Southeast Kentucky Community Access Program (SKYCAP)

SKYCAP uses lay health workers, called Family HealthCare Navigators (FHN) to improve the health of the target population, who face barriers such as inadequate insurance. ii. FliNs work as a liaison between clients and their families, mental health and healthand human service providers to enable and facilitate our work. FliNs report to network members the specific characteristics of conditions, which impede clients from obtaining available services. iii. By working with multi disciplinary teams to establish action plans for clients and families, our safety-net providers improved the way they related to each other. This method assured action plans were carried out, linked clients with all needed services; connected clients to support groups; provided emotional and educational support for clients and their families. iv. SKYCAP tracks its work with low income families using a unique Management Information System, created by Data Futures, Inc in collaboration with all the project partners. This system provides a responsive data source for details with regard to all factors that effect health, from ambulatory sensitive diseases such as asthma, diabetes, hypertension, heart disease and severe mental illness to living conditions. SKYCAP's data management allows its partners to collect accurate tracking information on its clients and allows every entity addressing that person's needs to instantly see resources and gaps. This unique system provided not only providers. but the patients. with the information they need to effectively access health services. v. Although SKYCAP was confident of its methods, the enormous savings in uncompensated hospitalization and emergency room costs was much higher than anticipated.