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At Magen David Adom, Israel's national EMS service, help begins the moment the phone is answered. Because EMTs handle the calls, they can provide lifesaving instructions while dispatching ambulances and first-responders on Medicycles. And now, with 15,000 CPR-certified civilian Life Guardians joining our team, help can be just seconds away. As we celebrate Chanukah, please give the gift of life, and make your year-end tax-deductible donation today. At Magen David Adom, we're often saving lives before our ambulances even arrive. AFMDA Midwest Region 3175 Commercial Avenue, Suite 101 Northbrook, IL 60062 Toll-Free 888.674.4871 • midwest@afmda.org www.afmda.org December 14 • 2017 21 jn including in-home nursing, nutri- tion advice, help with social net- works and family interaction, and spiritual support. But unlike hos- pice care, in-home palliative care is not reimbursed by insurance. JHCN never charges patients and their families for services, so most of the professionals who work for LifeLinks are volunteers. As medical director, Forman oversees patient care and serves as a resource to other staff. He edu- cates community healthcare pro- fessionals about JHCN/LifeLinks and seeks grants and other modes of funding. In November, he coor- dinated a conference attended by more than 200 physicians about talking to patients about serious illness. Community doctors are increas- ingly receptive to LifeLinks, Krakoff said. "LifeLinks extends physicians' reach into a patient's home," Forman said. "It takes a big burden off them. And when patients don't have to make so many repeat visits to the office, the doctor has more time to spend with them when they do come in. " We're not competing with the physicians; we're not trying to take their patients away. We're helping to fill a gap." Forman describes LifeLinks as "anti-entrepreneurial" because under current insurance reimburse- ment models, it doesn't bring in any income. But Freedman and Krakoff hope Forman's medical credentials and business savvy will help convince funders that LifeLinks is a sound financial model. Forman recently secured a large grant from the Michigan Health Endowment Fund that includes a rigorous data collection compo- nent. LifeLinks is now measuring the number of days its patients spend in the hospital, the num- ber of emergency room visits, the number of days in intensive care and the number of visits to the doctor's office. For most patients, these mea- sures decrease significantly once they join the program, meaning the cost to insurers would be lower — if only insurers covered LifeLink's services. Forman says he hopes his research will convince the Centers for Medicare and Medicaid Services that programs like LifeLinks add value for the patient while reduc- ing costs. If government payers start reimbursing providers, private insurers would likely follow suit. He feels the field of in-home pal- liative care is bound to grow and to become as accepted as hospice care. PATIENT PEACE OF MIND For patients and their families, the benefit of LifeLinks is not econom- ic; it's the tremendous increase in comfort and reassurance they feel, Forman said. Receiving more care at home, along with social and spiritual support, gives them peace of mind. Janet Levine of Huntington Woods turned to LifeLinks last spring when her husband, Ellsworth, "Ells," was struggling with Parkinson's disease and depression. As a longtime Jewish communal volunteer, Levine was familiar with Jewish Hospice and Chaplaincy Network. The rabbis came to visit, followed by social workers, who explained the LifeLinks program, and a nurse. "They were just there for us. They provided emotional and spiritual support, which we really needed," she said. "It's an invalu- able part of our community." Forman has started explor- ing ways LifeLinks can provide increased support to family care- givers of its patients. Caregivers often neglect their own wellbe- ing and hesitate to ask for help for themselves. They are relived when they learn that someone is interested in them as well as in the patient. Recently, LifeLinks started add- ing "enrichments" to the patient experience. Musicians visit to play and sing for them, through the late Carole Jo Lasser Fund for Music Enrichment. Beauticians style hair and do manicures. Plans are afoot for art and pet therapy and life review activities. LifeLinks is unique in the United States, Freedman said. "There is such a need, but not many hospi- tals or physician groups are willing to take on patients they don't get paid for." Because LifeLinks is not cov- ered by insurance and patients are never charged for any of the ser- vices, the program relies on dona- tions and grants. While he misses his oncol- ogy colleagues and his patients, Forman is happy in his new career. "It's the most meaning ful work I've done in a long time," he said. "It's been rejuvenating." •