Edwin Fonner,
Jr., DrPH
The Community Health Council of Manhattan KS (CHC) is the applicant. CHC's members and key partners in this effort include Pawnee Mental Health Services, Homecare and Hospice, Meadowlark Hills Retirement Community, the Riley County Health Department, and the North Central-Flint Hills Area Agency on Aging. CHC has effectively managed HRSA's Rural Health Network Development and Community Access Program (CAP) grants. Access demonstrations for the uninsured are underway in the region as part of our CAP program.
Outreach Candidates. Candidates for outreach include the local medical society, members of the state pharmacists association, the agricultural extension service, local health departments, long term care staff, senior centers, and a ministerial alliance representing faith communities. Target populations include persons 85+ years of age, living alone or institutionalized, at higher risk of medication errors, and living with activity limitations and few social supports. The target also includes any local family caregivers.
Area Served. Our sparsely settled, all-rural region (population 142,140) has large proportions of elderly with limited opportunities for screenings, drug utilization review, and disease management. Isolation places elderly at risk of ER visits, declines in health status, and prematurely in need of institutional care. Much of the area is designated medically underserved.
Proposed System Enhancements. Our goal is to better align healthcare providers and community organizations around the anticipated needs of frail elderly in the region. We want to identify, inform, and initiate interactions with frail elderly and their caregivers related to use of medications and potential need for social supports to maintain independent living. Objectives are to (1) build awareness and organize community groups and providers, (2) employ a minimum data set and web site to set benchmarks and share information, (3) roll out a medication management program, and (4) identify and address social support needs of independent living, high-risk elderly. We want to help these elderly to continue living in their homes and ease the transition to assisted living when it becomes necessary. The program promises to stimulate better coordination of services by regional providers, improve access to care across a broader region, reduce or contain prescription costs, and reduce the risk of medication errors, social isolation, and premature institutionalization.
Time Frame. Year One activities consist of curriculum development, development of baseline data, integrating assessment and case management processes, contacting community leaders, and outreach to 750 at-risk elderly. Years Two and Three will stress identifying at-risk populations, community outreach, and case management. By the end of Year Three, we hope to have local capacity to work with up to 2,500 elderly and 150 others with severe activity limitations. [Back to Main Page]