A rural hospice, regulated by its neighbors, not the state

NPR ran this story yesterday about a volunteer hospice in Port Angeles, Washington the county seat of nonmetropolitan Clallam County, population 71,404.  Though the feature is ultimately about death, it's actually a feel-good story of a non-profit that is serving its community very well.  Rose Crumb, a retired nurse who is now 91, founded Volunteer Hospice of Clallam County some four decades ago:

"[Rose] let people know hospice is not all about dying," said Bette Wood, who manages patient care for VHOCC. "Hospice is about how to live each and every day." 

In a nation where Medicare pays nearly $16 billion a year for hospice care, and nearly two-thirds of providers are for-profit businesses, the tiny volunteer hospice is an outlier.

* * * 

She was the first in the region to care for dying AIDS patients in the early days of the epidemic. 

But the real rural angle on the story is here, regarding the exemption from state regulation for hospices like the one in Clallam County.  The story quotes Leslie Emerick, director of public policy and outreach for the Washington State Hospice and Palliative Care Organization.

They don't have a reputation of negligence or complaints as far as I'm aware, but there's always the possibility of that when they're unlicensed or unregulated.   

But Astrid Raffinpeyloz, VHOCC's volunteer services manager, points out that the hospice wouldn't have lasted long in a small town if there were problems.

We don't have oversight from the government, but we have minute oversight from the community.