Cindy Rice, Executive Director, Partners in Care
Nominated by: Celia Orona, Volunteer, Partners in Care

I first met Cindy Rice eight years ago when we both served on the bioethics committee of our local hospital. Her quiet, unassuming demeanor belied an indomitable spirit and strength of character, and I soon learned the meaning of the phrase still waters run deep. Over the years, I have witnessed the many facets of this remarkable woman.

Cindy’s professional journey began in 1989 when she worked as a cardiac nurse in Sacramento. However, the following year, two events converged to shape her lifelong vision. First, her father was diagnosed with cancer. As the disease progressed, the family was served by the hospice. Cindy quickly realized this was the approach to healthcare that she wanted to be involved in, and so the second change occurred: she moved to Placerville and began her work with Snowline Hospice as a palliative care nurse.

Recognizing the value of a holistic approach, Cindy’s nursing endeavors lead to the development of a palliative care program at Marshall Hospital in Placerville. In addition to medical care, patients with a serious illness were able to receive psycho-social support and/or spiritual guidance. However, once discharged from the hospital, patients did not receive follow-up care in their homes.

In addition, there were others who fell outside the safety net. Their concerns were comprehensive. “How do I negotiate the healthcare system?” “What resources are available to me?” “What changes can I expect as my disease progresses?” These patients faced a life-threatening illness but were not yet hospice-appropriate and did not qualify for Medicare benefits. Clearly, there was a need to be met.

Again, Cindy stayed with her focus: to bring palliative care to those in need. She and others in the healthcare community asked a key question: Why should a person wait for a terminal prognosis before receiving holistic care? After many months of meeting and planning, the idea for an innovative program emerged. In 2000, Cindy was a key player in bringing a free community-based palliative care program to El Dorado County.

Funded by a generous grant from The California Endowment, Partners in Care (PIC) came into existence. The program serves El Dorado county residents who have been diagnosed with life-threatening illness. By providing free consultative services to the patient and his or her family members, PIC staff is meeting the needs of the most vulnerable of our residents: those who do not qualify for hospice care under Medicare. The typical client is elderly, has few family members living close by, and is un-insured. Lack of transportation is also a barrier to healthcare, as the majority of clients live in remote rural areas of the county. Indeed, home visits have proven to be a challenge, especially with the cost of fuel as team members drive to such areas as Georgetown, Grizzly Flat and Somerset.

With the program in full swing, Cindy again showed how valuable her leadership skills are. Physicians were initially skeptical about its efficacy. Would PIC team members serve as adversaries or collaborators? Through Cindy’s quiet and non-threatening advocacy, area doctors quickly found that the program was extremely helpful to them and their patients. The program’s collaborative approach created a winning partnership. Today, El Dorado county physicians are the program’s staunchest supporters. In fact, during the first year of operation, no marketing took place. It was through word-of-mouth and physician support that clients found the program.

From the beginning, the tone of collaboration and cooperation with other agencies in the county was evident. PIC has emerged as a respected organization serving the vulnerable and disenfranchised. More than 500 clients have been served to date. However, the number of clients do not tell the entire story as it has been estimated that each client also has at least one family member whose needs are also being met through PIC.

As the months turned into years, Cindy’s role changed. Although she began as the nurse in the multi-disciplinary team, it was not long before she became the team leader. Included in this position were administrative duties, coordinating funding sources and working with the board.

After four years in operation, funding became scarce and the program appeared doomed. Grants, donations, and fund-raisers were not meeting the organizations financial need. Many in the community urged Cindy to give up. A free program could not be sustained. Yet, she held firm and would not discontinue service. Instead, the staff, following Cindy’s lead, agreed to continue to provide care, even if it meant working half-time – a sacrifice all were willing to make.

Her faith in and commitment to the program was rewarded. The program prevailed, albeit with a month-to-month existence, a practice that lasted for several years. In fact, not only did the program prevail, other changes took place that brought the organization to a new phase of development. One such change was incorporation, a move that meant Cindy worked with attorneys and accountants to negotiate the legal system.

A second critical change occurred when the Board recommended the opening of a thrift store in order to have more reliable sustainability for the program. Again, Cindy stepped up to the plate. She oversaw the incorporation of the organization and went from team leader to executive director. She quickly learned the basics of accounting, developing policy and personnel procedures, understanding building codes, and working with County planning department contractors. Yet each hurdle was met with quiet fortitude and faith. Staff and board members continued to follow her lead, trusting that the program would remain a viable part of the community.

Throughout each phase of the program’s development, Cindy has not only served as the palliative care nurse and team leader, she is also active in the community as PIC’s representative. She has been an educator, mediator, collaborator and coordinator. A strong proponent of teamwork, she has worked to partner with other community leaders. Her dedication to bringing palliative care to those in need is becoming a reality.

Central to her vision is the knowledge that her constituents may be geographicallyisolated, but they are never alone with a program like PIC. Today, program funding is still precarious, but there is no longer any question whether PIC will remain serving the community, thanks to a leader who ignored the odds against her, but did not ignore the need.

Article posted on 1/17/08