1. What prompted your interest in serving on the NHPCO Board of Directors?

I am near completion of my first successful three year term on the NHPCO Board of Directors. I am very interested in another three year term to continue to further the mission and vision of this organization. In July the Board will take time specifically for 2013-2015 strategic planning. I would like to be on the Board to participate in and help execute the outcomes and goals from this planning.

2. What special expertise would you bring to the board?

See the statement of characteristics to be evaluated for guidance on this question. I served on the board of the Minnesota Hospice Organization, now the Minnesota Network for Hospice and Palliative Care (MNHPC) care for 7 years, with an unprecedented two year term as President. I continue with our state organization to be an active member of the Standard’s Committee. I am on the NHPCO Membership Committee and I have served on this committee for the pat two years. I have had the honor and privilege being the Chair of the NHPCO Education Committee and participate on a number of education sub committees. I have worked with our key stakeholders: EMT staff in our metro area, various payers and quality providers and all those associated within our large Fairview Health System to plan the use of Honoring Choices, Minnesota. This is a document to help with discussions on the choices for individuals when they are not able to speak for themselves and their wishes to be recognized across our local area and ultimately our state. Over the past two and half years we developed a pilot group, educating staff to become facilitators. These facilitators worked with a subset of patients within one of our hospitals, clinics, and our homecare and hospice agency. Together we utilized the POLST (Provider Orders for Life Sustaining Treatment) format to document these discussions. I have been a key contributor in the planning and education for the nearly 350 staff at Fairview Home Care and Hospice and the successful utilization of the POLST.

Since our Fairview Health System was chosen one of the pioneer ACO’s in our state, I bring the learnings and experiences which are far from over.

I am also in the active leadership of one of the largest hospice programs in our state (which includes urban and rural patient and families) including the University of Minnesota Medical Center.

3. How can the NHPCO meet the needs of a diverse group of hospice and palliative care providers? (i.e. rural vs. urban, community based vs. corporate, small vs. large)

I think it is very important for NHPCO to continue to listen to the membership of NHPCO. I find this is a big part of my responsibility in the position of National Director on the Board of NHPCO. It is important to bring back to the leadership and committees the information shared from members forward. We must to continue to elicit their feedback in various ways and manage the collective needs for the organization. I think it is vitally important to continue the relationship NHPCO has with the Council of States and create the best working relationships with all the state organizations as possible. It is important we collaborate and collectively work together with the legislative advocacy agenda for NHPCO.

4. What leadership positions, beyond hospice and palliative care, have you held?

In 2003-2005 I was the President of our Association and on the Board for the Villages at Eagle Valley. I helped establish and create the non-profit organization ArmInArmInAfrica (AIAIA) in 2005 for the people residing in Gugletu and Malugeni South Africa. Since 2005 I have been on the executive committee serving as Secretary for AIAIA as well a member on the Board of AIAIA.

5. Health care reform initiatives could significantly change the health care delivery system in the next three years. What roles do you think hospice and palliative care should play in the health care continuum that it currently does not?

Hospice and palliative care needs to be in the discussions of health care systems making changes in care transitions. Often hospice and palliative care is thought of last in line and late as an option for better care. Becoming earlier at the discussions of how to adopt new systems it is challenging for hospital systems to think beyond the walls and appreciate that hospice and palliative cares are the extenders for very good care in the patient’s home. I also think hospice and palliative care could have a more focused impact with the medical community primarily physicians. So many physicians still do not understand what hospice care provides and wait far too long to include these services in a patient’s plan of care.

6. Other than health care reform, what do you think are the most important issues/challenges facing hospice and palliative care in the next five years? What do you see as NHPCO’s role with regard to those issues? How would you as a board member help NHPCO fill that role?

The Medicare Hospice Benefit (MHB) stands at a critical evaluation point currently and in the next year or two (especially after this year’s election) significant changes will likely be proposed or occur. NHPCO must be at the political and policy tables to help shape the discussions and ultimate outcomes from Med PAC and other entities. I certainly, as a board member, would be a voice to other members to help educate them about the issues at hand and help get them involved. Having gone to “the Hill” and speaking to our House Representatives and Senators since 1982, I would continue these discussions inviting newer state hospice providers to keep the discussions going.

Another issue is managing the quality outcomes of hospice care with just the beginning of our publicly reported data from the last quarter of 2013. Public reporting to CMS has never before occurred for hospice programs. NHPCO’s role is to continue the education to the membership on the CMS requirements. Because there are varied bodies accrediting hospices the question of NHPCO being in the business of accreditation is another question to be discussed.

A challenge facing hospice and palliative care will be the retirement of very experienced leaders within the hospice and palliative industry. As a board member I would be looking around nationally /locally and talking with schools of business, nursing schools to further the leadership development for these EOL leadership positions.

7. Describe an innovative or visionary achievement you led that had a broad effect in your community or state.

Our state organization is completing, after two years, the education to over 115 Skilled Nursing Facilities (SNF) in conjunction with the Department of Health and Minnesota Network for Hospice and Palliative Care. I started this conversation at a Board meeting and then expanded the idea with the Standards Committee. The goal was to have this project meet the 2008 Condition’s of Participation for the uniform education from the hospice programs and the SNF staff. The other goal was to have the inclusion of the Department of Health so they would have input in this education plan and how it would involve new staff in their orientation and beyond. My vision was to include our regulatory body, the Minnesota Dept. of Health in this project, ultimately getting their blessing so the education tools could be used by all SNF. Each hospice program would not have to create their separate tools rather we could use the same ones for all the facilities. This idea was before there were templates provided from NHPCO. This project has been a win-win for our Minnesota programs, local Skilled Nursing Facilities and the MN Dept of Health. After the Department of Health made some changes they approved the education document. It was an example of bringing many people together representing various areas to a collaborative, positive, shared outcome.