Karla Earnest, Director of Iowa City Hospice presented at the October 20th meeting.
Visiting Rotarians and Guests
Karla M Earnest-- Speaker
Mike O'Leary-- Guest of Jim Peterson
Moni Marcelo-- Guest of Amanda McFadden
Lara Celeghin-- Rotary Youth Exchange
Roxie Mitchell--Guest of Deb Galbraith
Victoria Morotov-- Visitor from Moldova
Kermit Shekar-- IC Noon
Pat Barron-- West Chester, PA RC
Cassi Elton-- Guest of Deb Dunkhase
President Myrene Hoover took an official vote of the club on some bylaws changes.  The two changes are as follows:
  1. In Article I, rework the selection process for President-Elect so that, following the members’ vote for nominees, if less than three nominees are determined to be willing to serve, then, instead of an election by the members, the Board will appoint the qualified and willing person that received the highest number of nominee votes by the members.
      2.  In Article II, add 2.7, Termination of Membership.  This delineates the procedure for resignation of a
           member by written request to the Secretary.  Failure to pay dues after a discussion of such failure for a
           delinquent quarter may lead to a vote of the Board for termination of membership.
Both article changes were approved by more than a 2/3 vote of those present at the meeting.
Deb Ockenfels reported that virtually all of the Project Warm coats have been distributed.  Total distributed were at least 8870 coats.
Pam Ehly read a thank you note from the Horn media specialist thanking the club for the book on recycling that went to the school library.  Pam and Margy also enjoyed distributing dictionaries to the 4th graders at that school.  Myrene Hoover said we also received a thank you note from Elder Services for the grant they are receiving this year through our collaboration with the Johnson County Community Foundation.
Brian Adamec is wrapping up the Nut Sales this week so orders can be delivered before Thanksgiving.  Brian also coordinates distribution of Soap for Hope and thanked those who have recently supplied the basket with toiletries to distribute to the Crisis Center and other agencies.
This week and next week Happy Bucks will go to Polio+.
Rotarians in the News
Pam Ehly and Margy Winkler were photographed during their book delivery to Horn.
Rick Dobyns has been endorsed for his second term in on Iowa City City Council by all of the local papers.
Former member, Katya Boltanova was featured in an article on the need for seamstresses in Iowa City. 
Happy Bucks
Deb Dunkhase was happy that the Play to Read Board has begun its work.  Several IC AM Rotarians are involved.
John Ockenfels celebrated having graduated from the Rotary Leadership Institute in Omaha.
The Knapps were happy to have attended the District 6040 Conference in Kirksville, MO with Past RI President, Ray Klinginsmith.
Phil Peterson was happy to be sitting between two potential new club members. 
Pat Schnack was happy that her husband is out of town for a few days giving her more peace and quiet than usual.
Liz Loeb is happy that she is headed to New York.
Sue Cronin is happy to be back from her extensive travels.
Dick Huber put in bucks for the Hawkeyes.
Bryan Clemons celebrated his wife's 75th birthday in Rome and had a lovely time touring Italy.
Jim Peterson is on his way to Xicotepec to plan out the next spring work week and he will stay for an extra few days to celebrate Day of the Dead there.
Amanda McFadden had a fun time with family visiting the UNI campus where most family members graduated.
Myrene Hoover is glad that her kids and grandkids have been able to move back into their own house after the big remodel.
Casey Cook is thankful that his wife is home safe and sound after spending some time stuck in the Atlanta airport. 
Mike Messier is happy that this year there have been a few extra weeks of golf because of the nice weather.
There were several other happy bucks-- all going to a good cause!
Mike Messier introduced the relatively new Executive Director of Iowa City Hospice, Karla Earnest.  Karla was previously Nurse Manager at Mercy Home Services.
Earnest noted the many connections in the health care community in Iowa City with Hospice.  Hospice has gained a very good reputation over the years with families in need of hospice care for a loved one and with health care providers in the area. The Iowa City Hospice is a non-profit and accepts patients from a seven county area around Johnson County.  Johnson County provides by far the largest number of clients.  It is a home-based hospice service, but there are beds reserved at each of the area hospitals for in-hospital care when it is needed or when families need some respite time.
Earnest mentioned that the history of hospice care goes back to the 14th century when the Knights of the Hospitaller provided care for the dying.  The modern movement began in 1879 with the Irish Sisters of Charity who began hospice care in Dublin, London and Sydney, Australia.  Our current mode of hospice care began with Florence Wald, Yale School of Nursing, who started Hospice, Inc. in Branford, CT in 1971.
In 1979 the HCFA, federal health care administration, started a demonstration project to see if hospice care was cost-effective.  When it proved cost-effective it became a benefit under federal programs in 1984 and was reconfirmed as a part of Medicare in 1986.
The Iowa City Hospice movement is credited to a group of three women who began a hospice project in 1979, Martha Lubaroff, Helen Zervis and Mary Child.  In 1982 this group hired a nurse coordinator and acquired space inside Mercy Hospital for the administration of home hospice services.  In 1984 the program acquired medical certification and could finally grow with regular funding.  In 1987 Iowa City Hospice established its first office outside the hospital, and finally moved to its current location at 1025 Wade St in 2000.
Hospice is an idea, not a place.  It brings patients with 6 months or less to live together with those who can provide palliative care.  While generally it is a doctor or nurse who refers a client to IC Hospice, it can also be a family member.  Regardless who initiates the hospice service the client's doctor must certify that the patient is expected to live no more than 6 months.  (If they do, that's ok; they can graduate from hospice care and then come back in again should they relapse.)
IC Hospice has a number of special programs.  There are volunteers to help care for pets until a hospice client is feeling up to taking care of the pet themselves.  Pet therapy is another service that has proven to improve the quality of life for hospice patients.  The Legacy Project helps clients to record their memories and life stories.  The 11th Hour Volunteers are specially trained to work with those who are actively dying.  Advance Care Planning is another program designed to make sure client wishes are honored regarding DNRs and extent of care to be given toward the end of life.  There is also extensive online informational support for family members who want to find out more about the diagnosis their loved one has been given.
The IC Hospice has been selected to be a participant in a new experimental model where people who otherwise qualify for hospice care are kept in the program even if they decide to take therapeutic measures in addition to palliative care for specific types of serious conditions (congestive heart failure, COPD, Cancer, HIV/AIDS).  This pilot is due to begin on January 1, 2016.