Rick Firth with Hospice Palliative Care Ontario
Hospice Palliative Care Ontario is a provincial association for hospices and palliative care providers, professionals, and volunteers throughout Ontario. They envision a future where every person and family in the province of Ontario can quickly and easily access the finest standard of hospice palliative care when required.
They are all about promoting the development and/or expansion of hospice palliative care services in Ontario, research in the field of hospice palliative care, and education pertaining to hospice palliative care services for health professionals, volunteers, and the general public.
Our team sat down with Rick to learn more about the day in the life of our customers.
What are your roles and responsibilities at Hospice Palliative Care Ontario?
I am President and CEO. I focus on developing and achieving our corporate strategies. I work with the board to develop what the high-level strategic plan is, aligned with our mission, vision, and values, and then I take that and work with the staff team to operationalize it and achieve the plan.
I am also responsible for our culture, member engagement, and the public policy work that we do within the healthcare sector here to improve access to hospitals and healthcare. That’s where I spend probably 80% of my time and the other 20% is around fundraising and finding money.
What does your typical day-to-day look like?
Right now what it looks like is about 4-8 hours a day of online meetings three days a week. That is pandemic driven, but I don’t know how much that will subside. But generally, it’s three days a week that are focused on external meetings with partners, members, and stakeholders. There is a lot of troubleshooting right now as the health system is under immense stress.
I try to hold one day a week for reflection and planning so that I don’t lose sight of the big dots are that we’re chasing. And then I spend about one day a week with my direct reports and evaluating progress.
That’s what it normally looks like pre-pandemic except that there were fewer online meetings and more traveling for in-person, which I preferred. Online meetings are huge for us. We are not a big organization, right now we have about 14 paid staff and two dozen interns. In the first year of the pandemic, we clocked 1.5 million minutes on Zoom and hosted over 2,500 meetings. There was a staff person on every one of those calls as well.
We did a lot of bringing people together-type calls. We would do support calls for healthcare workers that were stressed. We had about 300 people show up to those calls. We’ve never done that type of volume before with online meetings.
What motivates you to wake up and go to work?
I’ve long been a person that told my employers and boards that I’ll move on when it gets boring and when there’s no reward. I don’t like maintenance because I believe status quo is actually stagnation, and I don’t like being in organizations that are stagnating, so knowing that we are making a difference every day in the lives of the people who are benefiting from what we do.
Seeing new hospices open because we secured the funding, we got them operating dollars or capital dollars, seeing the number of caregivers come onto our website to grab a single resource or take an entire course to get help with caring for somebody at home or talking to the volunteers, really makes me proud.
There are generally about 16,000 active volunteers in the hospice sector of Ontario. There’s turnover of course, but we’ve trained over 9,000 new volunteers since 2016 in our online platform. And hearing the feedback from them about how they love the training and how it equips them to go out and met someone they’ve never met before and sit with them and provide support while they are dying at home or in hospice, that’s what really keeps me going.
Consistency is the highest in hospice across all of healthcare. Talking with caregivers and families, they said the overall satisfaction is at 97%.
What is the hardest part about your job?
The hardest part is money. As a charity, never having enough money to experiment, to take risks in creating new services that our members would use and new revenue sources. We took a business approach and introduced quite a bit over the last four to five years to lessen our dependence on donations and grants so that we’re generating more revenue directly from our members and stakeholders.
But there is no venture capital in nonprofits in Canada. There’s no pool of money that we can tap into to take a chance on something. So that’s always a stress. I find that many of the big funders, big foundations, and corporations want to give their money to something that is very narrowly defined. They often want it going to a time-limited project or to what they think is the frontline without realizing that the frontline doesn’t exist without the back office. The consistent development of defining new standards, training, and services, finding new ways to care virtually, those initiatives all rely on funding. It’s sometimes very difficult to get sustainable ongoing funding for that.
A lot of people believe that all healthcare in Canada is government-funded, and that’s absolutely not the case. The only thing the government is obligated to fund is what happens in the hospital. That’s a federal issue, but everything else like the rest of the care: at-home care, hospice care, long-term care, that’s all up to the individual providences on how they fund that. And in our sector, hospice is only funded at about 50%, so they fundraise the other 50% to deliver that care. They do it in a way that they never charge the patient or the family for anything. We don’t get money for our operations here, so we have to find private donors to keep us moving forward.
What has been your biggest accomplishment in your current role?
I think it’s the presence that Hospice Palliative Care now has within healthcare. I came over here in 2009, there were two associations. Minister of Health said that as long as there are two, I don’t have to listen to either one because you won’t agree on what you should do. I brought them together, so now we only have one that encompasses everybody. In 2010, the provinces of Ontario did not have a palliative care policy or a framework, or anything, they didn’t even know how much palliative care was out there.
So we worked with the government and we brought that together. We did a very comprehensive, involved process to figure out what we had and what we should be doing. And from that, we published a declaration with the government, and that has grown now over the last 10 years. It has resulted in a policy in place, there’s a preferential framework in place from the government on what palliative care should look like, there’s a body in place that advises government on the implementation and growth. So it’s really changed. We have competencies and standards for doing things that weren’t in place before.
But what I’m most proud of is the growth in the hospice sector itself. I came from running a hospice and in 2005, we had about 20 in-patient hospices in the province which was roughly 200 beds and $11 million in funding. Where we are now as of the end of December, we have 86 locations with almost 500 beds and about $75 million in funding annually. There are another 150 beds in the pipeline, which will be about another 20 new hospice locations. And roughly 35-40% of that growth has been in rural Ontario, to smaller communities that never had access before. Bringing access to people where they need it is what I’m most proud of.
What is something most people don’t know about you?
One thing that many don’t know outside of my friends is one of my hobbies used to be expedition driving. My longest trip was from Toronto to San Diego to Mexico, then back up to Calgary off-road. We clocked 15,000 km, 28 Land Rovers, off the grid for usually 3-4 days at a time. We took the highway to San Diego but started from San Diego offroading. Another trip we did was through the backside of Yosemite, which made all the rangers scratch their heads saying, “where did you come from?” since we didn’t come in the gates. Then went across Montana and through Utah. That one took us three weeks.
I’ve also done it locally all around the provinces. We have to carry our own water and fuel since there aren’t any gas stations. I don’t have any new trips planned, I actually sold all the vehicles. But I think when we’re able to travel, we’ll go to Italy or India. I’ve been to India a few times for about a month at a stretch, leisurely and taking it easy. I might do that again soon.
What Hospice Palliative Care Ontario means to us
“One of the things that becomes clear as soon as you meet Rick is what an engaged and committed leader he is. Rick is always questioning, always exploring new ways to do things, and never loses focus on his organization’s critical mission to deliver the highest quality care to their patients. With such an amazing leader at the helm, it’s no surprise that HPCO has been able to deliver phenomenal results with a small but mighty team!“
– Rachel Santos | Senior Customer Success Manager
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