Episode 2: Katie Morgan

Did you know one chance encounter led to the creation of a nonprofit organization changing lives in Southern Indiana?

We're joined today by Katie Morgan, Founder & Executive Director of Vulnerable Adult Care Advocates (VACA).

Katie discusses the inception of VACA and the vital role of guardians in supporting vulnerable adults (00:00-03:00). She shares her journey from not knowing about guardianship to founding and scaling a nonprofit dedicated to elder care (03:01-08:00). Learn about the challenges of managing a volunteer workforce and operating at scale (08:01-13:00), and the future goals of VACA, including expanding services and increasing awareness (13:01-18:00). Visit vulnerablecare.org to learn more about volunteering with VACA.

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Transcript

Ariadne: Welcome to CareCraft. We're a podcast that explores the heart and science behind care management. And today we're super excited to have Katie Morgan with us. Who's the founder and executive director of Vulnerable Adult Care Advocates, VACA, a nonprofit providing guardianship and patient advocacy services in Southern Indiana.

She's also a regional champion of the Indiana Geriatric Society. So Katie, thank you so much for joining us today. First off, you know, a lot of our podcast talks about care management, but there's so many different titles that care managers have, you know, there's patient advocates, patient navigators, care coordinators, care coaches, et cetera would love your perspective on what you see as the differences in a care manager versus a guardian versus a patient advocate in your organization.

Katie: Well, thanks so much for having me. I appreciate you having given me this opportunity to talk with you. There are quite a few differences but they all need to work in conjunction with one another. A care manager really doesn't have any kind of [00:01:00] legal authority to make certain decisions, whereas a guardian is the one that does the decision making for the incapacitated person because they no longer have the cognitive ability to understand.

Ariadne: That makes perfect sense. And I'm curious, you founded this organization I believe back in 2021, what led to that founding and what need did you see in the community that got you excited to do this?

Katie: Yeah, it was definitely a journey. Not something that was on my radar in any way, shape or form. we actually incorporated in February of 2020. So we didn't become fully functional until 2021 for obvious reasons.

My husband actually is a paralegal for an elder law attorney and she approached me one day. I have three special needs children. And she said that she had noticed. And she had this unique case where this lady was in need of a guardian, but her family just was not able to do that [00:02:00] for her.

So she asked if I'd be willing. I believe my response was what the hell is a guardian and why do I want to do that for a perfect stranger? But she kind of explained to me that it really is more about advocacy and protection for people that can't do it for themselves. And I was like, well, it is kind of what I've been doing for my kids.

So I'll give it a shot. So that turned into within six months having four clients. And I was like, I had no idea. that that was such a need. I just always assumed the family members took care of it and I didn't realize that there were so many people that just either have been separated from their families or just their family members really are exploiting them or different things.

So I ended up going to the National Guardianships Association's national conference because it happened to be about an hour away from my house that year. And that's where I learned that there was a huge need and that there was no state appointed guardianship in the state of Indiana.

[00:03:00] So they leave it up to individual counties and they will do a grant program. So that's when I started thinking, well, you know, the people that Need this the most can't afford normal guardianship services fees. So that's when I had the idea of like, well, if we start up as a nonprofit, then we can get grant money and maybe some community donations to help supplement the costs associated with the, or the time management and the going to doctor's appointments, the making sure that we're handling their financial affairs correctly, things of that nature.

So that's kind of how the whole thing got started. It was really strange cause I had never done anything like this before, especially starting a nonprofit. So definitely a learning curve.

Ariadne: Oh, wow. Well, so it really sounds like you started and kind of learned how to be a guardian with, small set of clients and then, you know, have grown the organization to support much more than that.

I [00:04:00] guess what was your early days of like being a guardian directly like and how did you find that experience?

Katie: Well, it was very challenging at first. Cause I was not used to the amount of record keeping I had to keep up with. But once I figured that out and got a system in place to every time I have a phone call, I need to document it.

Every time I send out a check, I know I need to take a picture and I have it documented in a spreadsheet, things of that nature, it definitely became a lot easier. It was a little more commonplace for me, but definitely at first it was just like, what do you mean? Why should I have to do that? I've never had to do that before.

Ariadne: Yeah. And now your organization has how many individuals are you supporting and how many individuals are on your staff?

Katie: We are up to 38 individuals in five different counties. We started with four in one county. So definitely proud of the growth we've made. And I only have really a staff of myself and an assistant.

But we [00:05:00] use volunteers a lot because we're set up a lot like the CASA model for children. We use , our volunteer advocates as our eyes and ears. So basically a person will get an assigned. Individual and we'll meet with them once a month or once a week for roughly a half an hour at a time.

Obviously, life happens. So if they skip a week, just make it up by doing an hour the next time you're there. And that way they can provide a little bit of companionship, which I think during the pandemic, we all realize is desperately needed and. That way they can also kind of check in. They could be like, Hey, I'm seeing a little bit of weight loss or they're losing their appetite or grumpy or things like that.

So that, that way I know to look into those issues for just to make sure their healthcare situation is better.

Ariadne: Got it. So how it sounds like you have volunteers are doing more of that companionship and interacting with them on a daily basis, and then you're still providing some of the oversight for the guardian.[00:06:00]

Katie: Yes, yes, I go and visit with each individual once a month to ensure that my volunteers are actually doing what they say they're doing. And that way I can also lay my eyes on them and talk to them and see if I see any declines that have taken place. And, you know, also just, it's good to just check up on their environment, making sure that, you know, I'm not saying nursing homes are all bad, but just making sure that they are not being overlooked in any way.

Ariadne: How have you enjoyed, I'm sure the challenges have changed since you were, you know, first getting started yourself to now running an actual organization and overseeing volunteer staff and, and a much larger kind of portfolio of clients? How is that? Been for you and navigating all those changes.

Katie: Interesting. It's actually not too terrible at this point. I know that at first my main problem was really with funding and getting our name out there so people know about us. Now my main challenge is keeping up with the amount of volunteers [00:07:00] needed so that I don't have to waitlist anybody.

Ariadne: How did you get your name out there in the beginning? How has that changed?

Katie: A lot of marketing, tons and tons of marketing. I went to just about every networking group I could think of. Like I said, luckily my husband was already kind of in the field with being a paralegal for elder law. So he was able to talk to people and say, hey, did you realize there's a service out there?

Because especially when he would have people come in. Basically talking about something, needing something like a guardianship, of course they would refer to it as a POA because that's what a lot of laymen think of. They would say, well, I want a POA, but you know, it's, you know, grandma or grandpa really is not cognizant enough to sign a POA.

And that's when he's like, okay, we cannot allow you to do that. That's against the law, but here are your alternatives. You can do this, or if you want, you can use this service that will do it for. You know, a maximum, especially for our Medicaid patients, our [00:08:00] maximum is 35 a month is what we charge. Yeah.

So a lot of people think that's a lot better than paying, you know, thousands of dollars in attorney fees.

Ariadne: I can imagine. And also hopefully a lot better for the individual themselves and having that advocate there and to, to help make those healthcare decisions, especially and what about your kind of volunteers?

What has that experience been like finding individuals, you know, that can handle this work that enjoy this work that are, you know, actually good at. Working with these individuals.

Katie: It's been challenging, but I try to make it as easy on my volunteers as I can. I really want them to be more on a friend level.

So I want them to get bonded with their person and kind of. I feel like, okay, I want to be here to stand up for them. So they don't necessarily make the decisions. They're not going to be the decision maker, but they can come to me and make their recommendations so that I can get a [00:09:00] better understanding.

But that way they don't feel like, you know, not everybody is going to be able to say, okay, it's time to call in hospice. And that's an extremely difficult. Decision to make, especially when you have grown attached to someone. So I like to kind of be able to separate them a little bit from that while at the same time, kind of separating myself, because that way I can make that objective opinion without feeling overly protective and overly cautious over my individuals.

That's why the volunteers work out wonderfully for the companionship side.

Ariadne: And how have you found just keeping track of everything? I think you were saying you're doing a lot of Excel when you're first getting started and understanding the documentation. Is that still the case today?

Have you moved to systems?

Katie: Yeah, I have discovered I actually use two different software systems. I use care tree a lot because that seems that's What is really good [00:10:00] for my volunteers, it's very user friendly and they can just use it on their cell phones to take their notes real quick and time, the amount of time that they're there works out splendidly for that.

When it comes to more of the documentation and things that I need on the back end, it's SEM software. And yeah, it's great. It's just, it's much more of a data driven software. And a lot of people that just aren't tech savvy find it harder to use. So that's what I use to keep everything separated.

And keep up with financial documents so that way, you know, because that's another thing. I do not let the volunteers handle the finances. That's just too much of a liability and, you know, again, it's not really fair if somebody's volunteering their time to expect them to put that much effort into keeping up with bills, somebody else's bills all the time.

Ariadne: How would you say the work that you're doing with these clients is divided? Is it? Mostly [00:11:00] companionship or like, you know, health care navigation or finances and other kind of social determinants of health that you're you're helping fill for them.

Katie: Honestly, it's a little bit of all of it.

I think the companionship is a pretty huge part because isolation really can be deadly. But that that's where the volunteers come into play when me, I'm the one that will do the health care navigation. more of the advocacy with calling around, finding the specific specialists that I think will help and benefit them the most.

And like I said, I'm the one that handles the financials so that we can get everything taken care of. And, you know, the financial piece isn't. As big of a deal, because we do deal with people that just don't really have money. So it's very little amounts that I actually have to worry about. And most of the time we've had to, or I shouldn't say most of the time, but there have been several clients that I've had to work with.

After they just were no longer allowed to [00:12:00] be in their house because of, you know. Health care problems. I had to go in and sell their house and make sure that their care is taken care of and paid for for a certain amount of time. And so that that's. I guess I'm more of the utilitary role, while my volunteers are more of the friends.

Ariadne: And I noticed on your guys's website you definitely have a lot of partnerships with different organizations and the community and, and can you tell me more about that and kind of, you know, establishing yourself as an organization and, and building that network?

Katie: Yeah. Well, some of them that we are partnered with on there obviously are people that are not people, but organizations that have financially donated to make sure that we are able to stay funded and able to continue doing what we do. The grant makers, things like that. Also then there's a few on there that are death do list so that we can try to help in that end of life stage [00:13:00] to just.

Make the transition as peaceful as possible. Again, it's like hospice providers. I think we've got some psych doctors just geriatric doctors, things of that nature. We all just kind of have to work together because it, it, you know, it's funny everybody talks about it takes a village to raise a child.

It really kind of does to help the elderly as well.

Ariadne: Yeah, that's awesome. What advice would you give others if they were interested in, in getting started in the space or, you know, opening their own nonprofit?

Katie: Just take a breath. It's so, you get so overwhelmed at first that It's scary, but you know, you can do it.

You could just keep trudging through. It'll be all right. And you need to understand that you're just trying to make the best decisions you possibly can with the information you're given. So don't second guess yourself.

Ariadne: That's awesome advice. It's there like [00:14:00] experiences that you've had directly that come to mind and.

And that you think could have taken your own advice.

Katie: Well, there's a few, so one, for instance one of my clients. 72 year old woman has been schizophrenic her entire life, which is now evolved into dementia, but she still has a lot of the paranoid behaviors.

She had actually fallen and broken her hip and did not believe that those x rays were hers. She knew that she was in pain. She knew that her hip hurt, but As far as she was concerned, she did not break her hip. The doctors were lying to her and she was refusing the necessary surgery because if she didn't have the surgery, especially at her age, they would cause blood clots and possible death.

Luckily because we were her guardian already, I was able to step in and say, no, no, this, this needs to take place. She's not in her right mind to make that decision. Unfortunately, with that situation, I was [00:15:00] dealing with a person that I don't think fully understood what guardianship meant. So the doctor was kind of telling me like, Oh, no, no the patient's refusing, I can't do this.

And I had to kind of escalate the situation up through the hospital so that they could understand that, No, you need to listen to me and I'm the one that can see you, not her. Well, we were able to get the surgery and she, she was doing great.

Ariadne: I'm glad that worked out. Is that a common situation you've encountered where, you know, a lot of medical personnel don't really understand guardianship and what's involved?

Katie: I wouldn't say it's common, but it does happen which is interesting because you would think that's something they should definitely know. But it, it doesn't take me very long anymore to be able to Kind of explain like this is the way it is. I understand what you're saying. And yes, the patient rights.

I understand that. But if they're unable to comprehend what you're telling them, then the [00:16:00] patient rights fall to me, not them at this point. And if there's a necessary medication or so, so on and so forth, they need to basically leave it to who's considered the legal decision maker.

Ariadne: Yeah. Is that something you've seen in, in like the community and, and some of the clients you've worked with as well?

 Yeah, because most people don't really seem to know how much about guardianship other than like the free Brittany movement. Which is not great.

Ariadne: Not the spokesperson you expected.

Katie: Right. Or that movie I care a lot.

I mean, it's just kind of painted Guardians in a very negative light, but the majority of us aren't predators like that. I understand that that is more of a sensationalized movie and it's good for movie purposes and everything, but the majority of us actually do want to watch it. help these people and that's why we're in it the way we are.

Like I said, I mean, I got into it because I was a mother of special needs children. So I, [00:17:00] I just realized that I have, my children kind of taught me how to do this job. And I have a unique set of skills where I'm able to help these people. And that's just really important to me.

Ariadne: Have you had a client since you've opened basically that are still with your organization?

Katie: I have actually the very first client that I was referring to before I even started the organization is still with me and still under my care. And she's doing fabulously. We've had to move her from a couple of locations, but you know, so we've had our challenges along the way, but she's still, she's lively as ever and doing great.

Ariadne: That's awesome. And you said the maximum someone would pay is like 35 a month, how are you able to keep the cost low and keep it, you know, kind of free for a lot of these individuals?

Katie: Grants a whole lot of grant writing goes into this job, but [00:18:00] that it's okay, though, because I think when I write the grants and everything they I'm able to convey just. how strong of a need this really is. And it's got to continue to get stronger based on just the aging population. We, we've got a lot of baby boomers that are now getting older and older.

And, you know, people don't realize that I've, I mean, I've had clients that are just in their forties or fifties that have vascular dementia already due to drug use or heavy alcohol use. So it's, it's not necessarily just a problem for people in their 80s and beyond. So that, that's, I think, kind of getting that piece out to where people understand that this spans across several different Decades and generations, they start to understand.

Oh, this is really a huge need. And there are a lot of people that could have this. I mean, because we've dealt with people that have traumatic brain injuries again, you know, just mental [00:19:00] illness and they're unable, you know, we have a few that are middle aged that just have mental illness and just can't make.

Decisions because they just don't understand what it is. They're talking about. I'm trying to think we kind of we take everybody across the spectrum. Really? We've had we actually have some adults that are just you know, developmentally delayed and have been their whole life. And so now their parents have passed and they don't have anybody to take care of them anymore.

So we do it.

Ariadne: Have you found a need to like specialize at all? Or is it kind of whatever referrals come your way? You, you know, try to find the resources, figure out how you can help that particular individual. Well, we

Katie: have an intake panel that meets once a month, so I will collect all the referrals and then we discuss it at the intake panel and just go through.

Trying to figure out, is this someone that we can really help? And if not, what resources can we point them in the direction of so that then we're not just turning them away. We [00:20:00] think that that's a vital piece that, you know, we don't want anybody to feel like we're just like, no, we're not doing it and leave them hanging.

So we try to find something, some alternative for them, if at all possible, because some of they are you know, mentally ill patients. Sometimes they're just beyond our scope of care and just, we wouldn't, we don't feel that we would be able to benefit them that's where we try to use other wraparound services like we have the Lifespring organization here in Southern Indiana that helps with a lot of mental health things.

So we can refer them to them and that way they're still able to get the help and care that they need.

Ariadne: How do you see or how do you hope your organization grows in the future?

Katie: Well, right now I'm just kind of happy that it's stable.

But no, I mean, I would love to see it grow. I'd like to get a lot more volunteers involved, which means I'll get more clients [00:21:00] and hopefully be able to get find some more grant money and be able to pay for some staff to really start doing more. case management and data processing so that I can kind of be out there visiting more and making sure everybody's well taken care of.

Ariadne: That's awesome. What role do you see those case managers playing in your team? That isn't there today.

Katie: That's a good question. I would like to see them kind of be more on the lines of keeping up with, like, they have a certain amount of individuals. There's a Supposed to take care of and then they can manage more of the volunteers, make sure that the volunteers are actually going and filling out their processes of the way they're supposed to things like that so that we get everything into our systems.

So it's all organized and it's easy to find and run the reports.

Ariadne: And those are the reports that you have to document to the courts [00:22:00] or which reports?

Katie: Yeah, at least every other year we have to document how all the finances have been spent and have everything laid out specifically a lot of, a lot of ledgers.

We have to, you know, tell the court what the status of the person is, if they're better, if they're worse. what we need to do what their care plan is if they've moved locations, which usually the court already knows because we usually go and talk to the court and ask for a court order prior to, so that that way we, you know, we're on the up and up.

We try to make sure that everything is very well documented so nobody can, we don't want to give the impression of any impropriety.

Ariadne: Yeah, that makes perfect sense in this context. And I know you were talking a little bit about just how the need you see in society is really growing with baby boomers aging and just the kind of unmet need there.

How do you see that trending in the future? [00:23:00] And what do you hope to see kind of come out either through government programs or other types of community organizations?

Katie: Well, yeah, I'm hoping that because I know that it's been. It's not just me bringing it up with the aging population, it's been brought up a lot on the news, and I'm hoping that the awareness out there can spur more momentum toward these kinds of services with, you know, as you said, maybe more government spending or more people, more philanthropy groups based toward the elderly, because the elderly population really gets overlooked a lot of times, and and I get it.

It's not, it's not the most glamorous situation, but there is a huge need. And I'm glad that people are starting to understand that. So I'm hoping that we're able to find more people willing to come in and start. Trying to help fund programs such as mine.

Ariadne: Well, I hope so too. [00:24:00] And I know you are a regional champion of the Indiana Geriatric Society.

So can you tell me more about what you do with them? Yeah,

Katie: okay. So the Indiana Geriatric Society is like a branch of the American Geriatric Society. So it is a group of, you know, geriatricians or any kind of doctors or nurses. or anybody really in the medical field that deals with elder care. So really it's just with being a regional champion, it's really more of the, just in the adjacent counties, everybody getting together and just having meetings so we can network, we can know what other services are provided by who, and so we know where to.

Send our people when we need to and just learning really where a best practices, especially when things are constantly being updated, especially in the medical field at a very quick pace, we're able to stay up to date. So we're giving our patients the best level of care.

Ariadne: [00:25:00] I don't doubt it. I mean 38 individuals is a lot. If there are volunteers or individuals that want to connect with you. What would you say is the best way to get in touch?

Katie: Best way to get in touch really is through my website, vulnerablecare. org. We have an area where you can make a referral. We have an area where you can sign up or do the volunteer application.

And also it's Got my email and my phone number right there. So you can find out everything you need to know right in that one spot.

Ariadne: I hope that, you know, more volunteers come and I hope your organization continues to grow. So thank you so much for the time today.

It was great learning about everything you've been able to accomplish.

Katie: Well, thank you so much for having me.