Richmond Academy of Medicine Trust
2821 Emerywood Parkway
Suite 200
Richmond VA 23294-3726
Mission Statement To encourage advance care planning conversations among individuals, families and healthcare providers throughout our communities so that individuals’ healthcare choices are best honored.
Leadership
CEO/Executive Director James G Beckner
Board Chair Peter A Zedler MD
Board Chair Company Affiliation retired
Contact Information
Address 2821 Emerywood Parkway
Suite 200
Richmond, VA 232943726
Telephone 804 622-8141
Fax 804 788-9987
E-mail honoringchoicesvirginia@ramdocs.org
History and Background
Year of Incorporation 1975
Financial Summary
 
 
Projected Revenue $277,000.00
Projected Expenses $277,000.00
Statements
Mission To encourage advance care planning conversations among individuals, families and healthcare providers throughout our communities so that individuals’ healthcare choices are best honored.
Impact

Building upon the evidence-based model created by Gundersen Health System, Honoring Choices brings together three competing health systems - Bon Secours, HCA and VCU - and community organizations with a goal of making advance care planning (ACP) a routine component of every patient's care experience. Through our collaborative the medical team is trained in facilitating value-neutral conversations between patients, their loved ones, and their providers that will allow an individual's goals of care to be honored. This person-centered approach helps individuals to navigate the complex future medical decisions that may need to be carried out by a trusted loved one if the patient is unable to speak for him or herself. The documentation generated from these conversations allow the medical team to deliver the care the patient wants - no less than expected and no more than desired. Knowing that encouraging ACP can help a patient live well, we also see the impact on the patient's loved ones who are equipped to feel confident in their knowledge of the patient's goals of care and the impact on the medical team that is supported in knowing how to best support their patient.

 
Since January 2015, we have implemented the program in 37+ clinical sites across our three health systems; these clinicians offer ACP conversations to their patients (as well as community members as demand allows) at no charge. Our next phase of growth is to expand into the community.  
Needs
We are looking for partners to help us in taking this work from the health system setting into the community.  There are some building blocks we must put in place prior to implementing a community engagement strategy.
  1. Diversify catalogue of resources.  Our facilitators who care for patients from traditionally underserved populations report that Gundersen-developed tools are not meeting the needs of their patients.
  2. Improve ability to share planning documents across systems and between providers.
  3. Identify and develop platforms and partnerships that make ACP information broadly accessible.
  4. Develop sustainability strategy for community-based work.
Background

Honoring Choices® Virginia is a collaborative initiative of the Richmond Academy of Medicine Trust, a tax exempt nonprofit organization that serves as an incubator for programs that improve patient care in our community. The mission of Honoring Choices is to encourage advance care planning conversations among individuals, families and health care providers throughout our communities so that individuals’ health care choices are best honored. Honoring Choices Virginia is a partnership of the Richmond Academy of Medicine, Bon Secours Richmond Health System, HCA Virginia and VCU Health. It is governed by the Richmond Academy of Medicine Trust Board of Trustees, which is comprised of past and present RAM leaders, and the Honoring Choices Virginia Advisory Board, which is comprised of community representatives.

Three years ago RAM pulled together 100+ community leaders to have a dialogue about how we could collectively work together to improve the quality of care patients receive at the end of their lives. From that meeting, a common vision was developed, and the Academy and the three health systems evaluated various approaches to helping patients make informed, advance medical decisions. They selected the Respecting Choices model developed by Gundersen Health System, which is now being implemented in communities across the globe. It requires three key elements of its participating partners – (1) system redesign; (2) education and facilitator certification; and (3) community engagement. For community engagement, partners are encouraged to reach out to their community with common, consistent and repetitive messages; further, partners should develop unique strategies to meet the needs of special population groups.

 
CEO Statement

What does it look like when advance care planning goes the way it should?

A patient, we’ll call him Mr. Smith, was experiencing stroke symptoms and drove himself to the ED. Upon admission, he stated he did not have family or an advance medical directive. After receiving an invitation to talk more about what care he would want if he could no longer speak for himself, Mr. Smith agreed to have a conversation that resulted in choosing a close friend to serve as his surrogate decision-maker. Mr. Smith’s friend joined him and an advance care planning facilitator in a discussion about what quality of life meant to him, resulting in completion of an advance directive, and the friend affirmed his willingness to honor Mr. Smith’s care decisions. Sadly, some time after his discharge Mr. Smith suffered a cardiac arrest and was brought into the hospital in a vegetative state. Using the advance directive and what he learned in the conversation with his friend, the health care agent was able to make the decision to withdraw support per the patient’s wishes.

How would this case have gone if there had not been an advance care planning conversation? Anecdotally we hear that a majority of hospital ethics cases involve some layer of advance medical decision-making that didn’t go as it should – there is no advance directive on file, a next of kin cannot be identified, a health care agent is unsure of what the patient would want. These cases cause delays in critical medical decision-making and significant distress for the grieving family and for the health care team caring for the patient.

Two years ago the Honoring Choices® Virginia collaborative launched its first nine clinical sites; today, we are live in 37 clinics, in-patient units and home care programs across the three participating health systems – Bon Secours Richmond, HCA Virginia and VCU Health. Our clinical leadership meet on a bi-weekly basis to ensure the program is consistently implemented across the care settings (allowing for customization to fit practice workflow and individual strengths) and to address community-wide barriers such as difficulties in sharing information across systems. We believe we are a first-of-its-kind community-wide collaborative in this region and that we are demonstrating every day the impact our health care partners can make when we collaborate to address the needs of our citizens.

Nearly 150 facilitators are available to make sure our community members have the opportunity to have the types of conversations that would allow, in the event of crisis, their medical team to honor their advance health care decisions. They are working to normalize these conversations as a routine aspect of the care experience, so that individuals from age 18 to 108 can thoughtfully consider what medical decisions they would want a surrogate to make for them in the event they cannot speak for themselves.

Areas of Service
Areas Served
Area
Metro Richmond
Board Chair
Board Chair Peter A Zedler MD
Company Affiliation retired
Term Nov 2015 to Oct 2017
Email pzedler@yahoo.com
Board of Directors
Board Members
NameAffiliation
Harry Bear MDVCU Health System
Ritsu Kuno MDPar Access
Ken Olshansky MDretired
Richard Szucs MDCommonwealth Radiology
Board Demographics - Ethnicity
African American/Black 0
Asian American/Pacific Islander 1
Caucasian 4
Hispanic/Latino 0
Native American/American Indian 0
Board Demographics - Gender
Male 5
Female 0
Governance
Written Board Selection Criteria? No
Written Conflict of Interest Policy? Yes
Percentage Making Monetary Contributions 100
Standing Committees
Advisory Board / Advisory Council
Other Boards
The tables below contain information about other groups that advise this nonprofit on operations and projects.
Advisory Board Members
NameAffiliation
EX OFFICIO J. Brian Cassel Massey Cancer Center
Egidio del Fabbro MDVCU Massey Cancer Center
Ken Faulkner Pastoral Care VCU Health System
Mary Ann Hager RNMassey Cancer Center
Barbra Headen RN, MBAHCA Virginia
Nathan Kottkamp EsquireMcGuire Woods
Ritsu Kuno MDPulmonary Associates
Bill Nelson MD, MPHVirginia Dept of Health (Retired)
Diane Reynolds-Cane MDCentral Area Health Network
Karen Roesser RN, MSN, AOCNSThomas Cancer Hospital
Barbara Rose Deputy County Attorney Hanover Co. (Retired)
Steve Rosenthal EsquireTroutman Sanders
Anthony "Tony" Spensieri MD, MBA, FHM, CHCQM
Kelly Stuart MD, MPH, MTSBon Secours Richmond Health System
Richard Szucs MDCommonwealth Radiology
Thelma Bland Watson PhDSenior Connections
Leanne Yanni MDBon Secours Virginia
Executive Director
Executive Director James G Beckner
Senior Staff
NameTitle
Robin Clair Cummings MSHADirector, Honoring Choices Virginia
Staff
Full Time Staff 1
Part Time Staff 0
Volunteers 17
Contractors 0
Plans
Organization has a Strategic Plan?
Whistleblower Policy Yes
Programs
Description
Fiscal Year
Projected Revenue $277,000.00
Projected Expenses $277,000.00
Form 990s
IRS Letter of Exemption
Detailed Financials
Expense Allocation
Fiscal Year201520142013
Program Expense$245,846$136,516--
Administration Expense$4,839$3,931--
Fundraising Expense$0$0--
Payments to Affiliates------
Total Revenue/Total Expenses0.522.42--
Program Expense/Total Expenses98%97%--
Fundraising Expense/Contributed Revenue0%0%--
Assets and Liabilities
Fiscal Year201520142013
Total Assets$83,423$202,075--
Current Assets$82,137$202,075--
Long-Term Liabilities$0$0--
Current Liabilities$2,102$189--
Total Net Assets$81,321$201,886--
Short Term Solvency
Fiscal Year201520142013
Current Ratio: Current Assets/Current Liabilities39.081069.18--
Long Term Solvency
Fiscal Year201520142013
Long-Term Liabilities/Total Assets0%0%--
Capital Campaign
Currently in a Capital Campaign? No
State Charitable Solicitaions Permit
Solicitations Permit
Solicitations Permit 3/2017View
Comments
Organization Comments
Our fiscal year is 11/1 to 10/31; therefore the 990s cover the following periods:
 
2013 990N: 11/1/2012 - 10/31/2013
2014 990: 11/1/2013 - 10/31/2014
2015 990: 11/1/2014 - 10/31/2015
 
There was no financial activity in FY2013; therefore, there are no financial statements for that year.