By Deb Murphy
In February of this year, Pioneer Home Health Care had finished the process of bringing Hospice of the Owens Valley services under its umbrella, completing the state licensing procedures, making out the check and sending the packet off to the San Bernardino office of the Public Health Department’s Licensing and Certification. Seven months and Pioneer’s Pat West is still waiting.
In June, West was notified that a new check was required. The one sent in February had expired as it sat in the packet with all the documentation and forms.
“We’ve done everything we can,” West said. When West contacted the office she was told the department was short-handed and only processing one hospice application a month. There are 20 applications in the queue. West has no idea where Pioneer sits in that 20-month long line. She was also told the application would not be reviewed until the new check was received.
The new check and a list of questions were sent off to San Bernardino. “We wanted to know if there were things we could do to make sure we passed inspection,” West said. “We’re doing the best we can for the community.” To date, no response. So, they wait.
According to Public Health’s website, there are more than 120 hospices in California, basically, two per county. Inyo and Mono counties have none. According to West the closest in-home hospice service provider is in Ridgecrest, but you have to live in Ridgecrest to participate.
Three years ago, Hospice of the Owens Valley, an all-volunteer organization, approached Pioneer. The organization had been providing end-of-life care for more than 20 years. “They gave us their assets,” said West and Pioneer began the process of planning, staffing, training, developing policies and finally licensing and state certification, required for Medicare/Medical reimbursement. Licensing is just the first step, allowing Pioneer to take on hospice patients and their families.
West has tried to apply a little pressure through Representative Paul Cook and state Assemblyman Frank Bigelow (District 5, including Mono County). “We have no hospice program in the licensing area of need,” she said. Pioneer currently provides home services from Lone Pine to June Lake.
Pioneer had to expand and train staff and volunteers to grow from helping patients “move toward wellness after illness or surgery,” said West, to hospice care. “Hospice patients are aware of their terminal diagnosis and have made the choice to spend their time at home with friends and family with no life-extending treatment.” The choice is between more time or the quality of the time left.
“The focus is different,” West said. And so are the support teams. Volunteers, nurses and social workers are still necessary with the addition of chaplains and bereavement coordinators. “The hospice team works with the care partner to mitigate the symptoms” and provide support, training and relief for the patients families.
During the wait for licensing, Pioneer has lost some of their staff and volunteers. “We still have eight core volunteers left,” West said. Licensing allows Pioneer to take on hospice patients with the only reimbursement from insurance coverage. Certification is required before those services can be covered by MediCare or MediCal. In the interim, West will be providing the service to those not covered by private insurance with no reimbursement.
Inyo County Supervisor Jeff Griffiths brought the situation to the Board last week. “Urban areas have options,” he said as he reported on Pioneer’s licensing delays. “We have just one.”