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Rural Hospice Op-ed

NHPCO and HAN are pleased to share the op-ed below by board member Sandy Kuhlman that was published in today's Wichita Eagle, shining a light on challenges for rural providers. This op-ed is part of the strategic activity of the My Hospice Campaign.

Make hard work easier for rural hospice caregivers

By Sandy Kuhlman
June 22, 2018 - The Wichita Eagle

Kansas has always been known as a place where people look out for one another and do whatever it takes to get the job done.

I see it in my husband, a farmer who works long and intense days, but who wouldn’t dream of doing anything else. And I see it in my hospice co-workers – nurses, social workers, chaplains, physicians and volunteers who go to unimaginable lengths to make sure our patients have the care and comfort they deserve at the end of life.

As a hospice nurse for more than 35 years – serving patients in 16 counties across 15,000 square miles – I’ve seen it all. There was the nurse who, in order to reach her patient, traveled the last mile across farmland by tractor. Or the hospice staffers who found someone to quickly grade a country road so that an ambulance and pickup truck could bring a very sick patient into town to weather a snowstorm.

Hospice is the type of health-care service most people try not to think about until they or a loved one need it. This comprehensive, coordinated care provides pain control, symptom management and spiritual and emotional support when a “cure” isn’t in the cards. Hospice allows patients to die comfortably and with dignity and to enjoy quality of life when their quantity of days is limited. It’s the type of care – compassionate and realistic – that all Kansans need and deserve.

But it’s getting harder, even impossible, to maintain. Because of shrinking resources, a stretched-thin workforce and national policies that don’t reimburse doctors for end-of-life care, we’re reaching a critical point where something has to change.

Today, the unintended consequence of decades-old policies keep many rural physicians from participating in hospice care, because they can’t bill for the services they provide. Many provide care anyway, without any hope for reimbursement.

But this scenario is not viable for the long term, especially as our population ages and increasingly requires quality end-of-life care. Across the state, all health-care providers are struggling for sustainability. Our population continues to dwindle. Providing care costs more, and we have fewer medical resources over wide swaths of land.

Many adult children of elderly parents have moved away – increasing the need for readily available, skilled health-care professionals who can step in.

We need Congress to enact the Rural Access to Hospice Act legislation led by Kansas Reps. Lynn Jenkins and Roger Marshall. It would allow many rural physicians to receive payment for providing hospice services and increase access to patients across the state. This common-sense, bipartisan legislation is supported by leading national groups, including the National Rural Health Association and the National Hospice and Palliative Care Organization.

I urge our entire Kansas delegation to support this critical piece of legislation.

Until then, my co-workers and I will continue caring for our patients with the compassion and respect they deserve – going to extraordinary lengths when the situation merits. We will treat your families like our own and live up to our reputation as committed caregivers and Kansans: We will do whatever it takes to get the job done.

Sandy Kuhlman, BSN, RN, is executive director of Hospice Services, Inc. in Phillipsburg.

Read this op-ed online.

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