Ohio county launches mobile health care program

The grant-funded program assists patients in their homes after they have been discharged from the hospital

By Kelli Wynn
Dayton Daily News

JEFFERSON TOWNSHIP, Ohio — Jefferson Township, a rural area located west of Interstate 75, has an aging population, no public transportation and is disconnected from Dayton-area health facilities.

That is according to a 2015 health assessment by Reach Out of Montgomery County and local medical students.

“The city of Dayton is pretty much covered with health care establishments, but Jefferson Township and the areas on this side of town, on out towards Eaton, don’t have very many health care facilities,” said the township’s Fire Chief Larry Sexton. “So one of the things we were trying to do was establish a clinic inside one of our fire houses that is in a rural area for our residents and those outside of the township.”

Now, township officials and the staff of Reach Out of Montgomery County are searching for grants that would provide funding to renovate the township’s 1970s-era fire station at Dayton-Liberty Road. The renovation would allow space for a clinic in addition to the fire station.

In the meantime, the township has partnered with Reach Out, a free clinic at 25 E. Foraker St., Dayton, to offer free health care-related case management visits to township residents who are discharged from local hospitals.

National, this type of program is called mobile integrated health care, but the township’s program is called the Jefferson Twp. Community Care Team, believed to be the first of its kind in this county.

Here’s how it works: Reach Out staff receive data from local hospitals about township residents who have been discharged. Reach Out then contacts the resident to see if they would like a follow-up home visit made by township Battalion Fire Chief Chad McInturff.

“The goal is that we’re attempting to reduce return hospitalizations with these patients by getting them access to primary care physicians, by helping them navigate any paperwork needed to get home health nursing in or any other resources,” McInturff said.

Some of his responsibilities include taking basic vital signs, making sure the patient has meals, getting prescriptions filled and making follow-up visits. “That way we can avoid an actual re-admission into the hospital,” he said.

The program’s goal is to bring in more health care resources to township residents, “rather than have them rely solely on emergency rooms at the hospitals for their primary health care,” McInturff said.

Sexton said one of the reasons people are re-hospitalized is because they don’t follow recommendations after being discharged from the hospital.

“A lot of these folks don’t have the means or don’t have a family physician,” Sexton said.

Dr. Sharon Sherlock, executive director of Reach Out, said one of the benefits of the program is that it can save the residents money because it prevents them from having to go to long-term facilities.

Bryan Bucklew of the Greater Dayton Area Hospital Association called the program innovative.

“What Reach Out is doing needs to be commended and supported,” he said.

A $15,000 CareSource Foundation grant pays for McInturff to do the visits.

McInturff estimated that he visits 5 to 10 residents a week.

“It’s a pilot now for six months, but Reach Out has been hot-spotting patients at risk after hospitalization for about three years with substantial returns for the community,” Sherlock said. “We strive to keep people safe at home, connected to care and avoiding unnecessary visits back to the hospital ER.”

Sherlock said she met with township trustees in December to discuss their constituents’ concerns about limited access to health care services.

“We decided the trustees needed data to help them explore alternatives to accessing care,” Sherlock said.

Medical students who represented Reach Out, Wright State University and the University of Dayton collected the data, which included information from the 2013 “Access to Care” report by the Health Policy Institute of Ohio. The report said that Jefferson Township was an “impoverished area with mal-distribution of health care providers and services” and predicted “a further medical access concern was to be expected in 2014 due to an unprecedented number of new medical enrollees compounding the current problem of professional shortage of primary care providers in the Montgomery County area.”

The data collection was highlighted in Reach Out’s Jefferson Township Community Health Assessment in April. The assessment report included survey responses from nearly 140 township residents and resulted in three recommendations to township trustees.

Those recommendations were to begin a community paramedic program that would include home visits for township residents who have been discharged from area hospitals or emergency rooms, renovate the fire station on Dayton-Liberty Road for the purpose of having a space for health and safety programs, and submit applications to the state for a rural health clinic.

“These recommendations would increase access to health services and impact some of the poor health outcomes identified in the Montgomery County and Public Health annual reports,” Sherlock said.

The report also stated that a Jefferson Township Local Schools employee said she believes unreliable transportation has caused delays in parents keeping their children’s medical appointments. The school employee said families often used ER or urgent care facilities “due to the inability to obtain prompt appointments with their family physician.”

One of the questions addressed whether residents would use a physician’s office if one were placed in the township. Eighty-five percent said yes.

©2015 the Dayton Daily News

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