The American Association of Cardiovascular and Pulmonary Rehabilitation’s (AACVPR) Day on the Hill, which was March 4-5 this year, is an opportunity for cardiac and pulmonary rehabilitation professionals to visit Washington, D.C. to advocate for their profession and ask legislators for support for beneficial legislation on Medicare decisions. It was Stacey Greenway’s 10th year participating in this event, a milestone made all the more significant by her recent election as treasurer to the AACVPR board.
Stacey, the director of cardiovascular disease management services at ECU Health Medical Center, wasn’t initially interested in health care policy, but her zeal for her work inspired her to get involved.
“I’m passionate about what I do, and when I realized the impact these legislative decisions make on our patients, I wanted to get involved,” she said. “When the North Carolina Cardiopulmonary Rehabilitation Association (NCCRA), which works on the state level, asked if anyone was interested in participating in Day on the Hill, I thought how cool it would be to help our patients and our programs. After the first time, I was hooked.”
Each year, the AACVPR’s legislative priorities are different, but the goal is the same. “We want to help the legislators see things from the patient perspective and put a face to the people these bills are affecting,” Stacey said. “From that angle, you see the increase in a patient’s quality of life. From a health system perspective, it decreases the rates of hospital readmission. It’s a win-win.”
This year’s priorities centered on two bills: HR-955/S.1849, the Sustaining Outpatient Services Act, and HR-1406/S.3021, the Sustainable Cardiopulmonary Rehabilitation Services in the Home Act. The Sustaining Outpatient Services Act seeks to correct a legislative error from a previous bill that reduces reimbursement for cardiac and pulmonary rehabilitation services when they are provided in off-hospital campus clinics. The reduced reimbursement rate makes cardiac and pulmonary rehabilitation services financially unsustainable and thus eliminates patient access to these resources, especially in rural communities. “Some rural hospitals, which don’t have a lot of real estate on campus, haven’t even tried to open a rehab clinic because of this issue,” Stacey said. This bill would establish an exemption status to certain hospital outpatient services, including cardiac and pulmonary rehabilitation, from that fee reduction.
The Sustainable Cardiopulmonary Rehabilitation Services in the Home Act would allow Medicare beneficiaries to receive cardiac or pulmonary rehabilitation services through real-time telehealth in their homes. This hybrid type of service was very successful during the pandemic, and it allowed more patients to be treated from across eastern North Carolina.
“Think of that 45-year-old patient who had a heart attack and would benefit from rehab services but has also been cleared to work and needs to make an income,” Stacey explained. “This bill would allow that patient to not have to make a choice between income and health; they could do both.”
During her time in Washington, D.C., Stacey and 74 other AACVPR members spoke with their respective House Representatives and Senators to advocate for these bills. Stacey said overall, the discussions were productive.
“I had some good conversations about both bills,” she said. “The telehealth bill was one the legislators could wrap their heads around easier; it was something they were familiar with. That was encouraging.” While more work needs to be done to increase support for the outpatient services bill, Stacey said she felt the needle moved a bit. “This is partly because the government seems to be changing their focus from thinking about the up-front costs of health care to the savings incurred on the back end,” Stacey said. “That means things are changing, and I’m hoping we’ll get a few more co-signatures on that bill.”
As a board member, Stacey said she now has other opportunities to support her profession.
“To represent eastern North Carolina and discuss at the national level some of the things that impact those who practice locally is really important,” she said. Because she was on the board this year, Stacey was also able join the board meeting the day before Day on the Hill and participate in the selection of a new legislative firm. “We met with the firm and prepped for Day on the Hill, but we also strategically planned for the future,” Stacey said. “It was exciting to be involved in that process.”
Stacey’s interest in running for the AACVPR’s treasurer position stemmed from her desire to stay involved in the national organization and escalating care for patients.
“The board is involved in regulatory and government relations, and that’s one of my big interests. Day on the Hill is just one way we stay involved. It’s a way of understanding and supporting initiatives and bringing that back to ECU Health,” she said. “We have six cardiac and pulmonary rehab programs within ECU Health, and I want to make sure those programs are aware of the initiatives the AACVPR promotes to escalate their practice and ensure we’re doing the best we can for our patients.”
Now that the initial conversations with Congress members are over, the next step is to follow up in a few weeks with those representatives still on the fence. “We’ll also bring in a constituent from that person’s district to speak to the impact of these bills,” Stacey said. Some representatives have already signed on to at least one of the bills, including Rep. Don Davis, Rep. Deborah Ross, Rep. Greg Murphy, Rep. Wiley Nickel and Rep. Jeff Jackson.
It’s important to be involved in the policy issues surrounding health care, Stacey said. “You don’t go into health care thinking about these operational or political issues, but when you’re faced with the repercussions in the clinic, you see the impact it has.”
She encouraged all health care professionals to get involved: “Let’s do this for the betterment of the patient experience,” she said. “For me, this has been one of the highlights of my professional life.”
For more than 25 years, the Pediatric Asthma Program at the Maynard Children’s Hospital at ECU Health Medical Center has worked to help patients and families living with asthma lead healthy lives.
Jeanine Sharpe, social work care manager for the Pediatric Asthma Program, said the goal of the program has always been to decrease emergency department visits, reduce school absences due to asthma, provide education and improve quality of life for patients and families.
“Currently, there are about 5.1 million children under the age of 18 that have asthma in the U.S. and it’s the leading chronic disease for children,” Sharpe said. “Just for our service area last year, we had 1,687 pediatric asthma patient referrals. It’s the number one reason for school absences and the number two reason for hospital admissions for children. But we know that asthma is a controllable disease. What we find is that a lot of times the missing piece is just education.”
Sharpe said the program has touched many families over the years, whether it’s just one interaction or years of working on a family’s case. One family that has seen the impact of the program recently is the Carr family.
Dalton Carr III was diagnosed with asthma three years ago and struggled with wheezing, coughing and attacks in the years since.
Dalton III’s mother, Shanika said she was scared when her son was first diagnosed and she wasn’t sure how to handle certain situations. This past December, Dalton had an incident and was seen in the emergency department for his asthma.
“That’s when I met Ms. Sharpe,” Shanika said. “I was confused at the time, but ever since I met Ms. Sharpe, it’s been easier to learn things. I was confused with the things different doctors were telling me and I really didn’t understand how serious it was.”
Dalton III’s father, Dalton Jr., said it has been a great experience working with Sharpe and the Pediatric Asthma Program team.
He said the education and support offered have helped their son be confident and join in the everyday activities of other children his age. While he used to struggle, today he does not wheeze, cough or have flare ups from his asthma. Dalton Jr. credited the work with the Pediatric Asthma Program for this turnaround.
“She got us in a good routine for him. Ever since we’ve gotten Dalton on a consistent routine, he hasn’t had any problems,” Dalton Jr. said. “It’s even to the point where he can tell us when he needs his pump. He might say, ‘Mom or dad, I need my pump’ or ‘I’m good.’ He plays football and he’s running and tackling and it’s a lot but with Ms. Sharpe being in our lives these last few months, it’s just helped a lot.”
Dalton Jr. encouraged families to reach out for help and to learn what might work best for their child’s asthma.
Malorie Whitaker, respiratory care manager at ECU Health Medical Center, said the program is designed to help patients from one to 18 years of age feel more comfortable while they manage their asthma and participate in normal childhood activities.
She also said the program is set up to meet children where they are and eliminate barriers to care.
“Sometimes they’ll come into our office to do different testing or do some education, but usually we meet them,” Whitaker said. “So we’ll get into the homes, we’ll go into the schools, into the clinic, wherever they are. Some of these kids that we see don’t have transportation or transportation is difficult for them, so that’s why we like to go into the school or into the homes to help them.”
To learn more, or to speak with someone close to you, visit the Pediatric Asthma page or call one of the ECU Health locations offering pediatric asthma services.
- ECU Health Bertie Hospital: 252-833-2861
- ECU Health Chowan Hospital: 252-833-2861
- ECU Health Edgecombe Hospital: 252-641-7382
- ECU Health Medical Center: 252-847-6835
- ECU Health Roanoke-Chowan Hospital: 252-209-3117
WASHINGTON, NC – Compassionate, a strong patient advocate, calm and comforting are just a few ways respiratory care practitioner Karen Holland is described by patients and their families as well as the doctors she works alongside. Karen was recently awarded the Pulmonary Health and Illness of the Lung (PHIL) Award for excellence in respiratory care; nominated by two physicians who care for patients at ECU Health Beaufort Hospital.
Karen often works with the most critical patients and over the past two years many of those patients had COVID-19. The physicians who nominated her commented on the many incidents of witnessing Karen sitting at a patient’s beside as their condition was deteriorating, educating and explaining to patients what was happening. Karen’s demeanor is calm and comforting and patients often call on Karen to talk with their families, even after the physicians had talked with them to help explain and calm fears. She is a strong advocate for her patients and provides special attention to make sure patients and their families stay in communication throughout their hospital stay.
Karen was presented with the PHIL award by Alene Payne, manager of respiratory care at ECU Health Beaufort Hospital. The PHIL Award was established by the FACES Foundation to recognize outstanding respiratory practitioners who provide care and treatment for patients with respiratory illness. ECU Health recognizes two PHIL Award winners each year – one from ECU Health Medical Center and one representing the ECU Health regional hospitals. Karen was named as the regional recipient. This is the fifth consecutive year the regional award has been received by an ECU Health Beaufort Hospital team member.
Karen is a graduate of the Pitt Community College respiratory therapy program and began her career as a respiratory care practitioner in 1995 at ECU Health Medical Center (then Pitt County Memorial Hospital) and joined the Beaufort team in 2012. She is an amazing respiratory care practitioner and also a strong proponent of every discipline involved in caring for a respiratory patient. She recognizes the benefits of the entire care team and is a positive support for all of her colleagues.
Payne presented the award to Holland surrounded by her colleagues and hospital leadership. One of the physicians commented, “Karen is not only an excellent therapist, but you know she care about her patients; this is more than just a job for her and it shows in all that she does.”