Program Challenges

The program implementation process was not without challenges.  Extensive efforts were undertaken to communicate the program goals and protocols throughout the community, with the intent of fostering a wide network of collaborations with home health and social service providers across the community. 

A few home health providers in the Upper Arlington area were concerned that National Church Residences/InCare, a provider of comprehensive senior services in the area who was also operating the STAY UA pilot program, was retaining an undue number of referrals which gave them a financial advantage, and represented a conflict of interest.  National Church Residences/InCare’s response to community concerns was presented in a White Paper prepared by National Church Residences in September 2009.

The result of the discussions and plans between National Church Residences/InCare and the City were to continue working together, following the ethical standards presented in the white paper to avoid any appearance of conflict of interest issues.  This careful consideration of the program structure offered an opportunity to reflect on the program development phase and implement important refinements.  Lessons were learned and we share them for your benefit here.

Advice From Lessons Learned

Awareness and Support

Awareness of the community’s older adult needs and support from elected leaders, Fire Division, and Administrative Staff are essential components for program implementation and sustainability.  

Recognition and Communication
Recognition of the local competitive health care environment and working to communicate appropriately to all potential partners/providers is essential for program success.  In Upper Arlington a World Café (community conversation) was conducted to bring all community stakeholders together, to dispel myths and share the vision for the program, and to receive feedback and ideas regarding how the program could be most successful.  

Building Partnerships
Time spent building a strong public/private partnership is time well-spent (i.e., assuming that employing a service coordinator is likely not feasible for most governmental agencies, building a trusting relationship with the private partner for a program such as STAY UA dictates the success of the program).  

Program Funding
Identification of on-going program funding is essential in order to avoid raising community expectations and then not following through with expected services.  Grants and philanthropic opportunities should be researched and pursued.  

Oversight Structure
Building the appropriate oversight structure to include an ethics committee and/or advisory council for the program provides assurances of quality and supervision that is important to the program’s image.  

Program Success
Prioritizing self-determination, confidentiality and freedom of choice is essential to program success.

At the end of the pilot test period, a competitive Request for Proposals was issued and a subsequent contract was entered into for implementation of the ongoing STAY UA program. 

With the understanding that the demographics and needs of every community are different, we have provided implementation guidelines and forms that are intended to assist you in considering a Firehouse Service Coordination Program for your community.  We hope these resources offer the helpful insight you might need for all aspects of establishing a similar program.