When Housecall Providers joined the CareOregon family in May 2017, we welcomed the CareOregon Advanced Illness Care team into our continuum of home-based medicine. The community-based palliative care team delivers care to approximately 200 seriously ill Medicaid patients a year in the home, clinic or hospital.
Unifying these home-based services under one roof makes care transitions smoother, cuts down on patient wait times and improves the efficiency of communication. But more important, it provides the most-vulnerable patients in our community with the compassionate, wraparound support they need to navigate their serious illness.
The team includes nurses, social workers, outreach specialists, a chaplain and a pharmacist. They provide symptom management, care coordination, and advanced care planning for our patients who are facing serious illnesses like advanced cancer, congestive heart failure (CHF), Chronic obstructive pulmonary disease (COPD), degenerative neurological conditions and end-stage liver and kidney disease. These patients are disproportionately affected by poverty, housing instability, food insecurity, behavioral health conditions and substance use disorders. Many have lost their income and housing due to their inability to work because of declining health. Not lost is their strong spirit and sense of gratitude for the care and support they are receiving.
Nationally, the U.S. faces an enormous shortage of palliative care clinicians because of high demand. Yet our Advanced Illness Care team has had few openings since becoming part of Housecall Providers. This speaks to the amount of support the team members feel they receive from their manager, Kelly Ambrose, and fellow colleagues as well as the satisfaction the job offers clinicians looking to make a true difference within the safety net population.
In 2014, California passed Senate Bill 1004 requiring all Medicaid managed care plans in the state to provide access to palliative care for eligible members. While this was a giant step to offer all Californians the support to manage their serious illnesses, health plans and practices were not in the best position to implement the law, even four years later.
Oregon plans to follow suit in 2020 with SB 179, a similar law to California’s. All we have learned with our Advanced Illness Care team puts Housecall Providers in a solid position to scale the program if the law takes effect. We will also be in a position to offer guidance to coordinated care organizations (CCOs) across the state that want to replicate and partner with a program that shows not only strong patient engagement and outcomes but staff resiliency as well.