Money isn't everything.
That was the conclusion to the Health Systems Agency's project review committee in abruptly reversing its position and giving approval to the fledgling Montgomery Hospice Society's plan to care for terminally ill patients.
Only last month the committee, had recommended that the Hospice Society not be given an immediate go-ahead because it was not a hospital-based group and did not have enough money.
"all of us on the comittee decided wewere concentrating far too much on their lack of funding and not on the service they want to give them our blessing." said Charley O. Eldridge Jr., chairman of the committee.
"it was a very moving evening for us," said Sally Ketchum, administrative director of the society.
Hospice care for terminally ill patients, begun in Britain in the 1960s, has been growing rapidly in the United States since the first hospice opened in Connecticut 10 years ago. There now are about 200 groups throughout the country.
Hospice groups seek to relieve patients from pain, and to comfort their families during the patient's final weeks and months of life. It is a concept of health care that recognizes the wish of many patients to die at home but also provides inpatient faclities.
Hospice-realted activities can include free-standing facilities such as the in-patient six-bed Washington Home Hospice, hospital-based care such as that offered at Holy Cross Hospital, hospital of Silver Spring, coordinating agencies such as the Hospice of Northern Virginia or largely volunteergroups focusing on home care such as the Montgomery Hospice Society is proposing.
The Montgomery Hospice Society hasbeen waiting out the paperwork for certification in the basement of a church on Wisconsin Avenue in Bethesda. The society has about $25,000 in contributions for initial operating expenses and 30 trained volunteers.
The society must get a certificate ofneed from the Maryland Department of Health and Mental Hygiene before it can begin services, and the first step was the approval of the project review committee. The committee denied that approval last month on the basis of a Health Systems Agency staff report that said the society's proposal for providing hospice care was not financially feasible, that the society did not have agreements for inpatient care program, additional service was not needed.
The Hospice Society disputed the report, saying that funds would be forthcoming once it began to offer service and that a hospital-based hospice did not serve the entire community because each patient's physician had to be on the staff of the hospital for hospicecare to be given. The society has begun talks toward an agreement with a local hospital for the use of beds.
Eldridge said the Hospice Society still may have problems getting a certificate of need from the state. "if the state reviews it according to normal guidelines, they're going to havethe same questions we had initially. We don't think funding is a pertinent issue," said Eldridge.
He said some members of the project review committee may accompany the Hospice Society representatives next month when they go to Baltimore to apply for their certificate of need.