2006 is the final year of the Healthy Communities Access Program (HCAP) grant. This grant is a three-year grant that AHEC and the six partners in the grant received from Health Resources and Services Administration (HRSA) in September 2003. The partners are providing needed services to Coos and Curry Counties on Oregon's south coast. The programs established by the grants are showing sustainability because of the nature of the services offered.

Nurse Case Managers Located at Curry General Hospital, Coquille Valley Hospital, Waterfall Clinic, Powers Clinic, Coos Public Health Department and Curry Public Health

• Providing prescription assistance, as well as medical case management for their patients.
• These services are helping reduce the emergency room visits by persons who cannot access care in any other manner.

During this final year of the grant, the Case Managers will continue providing those services and referrals to labs and specialists that were begun in the second year of the grant. The following is a human interest story from one of the Case Managers who felt that her skills had an effect on the lives of this couple.

"Over the summer, we had a middle-aged unemployed, but newly wed gentleman enter our facility with a CVA diagnosis and no insurance. My therapy skills were immediately put to work talking with his new wife in regards to payment for the hospital's services and providing grief support in light of their changed future together.

In addition to this added stress, the patient's wife was meeting his grown children for the first time. She was assured by one of his out-of-state sons that he would pay for any kind of rehab that his father needed. What really occurred were the children briefly visiting their father in the hospital and then unloading his house of any valuable possessions that they could find. Thus, not only the patient's health, but his assets were slipping away!

My first step in helping this couple was contacting the Social Security office to set up an appointment/interview that they would be conducting over the phone with his wife since the patient was not able to speak coherently. I also contacted Seniors and Peoples with Disabilities to advise them of the case and what I had already done. The hospital agreed to keep the patient and transfer him to the Swing Bed Program since his wife was not strong enough to care for her husband at home. I also contacted Hearthside and faxed them information on the patient as a possible placement for him to rehab once funding came through.

During the patient's stay in the Swing Bed Program, he received physical therapy, occupational therapy and speech therapy. His wife sat with him every day and helped him with his meals. During this time, I visited with her frequently to provide support and process the myriad of emotions that she was experiencing. I also had several phone conversations with Social Security in Salem who were helpful and emphatic to this patient's needs for continued and more rigorous rehab. Within what seemed like just a few weeks, our patient received his Presumptive Disability and Medicaid. The patient's stay at our facility would be reimbursed and Hearthside was ready to accept him for placement.

A one week follow-up phone call with the patient's wife (after he had been transferred to Hearthside) revealed that our patient was advancing well after his placement. His wife was grateful for the guidance and support that she had received while at the hospital. It felt good to have been a part of that process of helping them solve a difficult financial problem during a difficult life changing time."

Outreach Specialists Located at the Two Health Departments

• These Outreach Specialists continue the work of connecting the uninsured to state insurance programs. Coos and Curry Counties have the lowest insurance rates in the state. It is true that part of that is due to the large elderly population, but it is also due in part, to the work of these highly skilled workers.

For more information regarding the work of the grant, contact the AHEC office at 800.501.1566 or ahec@healthyoregon.com.