Khalil Bourgoub

Quintessential care for all. And all means all.

By: Craig Dresang, CEO, YoloCares

At one point in his life, Frank was a real estate attorney.  He had a wife and two kids.  They lived in an upscale suburban home with a backyard pool and a three-car garage.  On weekends and some evenings, he played guitar in a local band with his old college buddies.  Summer vacations, extravagant Christmas parties, and neighborhood barbeques were highlights of what seemed like an ordinary, but very comfortable, life.  

The day after his 44^th birthday, his wife told him she was filing for divorce.  He was stunned.

With no advance notice, she packed her bags and left.  He learned later that she moved out of their home and directly into a secret lover’s townhouse in southern California.  Frank was devastated.  To cope with the shock and anxiety, he started drinking heavily.  A toxic mix of alcohol and depression began to impact his job.  After several months, his employer suggested he take some time off to get his life in order.  Missed appointments, a pattern of mistakes, and an increasingly combative personality resulted in Frank losing his job.  

He sunk even deeper into depression.  Frank’s life had become completely unmanageable . . .  drinking more and eating less.  Bottles of vodka were on the menu for breakfast, lunch and dinner.  Attempting to simultaneously keep his house and pay for an addiction, he depleted his retirement account, sold his car and boat, and pawned off most of the contents in his home including a Rolex watch that his father gave him as a graduation gift when he finished his education at Stanford University.  When those resources ran out, the bank repossessed his home.

For a while, couch surfing became a way of life, staying with old friends and a few distant relatives.  When the welcomes finally wore out, he decided to set up camp near the American River, not far from the home where he once built a life.  He eventually found methamphetamine to be a cheaper and more potent escape than alcohol.

Fast forward: Now 70 years old, Frank was an anomaly.  Most people experiencing long-term homelessness and/or severe addiction only live to be about 52 years old at best.  One morning, a shop owner in Midtown Sacramento found him unresponsive at her business’s main entrance.  She called the paramedics, and Frank was taken to the hospital.  While there, he received a terminal diagnosis.  Hospital staff did not want to release him back onto the street, so they called YoloCares.

The next day, Frank was admitted to Joshua’s House, the West Coast’s first residential community for terminally ill individuals experiencing homelessness.  Owned and operated by YoloCares, Joshua’s House provides a home along with medical and psychosocial support for people like Frank.  At first, having structure and support was a challenge for him.  Afterall, he had been living on the streets for nearly two decades.  By this time, his sense of normal did not include a comfortable bedroom of his own or living in a three-bedroom cottage behind a tall fence and gates.  Adapting to a culture that holds boundaries can be a challenge initially.

YoloCares staff who are specially trained in trauma-informed care (TIC) courageously and patiently walked him through a settling period.  Unlike other approaches or care models, TIC shifts the focus from, “What’s wrong with you?” to “What happened to you?”  It is a relationship-based approach to healthcare.  It gives the clinical team (physician, nurse, hospice aide, social worker, spiritual care coordinator, and caregiver) a complete picture of a patient’s situation.  Building trust and creating a safe environment are key components of TIC.

When Frank’s interdisciplinary team members learned that he loved playing the guitar and that he once was in a band, they explored this aspect of his life during their weekly interdisciplinary team meeting.  One of the nurses said, “We have spare guitars at YoloCares.  In fact, we have more than we need.”  Musical instruments are frequently used for music therapy with children in the YoloCares for Kids program.

The next day, Frank’s nurse brought him a guitar.  When she walked into his room, his eyes lit up.  She said, “This is for you.  We know you love to play.”  She handed him the instrument, and his eyes began to well-up with tears. He immediately began to play.  For the first time in a long time, Frank was smiling with an expression of pure satisfaction and joy.

Another recent patient-resident landed at Joshua’s House after being referred to YoloCares by a local hospital.  By the time she arrived, she was just days away from death.  She had not seen, or talked to, her family for more than two decades.  But after seeing the facility’s warm homelike environment, three of her family members decided to come visit. In fact, they became comfortable enough to make their visits an everyday occurrence.  The patient’s condition had severely compromised her vocal cords, leaving her unable to speak.  The evening before her death, she and her family had reconciled their previously broken relationship.  That same night, the patient miraculously mustered strength to whisper, “I love you.”  Everyone in the room was reduced to tears.

The stories connected to Joshua’s House have become a case study in how to facilitate a more meaningful life and death for previously unhoused individuals.  The program already has a track record of shattering otherwise impenetrable barriers, and fostering reconciliation, dignity and hope when it matters most.

Joshua’s House has been open for just nine months, yet it has already provided more than 1,000 days of patient care. Every 36 hours a Sacramentan dies on the streets.  The problem of homelessness is not getting any better. The homeless crisis is visible every day while driving to work or running to the grocery store.  A primary goal for YoloCares is to inspire five other similar movements/programs across the West Coast within five years.  To that end, the organization has already partnered with an agency in Sonoma County to replicate a Joshua’s House-like program there.  This small experiment of five cottages with three bedrooms will hopefully become a model for many other communities.  

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Special Note: There are no walk-in services at Joshua’s House.  Patients need to be referred by healthcare systems and partners who are well-versed in moving individuals through the care navigation process.  Besides Sacramento, patients have come from Nevada, Santa Rosa, Butte County, and Stockton.

Joshua’s House relies on philanthropic support for its day-to-day operations.  About $1 million annually is required to keep its doors open.  For information on ways to give or get involved, visit us at www.yolocares.org 

The last new person you meet

In honor of National Volunteer Month

By: Craig Dresang, CEO, YoloCares

Often, the last new, and truly authentic, relationship that a hospice patient will form is with their hospice volunteer.

The bond between volunteer and patient can be profound, and it often develops quickly. 

Unlike family members, or the clinical team providing care, the volunteer walks into a patient’s life electively and with no agenda. Family members frequently carry a sense of duty or obligation.  Caregivers and the clinical team (physician, nurse, aide, social worker, chaplain) are paid to be at the bedside.  It is their job.  But the volunteer is the only person who shows up voluntarily. 

Many years ago, Brooks McCormick, a descendant of the famous family that once owned the Chicago Tribune and International Harvester, was one of my former agency’s most active and reliable volunteers.  When asked what he liked most about his volunteer work, he said, “The fact that I am the last new relationship that a patient will make gives me immense satisfaction.  I get to see firsthand how a new friendship positively impacts a patient’s emotional and mental health.”  McCormick explained, “The benefits that a volunteer brings to a patient relationship cannot be understated.  We help reduce loneliness, lower stress levels, and manage anxiety in ways that traditional medicine cannot.”  Some patients experience a renewed sense of purpose and fulfillment, and according to McCormick, “The volunteer gains something valuable too.  Spending time with someone who is living on the edge of life gives me perspective.  I learn a lot from my patients.  Each person’s life is so different and so fascinating.  Many of their stories are breathtaking.  I am constantly learning.  The experience keeps me grounded and grateful for every day.”

McCormick’s experience is consistent with the latest research. Studies suggest that volunteers receive significant benefit from their volunteerism.  People who volunteer experience a boost in their mental health — good news at a time when more than a third of Americans report feeling symptoms of anxiety or depression.

The Journal of Happiness Studies is an international peer-reviewed journal devoted to theoretical and applied advancements in all areas of well-being.  Recently, researchers examined data from nearly 70,000 subjects. Participants answered survey questions about their volunteering habits and mental health, including their distress and functioning in everyday life. Those who participated in the survey provided feedback every two years for nearly two decades.

Compared to people who did not volunteer, folks who served as unpaid workers in the past year were more satisfied with their lives and rated their overall health as better. Additionally, the researchers found that people who volunteered more frequently experienced greater benefits: Those who volunteered at least once a month reported better mental health than participants who volunteered infrequently or not at all.

Volunteering appears to be intrinsically rewarding — when we help others, we tend to experience what researchers call a warm glow.  In addition, volunteering is likely to help boost a sense of social connection.  Older adults can stay engaged with others long after retirement by volunteering.

Volunteer work can also be a way to build professional skills and try out leadership opportunities, which are especially relevant to young adults. In the study, researchers found that participants ages 16 to 24 and 55 to 74 were most likely to benefit from volunteering, perhaps because of the opportunity to build social connections and new skills.

Even though patient-care volunteers are a critical component of the care team, there are numerous other ways that volunteers have helped, and continue to help, advance the mission of the organization.  In fact, volunteers are the reason why YoloCares exists.  Nearly 50 years ago, a group of grass-roots do-gooders from Yolo County did something extraordinary.  They banded together to challenge the status quo and do what the healthcare system (at that time) could not: They invented and launched an alternative model of care that would give quality of life at the end of life; birthing an organization that would deliver compassion, respect and dignity for terminally ill patients.

Together, these gutsy individuals selflessly poured their energy, time and resources into a movement that would eventually make a profound difference in the lives of thousands of people. They did this without employees, without Medicare reimbursements or revenue, and with virtually no community support. Yet, through determination and a shared vision they breathed life into a fledgling micro-organization called Yolo Hospice.

In more recent years, another group of audacious volunteers pioneered yet another initiative to strengthen their community.  To care for terminally ill Californians who are experiencing homelessness, they transformed an idea into reality and established Joshua’s House in Sacramento.  Joshua’s House is the first hospice housing program for unhoused individuals on the entire West Coast.  Ten years in the making, this unique approach to caring for the State’s most vulnerable population garnered goodwill energy from hundreds of volunteers, faith communities, two Sacramento mayors, Sacramento City Council, Sacramento County Board of Supervisors, health systems, and countless donors.  Since opening in July of 2025, more than 885 days of patient care have been provided to Joshua’s House residents.

This sort of volunteerism is the ultimate exercise in democracy.  People vote in elections every year, but when someone volunteers, they vote every day about the kind of community they want.

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Last year, YoloCares relied on the goodwill, service and generosity of more than 100 volunteers who contributed nearly 5,600 hours of volunteer support.  The Independent Sector estimates the value of those volunteer hours at nearly $200,000.  However, the true value of our volunteers is most clearly seen in the lives of patients, families and clients.

For more information regarding available volunteer opportunities, visit our website at www.yolocares.org or contact Elisa Stone, volunteer manager at YoloCares: estone@yolocares.org

Thoughts about leadership

By: Craig Dresang, CEO, YoloCares

During the last few months, I have had good reason to reflect on my years in leadership.

My YoloCares team secretly nominated me as one of the Sacramento region’s Most Admired CEOs.  At first, I felt embarrassed.  Like many organizational heads, the things I notice most are my deficiencies, mishaps, and shortcomings. So, for me, this has been an exercise in humility.  I am keenly aware that any leader is only as good as the team that surrounds them.  A stand-alone leader is no leader at all.

After being notified that I was indeed selected as one of 20 awardees, all I could think of is that the work I do at YoloCares is not for recognition or accolades.  No award needed.  It is only and always about the care we design and deliver for our patients and families . . .   and the ways we can support communities across six counties.  I have since moved on to a place of gratitude for my team’s vote of confidence and for their unified support for our shared vision and mission.  As a group, they are some of the most intelligent, thoughtful, collaborative, and experienced teams I have worked with during my 35 years in leadership. As human beings, they are all top-shelf individuals who I would seek out as close friends if they did not report to me.

One of my earliest mentors was a Franciscan nun named Sister Anne Dresang.  She was my aunt.  Four feet, ten inches tall.  A reserved and understated force of nature.  We were not especially close when I was younger, but during my time in seminary and early in my career, we kibitzed frequently about the state of the world, and the role that both healthcare and education could play in making the planet a more just and compassionate place.  While I was living in Chicago, Sister Anne would frequently visit during her trips to the Mother House in Wheaton . . .  just 20 minutes from my house.  There were many nights when I would have her over for dinner and we would get so lost in conversation that I would have to drive her back to the Franciscan Mother House at midnight.

Sister Anne spent her life trying to improve healthcare in her community of Appleton, WI.  She received a bachelor’s and master’s degree in nursing from Marquette University College of Nursing in Milwaukee.  For more than four decades she lived in the convent on the third floor of St. Elizabeth’s Hospital, the hospital where I was born and where my mother died 30 years later.  Among the many titles she held during her tenure at Saint Elizabeth’s, was chair of the capital campaign to build a new hospital wing.  As a result of her leadership and ability to garner financial support, the campaign wrapped up two years early and construction began for the hospital’s expansion ahead of schedule.

After reflecting on my own leadership journey, I now realize that much of Sister Anne’s wisdom, counsel, and spirit has seeped into my management style and philosophy. She used to say, “Nuns get it done.”  She was right, and I would do well to follow in her habit.  For those in leadership, or wish to be, I offer my own lessons from a Franciscan nun who was a quiet, understated leader:

• Integrity is your most powerful asset. What you say and what you do must be aligned.
• Find work that makes your heart sing and run with it.
• Do not over-complicate issues or problems. The simplest solution is usually the best.
• You will make mistakes, so own them. And then move on.
• Enjoy the journey. The path you are on is your path.  Claim it. Have fun with it.  Then let it go at the end of the day.
• Do not rush to judgement on any situation. As a difficult problem or challenge emerges, there will always be more that you do not know, than you do know.
• Do not borrow trouble. You can only address what is in front of you today.  Don’t worry about problems that have not yet happened.
• Rumi, the famous Islamic scholar, said “The past and the future veil God from our sight; burn up both of them with fire.”
• No margin, no mission. A lofty mission is of no use if you cannot generate a profit margin to sustain your work.

Little did I know when we were having our many late-night conversations, trying to solve the world’s problems, that a tiny nun’s insight would influence my decades-long career.  As I look back on those times of connection, and the notes I wrote down in the now yellowed pages of my journal, I realize that any accomplishments I have garnered have come through the gifts of others, and to them I am immensely grateful. 

YoloCares CEO Craig Dresang, named as a Most Admired CEO by SBJ

YoloCares CEO, Craig Dresang, has been selected by the Sacramento Business Journal as one of Sacramento’s Most Admired CEOs. This recognition reflects Dresang’s steady leadership, resilience, and deep commitment to advancing YoloCares’ mission. The nomination came from the agency’s Senior Leadership Team, who put Dresang forward in quiet admiration of the way he leads—with integrity, vision, and an unwavering focus on compassionate care.

This honor affirms what YoloCares experiences every day: Dresang’s leadership has guided our organization through periods of growth and challenge while keeping our mission and values at the center of all the agency does. YoloCares is very proud to celebrate this well-deserved recognition and to work alongside a leader who inspires, supports, and believes so deeply in the agency and the communities it serves.

 The cost of inclusion

By: Craig Dresang, CEO, YoloCares

For nearly 50 years, our organization has provided individualized end-of-life care and unparalleled support –without bias and without condition –to every person regardless of political affiliation, religion, gender, sexual orientation, socioeconomic status, physical or mental ability, background, personal ideology, or even citizenship. Period.

Moreover, the healthcare industry’s core ethical principles have long demanded justice, along with autonomy, beneficence, and nonmaleficence. Justice in healthcare ensures fairness, equity, and impartiality in the distribution of healthcare resources. History has shown that equity requires intentionality. Intentionality necessitates clearly stated goals and values.

Justice in healthcare should not be controversial. In fact, whenever and wherever injustice exists, there is a professional and moral obligation to call it out and address it. As Martin Luther King Jr. famously pointed out during the 1966 Medical Committee for Human Rights Convention in Chicago, “Of all the forms of inequality, injustice in health is the most shocking and inhumane.”

When it comes to politics, YoloCares has always remained apolitical. While the organization’s core values and beliefs could be manipulated into a political statement, they are not. Afterall, the agency’s patients, families, clients, 100+ staff members, 200 volunteers, advocates, and thousands of champions reflect the political landscape of America.

Every faith community under the sun would — and has — backed the agency’s core values of dignity, respect, compassion, and inclusion. From priests and rabbis to shamans and atheists, faith leaders and secular humanists recognize these core values as universal principles. They represent the agency’s moral code . . . a statement that each life matters. No matter what.

In the early days of 2025, the country was being primed for a collision of values. Powerful voices launched an attack on institutions that overtly foster diversity and inclusion. Suddenly, programs designed to bring people together, were being remade as wedges to divide whole groups of otherwise neighborly folks. Since hospice in America was an outgrowth of the Civil Rights Movement, the change in climate felt like an afront on traditionally held values in healthcare. Equity in care (and employment) has always been a central doctrine for end-of-life care providers. A history of the movement shows that early hospice providers were at the forefront of caring for the first waves of AIDS patients; those who have been marginalized, unhoused, uninsured; and immigrants who had little to no access to healthcare.

A year ago, there were a slew of executive orders intended to overturn the Federal government’s commitment to diversity, equity, inclusion and belonging (DEIB). Under pressure, many large corporations followed suit. IBM scraped its most meaningful diversity initiatives. An internal company memo referenced, “inherent tensions in practicing inclusion.” Farm equipment manufacturer John Deere said it would no longer support “cultural awareness” events. The nation’s largest newspaper publisher announced that it would stop publishing diversity data. It scrubbed its website to remove any reference about inclusion. The nation’s chief diversity officer was abruptly kicked out of a job, and the Department of Education banned every institution of learning (preschools to universities) from recognizing the value of diversity.

Meanwhile, at YoloCares, constituents from six counties were asking where the agency stood in this new environment. A fair question since more than a few of them were, and are, generous funders of DEIB initiatives . . . work that is in-keeping with the hospice movement’s founding spirit.

In response, the agency published an article during Black History Month, featuring the personal and professional journey of its black female board chair and former healthcare CEO, penned by its own openly gay chief executive officer. The candor of someone’s real-life experience was simply a bridge too far for a few individuals. A line was drawn in the sand and the idea of future funding evaporated like valley fog.

In the article, Jackie Clark, YoloCares board president, said, “The national move away from diversity, equity and inclusion (DEI) and affirmative action, is deeply troubling. Contrary to some common beliefs, there are no hiring quotas attached to affirmative action or DEI. Historically, Congress has, in a bipartisan fashion, created federal procurement programs to counter the effects of discrimination that have raised artificial barriers for businesses owned by disadvantaged individuals, including women and minorities.” Clark continued, “Affirmative Action simply gave me, and others, a seat at the interview table. It afforded me the opportunity to show what I could bring to a position. That’s it. The rest was on me.”

In every corner of American industry, and especially in healthcare, Clark said, “We should hire the best and the brightest, and understand that excellence is not confined to any one demographic.” Some interpreted those words as a political statement. They were not.

So, you can imagine my surprise — and deep disappointment — when a local six-figure funder/foundation dismissively withdrew future support because of the organization’s publicly stated commitment to diversity and inclusion. It happened during last year’s Black History Month. Ironic, really. One family member familiar with the situation said, “You should zip your lip, or loose support.” Her comment made me wonder why we were being bullied into a betrayal of our, and the healthcare industry’s, longstanding values.

Multiple studies, particularly from McKinsey & Company, demonstrate the significant value of diversity in the workplace. Companies with higher levels of gender and ethnic diversity tend to outperform their peers financially. In addition, companies with diverse teams show improved innovation, decision-making, and market capture abilities. Companies in the top quartile for diversity are more likely to have superior financial returns compared to those with lower diversity levels.

Valuing, and connecting with, fellow humans who are different from each other has been twisted into political theatre. Yet, it has always been a moral and spiritual challenge that demands us to answer: What kind of humans do we aspire to be?

From the beginning of time, survival depended on connection. Single-celled organisms evolved into new and more complex organisms. Life on Earth was simple. Cells existed, functioned and reproduced as free-living and isolated entities. But then, something remarkable happened. Different cells joined forces. They worked together instead of alone. This change, known as multicellularity, was a pivotal event in the history of life on Earth. Multicellularity – different cells connecting with each other – gave birth to an extraordinary diversity of organisms and structures, and an endless variety of plant and animal life. It was diversity beyond measure, and as a result, humans began to populate the earth. Here is the point: By Divine design, diversity did not weaken life. It fostered and strengthened it.

Imagine what our species, and society, would become if we could embrace, instead of fight, our most basic evolutionary calling to connect, understand, and advance into something even more remarkable. During last year’s Black History Month, Clark, said, “Diversity grows us as humans. It expands our learning and understanding of the world. It broadens our knowledge and perspectives. Instead of being fearful, we should embrace it.”

The idea of finding meaningful connection in a galaxy of diversity – and allowing those connected differences to evolve into something more spectacular – is not a man-made idea. It is how the universe is Divinely created, and what the earth’s inhabitants are expected to do. For YoloCares, the cost of inclusion has meant the loss of a few dollars and a friend or two. So clearly, living our values carries consequences. But abandoning our moral drivers would mean abandoning our founding spirit . . . a price YoloCares will never be willing to pay.

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You can read more about the connection between the Civil Rights Movement and the birth of hospice, and about YoloCares’ distinct approach to patient care, in my opening chapter for End of Life Ethics In A Changing World, published by the Hospice Foundation of America. For more information, or to purchase, go to:
https://hospicefoundation.org/hfa-product/end-of-life-ethics-in-a-changing-world/
or
www.hospicefoundation.org