Advanced Home Health is Growing Treats Heart, Mind, Body and Soul

By Shelly Lembke  |  2017-01-26

The dedicated management staff of Advanced Home Care; Angela Sehr, Owner, Angie Macadangdang, Chief Clinical Officer, Debi Moroles, Director of Business Development, Deb Ryan, Administrator and Lisa Gaza, Director of Patient Care Services. 
--Photo courtesy of Colby Barrett

One Sacramento-based company has quietly and efficiently carved a niche into the home health care business by providing superlative care for patients and caregivers alike. The “whole-istic” business model of Advanced Home Health and Hospice (AHHH) has earned them not only professional accolades and a thriving business, but a stellar reputation for their positive results for even the most complex patient care. The beating heart of this organization is founder Angela Sehr. Sehr is a woman with a mission and a vision with patient wellbeing in the Sacramento area.

Born in Xian, China, home of the famous Terra Cotta Warriors, Sehr started college at 15 and became a nurse at 18. The youngest of nine children, her siblings are also high achievers with a judge, college professor, engineer and a teacher among her immediate family.

Shyly self-admitted as a teacher’s pet, she loved science from a very young age. She says her mother encouraged her children to all be independent. “Marry well, she said, but always be able to stand on your own two feet,” was her mom’s advice.

Sehr may now be the boss, but she is far from being afraid to roll up her sleeves when it comes to patient care. She paid her dues with years in hands-on nursing. In fact, she still takes care of patients herself, in addition to her many other duties. AHHH offers patients around the clock care, just one of the many aspects that separate them from their competition. “I go out to patients’ homes at 2 in the morning if they need it, just like everyone else on staff,” said Sehr.

Sehr is a Registered Nurse who has worked around the world with patients of all ages and many different health issues. She came to Sacramento, having worked in places like China and Saudi Arabia. She attended Sacramento State’s Nursing program and earned her BSN here, spending over a decade in pediatric care and found her way into Infusion care as a nurse for patients in need of this specialized help. She has built her company on years of caring for infusion patients. Her company carries her compassion forward, providing top-notch, compassionate care for patients and their families.

During a time when healthcare laws and models are in flux. Sehr’s company, AHHH has built a company that successfully and efficiently treats and maintains a base of anywhere from 600 to 800 patients, more than double similar programs of even healthcare giants like full-fledged local hospital systems. To meet the need AHHH has found, the company currently has a staff of approximately 400 highly-trained specialists performing an impressive array of care and support services, and specializes in “complex” patients, often avoiding such patients having to be readmitted to hospitals.

AHHH is as advertised. Staff is on-call 365 days a year, 24 hours a day. They provide truly advanced wound care, infusion nursing, orthopedic, occupation and physical rehabilitation, speech and swallow function therapy, specialized medical social workers and a chaplaincy ministering to the patients and their loved ones. The tiniest staff member is a therapy dog.

AHHH is a Medicare Certified Home Health Provider. They are licensed by the by the California Department of Public Health. They have provided care for premature babies, pre-and post op patients, patients such as diabetics with wounds that can be nearly impossible to heal. Many of these are patients the hospitals have given up on and AHHH has succeeded where others have failed, improving patient outcome in terms of health and healing. Sehr is intent that her teams utilize the latest technology to treat patients and makes available ultrasound and laser therapy, in addition to debridement if physician ordered.

The Low-Level Laser Therapy (LLLT) alone, per Sehr can be highly effective in treating, diabetic ulcers, venous stasis and arterial ulcers, and many other types of non-healing wounds.

The hospice care that Sehr’s company provides is a growing service, based on industry best practices, but also on her own experiences as a nurse. Most hospice patients they see are given six months or less to live, but that isn’t an outcome set in stone. “We don’t give up,” she says. “We’re not God, but people do ‘graduate’ from hospice. They do get better.”

Hospice care provides comfort care to patients and family. “Advanced hospice nurses are registered nurses specifically dedicated to end-of-life care. They are focused on pain and symptom management for our patients around the clock. In addition to serving the terminally ill, hospice clinical team counsel and educate caregivers and family members on the needs of the patient, guiding them through every issue that may arise. Our hospice nurses work as a part of an interdisciplinary team that develops and manages the care for our patients and their families.”

A vital part of their team are the hospice social workers who are there to support patients and their families. “Our social workers are trained to assist our patients and their families on developing an individualized plan of care, researching ways to relief stress and anxiety by non-medical means, and connecting them with appropriate local resources.

 “We understand that our patients and their families may have financial problems. Our social workers are equipped with the necessary tools and knowledge to provide counseling in these areas, as well as coordinating possible aid from other organizations,” Sehr commented.

What does it mean to be an advanced hospice social worker? According to AHHH, “It means to be a supporter of our patients and their families. Our social workers are trained to assist our patients and their families on developing an individualized plan of care, researching ways to relief stress and anxiety by non-medical means, and connecting them with appropriate local resources.

“A loss of a loved one, even if anticipated, brings a slew of emotions and grief for surviving family and friends. Our hospice bereavement professionals and volunteers are trained to provide counseling and support by understanding the loss and compassionately walking step by step with surviving spouses, children, or parents.”

“To help our patients cope with the end of their life, AHHH provides spiritual services by certified chaplains to promote spiritual and emotional well-being. Our chaplains may also work with the patient’s clergy and coordinate spiritual nourishment and revitalization.”

Sehr credits hospice volunteers for the selfless work they do as part of the organization. “Our hospice volunteers spend time with patients and their loved ones. They run errands and provide caregiver relief, companionship, and supportive services. Volunteers are the backbone of our hospice team.”. Volunteers form bonds with patients and family members. Patients and families often tell volunteers things they feel they can’t tell their loved ones and help open the way for people to talk honestly. Volunteers work alongside paid staff in every area of hospice care.”

AHHH truly treat the entire family, and that includes monthly bereavement support group meeting. “At Advanced Hospice, patients are nearing and passing the end of their life, leaving behind husbands, wives, sons, and daughters,” according to the company website.

“When a patient is diagnosed with a serious illness or is recovering from an injury, our medical professionals, nurses, and therapists work hard to rejuvenate him/her to normal life. In addition to purely medical procedures, medications, and techniques, a huge part of a person’s recovery depends on his/her psychosocial condition.”

AHHH is making a concerted effort to reach America’s veterans. “Veterans have done everything asked of them in their mission to serve our country and we believe it is never too late to give them a hero’s welcome home. That’s why our hospice is taking part in the We Honor Veterans program. Our staff understand the unique needs of veterans and are prepared to meet the specific challenges that veterans and their families may face at the end of life.”

AHHH measures its success with data, not just good feelings. Their clinicians log every visit in detail, right down to wound and physical improvement, modality effectiveness, length of visit and many more details. That data is analyzed for the benefit of each patient, but the accumulation of data is used by the company to improve patient outcome and patient satisfaction. The company has recently broken ground on its next project, a free-standing Hospice Facility. While starting small, at 6 beds, it will be the only hospice in the area and unlike any other, due again to Sehr’s experience and personal touch.

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Attacking Carmichael’s Homeless Problem: First, the Numbers

Commentary from ATLAS  |  2017-01-26

Past annual counts of Carmichael’s homeless people suggest that as many as 150 may be on our streets, but many hundreds more are out of sight – most of them children.

No one knows the exact numbers, but every two years volunteers take an on-the-street count of homeless people across Sacramento County. Besides the informal government-directed census, they also conduct voluntary in-depth interviews

While volunteer counters fanned out on the evening of Jan. 25, Winter Sanctuaries involving Carmichael churches were offering overnight housing and meals. Christ Community Church was a host overnight site for up to 20 men and women who were bused in from Citrus Heights. The church and 10 others are participating in Carmichael HART (Homeless Assistance Resource Team), a collaboration also involving businesses, nonprofit charities and schools.

Since last August, as many as 40 people have attended HART’s past six monthly organizing meetings to get information about the scope of Carmichael’s situation and devise solutions ultimately aimed at helping people move off the street into transitional or permanent housing with resources and, later, job prospects.

Carmichael HART has pitched in to help its counterpart in Citrus Heights, which for the first year has been operating its own Winter Sanctuary program to offer homeless men and women safe haven from the season’s cold and rain. Last year, Citrus Heights helped Rancho Cordova HART’s shelter program. Other community-based shelters also have been operating in Davis and Elk Grove for several years.

Besides Carmichael’s shelter, the Greater Sacramento Winter Sanctuary, involving dozens of the county’s churches, have offered overnight spaces for 100 or more people daily through March 31. Carmichael Presbyterian Church has been our community’s intake center where “guests” are registered, then bused to a host church by 6 p.m. The program runs through March 31.

Guests are given a dinner and loaned a cot and sleeping bag that they check back in before they return to the intake center by 7 a.m. the next morning. Many homeless people are repeat visitors.

Some nonprofits also operate other winter shelters around the county. Most exclude children under age 18 and pets. Organizers say the word gets out about the shelters although many people choose to stay on the street rather than accept restrictions related to hours, conduct and prohibitions of drugs and alcohol. Sometimes people are turned away once capacity has been reached.

County and school district figures show that many of Carmichael’s residents who don’t have a permanent address are children who have no say in where they spend their nights. They typically “couch surf” with friends or relatives, sleep in cars or move around to temporary day shelters and motels. Regular school attendance is a huge challenge.

Steve Young, a school community worker for homeless children and families for the San Juan Unified School District, says almost 3,000 of the 40,000 students in the district are “living in transition” – including about 790 in the Carmichael area.

“Truancy is a big issue when it comes to homelessness,” Young said at a Carmichael HART meeting. “A lot of kids are missing school because of it. There’s a lot of trauma where these kids are becoming homeless like a death in the family, a mental health issue or drug addiction. A divorce can lead to it, or the loss of a job. Right now, in Sacramento, you need to make at least $20 an hour to rent a two-bedroom apartment. We’ve got single mothers who are making $10 an hour and they’ve got five kids. They’re not making it.”

Shaun Dillon, a Carmichael community advocate, told HART that Sacramento County has a deficit of up to 60,000 affordable housing units.

Several plans are in the works to develop such units in the region, including a village of “tiny houses” grouped around common service facilities. Elk Grove HART operates four transitional houses to move people off the street and position them for the job market.

Ken Bennett of Sacramento Self-Help Housing says Carmichael HART may want to consider “shared housing” where four or more people pay about $450 a month for space in a rented residence with house leaders and counseling. Transitional housing is another model being considered. However, Bennett says, “The long-term goal of transitional housing requires financing and extensive partnering.”

Despite such challenges, Carmichael HART participants are upbeat about the strong turnout of community volunteers at planning meetings and winter shelters.

Scott Young of ATLAS, a nonprofit thrift shop operator and charity serving needy Carmichael people, said at a recent HART meeting:

“There’s a lot of capital in this room. We’ve made a good head start. Our winter shelters are meeting a need and giving us experience. However, they’re not getting us any closer to a permanent solution to homelessness. What we really need is more affordable housing. We’re learning about the population that we’re serving, about their needs and how they landed on the street. But until we see them in permanent housing and with better access to employment, we won’t be nearly finished.”

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Citrus Heights HART Providing Local Solutions to a Local Issue

Source: Citrus Heights Homeless Assistance Resource Team  |  2016-12-02

Homelessness is a large and complicated challenge nationwide and especially here in the state of California. Per the U.S. Department of Housing and Urban Development, there are approximately 113,000 homeless individuals in California – 20% of all homeless people in the United States. California has the highest rate of unsheltered homeless -67%. ‘Sacramento Steps Forward’ reports that the 2015 Point in Time Homeless Count revealed 2,650 homeless persons experiencing homelessness.

Citrus Heights HART (Homeless Assistance Resource Team) a group of nonprofits, street ministries, service and government organizations, churches and others formed in 2015 to develop solutions on a local level. The group’s mission is to provide resources that will enable at-risk people and those experiencing homelessness in Citrus Heights and adjacent areas to become independent, self-sustaining and participating members of the community.

Surveys indicate that Citrus Heights homeless prefer to stay in the Citrus Heights area and this is most likely true of other areas as well. CH HART is one of three HART groups which includes Rancho Cordova and Elk Grove HART. Each HART focuses on its own programs to address local issues associated with homelessness.

Citrus Heights HART focuses on a few programs: Homeless Outreach Navigator, Stand Down event for homeless veterans and Winter Sanctuary. CH HART has worked with the City of Citrus Heights to develop and activate a homeless outreach navigator program. The Navigator assists homeless individuals in various ways by connecting them with available services. Most social and judicial services are in the urban core/downtown which presents a challenge and obstacle to homeless and at risk populations in the outer core (suburbs).

“In 2017, we plan to advocate more aggressively for County services to more conveniently and effectively address issues in the areas outside of downtown core,” said Kathilynn Carpenter, founding member and Chair of CH HART.

CH HART held its first Stand Down event on March 30 of this year and assisted approximately 80 veterans with Veteran’s Affairs issues, legal services, medical, hair-cuts and showers, clothing, pet services and more. The second annual event is planned for April 18, 2017.

This past winter, CH HART participated in the Rancho Cordova Winter Sanctuary program and hosted a one week shelter at Holy Family Church. This winter, the group is hosting its own program and currently committed to four weeks beginning December 26.

The group has recently formed a Housing Committee to explore ways they can help with housing opportunities in more tangible ways through master leasing programs, transitional housing and other options.

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Funding for Winter Sanctuary Approved

Source: Sacramento County  |  2016-11-17

On November 1, the Sacramento County Board of Supervisors approved an agreement for $360,000 with Sacramento Steps Forward (SSF) for the administration of the Winter Sanctuary Program. The Winter Sanctuary Program provides nighttime shelter with local faith-based organizations, including transportation and two meals, for Sacramento County’s homeless population from November 21 through April 30, 2017. “This is the fifth year of funding this program in order to provide 100 additional beds for Sacramento’s homeless each night during the winter,” said Chair of the Board Roberta MacGlashan. “We are pleased and grateful to the 19 congregations that have agreed to host and look forward to other organizations filling in the remaining open nights.”

As part of the agreement, SSF will provide monthly reports of the number of persons sheltered per night, including the breakdown of men, women and families served and their geographic origination. The data will be utilized to determine potential areas of focus for future funding opportunities.

Sacramento Steps Forward coordinates the shelter, transportation to and from the shelter sites, and meals with, as well as outreach and referral efforts for ongoing supportive services.

Currently, congregations have been lined up to provide services for every night except 52. Sac Steps Forward and its subcontractor, First Step Communities (FSC), are working to recruit congregations to fill out the list, including those that can accommodate pets, and two congregations to serve as intake sites for persons who are unable to travel to the main intake site of Loaves and Fishes.

In recruiting these additional intake sites, SSF and FSC are utilizing data to determine where the highest populations of homeless exist outside of the immediate geography of Loaves and Fishes.

The County is also providing $75,000 to Volunteers of America (VOA) for the period of November 21 through March 31, 2017 for the administration of the Winter Shelter Program for homeless families. Offered since 2011, this program has provided shelter to 876 adults and children since its inception.

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Growing Old On the Streets is America's Dirty, Little Secret

Commentary by Association of Mature American Citizens  |  2016-10-20

University of Pennsylvania Professor Dennis P. Culhane is a recognized expert on the issue of the growing number of older individuals who are on the streets.  He says that in 1990 “the peak age of adults who were homeless was 30” and that today the peak age is 55.

The homeless are the invisible denizens of America's cities, says Dan Weber, president of the Association of Mature American Citizens. “But, the dirty little secret that has only come to light recently is the fact that the elderly are among the fastest growing populations living on the streets,” he reports.

The Department of Housing and Urban Development told Congress last year that there were more than 300,000 homeless Americans 50 years of age or more, 20% more than there were in 2007.

A recognized expert on the issue of the growing number of older individuals who are on the streets is University of Pennsylvania Professor Dennis P. Culhane. He says that in 1990 “the peak age of adults who were homeless was 30” and that today the peak age is 55.

Weber is calling on all candidates for election and re-election in November and those in the private sector to recognize the fact that more seniors are homeless than ever before and to take to heart the needs of “these hapless lost souls. Focus on their plight and let the truth be told, loud and clear. Everyone needs to pitch in if we are to solve this problem, which only grows bigger with each passing day.”

Some would blame the spike in homelessness among older Americans on the swiftly aging population. But, Weber says, it has more to do with the rising cost of health care and health insurance, the lagging economy, the impact of such diseases of old age as cancer and Alzheimer’s and, perhaps the most damaging cause of all, the lack of affordable housing.

“In fact, talk to any health provider who deals with the homeless and they will tell you that there has been a dramatic shift in recent years in the illnesses from which they suffer. It used to be that the homeless suffered mainly from drug abuse and mental illness. Nowadays they are more likely to have the chronic diseases of old age,” Weber notes.

Mel Martinez and Allyson Y. Schwartz are the co-chairs of the Bipartisan Policy Center Senior Health and Housing Task Force. Martinez is a former U.S. Senator from Florida and Schwartz is a former Congresswoman from Pennsylvania. They published an Opinion Article in U.S. News and World Report last month in which they concluded that “preventing and ending homelessness among older adults should become a major national priority in the United States. By setting goals to end homelessness; increasing available low-income senior housing; and by understanding that the challenge requires participation from public and private partners at all levels, we can and will find ways to ensure that all U.S. seniors have the shelter and security that they deserve.”

Meanwhile, Margot Kushel, professor of medicine at University of California, San Francisco, is an expert on the elderly who become homeless. She says that providing them with housing is the key to fixing the problem. “A lot of these people have been healthy their whole lives. But it doesn't take long for their health to plummet once they're homeless. Once someone is housed, depression often lifts, stress fades away, infections heal. It's instant.”

Says Weber, “everyone has his own set of priorities, but one thing we all have in common is that we are all growing older. It's one of the hardest things we will all do in this life and so we should have compassion for those who need our help.”

The Association of Mature American Citizens [] is a vibrant, vital senior advocacy organization that takes its marching orders from its members. We act and speak on their behalf, protecting their interests and offering a practical insight on how to best solve the problems they face today. Live long and make a difference by joining us today at

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San Juan Unified Piloting K-8 Home School Program

Source: San Juan Unified Scholl District  |  2016-08-18

San Juan Unified is piloting a K-8 home school program and is currently enrolling students for the 2016-17 school year. The optional home school program helps meet students’ individual needs and offers support to families who choose to educate their children in kindergarten through eighth grade at home, partnering with a San Juan Unified credentialed teacher.

As part of the program, students must receive at least 4-6 hours of daily instruction in English and complete coursework meeting California standards for each subject. Additionally, parents or guardians must meet regularly with the assigned credentialed teacher, with flexible scheduling available. By participating in the home school program, families receive curriculum, ongoing guidance and vouchers for materials and activities for the school year.

For questions regarding enrolling your child, please call (916) 971-7017 or email

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Get Ready to Roll This Spring by Cleaning Up the Garage

NewsUSA  |  2016-05-24

Time for a Spring Spruce-Up.

(NewsUSA) - Sponsored News - As spring blooms and temperatures warm up, it's time to open up the windows and go outside. This means getting into your garage and dusting off the cobwebs from your lawnmower, wiping down your outdoor table and chairs, and getting your car primed to take you where you want to go this summer season.

According to experts, outdoor equipment such as trimmers, blowers, chainsaws and even patio furniture need some time and attention to get them ready for use after sitting all winter. This is especially true for cars that have borne the brunt of snow, ice, slush and other winter-related weather.

Here are some tips for getting your machinery, vehicles and outdoor equipment ready for summer use and entertaining:

  • Get your lawnmower out of the corner of the garage. Wipe down all surfaces with a dry cloth, oil moving parts to ensure they are well lubricated, and make sure the blade is sharp. Sharp blades are better for your lawn and put less stress on the engine. If you added a fuel stabilizer like STA-BIL Storage prior to putting it away for the winter, it should start up smoothly. Should you have some hard starts, try a revitalizer like Start Your Engines! to get it revved up quickly.

  • Prime your automobile. With the cost of driving at a six-year low, you'll want to take that long-overdue road trip this summer, so ensuring that your auto is in tip-top shape is paramount. According to the AAA, driving costs are affected by how well your vehicle runs, and that includes the inside and outside of your car. Performing regular maintenance can ensure more efficient operation and help prevent costly repairs. One way to save money is by detailing the car yourself using products such as 303 Automotive Protectant to protect interior surfaces from cracking and fading. Originally engineered for aerospace and aviation applications, 303 Automotive Protectant safeguards against harmful UV rays that can cause discoloration. In addition, it keeps surfaces looking newer, leaves a dry matte finish so there's no oily feel, and helps repel dust. For the exterior, consider 303 Automotive Speed Detailer, which will instantly clean, protect and give your car a showroom shine. It's a great way to keep your car cleaner between washings. And at every fill-up to keep the engine running smoothly, use STA-BIL 360 Performance, a fuel treatment that protects your engine above and below the fuel line to keep your engine running cleaner, stronger and with greater performance.

  • Assess your outdoor furniture. No matter what material your outdoor furniture is made of, start by wiping down the surfaces. Plastic furniture, if left uncovered all winter, may just need a little soap and water to remove any dirt. To protect your outdoor furniture's hard surfaces from harmful UV Rays, apply a layer of 303 Protectant. You'll also want to protect your fabrics from water and other debris, so try 303 Fabric Guard.

For more information, please visit

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