Placerville’s Snowline Hospice is expanding its patient caseload by 8 percent to 10 percent annually, and an increasing number of those patients are coming from Sacramento County. That’s why the nonprofit opened an office at 100 Howe Ave. in Sacramento in December.
“We’ve cared for Sacramento residents, hundreds and hundreds of them, more recently in the last decade or so,” said Michael Schmidt, the nonprofit’s executive director. “Mostly, if you mapped it out, it would be eastern Sacramento County.”
None of Snowline’s terminally ill patients or their families ever receives a bill from the nonprofit, he said. Instead, nearly half of the organization’s roughly $13 million budget comes from funds raised by six thrift stores and a small-but-productive up-cycling center that sells recycled materials to brokers all over the world.
So popular are Snowline’s thrift stores in Camino, Placerville, Cameron Park and Folsom that many local residents think the nonprofit’s mission is operating secondhand stores, not a hospice, said Jennifer Eells, the community outreach director.
Snowline employs doctors, nurses, social workers, spiritual counselors, home health aides and other professionals to help patients and their families meet their end-of-life needs in their homes – whether they are medical, spiritual, emotional or psycho-social, Eells said. The nonprofit started out as an all-volunteer organization in 1979, she said, and volunteers continue to play a crucial role in offering respite or running errands or bearing witness to a death when no relative can be there.
Medicare pays about $200 a day for hospice care, Schmidt said, and those fees actually have dropped by 2 percent every year since 2013 because of the automatic federal spending cuts known as budget sequestration.
“When someone transfers or comes onto our service,” Schmidt said, “they get a lot of care in the beginning to help them understand the services and how it’s delivered with the whole team to support families and patients where they are, with regard to their life-limiting situation. We are not there normally around the clock, 24 hours a day. It’s intermittent, regularly scheduled visits, and it’s a six-month unlimited benefit.”
Sadly, Schmidt said, many patients Snowline serves die within nine days. MedPAC, the Medicare watchdog group founded by Congress, has reported that nonprofit hospices tend to serve the sickest patients, those whose care will be more costly and who will live an average of 69 days. For-profit hospices, by contrast, serve patients who live an average of 102 days, and many recover and leave hospice care.
Consequently, nonprofit hospices often have to look for ways to supplement their income. At Snowline, that duty falls to employees and volunteers at thrift stores and the processing center. In 2014, the processing center alone handled 1.6 million pounds of clothing, 16,000 pounds of shoes, plus 845,000 pounds of appliances, metal and wire, said Todd Pieplow, the director of operations and logistics.
Donors drop off their items at stores, at the processing center, or at community garage sales or e-waste events. From the moment items arrive, Pieplow said, every employee sorts the items with an eye toward ensuring no one will have to redo their work.
“If we handle it right the first time, we can put it right on the truck and we have organizational efficiencies,” Pieplow said. “The value really is in the sort. If you don’t sort it properly, the value goes way down. … You don’t want to put wet or soiled clothing in the bale because it would contaminate everything around it. There are only so many buyers, and most of the buyers are brokers. You have to protect your reputation for quality.”
One Snowline employee knows well the foreign demand for American castoffs. Affie Tamuno-Koko, Snowline’s quality coordinator, grew up in Nigeria and shopped as a teen at the massive market where these goods are sold.
“I would wear the shoes to school, and my classmates were like, ‘Wow! I like your shoes. Where did you get them from?’” said Tamuno-Koko, who grew up poor and demurred when it came to her source. “They’d say, ‘OK, well, when you go back, here’s some money. Get me some.’ I was paying $2-$3, but they would give me like $30 or $40 to buy them similar shoes because that’s how much they thought it was worth.”
Without these earnings, Tamuno-Koko said, it would have been difficult to buy the books she needed for school.