Get to Know Deborah Wolff-Baker, MSN ACHPN FNP-BC GS-C
Developed and directs a Home Based Palliative and Primary Care Practice in Sonoma County, California
Member, Gerontological Advanced Practice Nurses Association (GAPNA)
Chairperson, Special Interest Group (SIG) on House Calls (GAPNA-National)
Co-Chair, National Health Affairs Committee (GAPNA-National)
Chapter President, GAPNA-State Chapter
Board Member, California Association for Long Term Care Medicine (CALTCM)
Ms. Wolff-Baker is passionate about advancing Home Based Primary Care and the role of Nurse Practitioners, as well as relieving barriers that prevent access to high quality, coordinated, patient-centered care and the Scope of Practice issues and barriers in general that make it difficult for Nurse Practitioners to provide it. She has developed and runs a busy Home Based Palliative and Primary Care Practice serving Older Adults in Sonoma County, California through an Independent Practice Association, Northern California Medical Associates. She is an active member of the Gerontological Advanced Practice Nurses Association (GAPNA), holding positions of leadership in both the National organization as Chairperson of the Special Interest Group (SIG) on House Calls and as Co-Chair of the National Health Affairs Committee, and in her State Chapter serving two terms as Chapter President. She is a Board Member of the California Association for Long Term Care Medicine (CALTCM), which is California’s Chapter of PALTC / AMDA.
She was a member of GAPNA’s consensus roundtable developing 12 Proficiency Statements representing the specialty of Advanced Practice Gerontological Nursing, and an item writer for the National APRN exam for specialty Certification in Gerontology. She is frequently invited to speak to APRN groups regarding the field of Home Based Primary Care, Transitional Care, and Chronic Disease Management – the nuts and bolts, challenges and opportunities. She was published in the June Journal of Gerontological Nursing on “The Expanding Role of Nurse Practitioners in Home Based Primary Care: Opportunities and Challenges”.
Deborah joined the AAHCM board in late 2018.
We recently spoke with Ms. Wolff-Baker about her experiences.
How did you become involved with the field of home care medicine?
As an RN for over 35 years, I spent more than 25 of those years working with homebound older adults through a Medicare Certified Home Health Agency. As an RN case manager I visited Agency patients in their homes and saw first-hand the challenges these homebound older adults and their families encountered upon returning home after a hospitalization. Many of these patients received care that did not always reflect their care preferences. They frequently had difficulty understanding their medication regimens and how to manage their own care. They often had mobility issues, cognitive issues or other areas of functional decline that left them unable to navigate their convalescence and the healthcare system in general. Their living conditions and social supports were often less than optimal and many of them lacked the ability to get into an office setting to see their primary care provider. I knew as an RN I made a difference, but I also felt that as a Nurse Practitioner, I would be able to change the way these patients received care by helping to develop models that allowed them to stay in their own homes surrounded by their family in familiar surroundings, receiving care that reflects their personal choices, values and preferences. I went back to graduate school in 2006 to become a Nurse Practitioner with that goal in mind, and tailored both my research and Practice to that end. I have a passion for providing longitudinal care that develops a unique relationship and serves patients over time in their setting of choice while allowing them the dignity of aging in place.
How has working in this field impacted your practice? What keeps you in the field?
My workday is busy, but I am filled with the knowledge that by making House Calls I am providing a service that is desperately needed for patients who are frail and would not be receiving this type of care otherwise. Family and caregiver burden is often lifted by the Home Based Primary Care (HBPC) services, resources and referrals I provide. As a Nurse Practitioner, my life is one of service and remaining true to my own values of providing care that makes a difference. HBPC does just that! Every patient I see reminds me daily of how well aligned my personal values are with the care I provide.
Why AAHCM? What drives your involvement?
AAHCM is the premier organization in the country to promote, grow and value HBPC. Since its formation, AAHCM leadership has been topnotch and has brought forth a platform that brings the issues of healthcare for the homebound population to the forefront of national conversation and policy. The organization has advocated for enhanced reimbursement structures and team-based care that has set the standards for HBPC. The Annual Meeting always gives great information, a boost of energy and enthusiasm to another year of practice.
How did you start? What advice can you offer to a person considering volunteering with AAHCM?
While doing a literature search for my post-graduate research classes, I came across the AAHCM website and its wealth of information as well as the published “How-to” manual entitled: Home Care Medicine – A Field Guide to Developing Successful Practices and Programs and the Frontiers Newsletter. These publications were a wealth of information and sparked my curiosity to join an Annual Meeting that was being held as a pre-conference to the AGS Annual Meeting I was attending. I met so many other passionate HBPC providers there I felt I had “come home”. From then on, I have worked to build relationships between GAPNA and AAHCM. As the Chairperson of the GAPNA House Calls SIG in those early years, I felt that it was important to make the most of volunteer resources and the combined knowledge of like-minded organizations serving homebound populations.
If you are passionate about HBPC and keeping this field growing while relieving the barriers to adequate reimbursement and access to care, become a member and volunteer with any committee; sharing your expertise and your stories are incredibly important to expanding our field and its best practices. Nurse Practitioners will find a home here as they work on issues such as the Home Health Planning and Improvement Act to allow NPs to sign for and certify Medicare Home Health patient services as well as other Scope of Practice issues. According to HCCI’s Moran Data in 2019, Nurse Practitioners are the largest segment of professionals providing HBPC services. As NPs continue to grow in numbers of providers as well as visits, it is important that we are well grounded in the knowledge and team-based principles needed to provide the high quality, coordinated, patient-centered care our patients need and know how to bill for and receive maximum compensation / reimbursement for our efforts. AAHCM will advocate for and teach you just that!
To learn more about getting involved with the AAHCM, please email us at email@example.com.