Ann Merkel and some of the group of original High Peaks Hospice founders gathered to create a video to document the story of High Peaks Hospice’s beginnings. L-R Standing- Fr. Rick Dennis, Katrine Krester Seated -Sr. Camillus, Ann Merkel, Dr. Robert Kasulke

It’s hard to imagine a time when hospice services were not available in our area, but just over 35 years ago, that was the reality…

We invite you to watch the video below as our founders reminisce and share how, through amazing acts of volunteerism, community support, and commitment, High Peaks Hospice came to be.

The Start of End Of Life Care in the Tri-Lakes Area of the Adirondacks

In 1986, Medicare determined that dying was no longer a diagnosis that warranted a hospital admission. Families were struggling to manage the death of their loved ones unsupported at home. Ann Merkel and her husband, the late Dr. C. David Merkel, lived in Saranac Lake. Ann Merkel grew up in New Haven, Connecticut where the first hospice in the United States started in 1974, so she was familiar with the support and care hospice provided families. The Merkels keenly felt there was a lack of compassionate care options for the dying in the area, so Ann and David decided to do what they could to start hospice services locally.

Medicare authorizing reimbursement for hospice care was still new, having just started in 1982. The program was unique, providing family oriented comprehensive services which included medical, nursing, social work, spiritual care, volunteer support, bereavement services as well as the availability of specialty care by physical therapists, nutritionists and speech therapists. It would cover all medications related to comfort and symptom management as well as durable medical equipment and oxygen. There are no co-pays or deductibles, no bills to process. Care could be provided anywhere, at home or facilities, and available to any person, with any diagnosis with a prognosis of 6 months or less.

In 1986 the Merkels went to work to offer hospice services locally

Their first step was to reach out to Katrine Krester, Director of Franklin County Public Health Department. As a state health agency it had the authority to provide hospice services but the Tri-lakes spanned multiple towns and two counties, so an independent hospice would need to be formed. Katrine worked hand in hand with the Merkels to learn about hospice and understand the regulations. They contacted the NY Department of Health to begin the process of becoming a certified hospice program. The message they received from the DOH was that it would be impossible to organize such a comprehensive program in such a small community. It was too complicated and required so many services. It was out of reach for such a rural area.

Ann and David Merkel were not discouraged. They began the process by completing a Certificate of Need providing statistics on the number of deaths and the lack of available care options for the dying. Dr. Merkel hand carried 27 copies of the certificates to the Department of Health in Albany delivering each to the appropriate office.

The Merkels then proceeded to rekindle the health care spark from Saranac Lake’s legacy as a haven for tuberculosis care. With that spark and the extraordinary volunteer spirit of Tupper Lake, Lake Placid and Saranac Lake a local hospice movement was underway.

Ann and David gathered a team

Dr. Merkel engaged with his partner Dr. Robert Kasulke to spear head the medical care. Dr. Kasulke became the first High Peaks Hospice Medical Director, and today he continues to serve as Medical Director for the Hospice in Jefferson County.

One by one professional and lay volunteers stepped up to commit their time and expertise to provide all the necessary services required to receive hospice certification.

Jimmy Bevilacqua served as the required compounding pharmacist available 24 hours/day.

Sr. Camillus, director of Uihlein Mercy Nursing Home in Lake Placid, worked to ensure hospice services would be available to nursing home residents. She also provided an opportunity for new hospice volunteers to be introduced to working with the infirm.

Alice Scollin, with masterful organizational skills, recruited and coordinated volunteers for family support or office work.

Funeral director Andy Fortune started the bereavement program, supporting families for 13 months following the death.

Father Rick Dennis took charge of the spiritual care and coordinated with other ministers, to provide end of life comfort in patients’ homes. Fr. Dennis’s wife Connie Dennis, who was the Executive Secretary at the Saranac Lake Voluntary Health Association, facilitated the loan of medical equipment from SLVHA to hospice.

The original office for Hospice was a den in the Merkel residence. However, the community helped here too and offices spaces were provided free by the Trudeau Institute and the American Management Association. Madden’s Storage donated office furniture.

Most projects of this magnitude take years to come to fruition, but in less than a year High Peaks Hospice opened on a strictly volunteer basis, providing home care in the Tri-lakes.

In 1988 they received their license from the NY Dept of Health and became eligible for reimbursement through Medicare. Two years later a small hospice support group in Elizabethtown asked if High Peaks Hospice could extend their reach and soon all of Essex County was added. In the early 1990’s the Hospice of Warren County joined in. What started as a mission of two people quickly became a triumph of volunteerism and community spirit.

High Peaks Hospice became available to much of the Adirondacks to provide dignity, comfort and peace at the end of life

High Peaks Hospice currently serves 5,400 square miles including all of Essex and Warren Counties, southern Franklin County, northern Washington and Hamilton, and part of St. Lawrence Counties. Dr. David Merkel served as Medical Director of Hospice until his death in 2012. For many years Ann Merkel remained very active in High Peaks Hospice, serving as the initial Executive Director and then president of the board of directors. She has also served as past president of The Hospice and Palliative Care Association of New York, where she worked to expand access to hospice care in rural areas throughout the state.

Ann Merkel, along with many of the original founders, gathered in 2022 to reminisce and record the video included above.

We thank our Founders for their dedication to High Peaks Hospice, our former nurse and current Board Member Peggy Wiltberger for coordinating the video and providing the written history, and videographer Jim Griebsch for donating his talents to film and capture our history.

We invite you to watch and leave your comments. Without these founders’ efforts we would not be where we are today 35 years later.