Mon 10 Apr 2006
I finally met up with Susan from Hospice on Friday morning. She has been the innovator behind this whole outreach project. We met up in the Carlisle office, and I brought all the school contact information with me. Together, we sat down and composed a letter to the school districts describing our efforts and the services that Hopsice could offer. It’s always difficult to reach the exact wording, but the letter turned out well. It briefly stated Hospice’s purpose in contacting them (to provide grief and loss information) that the United Way of Carlisle generously provided the funding for this project. We emphasized their role as educators and primary figures in the lives of children who are experiencing a loss. Concluding, the letter offered in-service training for faculty, parent information programs, and student classroom presentations. Susan hopes that some schools may choose to utilize several of these services, as she knows that not all counselors or administration are properly trained to handle grief counseling. I was also able to look at the materials we would be packaging and sending with the letters to each school. I was amazed at how imformative and age-appropriate the materials were. After we composed a rough draft of the letter, I formally typed it up to keep on file. I plan to meet with Diana this coming week to obtain formal Hospice letter-head paper to print out all of the letters. Additionally, Susan and I spoke and decided to use Diana’s suggestion of sending the letter to several individuals within one school. Originally, I was going to contact each school to find out whom to direct the letter (either principal or school counselor). Everyone agreed that sending the letter to the principle, school counselors, and the school nurse would place all of them on the same page so that hopefully they will collaborate and discuss the letter. Ultimately, we hope that at least one individual in the school will request for more information or call to inquire about other services that Hospice could offer. The issues of grief and loss are important and highly impact a child’s life, and Susan and I hope that our efforts through this new project will increase the awareness of these issues in schools.
After viewing the materials we would be sending to the schools, I really became more of an advocate for this project. At first, I thought this was a good idea but assumed that many school counselors would be equipped or properly trained to handle grief issues. Having a loved one that recently passed away, I understand the trama that families can go through. Not only did we lose my grandmother, but our whole family dynamic shifted as we had to take on the responsibilities of caring for the individuals that she previously had. My younger sister is thirteen, and I could not imagine trying to accept and come to peace with this situation at her age. Paging through the materials actually gave me hope that, even if someone like her didn’t feel comfortable talking to family members about their emotions, that they would have somewhere to turn. Many of the booklets were set up in journal format so that students could discuss different topics about the loss in a private place. The kindergarten material also made this sensitive issue understandable to younger kids. Mostly, it provides an outlet or pathway for communication. I know that in many school districts, counselors are either not prepared to manage grief counseling or the student does not know where to turn. Involving the school nurses is an excellent way to make connections between counselors and staff when children may repeatedly arrive at the nurses office because of emotional issues. Nurses would also be able to recognize this and be able to provide some help. I really hope that many schools will choose to access the services that Hospice can provide. They have many trained grief counselors who could do wonderful in-service day sessions or parent information sessions. For many people, death and grief are some of the most difficult topics to discuss. Through this project, Hospice is providing an opening for communication and could teach invaluable information to staff, teachers, parents, and students. I am disappointed that I will not be present to see the development or outcomes of the project. I feel and can see that Hospice really cares and has a passion for the types of services they provide. They take care of individuals in their last days, like my grandmother, but they also can provide a tremendous amount of support for the families that are still living.
On the current topic of financial management and budgeting being discussed in class, I was able to access Hospice of Central Pennsylvania’s annual report of 2004. Their income statement and balance sheet are very straight-forward and easy to comprehend. The largest portion of their revenue is donated by Medicare. This makes sense since Hospice coordinates with Medicare to cover the costs of patient care. After this, the majority of contributions for the year came from public donations. However, several individuals on the fundraising and other committees are seeing a decrease in funeral donations. In other words, there has been a decrease in the amount of families whose loved one has passed away under Hospice care and will request in the obituary and funeral arrangements that monetary donations can be sent to Hospice. Their least amount of revenue is generated by foundations. Under revenue they have listed investment income and unrealized loss on investments. This line is slightly confusing because I would expect it to be under expenses since it is a loss on investments. Overall, Hospice for this year exhibits revenue over expenses which produces a profit for their organization.
Continuing through the balance sheet, I felt that it was comprehensible, but it did raise some questions for me that I would like to discuss with Diana. For example, what does it mean when they just list depreciation as a line itself? Also, I expected assests and liabilities to be listed separately. They were, but included with liabilities was fund balances. In this way, the assests and the liabilities and fund balances match up. Is this just a way of showing that no money was lost on liabilities? Looking through the reading, it seems that fund balances would be the same as equity or reserve, becoming more clear that assests=liability + equity. As Perry Heath mentioned in his presentation, it is important to budget for revenue over expenses. I wonder if Hospice planned the budget in this way or not? Additionally, I wonder if they have the budget audited or if they simply seek a financial review. It seems as though Hospice of Central Pennsylvania is very organized and would seek auditing, especially having the United Way, Medicare, and other organizations involved in their cause.
Lastly, looking at the annual report made me realize how important it is for this Hospice to raise adequate funds. Some Hospices, as I believe I mentioned before, are for-profit organizations. Hospice of Central Pennsylvania is a nonprofit organization, and they do not turn any individual away that needs care. As a result, there are some expenses that Medicare will not provide for. Instead of denying services or items to a patient, Hospice covers the cost themselves in order to carry out their mission. In 2004, Hospice spent over $800,000 alone on patient care. Clearly, donations and funding are important for them to recieve in order to continue administering care to patients who would not otherwise recieve any help at all.