Sometimes there are good secrets; things we can’t share for a good reason. These past few months have held just such a good secret until last week. I think many of you know that I have served on the Board of Hospice of the Golden Isles for more than three years now. Fewer will know that I assumed the role of Chairman of the Board this past January. It is an honor and a privilege to serve such a fine institution, with such a long history of serving this community. I became involved with Hospice of the Golden Isles because of my personal experience with hospice care in my hometown, and because of my specific interactions with Hospice of the Golden Isles since I began my ministry at Christ Church. My secret involves Hospice of the Golden Isles. Before I share the secret, let me set the stage.

Hospice of the Golden Isles is a phenomenal hospice. When measured by the data that is collected on all hospice providers across the nation, Hospice of the Golden Isles scores better than most hospices, anywhere. Our quality of care is better than something like 98% of all hospice organizations when evaluated by these scores. The Honors and/or the Honors Elite status that Hospice of the Golden Isles is awarded each year is a testament to the staff we have.  They go above and beyond for our patients and their families, no question.  

Hospice of the Golden Isles is a medium-sized hospice. We are also a healthy hospice in all the ways that provide longevity and stability. Despite that reality, however, Hospice of the Golden Isles faces very real threats within the hospice world. Whereas the hospice movement was once all not-for-profit, motivated by a desire to offer people the best end of life care possible, it has become an industry within the medical world. For-profit hospices are the norm now, with about three quarters of Georgia hospices in that category. Over the years, medical companies have realized they can monetize the process of dying.  

Some for-profit hospices have a different mindset that a hospice like Hospice of the Golden Isles; the bottom line and return to shareholders enters into patient care decisions in ways it just doesn’t for hospices like ours. We’re known to take anyone, regardless of their ability to pay for care. (Some for-profit hospices find a way to steer those patients to us, rather than absorb such costs.) We also provide an inpatient facility, which does not even break-even, financially speaking – none do.  (Some for-profit hospices pretend they have agreements with us to take patients in-house when talking to families; we don’t have any such agreements. They simply drop their patients and we enroll them, even if it’s only for twenty-four hours –  the most expensive part of care.) If a hospice like ours does make money, that money is reinvested in patient care and services, not paid out to shareholders.

Another challenge is the shift in Medicare reimbursements, driven in part because of for-profit hospices. Turning profits, large ones in some cases, has gotten the attention of the Medicare folks. Some reforms being debated may mean that it will become even harder for non-profits, who invest more in quality patient care, to make ends meet. Perhaps the scariest issue is the onslaught of insurance companies that are buying up hospices left and right, to create their own networks. In the future, there will be a host of agreements and contracts for hospice care and smaller, independent hospices may get left out. For as big and healthy as we are, Hospice of the Golden Isles is vulnerable over the long term in the face of such developments.  

Even if Hospice of the Golden Isles were to continue to have incredibly high-quality care and serve more patients, eventually these trends will catch up with us. Our Board, well aware of the shifting sands of the hospice world in recent years, decided to be proactive in addressing these challenges while we were coming from a position of strength, lest we find ourselves in trouble and without options in the future. The big secret I’ve had to sit on, while we were working out details, is that we are affiliating with another hospice entity, Alivia Care of Georgia. The affiliation makes us even stronger and positions us for success for a long time to come.  

This affiliation is not a corporate take-over or a buy out, but a true partnership. Hospice of the Golden Isles remains locally managed and directed. We still have our staff, our name, our money, and most importantly, our mission. Our partners, Alivia Care of Georgia, are providing back office services that allow us to do things we couldn’t possibly do on our own because we’re just not big enough. Employee benefits, for example, have always been hard for an organization with only 100 employees. Now, we get to join a larger group for such negotiations and insurance companies offer better deals when there are 1,000 people in the pool.  

So who is Alivia Care of Georgia? When we first began exploring options for affiliation, we reached out to our close friends and neighbors in the non-profit hospice world, Community Hospice and Palliative Care, which serves north east Florida.  Community Hospice is a large non-profit hospice. They view hospice care the way Hospice of the Golden Isles does; making sure all persons are served, and running inpatient hospice houses because it’s the right thing to do, even if it loses money in the long run. As big as they are, they realized years ago that even they aren’t big enough to weather what’s on the horizon. They restructured themselves to create a parent company, Alivia Inc., which is now providing managed services to both Community Hospice and Hospice of the Golden Isles via Alivia Care of Georgia.  Alivia Care of Georgia is brand new, and Hospice of the Golden Isles helped form it with Alivia Inc. In fact, I serve as one of the three founding members of Alivia Care of Georgia. What’s most exciting in the way this has taken shape is that Alivia Care of Georgia is prepared to welcome other non-profit, community-based hospices in Georgia to join us. The more we come together, the stronger we all become. There is already another Georgia non-profit hospice beginning the formal affiliation process and several others considering it.  

Just to be clear, none of this was taught in seminary. I didn’t anticipate that I’d get this deep into the hospice world, and yet I’m pleased that I can volunteer my energy and gifts in this capacity. A priest’s ordination vows (and often our bishops) remind us that part of our ministry is to be lived out beyond the parish’s walls in the wider community, not just in service to parish members. We all do what we can, where we can, and this is one of the ways I am serving the Golden Isles, and now an even larger segment of the state in a way that fits with our theology of care for sick, the elderly, and the dying. Hospice care is an embodiment of Jesus’ call to care for the “least of these.” I cannot conceive of a world where all hospice care is profit-based. To think that our efforts have been able to secure the future for Hospice of the Golden Isles, and in time, other community-based hospices, is a good feeling.  

I am proud to continue a tradition of support for Hospice of Golden Isles at Christ Church, too.  Several members have served on the board over the years, including our own, Margie Dorsey, who has also served as Chairwoman. Our ECW chapter supports Hospice of the Golden Isles through grants, and many of our members make financial contributions to support its work, too. That’s how community-based hospices work. Everyone comes together to support persons at the most vulnerable and most difficult times of their lives. As your Rector, I also represent Christ Church’s support for Hospice of the Golden Isles. In a sense, “we” are doing this work together. As it should be.  

So that’s the big secret, or at least it was until last week. I know many of you have had positive experiences with Hospice of the Golden Isles and I trust those experiences will continue. It remains the hospice provider of choice for our area, and I am pleased it is positioned to remain so for the foreseeable future.  

Tom+

O merciful Father, who hast taught us in thy holy Word that thou dost not willingly afflict or grieve the children of men: Look with pity upon the sorrows of thy servants for whom our prayers are offered. Remember them, O Lord, in mercy, nourish their souls with patience, comfort them with a sense of thy goodness, lift up thy countenance upon them, and give them peace; through Jesus Christ our Lord. Amen.