OVHC seeks ‘Free to Be Healthy’ patients
STEUBENVILLE — The Ohio Valley Health Center at 423 South St. is in an unusual situation — it has plenty of providers for its Free to Be Healthy program but not plenty of patients, something that Executive Director Ann Quillen and Denise Lucas, nurse practitioner, want to remedy.
Free to Be Healthy 2.0 is a free program for patients at the center who have high blood pressure and/or diabetes. Providers work with patients to improve blood pressure, blood sugar and their overall health at the center, a free clinic that provides high-quality health care services to anyone who needs it, regardless of ability to pay.
“The program is geared to patients with high blood pressure and diabetes, and the reason that matters is when you look at the statistics here, where Jefferson County ranks in the state of Ohio, it’s abysmal,” commented Denise Lucas, nurse practitioner. “There are 88 counties in Ohio, and in general, Jefferson County is 78 out of 88,” she said in terms of health outcomes according to 2020 rankings.
The prevalence rate for diabetes, meanwhile, is 15 percent compared to 12 percent for the remainder of the state, and hypertension is noted at 35 percent, with Jefferson County ranking 36 out of 88 counties for this chronic condition.
“Diabetes is a problem as is high blood pressure and that’s why these are being targeted along with the fact that diabetes and high blood pressure are among the top five diagnostic codes for patients that we see here, so it sort of dovetails together and it points you to the right direction that this is what we need to pay attention to,” Lucas added.
To qualify for the free program, individuals must be 18 or older, medically uninsured or underinsured; be diagnosed with pre-diabetes, diabetes or high blood pressure; and be willing to keep medical appointments as suggested by a nurse practitioner provider and have lab work completed, typically every three months.
Lucas and Quillen noted added benefits of participating in the program include assistance with medications; assistance with obtaining lab work; home blood pressure cuffs; blood sugar meters and test strips; bathroom scales; diabetic shoes when needed; monthly food boxes from Urban Mission chosen expressly for the diabetic/hypertension patient; and a chance to win a $25 grocery gift card when appointments are kept.
The program has been in place since 2014 but has been re-energized.
“We reconfigured this in a different way because we want to serve more people but we also want to show our impact,” Lucas explained, noting the providers are predominantly nurse practitioners, advanced practice nurses “with years and years of nursing experience. Nobody here is new out of the gate, and I think everybody has either earned or is earning a doctoral degree.”
Lucas said she and her colleague, Dr. Janet Bischof, have “an actual IRB approved research study here because we are trying to prove our worth and our impact.”
The purpose of the study is to improve specific measures (blood sugar, blood pressure and other vital signs, cholesterol panel, weight, body mass index, medication adherence, smoking and alcohol use, depression and general overall health) in patients with pre-diabetes, diabetes and hypertension whose care is essentially managed by primary care nurse practitioners in a free clinic setting.
The research question is what critical health measures of patients with pre-diabetes, diabetes and hypertension would improve with consistent primary care oversight by nurse practitioners in a free clinic setting.
“We want to show our care is equal to or better than care provided by physicians because there’s still that disconnect about primary care, right? We want to show that we make a difference. We want to show our patients that, yes, we’ve made a difference; the clinic; the board of directors; the community at large; and really take a stab at improving the health ratings in Ohio,” Lucas said.
“We have eight volunteer nurse practitioners and doctors available to make the program happen but not enough patients,” Quillen said of what no executive director of a free clinic ever says. “It is an odd situation that you never thought you would be in, and I think COVID has contributed a great deal to that.”
In addition, the center has a volunteer dietician and pharmacist so patients not only see primary care providers, “they get some very specialized care that many times isn’t offered in a primary care practice so that’s kind of a unique aspect of what we also do,” Quillen said.
Added Lucas, “In addition to medication management, it’s one thing for me to write a prescription, but it’s another thing to go into our medication room and say here, this is what you need for your diabetes.”
Providers, in addition to Lucas and Bischof, are Dr. Charn Nandra, Dr. Anandi Murthy, Diann Schmitt, Jamie Clarke, Mary Meyers, Christine Radijov, Ronda Seelig and Pam Lizon.
Quillen explained the center provides care to anyone in the Ohio Valley who is medically uninsured, not just Jefferson County.
“We also provide care for people who are on Medicaid, and we also take care of people who are Medicare who maybe have fallen into that doughnut-hole period and they can’t afford to get their medications from the time their Medicare stops and it restarts again, so we assist those patients,” she said. “We also help people who maybe had to buy insurance, but they only could afford to do like calamity insurance so they have such high deductibles or such high co-pays, they can’t afford to do their care even though they have insurance, so we feel those people are still considered underinsured so we actually take care of those folks as well. We’re pretty broad,” she said, adding that anyone who’s at the 300 percent poverty level can qualify for care. “A family of four, you can make $79,000 and still qualify to be a patient here.”
If people aren’t sure if they have hypertension or diabetes, they should call the center. “Anybody who hasn’t had care, they haven’t sought care for whatever reason — they can’t afford it, uninsured, they feel like I can’t be stuck with a bill, whatever reason keeps them from going somewhere — they should consider us. They should call and present their situation and we’ll tell them if we’re the best option, and if we’re not, chances are we can help them know who is,” she said.
A $7,500 grant from the Esther Simmons PNC Charitable Grant launched the program and adding to it are a $40,000 grant from the Charitable Health Network and a $1,000 grand from Duquesne University.
“The grants are written, and there’s a lot that’s included in them,” Quillen said. “One of the big things is paying for our clinical nurse manager, which is key for good care coordination and a vital role in our health center.”
Lucas said the center is able to provide patients with medical items such as blood pressure cuffs “that will help them to buy into managing their care. When you’re struggling with your disease, these other little things that help you manage it put you on a level playing field with anybody else.”
The study runs parallel to patients’ treatment and maintenance.
“What we do is if you participate in the study, great; if you don’t, it does not impact your care in any way, shape or form,” Lucas said. “Participating in the study just says to my colleague Dr. Bischof and I that we are able to use your data for statistical analysis — nothing else changes.”
Quillen described the center’s care as comprehensive with a holistic approach; appointments with a dietician, pharmacist and cardiologist; and other services such as cancer screenings.
The study is ongoing with enrollment continuing, according to Lucas, with full data anticipated in hand come June 2023. To say the program has made a difference means to prove how so, according to Lucas.
“That’s what I want to do for this facility. I want to say we’re providing outstanding care, following national guidelines and here’s how we have helped our patients turn themselves around,” she said. “In six months we’ll have some preliminary data that will be exciting to see,” Lucas said.
The center is open Mondays through Thursdays from 8 a.m. to 4 p.m. and evening hours on the last Tuesday of the month. The phone number is (740) 283-2856.