The project involves the construction of a new 40,800 square foot Hendricks Hospice Care (HHC) outpatient service and in patient service program facility space. HHC is a non-profit entity that was started in 1982 by local community members to bring hospice care to Abilene. HHC became affiliated with the local hospital, Hedrick Medical Center, in 1993 and in 1997 started to utilize space within the Hedrick Medical Center hospital in Abilene. HHC continues to utilize 7,683 SF on the 7th floor of the Anderson Wing within the hospital for in-patient services. This area provides 8 beds, a small meeting space and a family shower space. Their counseling programs (which are a cost and not a revenue line item), are offered in community spaces throughout the service area that are offered at no cost by HHC to persons served. As a whole they serve 3 primary urban counties and 8 additional rural counties and are the only hospice service that takes children in the region. Staff is located in 3 different buildings on the medical campus. Fifty of the existing staff members work out of a 1,800 SF facility. This is made possible by virtue of the level of mobile services offered in the extended rural areas and rotation of workspace use. Based on requirements from Medicare, HHC utilizes volunteers to provide 5% of direct care to persons within the program. Volunteers typically are trained primarily to provide basic companionship support as many of the persons served suffer greatly from isolation issues.
The new facility will enable HHC to provide direct space for its counseling programs, volunteer trainings and to aggregate its administrative space. In addition, HHC will double the number of in-patient beds it is able to provide and move the current hospice program into a setting more conducive to the programming being offered to the persons served. It is anticipated that HHC will increase the number of in-patient persons served by at least 40% moving from the current 900 persons served per year to 1,260. In addition, it is anticipated that the number of persons served through their counseling programs will also increase by a margin of 25-30%. They currently serve 1,500 persons per year, at a growth rate of 25% they would project serving 1,875 in their counseling programs. As an adjunct to the benefits derived by HHC in being able to access the new space, the Hendricks Medical Center anticipates that having access to the 7th floor wing in the Anderson Building will enable the hospital to move forward with their plans to develop a neonatal NICU center.
In general, Presbyterian Medical is the primary provider of medical services to the lower-income population within the Abilene and extended county footprint. Hendricks Medical Center provides a substantial level of funding and support for this center and has noted in their planning documents increased support in order to elevate the entity’s capacity to serve this mission. However, Presbyterian Medical does not provide hospice care support or counseling and is not anticipated to be able to provide the acute levels of care required by infants within the NICU contemplated as part of the growth strategies. Based on information for the city of Abilene only, 33% of the employed and unemployed population base has public insurance and 54 % of the unemployed population has no coverage. In addition, roughly 29.5% of children live in poverty and 12% of persons over the age of 65 live in poverty. The median worker wage is $22,477. The Medicaid qualification wage for a family of 2 is $21,934 (with a mean social security income of $16,427 and median retirement income of $22,860).
HHC does not specifically track persons into the program on the basis of income. Qualification for participation in hospice services is made on the basis of terminal diagnosis. If a patient receives terminal diagnosis within 6 months then HHC is able to provide treatment which will be reimbursed under Federal insurance programs. It is anticipated based on the general population base that HHC will serve roughly 30% of its total in-patient base as low-income households (at 80% area median income – tracked based on charity care or persons on Medicaid) or 378 persons per year. Programming for counseling services and home support services is anticipated to have a higher base of low-income households served given 1) the rural nature of the clients served and 2) the outreach to persons with trauma from drug/alcohol or justice-based recidivism. It is anticipated that roughly 45% of the client based served in these programs will be from low-income households or an anticipated 844 persons served per year.
In addition to supporting the expansion of the HHC services and the capacity of the hospital to grow its NICU programming it is anticipated that a portion of the funding will be directly used to support the Community Health Needs Assessment (CHNA) implementation, with a conscious effort to direct these funds to low-income persons or areas of the community served by Hendricks Medical Center. The CHNA has identified several areas of need where the Hospital could have direct effect on the health outcomes for the population it serves, and this supportive funding will be used to help drive these changes based on interaction with CHHS or its affiliates and community stakeholders. The project will be located in an area with all three primary distress factors within a metro area and a secondary factor which aligns with the CDE mission: being located in a medically underserved area.
- Poverty Rate of 39.6%
- Annual Median Income of 49.74%
- Unemployment rate 1.38 x National Average
- Federally designated Medically Underserved Area
- 33 FTE Jobs Created
- 34 Construction Jobs Created
The Project is located in a highly distressed and medically underserved census tract within an underserved state for NMTCs as designated by the CDFI Fund for the 2013 and 2014 allocation rounds. It will provide needed services to the distressed community by supporting children and adults in need of terminal illness supportive care and family-based counseling services (both in patient and in-home care). It is anticipated that the center will provide expanded services to roughly 378 LIP patients and 844 LIP counselees per year provide94 total FTE jobs with 60 of the total jobs anticipated to be accessible to low income persons.