Like all health care practices across the U.S., the leadership of Housecall Providers prepared last spring as best they could for the time when the pandemic would overtake our city. At the first sign that COVID-19 had landed in Oregon, the team assembled a task force to create and prioritize their multi-layered response. Foremost on their minds was how to protect staff, caregivers and family members so we could continue to deliver in-home medical care.
While there is never a good time for something of this magnitude to strike a community, it arrived during a period when Housecall Providers was hitting its stride. The primary care and hospice censuses were both at or just below record highs, and the Advanced Illness Care program (community-based palliative care) was holding steady at its projected monthly numbers.
“As a hospice, we were very excited with what 2020 was going to hold,” says Hospice Manager Richard Holman. “We had hit our highest census in years and had growth indicators that suggested we were going to be able to serve even more members within our community – then came the lockdown.”
While we waited for the necessary personal protective equipment (PPE) to arrive, both primary care and hospice quickly implemented a telehealth option so that we could continue to serve our patients. Hospice was the first of those two programs to visit patients safely in home once the right amount of PPE was secured to resume house calls. Advanced Illness Care relied on telephone check-ins with patients and outside visits, too, when weather permitted.
“Pausing our new patient intake and house calls for the first six weeks of the pandemic definitely took its toll. It was heartbreaking to not be able to admit new patients to our primary care service temporarily, and this also impacted our bottom line,” says CEO Rebecca Ramsay, “but our focus had to be on those patients who were at the end of life and making sure the available PPE went to our hospice team members so they could care for them safely.”
That meant that during those weeks, roughly 80-90 patients did not come on service as quickly as we would have hoped. And due to the lockdowns imposed by care facilities across the metro area to keep their residents and staff safe, patients were not enrolling at the pace they normally would.
Now, with many of those assisted living residents and staff being vaccinated in the initial wave along with health care providers, face-to-face visits have been more frequent across all the programs. And an uptick in new patients coming on service has been noticed too.
“More and more patients living in all different types of environments are becoming comfortable with in-home medical visits because they are aware that most of our staff has been vaccinated, that they are tested regularly and are always wearing proper PPE,” says AIC Manager Kelly Ambrose.
Still, there are those homebound patients in private homes and adult care homes (ACH) that have not yet been vaccinated. At this point, Housecall Providers has not been provided with vaccine by the Oregon Health Authority (OHA) and therefore not able to offer this service to our patients. However, we have been very proactive in advocating for our patients to be prioritized for the vaccinations.
“Currently, we are partnering with OHA to identify ACHs that fell outside the initial long-term care strategy for patient vaccination, and we are highlighting the importance of including those homes in their planning,” says Ramsay. “We are also partnering with the public health agency in each of the three Portland metro counties (see Partner Spotlight) to implement a strategy to vaccinate all our patients that are homebound and living in private home settings, because these patients, too, were not part of the initial vaccine rollout.”
Housecall Providers has been offering scheduling and outreach support to these public health agencies to help expedite the vaccination process of this select group.
“This pandemic has required our staff to make rapid and significant changes to their daily work – adding to their already overflowing plates,” says Ramsay. “They have met the challenges presented this last year with grace, resilience, humor and passion for our patients, and we have become a stronger and more flexible organization as a result. I couldn’t be prouder, and I am honored to work with this team