 | Tom Welk
DMin is Director of Pastoral Care & Professional Education at Harry Hynes Memorial Hospice. He also teaches at the University of Kansas School of Medicine-Wichita. He has certification with the American Association of Pastoral Counselors in Clinical Pastoral Education. His memberships include Park Ridge Center for Study of Health, Faith, and Ethics, and St. Louis University Center for Health Care Ethics, Charter Board Member Kansas Health Ethics, Inc., and Ethics Committee Member for National Hospice Organization. He has received the President's Award of Excellence for Public and Community Awareness, for the "Dying Well" project from The National Hospice Organization. Tom's group presentations include: Association of Kansas Hospices, Midwest Congress on Aging, and Kansas Health Ethics Conference. Tom Welk can be contacted by fax at (316) 265-6066, by e-mail at: twelk@hynesmemorial.org, or at his office at (316)219-1791. |
Hospice
2003-02-01 13:49:00
Is 'hospice' care free?
: Is Hospice a free service? Is it only provided in the home, or can it be provided in another location?
ANSWER: The old adage "There is no free lunch" has much validity. All of us tend to get a bit suspicious of "free offers." We instinctively know we will probably be hit up sooner or later with some kind of hidden cost. Someone somewhere along the line will have to pick up the cost of the "lunch."Is hospice care a free service? Depends on how one looks at "free." There is a difference between saying it is a "free service" with no cost to anyone and saying that receiving hospice care is not dependent on the patient/family's ability to pay for the services provided (nursing, health care aide, social worker, chaplain, hospice medical director, volunteer).Some hospice programs make it very clear in their mission statements that patients will be taken under care "regardless of ability to pay or insurance coverage." However, those same programs will also acknowledge that the cost of the services provided must be underwritten from other funding sources. Most often that funding comes from generous donations from a variety of sources, such as grants, memorials, individual donations, bequests, etc.Community-based hospices set up as non profit programs especially rely on donations to supplement the reimbursement received from third party payers (Medicare, Medicaid and commercial insurance) to pay for the cost of the hospice services provided. Since these donations are given to a not-for-profit agency, the donor can use this donation for a tax deduction.Hospices set up as for profit, investor-owned corporations either will not take any patients under care who cannot pay for the services or only a very limited number of non-paying patients. Some will set up a foundation to which tax deductible donations can be made to pay for the cost of hospice care for those with no insurance and with no ability to pay privately.To sum up, there is no such thing as a "free lunch." So also, there is no such thing as "free hospice care."Is hospice care only provided in the home? It is important to understand that hospice is a concept of care, and not primarily a "place" of care, such as a hospital or nursing home. Hospice care (physical, emotional, social and spiritual support) is provided in a variety of settings: home, nursing home, hospital (though only temporarily to take care of an acute need) or inpatient facility.In the Sedgwick County area Hynes Memorial Hospice has an inpatient facility to care for terminally ill patients whose complex needs cannot be met in the home setting. This facility is staffed with RNs on a seven-day, twenty-four hour basis. It has a capacity of 12 beds, and is primarily reserved for patients with acute pain control or severe symptom management needs. Prior to the opening of this inpatient unit, patients with these acute needs were frequently hospitalized. Now this is no longer the case. The Hynes Memorial Hospice inpatient facility has the ability to address these needs, and at the same time provide a home-like environment for both the patient and family.
