Gift of Life Program

Gift of Life -

Prospective Patients

To find out if you or somebody you know may be eligible as a patient with Gift of Life, please look at the requirements below:

Patient Selection Checklist

1.  Completed medical/immunization records, x-rays, recent CBC Aids test, TB test, chest x-ray, additional tests if needed

Accompanying guardian must also have TB, HIV, same tests as patient to ensure they are not going to travel with any contagious diseases.

2.  Special Power of Attorney Authorization for Medical Treatment

3.  Patient profile for committee, medical and potential host family - gives background of child and his/her condition

4.  GOL to submit report to district along with funding request

5.  Once child accepted, Chairman requests letters of invitation from GOL Board, Pardee Hospital, and Medical Director or doctor performing surgery

6.  GOL Chairman should be keeping Master Directory, including all names, titles, addresses, phone numbers, e-mails and service performed for anyone involved in any manner with patient

7.  GOL Committee coordinates travel arrangements with Childspring International, International GOL, Angel Flight, Rotary Clubs, Helping Hands, etc

8.  Help find a Rotary Club or other local agency close to patient’s home for assistance with Medical Visa, transportation to and from hospital, follow-up care, etc.

Procedure Outline

1. Patient Selection

a.  Medical Director identifies the patient, determines timing, and travel schedule.

b.  Medical Director requests from the attending physician verification that both the child and accompanying guardian have been tested for communicable diseases, and are both healthy and capable of making the trip. In addition a Special Power of Attorney and Authorization for Medical Treatment, signed by the parent or legal guardian must be returned along with a personal profile prior to final acceptance by the Gift of Life Committee, and before the following verification and invitation letters are sent:

•  A letter from the hosting Rotary Club.

•  A letter from the physician performing the Procedure.

•  A letter from the hospital, Margaret R. Pardee Memorial Hospital

The 3 above letters are needed to acquire the visa, airline and necessary transportation documents.

 Gift of Life (GOL) Committee /Chairperson of the Rotary Clubs (CLUB INVOLVEMENT)

a.  Coordinate welcoming /arrival of GOL patient (and/or guardian)(Medical Director, District Rep, GOL Chair, Translator etc.)

b.  Coordinate arrival with necessary host families, translators.

c.  Upon arrival at host family – Visa and important and pertaining documents are given to GOL Chairperson who keeps it (safe deposit box) until patient and guardian return home.

d.  Host family coordinator works with host family to determine if any clothing or other necessities are needed. All necessities will be funded, and reimbursed to the purchaser when requested.

e.  Host Family Coordinator works with the Translator Coordinator and or Translator to help host families with scheduling, of:

•  Pre-surgical testing and office visits.

•  Director provides regular updates of patient/guardian with host family. (Communicating which host family patient/guardian are staying with along with updates of progress.)

•  Coordinates with Medical Director, GOL Chairperson, GOL Committee.

f.  GOL Chairperson:

•  Responsible for overseeing regular communications with board and International Services A Director.

•  Responsible for communications with respective organization who facilitated finding child/guardian.

•  Responsible for coordinating with hospital on PR.

•  Assisting Medical Director and District Regional Representative as needed.

Community Support

•  Public Relations

•  Hospital Coordination

•  Other Rotary Club Involvement

•  Pharmacy

• Host families

• Transportation

• Contributions (Gift Certificates etc) from businesses

• Fund Raising

Host Family Info

1.  Provide room & board for Gift of Life patient & chaperone. In some instances, certain foods are needed for the patient & chaperone. This information will be provided to the host family in advance as needed when information becomes available.

2.  Provide transportation to and from appointments. If assistance is needed, complimentary transportation arrangements have been made available through the local Cab company.

3.  Provide limited communication to their family back home in terms to telephone calls, letters, or e-mail if available. Please limit the amount of time spent on the telephone as this could substantially add up. Daily calls are not necessary. Short calls up to 10 minutes once a week or every other week would work. However this is left up to the host family’s discretion.

4.  Provide a warm and welcoming environment for guests.

5.  Duration of stay varies with each patient. Typically, reconstructive patients require a stay of approximately 4-6 months. If host family is not comfortable with this length of time, please let our Patient Coordinator know in advance so that other arrangements can be made. Other procedures require less time. If host family would like to know approximate length of stay, contact the Patient Coordinator for details.

6.  Pharmacy and other medical supplies as needed are provided to patients and chaperone compliments of local Pharmacy.

7.  Should other medical needs arise such as dental work, glasses, etc. the host family needs to notify Patient Coordinator as other medical professionals who volunteer their time and services can be called as needed. If no medical professional is available, the Gift of Life Board will need to address such needed services to provide the needed care.

8.  If host family needs to travel and are unable to bring patient & chaperone, please contact Patient Coordinator in advance if possible so that other arrangements can be made.

9.  Host family will receive help from community/Rotarians to take patient & chaperone out periodically.

10.  Patient & chaperone will be provided with all necessary toiletries, clothing and whatever is needed. This will be provided by the Gift of Life Program. If the host family would also like to purchase additional items for the patient & chaperone, that is up to the host family. Otherwise, the Gift of Life Program also absorbs this expense. All patients arrive here with very little in terms of clothing and other necessities. Patient Coordinator makes arrangements for procuring the necessary clothing, toiletries etc. that are needed by both patient and chaperone.

11.  Host family needs to keep Patient Coordinator informed about appointments and other activities so that all people involved in the patient are kept informed of the patient’s progress during their stay here.

12.  Gift Certificates from local restaurants, complimentary tickets to the Arts Center, Movie Passes etc. are acquired by Gift of Life Board members to give to the host family to help with some of the food and entertainment expenses as much as possible.