Today marks my 10th anniversary of becoming the founding Executive Director of The INN Between. But it wasn't supposed to be me. This is the story leading up to that day.
When I joined Debbie Thorpe’s exploratory committee in 2013, the meetings were held under the auspices of Fourth Street Clinic, the downtown Salt Lake City clinic for people experiencing homelessness. Fourth Street had was considering starting a medical respite program. Their CEO, Kristy Chambers, had recently completed a major capital campaign and building expansion and offered us the use of their new conference room. She attended the meetings along with representatives from State and local government, hospice agencies, healthcare providers, and concerned citizens attended.
Most months, we discussed ideas for establishing a home, getting our nonprofit paperwork filed, creating policies and procedures. A popular idea was to rent a 6-bedroom house, have an individual or couple live there, and use the other five for patients. (Little did we know, but a Salt Lake City zoning restriction prohibited more than four unrelated people from living in the same home). Hospice agencies would take turns providing charity hospice care since most of our patients would be uninsured. Being a nurse, Debbie envisioned the home operating very much like a nursing home, only utilizing volunteer nurses, doctors, and staff.
Toward the end of 2013, Kristy informed us that the Forth Street board of directors had decided to forego medical respite and focus on their core mission of primary care, so we turned to one of the original committee members, Dan Hull, founder of the Utah Hospice and Palliative Care Organization (now the Homecare & Hospice Association of Utah. His board allowed us to operate under their 501(c)(3) until we could obtain our own.
By the spring of 2014, it struck me that seemed to hash over the same information month after month with little forward progress. One thing about me is that I’m more of a “do-er” than a planner. One day, my frustration bubbled up: “We need to stop talking about this and figure out how to actually do something.” My comment didn't seem to be well received.
After the meeting, while walking to my car, I started chatting with two committee members: Jennifer Gregory, a nurse at a hospice agency, and Sharon Stone, an emergency room (ER) doctor. I like to call this the “after-the-meeting parking lot meeting.” It turned out to be a pivotal point in The INN Between’s trajectory. Jen and Sharon shared my frustration, but we didn’t just stand there complaining. We started brainstorming and quickly identified a community need we could address: hospitals need to discharge terminally ill homeless patients but have nowhere to send them.
Many people assume that if a person is terminally ill and in the hospital, they will stay there through end of life. However, hospitals are not equipped for this type of care or length of stay. They must prioritize their limited bed space for treating acute conditions.
Many people also believe that hospice refers to a facility where care takes place. While true in some communities (Salt Lake City had a “high-end” 12-bed hospice facility at the time), most hospice care is provided in the patient’s home. Hospice workers make sure the patient is as comfortable as possible and equally important, they train the family members to be caregivers and cope with the mental and emotional pain of their loved one dying. Hospice workers are only in the patient’s home for a few hours each week, and the family caregivers do the rest.
Hospitals typically discharge terminally ill patients to home-based hospice care. However, a homeless patient in the Salt Lake area would usually be discharged “to Fourth Street Clinic,” which typically meant a free cab ride back to Pioneer Park in downtown Salt Lake City, a homeless gathering place kitty-corner from the clinic. Because of multiple factors, hospice care cannot be provided to someone who is living on the streets or in a car, a shelter, or a motel, so people experiencing homelessness cannot receive end-of-life medical care. So getting these folks housed is critical.
Jen, Sharon, and I hammered out a referral program that would link hospital discharge planners with nursing homes willing to donate a bed to a dying homeless person. The Salt Lake hospice facility was unlikely to admit a homeless person on charity care; however, Jen had relationships with several nursing homes and was confident she could convince them to donate beds. Sharon knew the ins and outs of the ER, and my marketing and fundraising skills rounded out the team.
We put our heads together and came up with an actionable plan right there in the parking lot:
I would set up a free Gmail account and Google Voice number to print on the brochures.
Jen would create a brochure and get some business cards printed.
Jen and I would create a basic website using a free platform.
Sharon would help us get referrals by sharing the information with her hospital colleagues and other medical professionals.
Jen would contact hospital discharge planners and do “in-services” (training presentations at staff meetings) to foster referrals.
Jen would contact nursing homes to create a pipeline of beds.
Jen and I would take turns answering the phone and attending outreach events.
I would start fundraising.
The plan was simple and inexpensive to implement, so we got right on it. Jen’s outreach to the hospitals began to make a name for The INN Between, and we started getting a couple of referrals a month. Jen handled the referrals and successfully placed all the patients in nursing homes. The program was becoming well-known within the hospital community, and referrals were increasing.
This was happening around the time we stumbled on a potential location for a hospice home – the old convent on Goshen Street near downtown Salt Lake City. The INN Between was on the verge of a tipping point.
Jen took a leadership role and became the obvious choice for The INN Between’s first Executive Director. We just needed the funding to pay her! She and I came up with the idea of asking hospice agencies to partner with us to fund a portion of her salary. One day, Jen called and said, “I have a meeting with Eddie Norris, the owner of Canyon Home Care & Hospice, and you need to go with me.” She sounded very optimistic.
At the Canyon offices, we sat across a large conference table from Eddie, explaining our plans to open a hospice house and that Jen would be the Executive Director. We suggested a modest salary figure, considering it was a start-up. I would continue volunteering to write grants with the goal of the organization being self-reliant in one year. Eddie’s return on investment would be the potential for insured hospice patients; however, we made it a point to tell him most patients would be uninsured.
Eddie is a nice guy and a straightforward businessman – no frills. Jen and I weren’t sure how the meeting was going when he suddenly said, “I’ll do it.” He told us it was an important cause, and he wanted to make a difference by being a part of it. Jen and I looked at each other, both trying to tamp down the urge to stand up and jump for joy! Within a couple of weeks, we ironed out the details and signed a contract.
On November 6th The INN Between held its first fundraising event, A Simple Soup Supper, at St. Paul’s Episcopal Church in downtown Salt Lake. Jennifer and I greeted the guests. The event was well attended, kick-starting our potential donor and volunteer base.
During the Thanksgiving holiday, I felt inspired to look into the requirements to start a nonprofit. Although someone would commit to doing this task at ever committee meeting, it still hadn’t happened. Today seemed like the day, and I seemed like the person to tackle it. We had already registered the business name, so the next step was to create bylaws and articles of incorporation and file to establish a Utah Nonprofit Corporation. After creating the documents, I filed the paperwork, making Debbie Thorpe, Dan Hull, and I the founding officers of The INN Between corporate entity.
The next step was to complete the IRS 1023 application for nonprofit status. I mailed the application packet at the end of November, and we waited with bated breath. At that time, it was common to wait a year or more for the IRS to respond. However, our formal 501(c)(3) determination letter arrived in January, with an effective date of December 3, 2014. (Nowadays, the application is submitted online, and the 501(c)(3) status is immediately effective during the approval process.)
On December 15th, Debbie Thorpe, Ruth Zollinger, and I did a neighborhood outreach event in front of the convent to share our plans with the neighbors (read that story here).
Then, the unimaginable happened. During Christmas break, Jen called. When her first words were, “Are you sitting down?” I knew it was something bad. She proceeded to tell me she was offered an amazing job opportunity and couldn’t say no. I was thinking, “Well, this can work. She can do The INN Between stuff part-time.” Then she said, “The job is in Georgia… and I’m moving in a couple of weeks.”
I was speechless. How could this be happening? We had worked so hard putting plans in motion and were on the verge of actually opening a facility. I couldn’t think of anyone else who would be willing to take the ED position.
Then Jen said something I will never forget. “Kim, you should do it. You’d be great at it.” The thought hadn’t even crossed my mind. I had a great job as the Development Director at Community Nursing Services (CNS) with benefits and flexible hours that allowed me to take my kids to and from school and their activities. And, as a single mother of two tweens, would it be wise to leave that for a risky job with no benefits? Jen continued talking, trying to convince me. She had clearly thought this through and said there was no one else on the board who was as passionate about the cause as I was.
“But I’m not a nurse or doctor,” I told her.
“Kim, you can hire a nurse and a doctor. The INN Between needs a leader, and you have what it takes.”
When we hung up, I was in a daze. I called Debbie and Dan to let them know, wondering if Debbie might want the position. It was getting late, and I crawled on the couch with the kids to watch a movie and get my mind off it. But I couldn’t help running through the pros and cons. I would lose my health insurance, but the kids were covered by their father’s policy. I wasn’t a medical professional, but I had managed a retail store for five years after college and knew how to run a business. I hadn’t personally been through a hospice experience in my family, but I had gone on several hospice visits during my onboarding at CNS, so I had a little bit of real-world experience. Because I worked at one of the largest hospice agencies in Utah, I knew how to talk about hospice care for marketing and grant-writing purposes. And, because I was a good grant writer with established relationships in the funder community, I had 100% confidence in my ability to raise money for The INN Between’s mission. But what about Eddie? He committed to paying Jen, not me.
After a few days of ruminating, my passion for the cause overtook the logical decision-making process, and I decided to throw my hat in the ring. Debbie was thrilled to hear the news as she had no intention of quitting her job at Huntsman Cancer Hospital. Dan was also happy. Next, I had to talk with Eddie. To my surprise, he immediately said yes, sharing that he believed in me because of my passion.
When Debbie called to make the official offer, I accepted immediately and gave two weeks' notice at CNS. Ironically, CNS’s CEO Brent Jones originally got me involved with The INN Between committee (read the story). Knowing the project's importance, I had spent the last year trying to convince him to take The INN Between under CNS’s umbrella. Now, I was leaving CNS to start The INN Between myself!
I had toyed with the idea of taking the kids on a little vacation between the two jobs. However, I was excited to delve in, and with so much work to be done, I quit CNS and started my new role as the founding Executive Director of The INN Between the very next day, January 9th, 2014.
Today is my 10th anniversary of taking that leap of faith.
Over the subsequent eight months, I would experience some of the most difficult challenges of my life. Multiple obstacles almost halted The INN Between in its tracks. More on that in future stories.
Kim you are a mover and shaker! This is an interesting read. Thanks for sharing