Middleboro Case Study Executive Summary

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Middleboro Executive Summary to the Board – Cohort 5
The Hillsboro County Home Health Agency, Inc.
Florida International University
January 31, 2012

Effective June 1, 2012, Hillsboro County Home Health Agency (HCHHA) will be launching a new division offering Hospice services to Middleboro and surrounding community residents. This hospice center will provide end-of-life care in the form of medical, psychological, social and spiritual support for the terminally ill and their families. Hospice care services are typically structured according to the needs and wishes of each patient and their family. These may change over time and during the different stages of care (the last phases of an illness, the dying process and the bereavement period). Please refer to Appendix D for a complete listing of Hospice Services HCHHA plans to offer. HCHHA will also be closing its offices in Jasper, and supporting all current and future services/products currently provided under their 3 divisions from their Middleboro location. Problem

Currently, Hillsboro County has no Medicare Certified Hospice care provider. The only provider of hospice services is Valley Hospice, Inc., in Middleboro, and they mostly provide emotional support to adult cancer patients and their families. They do not provide the full array of hospice services needed throughout the Middleboro community. Recently, there has been a public outcry for providing this very valuable benefit and historically, it has not been available through any other local health agencies. The lack of Medicare certified or accredited hospice services in Hillsboro is a problem to the residents in need of these services, as they are having to go out of area, and this creates a greater burden for them at a time when they should be focusing their energies on their current situation. Solution

HCHHA will provide certified hospice care services in Middleboro and its surrounding communities. Hospice services are currently in high demand by the residents of Middleboro, as the current resources are limited and cannot meet the current demand due to increasing population in the area. HCHHA will create a hospice interdisciplinary team (IDT) in order to provide hospice patients any combination of the following services: nursing care, social services, physician services, spiritual support and counseling, home health aides and homemaker services, trained volunteer support, physical, occupational, and speech therapies, respite care and bereavement support. HCHHA is an established, well-respected and certified provider of services, and the expansion into Hospice will strengthen the bond between provider and community. Opportunity

The target market for hospice services provided by HCHHA would be those patients in Middleboro and the surrounding communities of Mifflenville, Boalsburg, Harris City, Minortown, Carterville, and Stateville (excluding Jasper), who are suffering from chronic illnesses and have been deemed terminal. There has been a population increase of 4% in this combined area over the last 10 years, and the projections are that the population will continue to increase as Middleboro continues its urban development (refer to Appendix A). Additionally, resident deaths due to illnesses that would require hospice care has also been increasing over the past 25 years, by an average of 35%. These would be among the leading causes of deaths in the county, related to malignant neoplasms, cerebrovascular diseases, motor vehicle accidents, alzheimer’s disease, syndromes of nephrosis, and chronic liver and cirrhosis (refer to Appendix B). For the last three years, the staff at HCHHA has reported that patients served by HCHHA programs immediately following hospital discharges required more intensive services than in the past (Middleboro Case Study, pg. 37). According to a study recently released by the state Medical Society and reported as a news article recently appearing in the...
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