The National Association for Home Care and Hospice announced last week that its board of directors has appointed Bill Dombi as Interim President. Immediately curious about how long an "interim" is and what might be in store for the association after the untimely passing of its 35-year and only president, we called Bill and were graciously given some time during what must have been an extremely busy week.
HCTR: Congratulations on your appointment. Start by telling us what it means. How do you understand your role as Interim President?
Dombi: The position is intended as a bridge to the next generation of NAHC, which will be defined by a strategic planning effort that is just in its beginning stages right now. [That effort] will look at what NAHC needs to be for the next generation in terms of advocacy, education, information, presentation, support, and all the things an association needs to do.
The concept of an interim leader was recommended to the board by NAHC staff. [We see it] as a way to provide an opportunity to create a new design in a deliberative fashion...not slow, but cautious enough to make sure we do it right. From there, we can define what we are calling NAHC 2.0 will need, in terms of staffing, membership, governance. Everything is on the table.
HCTR: What follows the Interim position?
Dombi: Who will fill the permanent position of President will not be determined until that strategic planning is completed, because the planning will define what skill sets the new President will need. They could be skill sets that fit me or not.
HCTR: Is the NAHC 2.0 effort initiated in order to fix something?
Dombi: No, this is not because anything is wrong but because this is one of those opportunities to revisit what you want to continue to do, what you want to replace, and what new things you want to do. Are there improved ways to do what you've done in the past that might require different resources, different mechanisms? Is there something in the governance we want to take a look at and perhaps modify for that next NAHC generation?
This Interim President position was not given to me with instructions to preserve the status quo. That was made clear from the beginning. Under my interim leadership, NAHC will be working to continue to improve, continue to grow, continue to meet the needs out there. But there will be, and already are, ongoing changes in that regard, and both internal and external things are under consideration. Some are underway already. We've looked at our budget, staffing, revenues, expenses. I met with staff just this morning and gave them a staffing reorganization starting point, with changes of command and responsibilities. It doesn't have any names attached to it because we're not there yet. But status quo is definitely not what we're doing at this point.
HCTR: Who will be involved in the NAHC 2.0 strategic planning?
Dombi: We've already been having weekly calls with the executive committee and periodic calls with the entire board. They have asked me to present a draft plan regarding what the strategic planning team would look like. I've recommended it be a combination of existing board members, some staff, and others who are not on the board, maybe even not NAHC members.
HCTR: Non members?
Dombi: The concern is that if the strategic planning committee is only NAHC staff and board, you just perpetuate the status quo and do not bring in the innovative thought process that an outsider would bring. We would hope to get innovation from everybody but outsiders coming in with a different perspective assures that we will. We expect members and outsiders would keep the interests of the industry in mind.
HCTR: It is starting to sound like a large committee. Will you be leading it?
Dombi: It needs to be a facilitated approach. We are arranging for a professional facilitator right now. I have also recommended that we keep it to a manageable size. It's the kind of thing everybody might want to be a part of but you can't do what you need to do if everybody is involved. In order to accommodate the interests of parties after that, we'll add a layer of public input opportunity and maintain transparency to the process throughout.
HCTR: Do you see this as a lengthy process?
Dombi: Our key decision is whether we get it done before the upcoming Annual Meeting or have a report of the steps we have taken by then. We've already announced that we are going to be doing NAHC 2.0 in our newsletter and we want people to understand that this is not just one of those reports that sits on a shelf and gathers dust. At the same time, making something like this happen overnight is not possible. I don't want to hazard a guess but what I can predict is that we will have made some progress before the Annual Meeting. Whether it's the full-blown, job-done kind of thing is a different question.
I can see at a minimum the design of 2.0 and scheduling of it could be done in the next 7 weeks but we cannot say now that we will be able to complete it by then. People have to arrange their schedules. We have to arrange for the professional facilitator, and we have to make sure the design of it is right. That usually means a bit of vetting before we release it. We want to perfect it and internal and external vetting will bring intelligence into the process. So I would expect we'll have the design and scheduling set but it's not likely that we will have held a session before the October meeting.
HCTR: This will be the first Annual Meeting without NAHC's founder at the helm. Is it not too soon to be talking about transforming the association?
Going to the
NAHC Annual Meeting?
Bring an extra box of tissues.
The first Annual Meeting in 35 years that will not be hosted by NAHC's founder will still have Val Halamandaris in the spotlight, Bill Dombi told us.
A video history of his life is being compiled and will be shown during one of the general sessions.
Val's enduring impact on the home health and hospice sectors will also be commemorated during the annual Caring Award ceremony.
The 2017 NAHC Annual Meeting will take place at the Long Beach Convention Center, Long Beach, California, October 15-17. For additional information and registration, go to the NAHC web site Annual Meeting page at http://longbeach2017.nahc.org
Dombi: There's an atmospheric thing at play here. People are very much still in the grieving process over Val's death, from his family on through the staff and membership. At the same time, and this is typical for an organization, when you have that kind of change, whether unexpected or planned, you stop and say "What opportunities does this bring?"
We see this sad event as bringing the opportunity for a top to bottom review and potential reinvention of the organization. That opportunity has a spark to it and sparks like that do not last long. I've heard an outpouring of support for what we've unveiled and we need to show action. People who support NAHC like the concept of reinventing NAHC but you have to act earlier rather than later when you have the high energy and interest to participate now. You can't disappoint people by weeks of inaction.
HCTR: What about your lobbying efforts? We have written about you already working with [CMS Administrator] Seema Verma. (See Pre-Claim Review Shut Down - For Now, HCTR, 4/5/2017). Now you are the primary association liaison not only to CMS but to HHS Secretary Tom Price and to MedPAC as well. Do you see any changes coming on the legislation and regulatory front?
Dombi: Secretary Price said all the things we would want to hear during his confirmation hearings. The support we've seen from the secretary's office with regard to CMS has been heartening as well. As always with regulators, the tests of whether they are where we want them to be are periodic and situational and this is going to be the case with Secretary Price. Obviously, we did not like what came with the proposed rule [for 2018], and Sec Price and Seema Verma both signed off on that, likely without having a full understanding of its potential impact. Now we are going to Price and saying, "Would you like to learn more about it? We would certainly like to talk to you."
So, back to your question, I can probably give you a better answer after that talk. Secretary Price generation one -- which included his confirmation hearings and suspending Pre-Claim Review -- was a positive experience. Price era two is where we're at now and we have yet to find out where he'll be. We were, frankly, surprised a bit at the direction that came out in this proposed regulation. At the moment, we're giving them the benefit of the doubt that they didn't fully understand its impact before they signed off on it.
HCTR: I have to ask one final question. In the event the 2.0 planning process does wind up designing the new President's job so that it fits you, are you up for putting off retirement for five to ten years?
Dombi: Ultimately, that's for two parties to decide, me and the Board. I've already told them the best I could guarantee them is five years. I have other plans for my life after that, which is a good thing for NAHC, that they're not saddled with any one person for ten years. It allows for somebody to create something, create that new NAHC, with a solid foundation to build on thereafter. So, whether I'm interested and whether the Board is interested remains to be seen after the strategic planning is finished and we know what kind of leader will be needed. Still, even if I'm interested and they are interested, I would be staying for three to five years, not for ten. If the country can survive changing Presidents every four to eight years, I'm sure it's a good thing for NAHC to do too.
©2017 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. firstname.lastname@example.org