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A three-week hearing begins today in Tallahassee to resolve an issue that’s gone on for years regarding a second hospice organization getting a license to offer outpatient services in Collier County.

This time, there’s a new twist — Hospice of Naples will support a Miami-based company over Hope of Southwest Florida.

“If another hospice is needed in Collier County, we would support VITAS over Hope, and we decided that after careful review of what VITAS said they would offer and what other service areas validate what they do,” said Karen Rollins, executive director of Hospice of Naples.

That decision by Hospice of Naples, which has been the only hospice organization in Collier, pits Hope of Southwest Florida against the for-profit VITAS, based in Miami. Hope operates Hope Hospice in Lee County and has programs elsewhere in the region, except in Collier.

VITAS may have the upper hand in the hearing before an administrative law judge because it gained preliminary approval for a Collier license from the state Agency for Healthcare Administration in February.

Hope officials, who petitioned for the hearing to contest the state’s decision, aim to overturn it and gain the license.

Other hospice organizations that applied for the Collier license have dropped plans to be a party in the administrative hearing. They were Evercare Hospice, a division of United Healthcare in Minneapolis; HCR Manor Care Services of Florida, a Toledo-based company that has two nursing homes in Collier, and Odyssey Healthcare, a Dallas company.

Hope applied three times before for a Collier license but in those cases the state had said there was no need for a second hospice provider and Hope couldn’t convince the state otherwise.

“My sense is they dropped out because they sensed that Hope is a superior applicant,” said Samira Beckwith, executive director of Hope. “VITAS did get preliminary approval but we uncovered some reasons, we believe, why that might have happened, some misunderstandings.”

Beckwith said the administrative hearing starts over from scratch, so it doesn’t matter who received the state’s preliminary approval.

At issue is outpatient care only, where hospice nurses, social workers and counselors offer a variety of comfort care to the terminally ill in their homes, nursing homes or elsewhere. The state is not considering granting a license for a residential hospice program.

The decision by Hospice of Naples’ board of directors to support VITAS was made this summer, Rollins said. That followed a decision this past spring not to file an appeal in the 2nd District Court of Appeal in Lakeland to fight the state’s decision that a second hospice provider is needed in Collier to serve an unmet need.

“Yes, we dropped that, mainly because we felt like it was better to focus our resources on reviewing the applications and trying to make sure we participate fully in this (hearing) process,” Rollins said. “We want to make sure the next hospice that comes in offers complementary services to ours.”

After reviewing the detailed applications that were submitted last fall to the state by VITAS and Hope, the Naples hospice directors decided VITAS’ services would complement what they offer, she said.

“A lot of the services that Hope offers is not much different than what Hospice of Naples offers,” she said.

For instance, VITAS has a program tailored to the Jewish community and having a 20-year presence in Miami-Dade may be good for this region, she said.

The for-profit VITAS has been in the hospice business since 1978 and today operates 44 programs in 16 states. The company has numerous hospice programs in Florida but Collier would be the first location in Southwest Florida. VITAS has applied for a license in Hillsborough. The state hasn’t issued a decision yet in that certificate-of-need cycle.

In its Collier application and as a condition of a license, VITAS pledged to make a $20,000 charitable donation to Hospice of Naples.

“It’s not going to be accepted,” Rollins said. “We made the suggestion they consider offering that to another charitable organization in Collier County of their choosing. The board of directors decided it did not feel it was appropriate. We have a responsibility to the whole community that funds received is of the highest integrity. We would not want to do anything to make (the community) wonder in any way, so it won’t be accepted and VITAS knows that.”

Beckwith, Hope’s executive director, said Hospice of Naples officials may believe that VITAS, as a for-profit company, wouldn’t seek donations from the community. But that doesn’t dovetail with a foundation that VITAS operates and how donation envelopes are made available to families, she said.

“We uncovered that they have a large foundation of their own but tell people they are for-profit and can’t accept donations,” Beckwith said. “If Hospice of Naples thinks that, it is not based in reality.”

Deirdre Lawe, executive vice president of development and public affairs for VITAS in Miami, said her company does have a foundation but doesn’t do large fundraisers. Last year, the foundation raised about $1 million compared with Hope Hospice raising $4 million or more in the community.

“Our donations are primarily from families and memorial gifts,” Lawe said.

The $20,000 donation to the Naples hospice was intended to convey that VITAS wants to work with the Naples organization and not be competitors, Lawe said.

VITAS wouldn’t try to prevent Hospice of Naples from growing, she said.

Another service that the Naples hospice isn’t involved in extensively is 24-hour care in the home of a client who needs acute intervention, such as frequent medication dosing changes, Lawe said.

“We will provide that level of care from the beginning” she said.

She said VITAS would contract with the local hospitals for when clients need inpatient care, adding that officials at Physicians Regional Medical Center at Pine Ridge Road and Collier Boulevard are receptive and that NCH Healthcare officials have indicated likewise.

Beckwith, of Hope Hospice, questions why Naples hospice officials believe that VITAS is the better choice when her organization has garnered considerable support in the community.

“I don’t know why they think VITAS would be a better second provider,” Beckwith said. “VITAS is expert in marketing and sales. VITAS is a big for-profit company.”

Beckwith said she expects the administrative law judge will take up to four months before making a decision. The state then makes another review.