What started as an idea for four independent elderly care organizations to work together to better respond to changes in the healthcare industry has, in the 20 years since, evolved into the one of the state’s most comprehensive, collaborative network of healthcare services and support for Rhode Island’s senior citizens.
Working together meant that Steve Horowitz of The Saint Elizabeth Home, Maryann Altrui of Saint Antoine Villa, Chris Woulfe of Scandinavian Home and Steve Farrow of Steere House had to sell four different boards of directors on collectively supporting a $500,000 annual budget for a fledgling, experimental entity – CareLink.
What helped make that sell was that these individual organizations would be able to remain separate from one another. Rather than merging and creating one larger organization, they would be collaborating and assisting one another in areas of need.
“There is tremendous consolidation occurring in the long-term care industry in Rhode Island,” said Horowitz around the time of CareLink’s beginnings. “Through CareLink, we will be able to gain the advantages of belonging to a multi-facility network without forfeiting our not-for-profit mission and individual autonomy.”
The boards committed the funding, and CareLink was born. Soon they had assembled an office with castoff furniture from a law firm, hired a consultant to learn from other likeminded organizations around the country, incorporated as a 501(c)(3) and then recognized their first immediate need – a CEO to oversee programming and organizational operations.
“My first desk was a folding table with a folding chair, and I think we may have had a telephone,” said Joan Kwiatkowski, who worked as a liaison for Lifespan before becoming the first CEO for CareLink. “For me, what was so exciting was the sense of freedom. These guys were up for anything. If it was a good idea and it meant good things for their clients and staff then they were open to trying things on. 20 years later there has never been a dull moment.”
In the beginning there were four total programs available within the CareLink network, including a full-service rehabilitation center. Today there are 39 programs across the state, from independent elderly housing to hospice care, utilized by 13 member organizations which employ 3,000 people and service about 5,000 clients every day.
What CareLink does, tangibly, for a member organization is help pick up slack where it is needed, prioritize and consult in regards to areas of need and provide valuable resources that may otherwise be unavailable them. It affords organizations the ability to think less about difficult details of running their operation like a business while maintaining peace of mind that those important responsibilities are being taken care of.
“[CareLink] allows us to do things together that we couldn't do alone,” Horowitz said in a recent interview. “It really gives you good insight into the future. We’re pretty well geared up to deal with changes that are going to occur in the healthcare field.”
For example, CareLink started a dental program, Wisdom Tooth, which can be contracted to members in-house so seniors have better access to oral care. They also offer services such as group purchasing, and Kwiatkowski reported that CareLink had saved members $1.3 million in purchasing costs last year.
CareLink helped bring the Program for All-Inclusive Care for the Elderly (PACE), the country’s only provider-based Medicare/Medicaid health plan created for adults 55 and older who are chronically ill and at risk of needing a nursing home, to Providence in 2005.
“CareLink has to be focused on stuff that matters,” Kwiatkowski said. “We don’t spend a lot of time on frivolous programming, we really focus on initiatives that are going to make them [our members] stronger so they can be better for their clients.”
After all, CareLink began as an initiative not to get its founders rich or on the cover of magazines, but as a coordinated effort to better address the needs of senior citizens in the state.
“I think the bottom line is the philosophy we all buy into is taking care of our elders the best possible way we can,” Horowitz said of the common threads between CareLink members.
The challenges of healthcare in general, especially for the elderly, will seemingly not be wholly solved any time soon. Even as she has worked for 20 years trying to improve the situation with CareLink, Kwiatkowski recognizes the major challenges ahead.
“We have a shrinking number of professionals, particularly at the personal care level, and we’re going to have to really think about who is going to provide that personal care,” she said. “Who is going to shower the future elder in their home? That is going to become more and more of a challenge for us.”
In just 20 years, CareLink has gone from an idea to a necessary piece of the Rhode Island healthcare picture, which is a progression that those around for its humble beginnings take a healthy amount of pride in.
“The caliber of leaders of my member organizations, these executive directors and their boards, are fearless, they’re smart, they’re creative and they’re just a joy to work with,” Kwiatkowski said. “I went into healthcare with the mindset that I needed to leave healthcare at least slightly better than when I entered the field. I do believe the CareLink board has allowed me the creativity and the resources to do just that.”