Carroll Hospice is joining Carroll County Health Care Services Inc., the parent organization of Carroll County General Hospital.
The partnership, in the planning stages for several months, won the approval of the hospital's parent corporation in April and overcame the final hurdle last night, when board members unanimously approved it.
"This is not a merger or consolidation," Charles O. Fisher, attorney and board member, said last night. "It is an affiliation agreement that makes Carroll Hospice a subsidiary of Carroll County Health Care Services Inc."
Carroll Hospice will continue its mission to care for the terminally ill and their families, now as part of the hospital family. It will remain an independently operated nonprofit organization, managed by its own board of directors.
"We have joined hands and partnered," Julie Flaherty, executive director of Carroll Hospice, said last night. "This is like minds pursuing like goals."
The parent company will make a $162,700 capital contribution to Carroll Hospice. The money will be used to enlarge the hospice center on Carroll Street in Westminster, purchase new office equipment and update the computer system. Hospice will also be adding an operations manager to its staff.
The "natural affiliation" will strengthen hospice's position in the community and allow it to fend off any unwanted takeover, Ms. Flaherty said. "Health care reform occurred without the benefit of legislation and forced everybody to attach to something," she said. "We sought out another nonprofit to associate with and through the affiliation with the hospital, we have cemented ourselves more firmly in the county."
Linda Harder, the hospital's vice president for marketing, called the affiliation "a good fit for both of us. We have an existing relationship, but as the parent company, we have an even better integration of care."
Ms. Flaherty was concerned with impending competition from several for-profit hospices that are considering expansion in Carroll County.
"The concept of hospice is being redefined by for-profit agencies, with a noticeable absence of the volunteer and bereavement component," Ms. Flaherty said. "We wanted to keep those components equal to our clinical services. Rather than allow ourselves to be bought out by a for-profit, we looked for an organization that shared our philosophy."
By joining the hospital, the nonprofit hospice strengthens its position against several for-profit competitors that may try to establish a local base.
"The jury is still out on for-profit hospices," said Susan Riggs, executive director of Hospice Network of Maryland. "They are required to have a volunteer, bereavement and spiritual component for Medicare reimbursement. Whether they will accomplish that with the same devotion, quality and energy as a nonprofit is a concern."
Tri-Home Healthcare Services and Hospice is the only for-profit hospice operating in Maryland now, but many other agencies are planning to add hospice services, she said. Tri-Home has offices Carroll County and receives many referrals through its HMO contracts and insurers.
"Ms. Flaherty's concerns with competition are valid," Ms. Riggs said. "Carroll Hospice is in a stronger position with the acquisition. It also has the assets of strength, history and longevity in the community. The other programs have to play catch up."
Agencies that concentrate on profits have more difficulty recruiting volunteers, she said. Since it was established in 1986, Carroll Hospice has relied on a solid group of volunteers. In 1994, 80 people donated 3,802 hours and saved the hospice $57,030 on its $1.5 million annual budget.
"HMO's don't get volunteers who donate 200 hours," she said. "That just does not happen in the for-profit arena. Would they have a bereavement camp for children? I doubt it."
Susan Hannon, director of bereavement services for Carroll Hospice, said many agencies are reluctant to provide bereavement counseling with no reimbursement.
"All our families receive counseling, regardless of their ability to pay or whether we are reimbursed," she said.
Hospice's greatest strength lies in its 24-hour availability to anyone anywhere in the county without regard to cost, Ms. Flaherty said.
"We have worked to create a model in this county that encompasses all care and stays locally based," she said.
The affiliation gives Carroll Hospice better access to hospital services and staff and a greater financial stability, she said.
"With hospice, we extend our commitment to the health provider to the community," Ms. Harder said.
Through Medicare, which certified the organization in September 1992, Carroll Hospice can offer federal health insurance benefits to its eligible patients.