surveys.
While this short session won’t
make you an expert, it will help
you become familiar with the VA
benefits that are most likely to be
relevant to Veteran patients under
hospice care.
Service-related Diseases, Illnesses
and Conditions
20 Minutes
Provides an overview of the various
military eras, and their servicerelated diseases, illnesses and
conditions—from both the clinical
and benefits perspectives.
Understanding the VA
30 minutes
Provides a basic understanding of
the philosophy and structure of
the Department of Veterans Affairs
and some of the benefits that are
available to Veterans.
Wounded Warriors: Their
Last Battle
1.25 hours
Deborah Grassman, the author of
Peace at Last: Stories of Hope and
Healing for Veterans and Their
Families, delivered this powerful
plenary at NHPCO’s 11th Clinical
Team Conference. She discusses
how the experience of war manifests
itself in many intricate ways,
offering invaluable perspective
to those serving Veterans at the
bedside.
Building a Veteran-centric Culture
30 minutes
Provides a context for joining We
Honor Veterans in transforming the
hospice and palliative care culture to
recognize our nation’s Veterans.
Hospice Veteran Partnership
Program
26 Minutes
Provides information about starting
a Hospice-Veteran Partnership, as
well as how to keep it going and
evaluate its success.
Visit E-OL on the NHPCO website for
general information about NHPCO’s
distance-learning program.
NewsLine
13
C
ACOs Today:
Are You Ready?
By Lisa Lapin, Michael Ferris, Kara Osborne,
Ted Ferris, and Katherine Northcutt, RN
reated by the 2010 Patient
Protection and Affordable Care Act,
Accountable Care Organizations
(ACOs) are one part of a national
health care overhaul that is
designed to cut costs and increase quality.
And their numbers are growing.
When first initiated, there were 32 ACOs
across the country. Today, there are 153
in 40 states, serving 2.4 million Medicare
patients.
Simply put, ACOs are a group of doctors,
hospitals, and other health care providers
who come together voluntarily to give
coordinated care to their Medicare
patients. Their goal with these patients,
especially the chronically ill, is to give
the right care at the right time, avoid
duplication of services, and prevent
medical errors.
Due to the many restrictions and
the complexity of the Affordable
Care Act regulations, it is unlikely
that hospice providers will be able
to serve as an organizing or founding
partner of an ACO. However, a hospice
can provide its expert services to the
ACO—which can be an excellent way to
increase its referrals and broaden its reach
within the community.
This article reviews the basic structure
of the ACO, but most of the discussion is
devoted to the roles that hospices can play
and a suggested action plan if participation
is a path the hospice wishes to pursue.
14
NewsLine
The Basic Structure of ACOs
Today’s ACOs are taking
on different configurations
depending on local markets, their
conditions, and the competition
between providers. There are
small physician-led ACOs which
are usually found in rural areas,
and there are large hospital- and
health-system based ACOs which
are usually found in urban areas
(and include both for profit and
nonprofit entities).
Healthcare systems have emerged
as the early adopters by being
accountable for the quality, cost
and overall care provided by
the ACO to the defined patient
population assigned to it. Now,
more than ever, these healthcare
systems are focused on providing
higher-value, post-acute care
that will result in improved risk
management and the control of
outcomes that impact Medicare
reimbursement, particularly for
rehospitalizations.
In the coming months, hospices
can control their own destiny
by becoming proactive and
participating in the development
of a local ACO, and by forging
alliances with those ACOs that
fully utilize hospice and palliative
care programs as the lowest-cost,
highest-quality venue of care for
select patients.
Hospices can control
their own destiny by
becoming proactive
and participating in the
development…
Hospital
SNF
Behavioral
Medicine
Pharmacy
Outpatient
Clinics
ACO
Hospice
Home Health
& Rehab
Physicians
NewsLine
15
The Roles Hospice Can Play
Hospice providers can play
various roles in the ACO,
including:
• Providing care for the
terminally ill
• Providing care for the highestacuity patients, without regard
to terminal diagnosis
• Reducing costs by keeping
high-need patients in the most
economical venue of care.
The value hospice brings to the
ACO relationship include:
• Reduction in hospital
readmissions
• Care coordination across the
continuum
• Reduction in costs for postacute episodes
• Reduced emergency room
visits and hospitalizations
• Shared payment risk based on
outcomes
• Decreased in-patient hospital
mortality rates
• End-of-life care expertise
• Palliative care expertise.
A hospice’s participation in the
ACO can contribute significantly
to the alleviation of patient and
family suffering and, at the same
time, ease some of the ACO’s
16
NewsLine
challenges, including readmissions
and length of stay. As well,
with appropriate recognition
and support, the emerging field
of palliative care will relieve
symptoms, including physical and
emotional pain; improve patient–
professional communication and
decision-making; and coordinate
care across the spectrum of health
care settings.
As you can see, hospice and
palliative care providers can offer
a very attractive range of benefits
to the ACO and its patients. And
as we already mentioned, they,
in turn, will gain the ability to
broaden their reach within the
community. It can clearly be a
win-win situation.
Taking Advantage of
the Opportunity
If you can prove to your local ACO
that your hospice can provide care
coordination to its sickest patients
while decreasing hospital lengths
of stay, admissions/readmissions
and infections, you will be
providing the obvious solution to
the ACO’s biggest challenges. (As
we already know, reimbursement
rates for hospitals are being tied to
readmissions.) The eventual goal,
of course, is to collaborate so well
with the ACO that your services
become the logical extension of
the care it provides to patients.
Disease management programs
are a good example. Those that
reduce hospital readmissions
would be invaluable to ACOs,
such as a CHF program that
focuses on reducing the
readmission rates of that
population. Other examples are
using adult learning techniques
for better patient and family
education; closer collaboration
with case managers to get patients
home faster; and working with
the emergency room department
to implement processes that will
prevent readmissions.
What to Do Today
First, Recognize There
May Be Risks
A key consideration for
participation in an ACO will be
the risk assumed by the provider.
For hospices, this becomes an
entirely new paradigm.
In the current fee-for-service
(FFS) payment environment,
incentives to providers are not
aligned with the goal of payers
to manage costs, or with the
goals of patients to receive
high-quality, patient-centered
care. Our silo-based payment
system encourages inefficiency
and waste, as providers are not
encouraged to share information
and coordinate care.
Accountability in the ACO model
is based on aligned incentives
across silos while still maintaining
a FFS payment structure (at least
in the short term). There are a few
mechanisms that are being used to
increase accountability, including
shared savings arrangements,
in which providers get to keep a
portion of savings; shared savings
plus risk, which generally refers to
providers who not only have the
opportunity to share in the savings
but are also at risk for some portion
of overspending; and partial
capitation, which allows providers
to receive upfront payments for a
portion of care for which they bear
the financial risk.
Participation in an ACO may,
thus, require a willingness to be
part of a “less-than-traditional”
relationship—and bear some
financial risk.
Get to Know the Local Players
It’s important to learn who the
local players are and where they
are in the process of an ACO’s
development:
• Keep tabs on any ACOs
that are announced in
magazines, newspapers, or
online. A helpful resource are
publications such as Becker’s
Hospital Review
that actively track
the announcements
of ACOs around the
country.
• Once you learn an
ACO exists in your
service area, you
need to get access
to its data (e.g.,
mortality rates,
lengths of stay, top
chronic diseases
that are causing
readmissions).
Knowing this
information will
help you when it is
time to approach
the ACO about how
your organization
can help solve its
problems.
7 Smart Questions
to Ask When You’re at
the Table
When you’re ready to meet with
your local ACO to discuss how your
organization can help serve its most
frail and medically complex patients,
start by asking good open-ended
questions to understand its needs:
1. What are the ACO’s plans for
providing care for patients with
terminal diagnoses?
2. Which patients will the ACO be
targeting for care transitions?
3. How will the ACO use hospice
and palliative care services?
4. How will the ACO select a
hospice and palliative care
provider to meet its patients’
needs?
5. What is the plan for those
patients who are frequent flyers
at the ER?
It is also important
to “get plugged into”
6.
your community and
maintain regular dialog
with local leaders so
7.
you are in the know on
any new ACOs which
may be forming. The
more time you have to
prepare, or stay ahead of
the curve, the better. As with most
changes in our industry, being
proactive about this entire process,
from the C Suite down, is key.
How will the ACO manage
chronically ill patients with no
further treatment options?
What is the ACO’s model for care
management related to hospice
and palliative care patients?
NewsLine
17
Develop a Strategy
As an organization, you need
to formulate goals that dovetail
with the new reality of ACOs,
and how they will affect you
and your community. Creating a
strategic plan to compete and win
when opportunities arise is an
important part of this process.
The plan should address how
you are going to (1) increase
admissions without increasing
costs; (2) improve profitability
and effect the case mix; and (3)
build marketing and education
campaigns that efficiently and
effectively communicate your
service’s value to patients.
You will need to perform a
thorough GAP analysis of your
current capacity to process
referrals and its ability to fit
together with the needs of the
ACO. A solid understanding of
where you are now will be a
baseline for determining exactly
what you need to do in order to
provide the ACO’s patients with
the highest quality care at a
reasonable and sensible cost.
The opportunity for your
organization, and our industry
as a whole, lies in managing the
care of the most fragile, highacuity patients in the home
setting. Today we are seeing
hospitals approaching hospice
18
NewsLine
and home care seeking solutions
that parallel their own efforts to
reduce admission/readmission
rates and inpatient mortality
rates.
Hospices are uniquely positioned
to provide the best solutions
for many of these highest-cost
patients within the post-acute
continuum, with a focus and
understanding of how to honor
the patient’s and family’s
preferences at the end of life.
However, the demands for
measurable outcomes will be
high, so you will need to be
prepared with hard data to
support your case as the best
provider to serve these patient
populations.
There also needs to be early
consideration as to how our
information technology will
integrate with and serve the
needs of the ACO. Know how
it currently works versus how
it will need to work into the
future. Effective electronic
information exchange with your
referral partners and ACOs,
as well as with patient and
family/caregivers, may be a
deciding factor in future referral
relationships. Hospices will
need real-time data management
in order to possess the best
information available for decision
making related to both the cost
and quality of care.
Prepare for Growth
In today’s world of ACOs,
growing hospice referrals
takes on a whole new level of
complexity.
“Care transitions” is one of the
hottest buzzwords in medicine
and will be at the core of
successful ACO operations. How
your hospice positions itself as
a key component in this process
will carry great value, especially
among referral partners who are
themselves ACO participants
(e.g., physicians, hospitals).
Marketing campaigns and
educational programs will
need to be clear on how to
communicate the value of the
hospice program in this process.
Your marketing team needs to
become more sophisticated, and
must be able to communicate
the hospice’s value to referral
partners. The idea of selling to
the C Suite now enters into the
equation as the ACOs become
key accounts. The team will also
have to develop relationships
with more people in each ACO,
including nurses, case managers/
discharge planners, pharmacists,
care coordinators, hospitalists,
and palliative care clinicians.
As their ultimate goal, the team
will want to become health care
system “navigators.”
To be successful, your marketing
team should be looking for
prime opportunities to present
case studies and other data that
illustrate where your organization
can reduce readmissions or help
to lower the hospital’s length of
stay. Because ACO savings will
hinge upon factors like those, it
is time to start accumulating data
and creating data-driven printed
materials to help them reinforce
the idea that hospice can take
care of those issues. This should
go without saying, but make sure
your printed materials are easy
to read, self-explanatory, and
include graphics that reinforce
your points at a glance.
Now more than ever, your
marketing team should be focused
on being effective and efficient,
and making sure their accounts
are rated and organized so that
their territory consists of the
top 25 best accounts with the
highest probability of producing
referrals and admissions. Also
make sure that you are tracking
the right metrics and making the
expectations for productivity clear.
Your marketing team should also
be sure to use the most effective
messaging for each audience,
be that your referral partners,
the ACO, or members of your
community. Each subsection
responds to a different message
because they each have different
needs and challenges, so your
As their ultimate goal,
the marketing team will
want to become health
care system ‘navigators’
NewsLine
19
marketing team should be
careful about matching the
messaging to those individually
unique needs and problems.
Your hospice also needs to be
easy to work with—from the
person answering the phone, to
the marketing representative,
to the nurse in the home. And
above all, don’t allow a new
focus on ACOs to distract staff
from adequately supporting
traditional Medicare and other
non-ACO patients.
When You Don’t Want
to Participate
What if your hospice decides
not to participate in an ACO, or
doesn’t have the opportunity
to? As a long-term strategy, you
should analyze your service
area to determine the needs of
the non-ACO referral partners
and patients. You should also
focus and expend resources
to secure the segment of the
market that you are able (and
willing) to serve. There should
be many opportunities to serve
patients within your community,
regardless of your involvement
in ACOs.
20
NewsLine
Time is of the Essence
Working with ACOs can be a
“win-win” situation. You bring a
great many benefits to the table
and, in return, you will broaden
your reach in the community.
But time is of the essence since
competition to be the ACO’s
provider of choice will be great.
Lisa Lapin and Michael Ferris are
principals in Simione™ Healthcare
Consultants, while Kara Osborne
and Katherine Northcutt serve as
senior managers, and Ted Ferris
serves as a consultant. Simione
was the first organization of its
kind dedicated entirely to home
care and hospice, a commitment
it maintains today.
Lisa Lapin and Mike Ferris
presented on this topic at
NHPCO’s 2012 Management
and Leadership Conference
and the session is now
available for purchase on CD
or as an MP3 file.
Visit DC Providers Online,
select 2012 MLC, and enter
“5F” in the Keyword Search.
Then scroll to the session
listing, “Accountable Care
Organizations as Part of
Health Care Reform.”
Introducing the
rewards program...
Your National
Hospice and
Get
Palliative Care
started
Organization
with
membership
500 FREE
entitles you to
Links at
exclusive access to
sign-up
AchieveLinks®¸ the
rewards program
that’s as unique as you.
Just visit www.AchieveLinks.com to
activate your FREE membership.
Then, your everyday purchases will
earn LinksSM reward points towards
must-have merchandise and once in
a lifetime experiences.
Advertisement
Advertisement
Don’t miss out on
your rewards! Activate
your FREE account now.
...that’s as unique as you!
www.AchieveLinks.com
HEALTHCARE CONSULTANTS
NewsLine
21
In this monthly feature,
NewsLine shines the
light on a hospice
organization which
has expanded services
or has partnered with
other community
organizations to reach
patients earlier in the
illness trajectory—
before they may need
hospice care. In a
Q&A format, members
hear firsthand from
the organization’s
senior leaders who
speak directly to
the challenges, the
benefits, and the
lessons learned.
22
NewsLine
Kansas City Hospice and Palliative Care (KCHPC) was
founded in 1980. During its 32-year history, it has
operated as both an independent, community based
program and, between 1995 and 2003, as part of a notfor-profit, multi-hospital system.
“When the hospitals were sold in 2003, we regained
our independence and, over the next years, introduced
a range of specialized services that were lacking in
our area,” says president/CEO, Elaine McIntosh. “Our
organization has a wide-angle lens on the subject
matter. We are committed to providing services that meet
whatever people’s real needs are, even when those needs
don’t always fit neatly into a certain box, such as hospice
or home health.”
That philosophy and approach to patient care was one of
the reasons that KCHPC received the prestigious Circle of
Life award in 2010.
In the following interview, McIntosh discusses the
program developments of the past few years, including
KCHPC’s focused attention on educating the community
about its breadth of services.
Between 2008 and 2011, your organization
introduced several specialized programs. Why such
ambitious expansion?
The hospice model is a beautiful thing, but most
certainly does not address the needs and circumstances
faced by everyone with a life-threatening diagnosis.
Quick Facts About KCHPC
•
Founded in 1980.
•
Serves three counties in Kansas and six
counties in Missouri.
•
Employs 300 FTEs and 525 volunteers.
•
Opened Kansas City Hospice House in
2006, a 32-bed inpatient facility.
•
Average Daily Hospice Census: 289.
•
Offers a range of non-hospice services:
2008: Launched Palliative Home Care.
2009: Acquired Solace House Counseling
Center, providing grief and bereavement
support for children and adults.
2009: Opened Passages, providing
counseling services for difficult life
transitions.
2010: Introduced Kansas City Palliative
Medicine, providing physician
consultation services to anyone in the
community.
Also serves as a clinical site for the
University of Kansas Hospice and
Palliative Medicine Fellowship.
We know that some people will never make the emotional leap it takes
to say yes to hospice, which is a major reason for palliative home
NewsLine
23
care. We also realize that grief
and bereavement has it own
specialized knowledge base, and
that the type of services which
really are effective for people are
often not paid for. This prompted
us to acquire Solace House and
offer the counseling services free
of charge.
There are also many challenges
associated with the transitions
that come with an illness—
loss of a loved one, becoming
a caregiver, aging, or the
accompanying financial issues—
so the Passages program was
introduced in 2009, extending
our specialized expertise and
understanding to another group
of people.
While each of our programs
has its own story, underlying
them all is a mission that’s
broader than the Medicare
hospice model. Our mission—to
bring peace of mind, comfort,
guidance and hope to people
who are affected by lifethreatening and life-limiting
illness—encompasses the
continuum of the ill person’s
experience, from diagnosis to
outcome, and beyond for loved
ones.
24
NewsLine
What are some of the key
factors that contributed to
your success?
Having a smart and willing
board of directors, all of whom
know our mission and are not
afraid of having us take on new
initiatives has certainly been
key. We have a lot of longevity
on our board, which makes
for deep knowledge and deep
thinking at the governance level.
We have also been fortunate
to retain sharp staff who feed
information to the organization
about what they see in the
community and are willing to
take on difficult challenges—
of working through the
conundrums and staying flexible
in spite of rigid regulatory and
financial pressures. But above
all, an organization can’t be
afraid to fail, which we have
done many, many, many times.
Palliative Home Care was
one of the first programs
introduced. How is it staffed?
What services are provided?
We had a service that vaguely
resembled palliative home health
for a number of years. But it
became clear that if we were
really going to serve the patient
populations we envisioned, we
had to put a lot more behind it.
Formalizing the team, staffing
it, understanding the differences
between palliative care and
hospice were very important.
The PC Home Care Team
looks a lot like a hospice
team, although there are some
significant differences. It has
a team manager, registered
nurses, home health aides,
social workers, a chaplain, and
a medical director. We contract
for the therapies, although all
KCHPC staff is available to
patients. Our art and music
therapists, child/teen specialist,
and lymphedema therapist all
help when needed.
Our services also bear great
similarity to those in hospice—
symptom management and
related teaching, counseling,
case management and so on.
However, because many of these
patients are at an earlier stage
of their disease and receiving
aggressive treatments, their
care is very complex. The
nursing staff is often dealing
with multiple specialists who
are involved with one patient’s
care. There could easily be an
oncologist, a nephrologist, and
an internist still quite involved
in the patient’s care.
While palliative care allows us
to reach people earlier in the
disease process, it also gives
them the opportunity to be in the
ambiguous zone when treatment
choices are being explored and
made. One day it’s full steam
ahead with treatment, the next
day it’s not, and so it goes, back
and forth. There is a tremendous
amount of teaching involved
to help the patient and loved
ones understand the disease,
the treatments, and various
complications, so they can then
make decisions that are right for
them.
What type of patients does
Palliative Home Care serve?
Our patients have all diagnoses,
but we see a preponderance of
people with cancer. Many are in
treatment, and many are going
through the transitions associated
with diagnosis and treatment—
the transition from being a well
person to a patient and all that
involves. From being independent
to dependent, from going home
and returning to the hospital and
back again, from receiving cureoriented care to comfort-oriented
care and, sometimes, being
discharged altogether.
In terms of age, all our patients
are over 18, but the skew is to the
younger patient, often with both
children and parents living, which
makes continuing aggressive
treatment the more desirable
course. It also makes these
patients more resistant to hospice,
which unfortunately has become
a proxy for the end. (The phrase
“end-of-life care” is not helping us
in this regard. I’d like to vote the
phrase off the island!) We also
have a pediatric program which
sees newborns to 18-year-olds.
Although a certain percentage of
patients are clinically appropriate
for hospice, they are not quite
“there” in their hearts, and some
never get there. A certain number
of patients die in the program,
some transfer to hospice and
some are discharged when they
stabilize.
You introduced a Palliative
Medicine program in 2010 as
a clinic within your hospice
inpatient facility. How is that
going?
Patients with all diagnoses,
including the frail elderly in
decline, are seen under this
program, and the majority are
often in transition regarding their
goals of care.
Although a certain
percentage of
patients are clinically
appropriate for
hospice, they are not
quite ‘there’ in their
hearts…
We have five physicians on the
staff and one advance practice
NewsLine
25
nurse who rotate through the
various sites of care, including
the clinic, but we are seeing an
increasing number of palliative
consults at home.
Our consults, however, also
extended to some oncology
practices. These practices were
recently acquired by the large
academic medical center in
our area and the University’s
Palliative Care physicians have
taken over those visits. We
actually think this will improve
access to the palliative care
consults at the oncology clinic
level, because of the overall
integration of the oncology
practice with the medical center.
How many patients are
you serving under each PC
program?
Palliative Home Care has a
census of about 35 and can
admit about 250 patients
annually. Our Palliative
Medicine program will see about
100 patients annually.
Has offering these services
helped increase referrals and
earlier access to your hospice?
Palliative home care definitely
opens the door earlier to some
patients. It has not impacted
our hospice length of stay
26
NewsLine
and it’s hard to say about
increasing referrals as there are
so many variables that impact
this. Roughly one-third of our
palliative home care patients
ultimately transition to hospice,
but sometimes that is only
because they are at the end
of life and need access to the
Hospice House.
How are these programs
funded—and is it a challenge?
Both palliative care programs
are subsidized through charity
events, grants, and donations
that come to us through our
Foundation.
In the Palliative Home Care
program, reimbursement does
not cover the per-visit costs, or
the range of services needed.
Some commercial insurers
recognize the value of palliative
care and readily make coverage
exceptions, but this does not
address the shortfall.
In the Palliative Medicine
program, the physician visits are
extremely expensive and sorely
under-reimbursed. A consult
may well take a physician an
hour or more. The medical
discussion and the family
meeting are very time intensive.
The reimbursement for this does
not even cover the physician’s
direct time, let alone all the other
associated costs. Then, make it a
home visit with travel time and
you are really in the red.
It should also be understood that
the back-office costs of all these
palliative programs are fairly
high. Credentialing, billing,
communication with the payers,
etc., can be expensive.
Has the location of the
Palliative Medicine program
within the hospice inpatient
facility created any confusion
or been a deterrent?
Not so far as we can tell—and it
does have a separate entrance.
That said, we have not yet
marketed the program heavily,
primarily because the medical
staff is already quite busy.
In 2010, you hired a new
marketing team to bring
greater awareness to your
services. How is that going?
As is true in other places, our
local market is quite glutted with
hospices and it is increasingly
difficult to reach physicians and
others. We have certainly found
that many of our traditional
referral sources did not know of
all the services which could be
obtained from KCHPC.
We do continue to focus on the
traditional referral sources as well
as the general public. A television
campaign was launched in 2011
to bring awareness to all of our
programs, and to begin to define
palliative care to the general
public. However, it’s a bit too
soon to tell its effectiveness.
Any words of advice for
hospice providers which are
looking to expand in the
current climate?
Have a strong balance sheet.
Palliative care, in any form we
have tried, is not profitable and
requires considerable subsidy.
But, we should all keep our eyes
on how things are evolving.
In our worst nightmare—an
unbundled per diem—we are
going to need to think long
and hard to figure out ways to
make sure people still receive
the magnificent care which is
currently known as hospice.
Any final thoughts?
The very idea of dying is of
course not easily accepted
by most people, and that’s
where palliative care becomes
especially important. It is
incumbent on us to bring support
to people in a way that respects
where people are coming from,
rather than trying to convince
them to accept hospice. One of
the promises of palliative care,
which is also potentially true of
the as-yet-untested “concurrent
care” model, is that it allows
people to hold seemingly
contradictory notions—to focus
on the possibility of getting well
and the possibility of death; to
obtain aggressive and expert
management of symptoms as
well as treatment aimed at
curing the disease; to have
hope for extended life as well as
having the benefits of hospice/
palliative care.
It’s incumbent on us
to bring support to
people in a way that
respects where they
are coming from…
Are you offering a non-hospice service?
And would you like your work spotlighted in NewsLine?
Complete our brief questionnaire.
NewsLine
27
28
NewsLine
NHPCO’s National Council of Hospice and Palliative
Professionals (NCHPP) is comprised of 48,000 staff and
volunteers who work for NHPCO provider-members.
Organized into 15 discipline-specific sections that
are led by the NCHPP chair, vice chair and 15 section
leaders, NCHPP represents the perspectives of the
interdisciplinary team—the very essence of hospice care.
These individuals—together with each Section’s Steering
Committee—volunteer their time and expertise to a
variety of NHPCO projects to help preserve and develop
the “interdisciplinary model” within the evolving world of
Featured This Month:
Bereavement
Professional Section
hospice and palliative care.
In this NewsLine feature, we shine the light on a different
NCHPP Section each month, so all members can benefit
from each discipline’s perspective on important topics.
It will also help members learn more about the work of
NCHPP and how to get more involved—whether it’s taking
better advantage of some of the Section’s free activities or
joining a Section’s Steering Committee.
This month we spotlight the Bereavement Professional
Section, and an article by Beth McGuire.…
NewsLine
29
How a Veteran’s Experience Can Inform
By Beth McGuire, MDiv, NCBF, CT
W
hile in the lobby of a hospice inpatient facility, George, a
Veteran of World War II, reflected on the impending death
of his wife, Olivia.
“This reminds me of the time when my ship was stationed off
the shore of Japan,” he said. “We were aiming and firing at the
Japanese on shore who were hiding inside graves on the side of
the hill and firing on our ships. My bunk was on top of four boxes
of super-quick fuses that were designed to explode immediately. I
slept on top of them. It was hurry up and wait. You work your ass
off, retire a little bit and then go back and do some more waiting.
It’s the waiting that gets you. You know the outcome is inevitable.
It’s a matter of time. There isn’t much to occupy the time and you
try to make the most of it you can.”
George’s story reminds us as hospice professionals that we
cannot ignore the significant context of the hospice patient or
client as a Veteran and how their military service may impact
their views of life and death. And while Veterans share a
unique culture, their military service experience varies greatly
depending on whether their service experience was during war
or peace time, what war or conflict they may have served in,
and how they were received when they returned home. These
different experiences are very apt to affect their view and the
views of their family members concerning end-of-life care.
To serve George well, the hospice clinician will need to
empathically grasp those courageous and anxiety-filled events
off the coast of Japan that were the context of his moment-tomoment experience. Today the imprint of those experiences are
measured in both the anticipation that he feels as he faces his
wife’s impending death and in a strong new awareness of his
own mortality.
30
NewsLine
Bereavement Practice
NCHPP Bereavement
Professional Section
Steering Committee
Section Leader:
Getting at the Experiences
Sometimes our understanding
of the complexity of a Veteran’s
grief response can come from
unexpected places.
For example, a Family Evaluation
of Bereavement Services (FEBS)
survey that was sent to a grieving
Veteran and his spouse was
returned with some eye-opening
commentary from the spouse.
She first related that her husband,
Jim, was a combat Veteran and
that “he grieves alone.” Later
she went on to speak of her
own distress in living in a home
with multiple urns of cremains
that Jim could not bring himself
to bury, scatter or otherwise
distribute.
The military teaches its soldiers
to be stoic or indifferent to
pleasure or pain. While this is
essential on the battlefield, it may
interfere with a peaceful death or
effective bereavement.
The We Honor Veterans website
suggests many ways to engage
Veterans in conversation to
understand their military
experience and identify their
needs: Tell me about your
military experience? When and
where did you serve? What did
you do while in the service? How
has military service affected or
imprinted you?
A few basic questions like
these can begin to help the
hospice clinician to more fully
comprehend the multiple “colors”
of the Veteran’s military context.
Recognizing What’s
Important to Them
Proud, stoic, and of strong
faith, 59-year-old Michael was
admitted to his local hospice with
a diagnosis of metastatic lung
cancer. Mike was a Veteran of
the Vietnam War and his military
service had affected his entire life
ever since returning home.
Emily, his wife of 15 years,
readily described their chance
meeting and deep commitment to
each other. As Mike’s condition
deteriorated—with his cognitive,
motor and communication skills
becoming compromised—Emily
became his spokesperson as well
as his caregiver and protector.
Rex Allen
Providence Hospice
Seattle, WA
[email protected]
Committee Members:
Patti Anewalt
Hospice and Community
Care
Lancaster, PA
Diane Snyder Cowan
Hospice of the Western
Reserve, Inc
Cleveland, OH
Robin Fiorelli
VITAS Innovative
Hospice Care
San Diego, CA
Brenda Kenyon
St. Vincent Hospice
Indianapolis, IN
Beth McGuire,
HMC Hospice of
Medina County
Medina, OH
Terri Ray
Gaston Hospice, Inc.
Gastonia, NC
Brian Shaffer
Odyssey Hospice
Gahanna, OH
NewsLine
31
He slept most of the day, waking only at mealtimes to be fed by
Emily. Each tiny spoonful that Mike was able to swallow was
served with patience and large amounts of love.
Each meeting with Mike and Emily brought the hospice team
new insights related to his military service. It soon became
apparent that Mike had been experiencing Post Traumatic
Stress Disorder for some time. Yet, no matter how debilitating
the manifestations of PTSD had been, the foundation of his
self-esteem and identity were rooted in his military service.
Mike wore his Veteran cap proudly and kept the American
flag over his bed. His trips to the VA hospital were viewed as
homecomings as he cherished his time with the Veterans who
understood his experience.
Over the years, the service medals Mike had earned while
serving as a rifleman in the Marines had somehow been lost. At
Emily’s request, the hospice team worked successfully to replace
Mike’s medals and 12 days later presented him with new ones.
No longer able to see, Emily described the medals and handed
them to him. Mike held the two medals up to his eyes, turned
them over in his hands and, to Emily’s surprise, saluted her. He
said, “God Bless You”—the first clear words she had heard from
him in weeks. In addition to replacing his medals, the hospice
team managed Mike’s symptoms, supported his family and
continues to offer bereavement assistance to Emily.
In Summary
The stories of George, Jim and Mike remind us that
understanding the impact of the patient’s military service on
family and life can help the hospice clinician better assess and
understand the assortment of grief reactions that may need to
be addressed and held as part of a plan of care——from anger to
relief to ambivalence to confusion.
By always meeting our Veteran clients and families where they
are, and respecting the contexts of their life experiences, we will
provide a level of service that is truly empathic and filled with a
compassion that is so richly deserved.
32
NewsLine
As the We Honor Veterans
website reminds us, simple
acts of gratitude, whether at
the end of a Veteran’s life or as
we support them through their
bereavement, can make all the
difference. Be sure to visit the
website for more guidance: www.
wehonorveterans.org.
Beth McGuire is the director of
bereavement services at HMC
Hospice of Medina County, a
position she has held since 1997.
She is also an ordained elder in
the United Methodist Church,
and certified in Thanatology
and Critical Incident Stress
Management. She is serving her
first term as a member of the
NCHPP Bereavement Section
Steering Committee.
The author extends special thanks to members of the
Bereavement Professional Steering Committee for their
contributions to this article.
Turn the page for
details on the Section’s
Free Activities...
Resources for Further Information:
We Honor Veterans
Gold Star Wives
Department of Veterans
Affairs—Mental Health
Gold Star Moms
Society of Military Widows
U.S. Department of Veterans
Affairs—Trauma and PTSD
Vet Centers
Military One Source
Veterans Families United
Foundation
Tragedy Assistance Program for
Survivors (Taps)
Hospice Foundation of America
Peace at Last: Stories of Hope
and Healing for Veterans
and Families by Deborah L.
Grassman
NewsLine
33
Free Section Activities
Monthly Chats
The NCHPP Bereavement Professional Section holds monthly chats—or
conference calls—which are open to NCHPP members.
Each chat, which is facilitated by a member of the Section’s Steering
Committee, is held on the first Wednesday of the month, from 2:00 to
3:00 p.m., ET. Note: Due to the NHPCO Clinical Team Conference, no call
will be held in November.
Joining the Chats:
Call 605-475-4825, and enter the Participant Access Code when
prompted: 699517#. (Please do not dial in earlier than 1:55 p.m. on the
day of the call.)
Coming Up:
On December 5, “Social Media and Bereavement Support” will be
discussed.
Quarterly Bereavement Coordination Chats
For those new to bereavement coordination, the Section has also
introduced quarterly chats that will focus on issues related to program
development and structure. These quarterly chats are held on the third
Thursday of January, April, July, and October from 3:00 to 4:00 p.m. (ET).
For details, contact Bereavement Section Leader, Rex Allen.
34
NewsLine
Section eGroup on My.NHPCO
One of the best ways to exchange ideas and tips with your
colleagues is through the NCHPP Bereavement Professional Section
eGroup on NHPCO’s professional networking site, My.NHPCO. (It’s
free for staff and volunteers of NHPCO provider-members.)
Each NCHPP Section has an eGroup on My.NHPCO (much like the
former listserves, but better), plus an eLibrary where members
post helpful information and resources to help one another.
If you’re not already a My.NHPCO user, visit the homepage and see
“Getting Started” in the top right corner. For specific questions,
contact the NHPCO Solutions Center at 800-646-6460 (Monday
through Friday, 8:30 a.m. to 5:30 p.m., ET).
NewsLine
35
Short Takes
eHospice Now Live!
In his October NewsLine message, NHPCO
president/CEO, Don Schumacher, announced a
new and exciting collaborative venture to serve
professionals and consumers around the globe:
ehospice.
Organized into country editions…
What it is…
On October 1, the UK as well as Australia, Canada
Africa, Kenya, South Africa, India and International
Children launched their editions. The U.S. version,
which is being spearheaded by NHPCO and geared
specifically for health care professionals, will
launch later this year.
It’s a digital resource that will feature an app for
mobile, web and tablet devices. Its goal is to serve
as a single point of access to information, best
practices, and hospice and palliative care providers
around the globe.
What it features…
• Free access to news, commentary and analysis
from hospice and palliative care professionals
worldwide.
• Best practices, inspirational stories, photo
galleries, job announcements, and events.
There will be specific country and regional
editions as well as an international edition and
an international children’s edition. All will be
accessible via the website and a single app.
Register, sign up for alerts, submit
content…
Take a few minutes to explore the new website,
register, and sign-up for alerts by country and/or
topic. (Once the U.S. edition is launched, it will be
listed among the options.)
• An interactive directory listing hospice and
palliative care providers worldwide. (With the
touch of a button, readers will be able to access
the expertise and experience of the global
hospice and palliative care community.)
NHPCO extends special thanks to David Praill, the CEO of Help the Hospices and the international
representative on the NHPCO board of directors, for leading this collaborative venture. His welcome
message offers insight on the vision and rationale behind it.
36
NewsLine
Serving Veterans:
A Free Tool to Help Evaluate Your Performance
Last year NHPCO introduced a “Veterans-specific” version
of the post-death survey, the Family Evaluation of Hospice
Care (FEHC), to help hospices evaluate the care they
provide to Veterans.
This version, called “FEHC-V,” includes six questions
(as the last section of the survey) that relate to the
care specifically provided to Veterans and their family
caregivers.
Using FEHC-V
The FEHC-V survey is available, free of charge, to any
organization that wishes to use it—and all of the necessary
materials are available online:
FEHC-V Fact Sheet
FEHC-V Survey (recommended format)
FEHC-V Survey Compressed Version (different format
with fewer pages)
Tracking and Analyzing Results
While NHPCO prepares personalized quarterly reports
for provider-members which submit their FEHC data to
NHPCO, as well as an annual, national-level summary
report, these reports do not yet include results for the
Veterans-specific questions. Because FEHC-V is still
relatively new, there is not sufficient volume to allow for
that level of analysis.
Not Familiar With FEHC?
The Family Evaluation of Hospice
Care (FEHC) survey is the most
widely used tool for measuring
and tracking the quality of hospice
care being provided to patients
and families. During development,
the survey was tested and
validated for consistency and
accuracy in capturing the
perception of quality from the
bereaved family’s perspective.
With nearly a decade of use by
the hospice community, the FEHC
tool has proven to be invaluable
for identifying, assessing, and
tracking quality indicators as
well as setting performance
improvement priorities. Last year,
over 200,000 FEHC surveys were
submitted to NHPCO by providers
nationwide.
Visit the NHPCO website to learn
more about FEHC.
However, to assist provider-members in tracking and analyzing results
from these Veterans-specific questions, NHPCO created a FEHC-V Data
Analysis Workbook.
Specific questions concerning FEHC and the new FEHC-V tool can be
directed to [email protected].
NewsLine
37
Member News and Notes
HPCANYS Receives Health Foundation Grant
The Hospice & Palliative Care Association of New York State (HPCANYS) has
been awarded grant funding from the New York State Health Foundation to
support the expansion of pediatric palliative care services.
The two-year venture will design and implement a faculty development
program to support further strategic dissemination of the HPCANYS
Interdisciplinary Pediatric Palliative Care curriculum. By increasing the size of
a qualified faculty in identified regions of New York State, HPCANYS seeks to increase the number of health
care professionals who are trained in the core precepts of pediatric palliative care and, in so doing, expand
access to this underserved population.
Kafi Wilson Appointed Assistant Medical Director
Unity (Green Bay, WI) has appointed Kafi Wilson, MD, to its clinical team as an assistant
medical director.
Prior to joining Unity, Wilson practiced as a hospitalist for six years. She is a graduate of
the University of Alabama’s School of Medicine where she completed a rotation at the Balm
of Gilead, the first inpatient palliative care unit in Alabama—an experience that she says
deeply influenced her career.
Margaret Conklin Appointed to NC Board of Nursing
Margaret Conklin, BSN, MPH, has been appointed to the North Carolina Board of Nursing
for a three-year term, beginning in January 2013.
Conklin currently serves as vice president of clinical services at Hospice and Palliative Care
of Greensboro (Greensboro, NC) and has led a successful and passionate career in nursing
and home care.
Kenneth Zeri Receives Leadership Award
The Aloha Chapter of the Association of Fundraising Professionals has selected Kenneth
L. Zeri as the recipient of the 2012 Paulette V. Maehara Leadership Award.
Zeri, who is the president/CEO of Hospice Hawaii and a member of the NHPCO board
of directors, was recognized for his work in spearheading the passage of key legislation,
including The Uniform Healthcare Decisions Act in 1999 and the POLST Act in 2009, as
well as negotiating with the University Health Alliance insurance company to launch a
concurrent care model.
38
NewsLine
iative care hospice care continuum bereavement hospital nursing home advance care planning community-based care palliative care hospice care continuum bereavement hospital nursing hom
unity-based care palliative care hospice care continuum bereavement hospital nursing home advance care planning community-based care palliative care hospice care continuum bereavement
re planning community-based care palliative care hospice care continuum bereavement hospital nursing home advance care planning community-based care palliative care hospice care continu
ng home advance care planning community-based care palliative care hospice care continuum bereavement hospital nursing home advance care planning community-based care palliative care
avement hospital nursing home advance care planning community-based care palliative care hospice care continuum bereavement hospital nursing home advance care planning community-base
are continuum bereavement hospital nursing home advance care planning community-based care palliative care hospice care continuum bereavement hospital nursing home advance care plann
re continuum bereavement hospital nursing home advance care planning community-based care palliative care hospice care continuum bereavement hospital nursing home advance care plann
ative care hospice care continuum bereavement hospital nursing home advance care planning community-based care palliative care hospice care continuum bereavement hospital nursing hom
The National Hospice and Palliative Care Organization presents:
COLLABORATE
ASSESS
RELIEVE
EVALUATE
It’s About How We CARE
NHPCO’s 13th Clinical Team Conference and Pediatric Intensive
NHPCO gratefully acknowledges the following organizations for providing support for the 13th
Clinical Team Conference and Pediatric Intensive:
Platinum Conference Supporter:
Gold Conference Supporter:
Silver Conference Supporter:
Bronze Conference Supporters:
NewsLine
39
Tip of the Month
The
Comprehensive
Assessment
and Initial Plan
of Care
The NHPCO Regulatory team has received many questions
from providers about the timing of the comprehensive
assessment and the development of the initial patient plan of
care, so this brief review may be helpful.
Comprehensive Assessment
Per the Centers for Medicare and Medicaid Services (CMS),
the comprehensive assessment must be completed no later
than five calendar days after the effective date of the hospice
notice of election. In other words, the effective day of hospice
election does not count as one of the five days. As an example:
If the patient’s election of hospice is effective on a Monday,
then the hospice has until Saturday to complete the
comprehensive assessment.
Initial Plan of Care
All members of the interdisciplinary team must be involved
in the comprehensive assessment process in order to identify
the patient and family’s “physical, psychosocial, emotional
and spiritual needs” and be in the position to contribute to
the plan of care that will address those needs.
The RN, in consultation with the other team members, must
consider the information gathered from the initial assessment
as the team develops the plan of care and determine who
should visit the patient and family during the first five days
of hospice care, in accordance with the patient and family’s
needs and desires and the hospice’s policies and procedures.
[Medicare Hospice CoPs (418.54(b)]
There is no specific timeframe for development of the initial
patient plan of care in the Medicare Hospice CoPs. However,
since the comprehensive assessment must be completed
within five calendar days after the effective date of the
hospice notice of election, the initial plan of care should
be developed from the outcomes of the comprehensive
assessment shortly thereafter.
Other Questions for the Regulatory Team?
Email [email protected].
40
NewsLine
Where can hospice palliative
care leaders engage with…
Don
Berwick
Ellen
Goodman
Dan
Heath
■
The former CMS Administrator and Founding CEO of the Institute
for Healthcare Improvement, Don Berwick?
■
Fast Times columnist, best-selling author and Senior Fellow at
Duke University, Dan Heath?
■
The nationally-known former Boston Globe Columnist and the CoFounder and Director of the Conversation Project, Ellen Goodman?
Only one place… NHPCO’s 28th
Management and Leadership Conference
April 25-27, 2013
Gaylord National Resort and
Convention Center
National Harbor, Maryland
www.nhpco.org/MLC2013
NewsLine
41
Videos Worth Watching
The 3 Winning Videos
from the 2012 Creative
Arts Contest!
ntest
Creative Arts Co
s
a video entrie
and social medi
of
photography
and creativity
the winning
to the talent
d to showcase
true testament
NHPCO is prou
Contest…. A
try.
Creative Arts
across the coun
all
bers
from the 2012
NHPCO mem
Contes
Creative Arts
© 2012 NHPCO
t Winners
On November 5th—at the opening
day of the 2012 Clinical Team
Conference—NHPCO will announce
the winners of this year’s Creative
Arts Contest, including three
wonderful videos. Be sure to
bookmark www.nhpco.org/awards
and check out these winning
contributions.
1731 King Street, Suite 100
Alexandria, VA 22314
703/837-1500
www.nhpco.org • www.caringinfo.org
NewsLine is a publication of the National Hospice and Palliative Care Organization
Vice President, Communications . . . . . . . . . . . . . . . . . . . . . Jon Radulovic
Editor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sue Canuteson
Advertising Inquiries . . . . . . . . . . . . . . . . . . . . David Cherry, 703/647-8509
Membership Inquiries . . . . . . . . . . . . . . . . . . . . . . . . . . . 800/646-6460
Copyright © 2012, NHPCO and its licensors. All rights reserved. NHPCO does not
endorse the products and services advertised in this publication.
All past issues of NewsLine are posted online: www.nhpco.org/newsline.
Links to Some
Resources on the
NHPCO Website
Quality and Regulatory
Quality Reporting Requirements
QAPI Resources
Regulatory Center Home Page
Past Regulatory Alerts
Past Regulatory Roundups
Hospice Compliance Calendar
Staffing Guidelines
Standards of Practice
Quality Partners Self-Assessment
System
Outreach
2012-13 Outreach Materials
Resources to Reach Underserved
Populations
Professional Education
2012 Monthly Webinars
2013 Monthly Webinars
End-of-Life Online (distance
learning courses)
Webcasts
NCHPP Home Page
Publications
Past issues of weekly NewsBriefs
Past issues of monthly NewsLine
Affiliates:
Past issues of ChiPPS Newsletter
Quarter 4 – 2012
FOCUS
ON COMPASSION
a quarterly newsletter
Roberto Mansanja and Neema Vesso of Bumbuli Hospice
meet some of the generous students of Superior Elementary
Superior Elementary Student Council
President, Henry Rock
Elementary School Students Raise Funds for Hospice in Africa
A Special Visit from Hospice Bumbuli Shows Them
the Impact of Their Generosity
Last Spring, HospiceCare of Boulder and Bloomfield Counties in Colorado
received an inspiring donation. The gift came from students of Superior
Elementary specifically to benefit HospiceCare’s FHSSA partner, Bumbuli
Hospice in Tanzania.
The students, who raise money each year for non-profit organizations,
decided this year they wanted to make an international impact. Their goal
was to raise $1,000 to be divided between another organization and
Bumbuli, and they exceeded that goal by $100. The funds were raised
through a school-wide competition among grades (with the winning
grade earning a Popsicle party and extra recess time) as well as a
fundraising concert which opened with a beautiful rendition of the Lion
King’s “Circle of Life.”
Just last month they were visited by representatives of Bumbuli
Hospice, Neema Vesso and Roberto Mansanja, who shared with the
students how their generous gift has been used to fund educational
materials for orphans and vulnerable children.
Using $55 per student, they were able to purchase for each student:
• A mathematics set
• Exercise books (9)
• Ball pens (5)
• Pencils (2)
• Backpack
• For boys: 2 shirts, 2 trousers, cardigan, 2 pairs shoes, 2 pairs socks
• For girls: 2 skirts, 2 blouses, cardigan, 2 pairs shoes, 2 pairs socks
“These students have given us a great example of the tremendous impact
every contribution makes on our African partners,” said Shelley Smith,
FHSSA director.
“Through this unique partnership, Superior Elementary students are
learning about the invaluable role of hospice in communities here and
abroad. And last year these students mobilized resources to touch the lives
of children who would not otherwise be able to continue in school after
the loss of one or both parents. It’s humbling to witness the capable
leadership and inspiring passion of students who are committed to a
cause,” said Darla Schueth, president and CEO of HospiceCare.
August, 2012 | 1
FHSSA | FOCUS ON COMPASSION
Quarter 4 – 2012
International AIDS Conference
and Reception
FHSSA staff attended the XIX International AIDS Conference,
held in Washington, DC in July. Over 20,000 participants attended
the conference from around the world. In conjunction with the
conference, FHSSA hosted an evening reception to provide a
networking opportunity for individuals committed to—or interested
in—the role of palliative care in HIV/AIDS internationally, with an
emphasis on Africa.
More than 100 guests attended and enjoyed the opportunity to
network both before and after the short program. The program
included a welcome and introduction to the event by John
Mastrojohn, executive director, FHSSA, a presentation of a new
toolkit on “Integrating palliative care into HIV services” by Kim
Green, deputy county director/Ghana, FHI 360, and a country
perspective of the importance of palliative care services for HIV/
AIDS treatment by Eunice Garanganga of the Hospice & Palliative
Care Association of Zimbabwe.
FHSSA Director, Shelley Smith with AIDS Conference reception guests
Guests represented a wide array of organizations, such as:
• Donors
• African national associations
• International NGOs
• Advocacy networks
• Community service providers
Co-sponsors of the reception were: Foundation for Open
Society Institute, America’s Health Insurance Plans (AHIP), the
Community Health Accreditation Program (CHAP), FHI 360,
and the Worldwide Palliative Care Association (WPCA).
FHSSA Partner, Kenya Hospices and
Palliative Care Association Receives
Prestigious Award at XIX International
AIDS Conference
KEHPCA’s Work Selected from Over 1,400 Nominees Worldwide
During a special session at the XIX
International AIDS Conference in Washington,
DC, FHSSA partner Kenya Hospices and
Palliative Care Association (KEHPCA) received
a Red Ribbon Award in the Treatment, Care
and Support category.
The Red Ribbon Award is presented every two
years at the conference to honor and celebrate
community-based organizations for their
outstanding initiatives that show leadership in
reducing the spread and impact of AIDS. The
award is a joint effort of the UNAIDS family.
KEHPCA was one of 10 winners chosen from
over 1,400 nominees from around the world.
KEHPCA is a national association that
represents all palliative care providers in Kenya.
Its mission is to scale up palliative care services
to bridge the gap between those who receive
services and those in need. KEHPCA advocates
for the integration of palliative care for children
and adults into health services in Kenya and
addresses issues of accessibility, affordability,
and quality.
Since 2009, KEHPCA has collaborated with
FHSSA in a number of ways including
partnering with Hospice of Lancaster County
as part of FHSSA’s Partnership program. It is
also one of the three original countries involved
in FHSSA’s Conquering Pain Project, and in
that capacity is leading the development of a
country-wide plan for the education of
hospital-based health professionals in oral
morphine use and prescription.
“KEHPCA is a true leader in bringing quality
palliative care to those in need in Kenya. We
have had the honor of working with them for
many years on ground-breaking initiatives and
are so pleased that their work has been
recognized by this internationally-known
award. They are so deserving of this
distinction,” said John Mastrojohn, executive
director of FHSSA.
For more on KEHPCA, visit: www.kehpca.org,
and to learn more about the Red Ribbon
Award, including past and current recipients,
visit: www.redribbonaward.org
August, 2012 | 2
Quarter 4 – 2012
People to People
FHSSA and NASW lead a delegation to South Africa
This August, FHSSA Executive Director John Mastrojohn and National Association of Social
Workers Chief Executive Officer, Betsy Clark led a delegation of hospice and social work
professionals to Durban and Cape Town, South Africa to learn first-hand about the approach and
challenges to providing palliative care in South Africa.
The goal of People to People, is to promote global awareness, facilitate the breakdown of cultural
misconceptions, and increase global perspectives. The group began their journey in Durban
where they received an orientation led by John Mastrojohn who provided an overview of hospice
and palliative care in Africa, emphasizing the tremendous need for palliative care on the
continent, followed by informative presentation by a hospice physician who described some of
the issues facing hospice and palliative care in South Africa including workforce shortages, and
changes in the diseases they care for.
People to People delegation visits the International
Children’s Palliative Care Network
Delegates visited hospice programs of
varying sizes as well as nongovernmental organizations such as the
Big Shoes Foundation which provides
palliative care to children with lifelimiting illnesses, and Stellenbosch
University to meet with students and
faculty in palliative care. During each of
their visits, they spoke with nurses,
social workers, and other members of
the palliative care team to further their
understanding of palliative care in South Africa.
These visits were interspersed with trips to
cultural sites within the country, including a
stop in a Zulu village and a visit to Mahatma
Ghandi’s compound. These excursions helped
deepen their understanding of various aspects
of South African culture.
“We learned that the hospice concept and
philosophy are quite similar to here in the United
States, and they face a similar lack of awareness
and understanding of palliative care,” said Clark.
“However, many of the challenges they face are
unique, including the lack of a formal payer
source for hospice care, and an increase in
multi-drug resistant HIV-related tuberculosis
among other challenges.”
Both Mastrojohn and Clark felt the visit was
extremely successful in providing a vivid
glimpse into providing palliative care in South
Africa, and allowing both delegates and hosts
to share experiences and gain perspective.
Conquering Pain—Enhancing Lives in Africa
Phase Two of Collaborative Program to Improve Pain Management Begins
FHSSA and the African Palliative Care Association
(APCA) continue to collaborate to improve pain
management among palliative care patients
receiving care in hospitals in six African countries.
The initiative builds upon ongoing efforts aimed
at strengthening pain management and palliative
care as a whole within the health system in each
of the countries.
The second phase of the initiative is underway,
adding two new countries: Rwanda,Swaziland,
and Zambia. Funding continues to support a
physician training in The Gambia and to expand
the work in Rwanda and Zambia.
A yearly review meeting was held in Kigali,
Rwanda in August. The meeting brought
together representatives of public hospitals and
ministries of health from across seven African
countries, as well as international experts in
palliative care and pain management.
Participants reviewed the progress being made
in strengthening pain management, shared
experiences and learned from each other about
national policies and responses to palliative care
and pain management. The six countries
participating in the project included: The
Gambia, Kenya, Malawi, Rwanda, Swaziland,
and Zambia. Representatives from Uganda
also attended and described their experience in
the distribution and safe use of morphine in
their country.
In addition, FHSSA has developed a three-year
strategy for the program, entitled, “Conquering
Pain – Enhancing Lives in Africa.” For more
information on this program, contact FHSSA
Director, Shelley Smith at [email protected]
or (703) 647-6695.
August, 2012 | 3
Quarter 4 – 2012
Public Screening of Okuyamba
Held in Los Angeles
Hospice Ambassador and Actress Torrey DeVitto
Hosts World Hospice & Palliative Care Day Event
The award-winning documentary, Okuyamba,
was created through a collaboration of the
Center for Hospice Care in South Bend, IN,
the Palliative Care Association of Uganda, and
the University of Notre Dame Film School and
tells the story of a group of nurses working to
ease the pain and suffering of people facing
the end of life in Uganda, where there is little
to no access to adequate pain control, and the
majority go a lifetime without seeing a doctor.
Okuyamba is available at no cost to hospice
programs interested in hosting an awareness
or fundraising event using the film. For more
information, contact Sarah Meltzer at
[email protected] or
(703) 837-3149.
More information about the film is available
at www.okuyamba.com.
FHSSA Board member, Doug Wagemann; Actress and
Hospice Ambassador, Torrey DeVitto; and FHSSA Board
member, Mike Wargo attend the Okuyamba screening.
In honor of World Hospice & Palliative Care
Day, a global day of awareness and outreach,
FHSSA hosted a screening of the film on
Wednesday, October 10 at the UCLA School
of Theater, Film and Television.
Torrey DeVitto, actress, advocate and hospice
ambassador served as special host for the
event. A five- year hospice volunteer, DeVitto
has been working to raise awareness of the
compassionate care hospice provides people
at the end of life.
“This powerful documentary shows how hard
it is for people struggling with life-limiting
illness in a part of the world where resources
are few but caring and compassion are
abundant,” said DeVitto. “Okuyamba
reminds us that there is hope even in the
face of death.”
August, 2012 | 4
Quarter 4 – 2012
FHSSA Launches into Crowdfunding
In September 2012, FHSSA created a crowdfunding platform as a new means to raise
awareness and support for its work. Sometimes referred to as crowd sourcing or social
fundraising, crowdfunding describes an effort by individuals who network and pool
their resources to support a cause.
FHSSA is pleased to work with Launcht, a company that partners with emerging
crowdfunding portals as the technology developer of the crowdfunding platform.
“We are pleased to help FHSSA make this platform a reality,” stated Freeman White,
CEO and co-founder of LAUNCHT. “Personally, I care deeply about hospice and
specifically FHSSA’s partners in East Africa, so enabling them to create an online
community through crowdfunding has been very gratifying.”
ADD
SPECIAL
MEANING
TO YOUR
GIFTS
Show the ones you love that you really
care. Each time you make a purchase from
one of these vendors, they will donate $10
to the National Hospice Foundation.
FHSSA Partners will create their own, custom crowdfunding campaign pages and
connect with their community, encouraging people to get involved and support their
work in Africa. In addition to hosting the Partners, FHSSA will create its own
campaigns, encouraging support for other important projects.
Donors will be able to go to FHSSA’s crowdfunding site, choose the project and
location in Africa that is important to them, and donate any amount.
FHSSA encourages all Partners to create their own crowdfunding campaigns.
Visit [email protected] to learn more.
FHSSA will help
Your Campaign Here
Technical assistance
Tell people about your campaign to help your FHSSA
partnership in Africa. Let them know the impact you are
making with their support.
Complete review of your
campaign
Marketing and promotion
Assistance with gift
administration
Transfer your funds raised to
your Partner
FHSSA Partners –
How to Sign Up?
Tell your story. Include the impact with compelling visuals.
$500 Raised of $5,000 Goal
3
funders
38 Days
remaining
Or if gift cards are what you’re looking for,
TisBest Charity Gift Cards allow the
recipient to make a donation to one of
250 national charities, including NHF!
www.nationalhospicefoundation.org/
TisBest
Remember also to purchase your greeting
cards through Cards for Causes, and 20%
of your purchase will go to The National
Hospice Foundation! www.cardsforcauses.
com. They offer cards for every occasion!
These programs will run through 2012 so
include NHF for all holidays to add special
meaning to your gift purchases.
3 Contact FHSSA:
[email protected]
www.nationalhospicefoundation.org/Shop
3 703-647-5176
3 $150 investment
3 Develop 60-day
campaign(s)
Fund This Campaign
August, 2012 | 5
Quarter 4 – 2012
Combined Federal Campaign
If you are a federal employee, you can participate in the annual Combined Federal
Campaign (CFC), which runs from September 1 through December 15. Support
through the CFC will help fund the work of FHSSA and its Partnership Program.
The CFC number to use is: FHSSA #11018
Does your employer offer matching gifts?
Many employers have matching gift programs that can double or even triple your
contribution. Make the most of your donation by requesting a matching gift form
from your employer. If you send a completed and signed form with your gift, we
will take care of the rest! Not sure? Want to learn more? Contact Sarah Meltzer at:
[email protected] or 703-837-3149.
The Foundation for Hospices in Sub-Saharan Africa is now doing business as FHSSA.
www.facebook.com/FHSSA
1731 King Street, Alexandria, VA 22314
CFC# 11018 • (703) 647-5176
www.fhssa.org • [email protected]
www.twitter.com/FHSSA_news
www.youtube.com/FHSSA
August, 2012 | 6

WHV Partners Give Thanks - National Hospice and Palliative Care

Transcription

Similar documents

Planning End of Life Care with Dignity

Lunch with Graham Walton

CHF Care Project - Quality Insights-QIN

Request for Hospice Order

THE GATHERING HOSPICE

April 2016 - Garden View Assisted Living

WHEREAS LifePath Hospice provides patients and families the

Issues in End-of-life Care - Alpha

GALA PPT - The Southern California Cancer Pain Initiative