It’s time for another installment of the Advocate Spotlight, in which NAHC Report draws attention to a committed and effective advocate for home care and/or hospice in the United States. These advocates for home care and hospice can provide important tips for everyone about how we can better persuade the public and our elected officials to adopt policies that will enable every American who needs and wants home care and hospice services to receive it.
In addition, we will learn about the concerns home care and hospice leaders have around the country. Some of those concerns will be universal to our community, but others will be particular to that state or region.
We shine our advocate spotlight now on Walter Borginis, President and CEO of the Visiting Nurses Association of Greater Philadelphia. Few people in home care or hospice have as much experience in advocacy as Walt, who has been fighting for home health and hospice patients for years. Walt is also a member of the NAHC Board of Directors and the Treasurer. Walt is also a board member of the Home Care & Hospice Financial Managers Association. Formerly, he served as senior VP and CFO at the Abramson Center for Jewish Life/Philadelphia Geriatric Center. A CPA and chartered global management accountant, he was the force behind a heroic reinvention of the VNA of Greater Philly, and he has lent his strategic skills for over 20 years to home care and hospice. In 2016, Walt was inducted into the Home Care and Hospice Hall of Fame.
We have asked Walt five questions and we think you will be interested in the answers.
1. What is your strategy for advocating for home care with state and/or federal legislators? That is, what is your pitch like and what seems to be particularly successful?
My focus begins with a discussion of how much people prefer home care to institutional care. After all, no one grows up thinking that they really want to be in a nursing home. In addition, home health is more effective and less costly than institutional post hospital care. To further the discussion, I have run zip code reports listing patients and compiled information on how many patients in their district we saw in the last year. For many congressional districts, we have a big reach—over 5,000 patients in a year. This proves we are serving their constituents. I also close by saying supporting home health is really supporting jobs (our biggest line item of expense), and state how many people we have living in their districts and overall. Their support means votes and they can appreciate that. Overall, the message is that their proposals may negatively impact their constituents and votes.
2. What is the most important legislative or regulatory issue facing the Pennsylvania home care community right now?
We are the third oldest state in the country. Every day, poor people exhaust their resources and convert to Medicaid to pay nursing home and other healthcare expenses. If the federal government moves to block grants for funding Medicaid, we will lose a lot of Medicaid funding and the rate of growth in that funding moving forward will never keep pace with the aging of the population. As a state, we have never attracted significant new industry and jobs. Our economy is largely healthcare and education based. There will be tremendous pressure to raise state taxes to keep the state solvent. This will further discourage new businesses from locating in Pennsylvania. A vicious cycle leading to even more decline. The next biggest problem is the lack of enough clinical staff to meet the needs of an ever aging population.
3. And what policy solution would you like to see to solve that issue?
One solution is to maintain the existing federal match for state Medicaid expenditures. I think the whole Northeast section would favor that given that they have big cities with larger poor populations.
4. Why did you get into the home care field and what keeps you there?
I have been in all aspects of not for profit healthcare in the Philadelphia region since 1981. I was working for a large nursing home that had an extensive home health operation. I made the change to VNA Philadelphia since people are happier with home health and hospice. In the nursing home world, patients, families and regulators are all opposed to you and no one is really happy. Home health and hospice provides services in your home, where you are most content and familiar. As the population ages, there should be a fast growing demand for our services unlike facility based care. As president of a 132 year old VNA that basically founded public health nursing in America in 1886, I have the responsibility to build for the next 100 years so everyone can have access to the home health and hospice serves they need and demand, especially the poor—the forgotten American of today. As a not for profit, we do so many things that serve the entire person, not just their medical needs. It is a great honor to lead this agency!
5. What is the one thing you want to do in life that you have not done yet? Travel to a certain locale? Sky dive? Ride in a submarine? Anything.
When I was two years out of college, my best friend and I traveled across country by car. We went 7,300 miles in ten days and drove 24 hours in four of those days. It was a great trip and we saw all of the important sites along the way—Grand Canyon, Las Vegas, Mount Rushmore, San Francisco, Disneyland, the Alamo, New Orleans, … I would like to do that trip again with my wife. She made me promise that we will not be driving any 24 hour days!
Thank you, once again, to Walter Borginis, CEO of the Visiting Nurses Association of Greater Philadelphia, for answering our questions, but even more we appreciate all the hard work he has done on behalf of home care patients and providers in one of our nation’s great cities.