Good Samaritan Foundation - SKYCAP

This proposal is for the Good Samaritan Foundation to consider funding expanding the University o fKentucky College of Medicine Center for Rural Health Southeast Kentucky Community Aocess Program (SKYCAP). The program is a national model developed by the UK Center for Rural Health (UKCRH) and partners in Harlan and Perry counties, for assuring health care access for uninsured and underinsured persons. This proposal is two fold, first to extend the program into two more counties in eastern Kentucky, and second, to develop a public information and patient education program to support the initiative. The University of Kentucky Center for Rural Health (UKCRH), in collaboration with partners in Perry and Harlan counties, has developed a national model for assuring health care access for uninsured and underinsured persons. During the first year, 157 persons in Petry and Harlan counties, who suffer from one or more of 5 ambulatory care sensitive diseases, completed a period of case management. Hospitalization costs for this group were reduced by 67.8% compared to the year before they entered the program. Emergency room use by these people was reduced by 88.2%. The estimated cost savings to the health care system in reduction of uncompensated care for this group is $305,250. In addition to cost savings, there is strong preliminary evidence that the program bas also improved the health status of its clients. . Research studies are being conducted to statistically measure improvements in HDL and LDL levels of persons with heart disease. Additionally data on hemoglobin levels (HAl C) for enrolled diabetic patients are being analyzed to measure the effect of case management and compliance with tteatment protocols by these patients. The program, Southeast Kentucky Community Access Program (SKYCAP), has two components. The first is a management information system that supports a computerized medical record that is shared among the major health and social service providers in Perry and Harlan counties where the program is operating. Data Futures,a local information management firm in Harlan, Kentucky, and the SKYCAP program director developed this innovative health information system. The second component is case management of clients who are diagnosed with heart disease, diabetes, asthma, hypertension, and mental illness. Lay health workers known as Family Health Navigators improve the health of clients and reduce unnecessary use of expensive services. The most effective interventions are obtaining access to medications clients need to manage their illnesses; linking each client with a primary care medical "home"; and educating cli~nts to manage their disease(s) and how to appropriately use the health care system. SKYCAP haSa1readydelivered more than 8,000 services and provided intensive case management services for more than 300 clients who have ambulatory care sensitive diseases. The UKCRH is asking the Good Samaritan Foundation for resources to extend this primary prevention program to Leslie and Knott counties. Both SKYCAP and its sister program Kentucky Homeplace,receive many referrals from these counties where patient tracking and case management would be appropriate. Both of these counties along with most of southeastern Kentucky, suffer serious health problems that can be stabilized, if not reversed, with adequate primary care. Based on SKYCAP experience, we expect about 3,300 of the 12,340 potential clients would use the service in the first year. Specifically, The Center for Rural Health requests $130,000 for each of two years ($260,000 total) to pay for the placement of the SKYCAP program in the offices of health and social service providers in the two counties.