What did not destroy us will make us stronger...

After the harsh challenges of the COVID pandemic, the non-profit Heart of Hope Asian American Hospice Care finally reinstated its full range of professional hospice services in October 2022.

On a sleepless night two years ago in August, I looked at a poster, a beacon of light in the darkness of the night, mixed with the treacherous impact of the waves. In tears, on behalf of Heart of Hope, I wrote a letter to inform the community that we had to suspend hospice services due to various reasons related to the Pandemic. Since 2011, we have spent five years promoting end-of-life care education in the Chinese community that is fearful of topics related to death and serious illness. Officially established in 2016, the only non-profit Asian American hospice organization in the United States was swept into the tide of the relentless Pandemic in 2020. My heart is filled with unspeakable deep sense of apology to our community friends who have supported us along the way. At the same time, I pray that even if we have to suspend hospice care, please help us to continue to serve and care for our Chinese-Asian friends in other ways as the pandemic rages on, until it ends or subsides. And I believe that one day we will be able to re-open our full range of professional hospice services to care for the terminally ill again with love in their final journey of life.

We are extremely grateful for the generosity of our community supporters and volunteers who have stood by us in the past two years despite the difficult circumstances. In response to this selfless love, we have not been let up in our efforts. With very limited staff and resources, we were able to provide 81 online seminars on professional life care and medical care to 11,460 people from all over the United States who signed up to receive important information on physical and emotional care and stress management during social distance and home isolation, end-of-life holistic care series, bereavement and loss counselling, suicide prevention and care for the bereaved, geriatric depression care, care for the loss and grief of minor children, advance directives and financial planning, knowledge and resources for Alzheimer's care, care for serious illnesses and cancers, and the latest medical developments, as well as other specialized health

care-related information... and more. At the same time, we also provide care and encouragement through one-on-one phone calls to those who have experienced serious illnesses themselves or family members during the pandemic, as well as to those who are grieving the loss of a loved one caused by COVID or other major illness. We maintain a warm and positive time for breast and women cancer patients during the pandemic, so that they can cheer each other up through online support groups and prevent the depressing pandemic and social atmosphere from affecting their confidence in treatment. In addition, we also provide professional end-of-life care volunteer training to equip people around the world who have a loving heart to help their loved ones, so that their love, combined with their knowledge and experience, can become a true blessing to patients/families.

We have always remembered that the ministry of end-of-life care began with love, a deep burden and commitment born of God's compassion. So, from the moment we had to stop hospice services in August 2020, we dried our tears and turned around and embarked on a journey of faith and grace to reopen hospice care. In the past two years , we have received more than 200 requests for hospice services from terminally ill Asian patients and family members in the San Francisco Bay Area. The helplessness, desperation, grief and tears over the phone from each patient who thought of us when they needed help the most and we were unable to provide hospice services in the moment served as a reminder and motivation for us. In the face of many challenges and difficulties, in the moment of physical and mental exhaustion and difficulty, it is those voices that make us step forward and continue to take the next step. In September 2021, God moved a community supporter to provide a 1 to 1 matching fundraising gift and with your responsive support helped us raise $500,000 in community donations to fund the relaunch of hospice care. So, with the support and leadership of our Board of Directors, since January 2022, we have continued to engage in a variety of community care services while beginning preparations for the hospice relaunch and beginning to hire administrative and medical staff in various departments.

If this is as easy as we thought and hoped it would be in April 2022, then we have lost our chance to witness Amazing Grace. The difficulties and frustrations of this process have turned my grey hair black and my black hair grey again... As a result of the State of California's efforts to clean up the highly fraudulent California Hospice agencies, legislation was passed that no new hospice agency applications will be accepted from January 2022 until January 2027. While we formally applied to retain our license when we stopped hospice care, the State of California has never processed a case where has voluntarily suspended license for two consecutive years. Internal voices differed on how to handle our application for reinstatement, and as a result, we were given repeated and divergent guidance from different bureaus, resulting in repeated delays in review and failure to renew our licenses by the August 2022 expiration date, and we almost lost our medical licenses. During this time, God helped us to stay calm and appeal to all levels of authorities with a firm and sincere attitude, with over 30 letters of appeal and communication. Occasionally, at times when there was no hope in sight, I was asked by staff, "Is it still necessary to carry on this cause with such difficulties and hardships? It would be good if we could just continue with our community education and care services.” I was not disappointed or upset by such a question, because I saw how serious and dedicated they were, and I knew how exhausted and worried they were. I just told them to keep doing what we could do until the end, and to leave the rest to God.

Finally, the top executives in charge of the California medical licensure and Hospice in California Department of Public Health met and resolved that we could renew our current license and continue to practice if we accepted and passed the full inspection set for brand new agency. The CDPH surveyor went through all of the information and documents related to the organization's medical systems setting-up, human resources system, and policies and procedures. In the following days, I continued to receive phone calls from the state government asking all sorts of questions, but I was unable to get a final decision. Finally, a week later, we were informed that Heart of Hope had passed the licence renewal process with "zero deficiency" and was allowed to continue practising. However, as far as I understand it, we put all our heart into it and worked very hard, but it was not perfect. So how did this "zero deficiency" come about? I am sure it is by God's miraculous grace.

This is just one of the many difficulties in the process. So, from now on, will everything be better, like eating sugar cane backwards? In our human nature, we do expect it. But we know one thing from our experience- because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not put us to shame, - Romans 5:3-5." We are humble and thankful in good times and hopeful in bad times.

Due to delays in the state government process, we were six months behind schedule. During the six months, we used the $500,000 start-up fund we raised last year to continue to provide a wide range of free community services while hiring and training new staff, including two part-time hospices Medical Directors, seven bilingual registered nurses, two bilingual medical social workers, three bilingual chaplains, three bilingual home health aides, and administrative staff. We have now begun providing hospice care and are preparing for the Center for Medicare & Medicaid's Medicare accreditation. The federal government will conduct an unannounced inspection of us and requires the facility to have seen at least five patients and have at least three patients receiving services on the day of the inspection. No one can predict when this three-day unannounced inspection will take place, which could be at the end of this year, early next year, or six months from now. We have to pass this three-day unannounced screening by Medicare and it will take another three months of CMS work before we are allowed to start claiming Medicare benefits. Currently, all medical and health care personnel costs for all of our patient care are completely uncovered and are paid for by Heart of Hope. At the same time, inflation has been unexpectedly high from 2022 onwards. Therefore, we would like to share with you once again the current situation, developments and needs of the Heart of Hope and hope that we can continue to count on your encouragement and support. In the future, we will continue to uphold the love and commitment that we started with, to provide high quality patient care and non-profit professional end-of-life care with the aim of caring for patients and supporting families, and to turn every bit of your selfless love into a sincere blessing for the Chinese and Asian communities.

I have been drafting this letter in my mind for a long time, but I do not know how to put into words, how to conclude it, how to explain the perseverance and state of mind of the Heart of Hope for the past two years... Looking back on the past, all the difficulties and hardships have become gratitude at this moment. Thank you for always being there! Thank you so much!

What did not destroy us will make us stronger...

Blanche W.S Chen
Heart of Hope Asian American Hospice Care

1879 Lundy Ave, Suite 223, San Jose CA 95131 | (408)986-8584 |
www.heartofhopehospice.org