Saturday, Nov 22, 2014

'Patient choice' argument still valid


In response to the Agency for Health Care Administration's recent approval for Hospice of Citrus and the Nature Coast to expand services into Hernando County, Hernando Pasco Hospice has filed a petition for a formal administrative hearing to contest the approval.

In effect, the HPH challenge attempts to ensure the people of Hernando County do not have a choice of provider at the end of life.

Hernando Pasco Hospice completed an application to provide services in Citrus County in 2004 and opened its first Citrus location in 2008, stating that choice is important to the quality of patient care. We agreed with that position given that optimum patient choice resides at the core of excellent hospice care.

Citing potential need for broader services for Hernando County residents with terminal illnesses, the nonprofit Hospice of Citrus and the Nature Coast filed a letter of intent with the Agency for Health Care Administration, signaling our interest in expanding to Hernando County. In that filing, I said: "The letter of intent is not a criticism of the hospice which serves Hernando County; many counties, including Citrus, have more than one hospice provider."

It is disappointing, however, that HPH, through its petition, clearly is advocating a position that would afford patient and family choice in every other service area statewide except its own. What's more, this petition represents a complete reversal by HPH from its previous position that "patient choice" is vital and that all good things happen on the service side when people are afforded provider choice. The Agency for Health Care Administration approved Hospice of Citrus and the Nature Coast's request to serve Hernando County and now HPH is suggesting it should be allowed to operate as the sole provider in Hernando County.

The idea arose as a result of the increase in need for pediatric palliative care services in Hernando County. Hospice of Citrus and the Nature Coast is the contract provider with Children's Medical Services in Ocala for Partners in Care/Together for Kids, serving children with life-threatening illnesses in 13 North Central Florida counties including Hernando. Bonnie Saylor, our chief operating officer, states: "The need for pediatric palliative services is growing in Hernando County and when a child needs to transition to full hospice care, Hospice of Citrus and the Nature Coast is not currently able to provide that service."

Hospice organizations are independent of one another, and in Florida, they are required to receive a certificate of need to provide services in a particular area. Hospice of Citrus and the Nature Coast, licensed in 1985, now provides hospice services in Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy, Putnam, Suwannee and Union counties. Hospice of Citrus and the Nature Coast provides pediatric palliative care services in those counties and Hernando County. We specialize in rural, home-based hospice care, inpatient hospice care, hospital-based hospice care, facility-based hospice care and pediatric hospice and palliative care. Patients may choose their location of care, physician, medical equipment company and pharmacy through a network of providers partnering with Hospice of Citrus and the Nature Coast. We are nationally accredited by the Institute for Jewish Hospice and have earned the Gold Seal of Approval from the Joint Commission, with "deemed status" for quality of care and billing practices.

The most recent Florida Need Projections for Hospice Programs, published in April 2013 by the Agency for Health Care Administration, indicates a growing need for hospice services in Hernando County.

Since 2009, the number of admissions for hospice services in Hernando County has declined while the population has increased. It is expected that the number of people over age 65 will increase 15.23 percent by 2018, creating a need for more hospice services.

Another hospice in Hernando County would provide patients with more services and more choices.

Anthony J. Palumbo is chief executive officer of Hospice of Citrus and the Nature Coast.


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