Volunteering in the United States of America

Hospice and palliative care volunteering in the United States of America (USA) has changed dramatically since its inception in the late 1960s. Inspired by physician Dame Cicely Saunders, the modern hospice movement officially began in the USA in 1971 with Florence Wald founding the first hospice, Hospice, Inc., a non-profit in New Haven, Connecticut. Then in 1983, the US Congress established the Medicare Hospice Benefit, whose Conditions of Participation (CoPs) mandated that volunteers must provide administrative or direct patient care in an amount that, at a minimum, equals 5 per cent of the total patient care hours expended by all paid hospice employees and contract staff. Hence, every hospice programme must have a volunteer programme in order to receive reimbursement for services rendered. The primary forces currently shaping hospice and palliative care volunteering have been regulations, care quality, skill requirements, liability concerns, and changing business objectives in a highly competitive environment.