Sierra Community Palliative Care is partnering with Mettle Health to help patients and families navigate potentially life-changing health care decisions.

Sierra is the palliative care arm of California-based Hospice of the Foothills, designed to care for nonterminal patients who have serious or chronic conditions. It seeks to aid with symptom management, prevent unnecessary ER visits, relieve primary care doctors from dealing with high-level pain and give patients the opportunity to voice their goals for care.

Sierra’s parent organization, the nonprofit Hospice of the Foothills, had previously collaborated with Mettle on a conference held last year. Deeping their partnership seemed like a natural next step, according to Mettle Health COO Sonya Dolan.

‘We wanted to give those people more of a runway to have bigger conversations, with also the understanding that we’re going to be in a place to talk about hospice care with them as well. So their program is not just a palliative care program, it’s meant to also kind of continue that care,” Dolan told Palliative Care News. “We want to also be the team that talks to the person about what hospice care is and helps them understand it before they get there, because there are absolutely misconceptions and ideas around what hospice is and what it isn’t that I think stops people from accessing it.”

Mettle Health took root in 2020 when hospice and palliative care physician B.J. Miller co-founded the for-profit company with Dolan, an artist and hospice manager at the time. Miller serves as president and counselor at Mettle Health. They launched the company using personal funds, as well as a loan from a social venture foundation.

They established Mettle to provide a unique model of patient and caregiver support — counseling by interdisciplinary palliative care clinicians. This includes one-on-one counseling sessions with staff, interdisciplinary team counseling sessions, group support and monthly family meetings, advance care planning services, end-of-life care assistance and research and resource coordination.

Mettle’s services are designed to cover gaps in the health care system and guide patients and families through health care crises. In addition, families can apply for limited grants that they could not otherwise access that allow for collaboration with multiple providers to address particular needs of families.

The program with Sierra could be a springboard for Mettle to pursue similar partnerships with other providers.

“It seems to me that this would also be something that other hospices may need. Hospices are starting their own palliative care teams to have connections with people before they’re appropriate for hospice,” Dolan said. “My hope is that we can be seen as a resource for other hospices who might be trying to do the same thing and provide an additional layer of support to both the people that they’re serving in the palliative care program and to the connected hospice.”

Sierra has also been working to develop additional partnerships to grow its program and better support patients. A collaborative approach that involves local providers is fundamental to Sierra’s model, according to Executive Director Viv Tipton.

This includes a collaboration with the health system Dignity Health to expand palliative care in their markets. The program is supported in part by a $94,000 grant to Sierra from the health system.

“As challenging as it is to bring people together, take the time to do so, identify needs, discuss with stakeholders, talk to the county, and get community buy-in,” Tipton told Palliative Care News. “It’s awesome to find you’re not alone when out on that limb.”