Within Lincoln County, the towns of Jefferson, Somerville, and Whitefield have been designated as Medically Underserved Areas (MUA) by the Health Resources and Services Administration under the U.S. Department of Health and Human Services.
Jennifer MacDonald has recognized the disparity between available care and the needs of citizens and is working to bridge that gap as the director of an affordable nonprofit healthcare program known as CarePartners Plus.
Annually, a single large hospital will donate over $1 million in “charity” causes, MacDonald said. She began to realize that many hospital charity cases are individual citizens visiting emergency rooms for preventable reasons.
With a background in nursing and experience in administrative healthcare at St. Andrew’s Hospital, MacDonald said she found herself in a unique position to diagnose some of the institutional problems and offer some possible answers. She realized that there was a more cost-effective and beneficial solution for both the hospitals and the local community.
Certain uniting demographics became apparent as she studied the cases of those who frequented the emergency room. Most could not afford health insurance. Many had pre-existing conditions, but because they could not afford primary care would wait until failing health forced them to the emergency room before they would seek any sort of health care.
Others could not afford the medication they needed and consequently ended up in the hospital, turned out with a limited supply of the necessary drugs, and be forced to return to the hospital once the medication had run out once again.
“It is not good holistic care, but we would accept them and write them off,” MacDonald said.
Especially in light of the current economy, stories of people doing their best to survive have become more and more common. “I heard a lot of stories about people cutting their pills in half trying to make their medication last longer,” said MacDonald. “Some would re-use their insulin needles to save money, or try to borrow medicine from a friend. I would hear stories of people guessing their blood sugar levels.”
The more she mulled over the data, the more MacDonald began to think that there must be a better solution.
Aided by a $300,000 grant from the Maine Health Access Foundation, and with the support of both St. Andrews and Miles Memorial Hospitals, MacDonald has been working to expand the CarePartners Plus program which is specifically designed to reach out and act as an “all inclusive safety net” to those people who cannot afford healthcare and are ineligible for Medicaid. About 220 slots are still available in this program.
Basic eligibility requirements include being between the ages of 19 – 64, being 200 percent (or below) of the federal poverty level, having assets equal to or less than $10,000 not including one’s home and car, being a resident of Lincoln County and being ineligible for government-sponsored or employer sponsored health insurance.
“The program is designed to help these people get the care that they need,” said MacDonald. Everything from mental health to prescription medication and primary healthcare will work within people’s budgets to try to be sure that they are taking all preventive steps available to keep them from failing health.
Rather than overburden hospitals, CarePartners Plus works with a network of primary care doctors who have agreed to see patients within the CarePartners network for a small co-pay of $10. The program includes in-patient and out-patient care, as well as affordable medications.
In a few keystrokes on her computer, MacDonald demonstrated how she was able to apply to receive both brand name and generic drugs free of charge. She smiled as she said, “I am not trying to hide anything.”
Through websites like needymeds.org or programs such as the Together Rx Access Card, or even local discount pharmacy programs at stores such as Hannaford Brothers, Rite Aid, and Wal-Mart, consumers may be eligible for medications free of charge or vastly discounted prices.
One of the major ways MacDonald augmented the Lincoln County CarePartners program, which also has branches in Cumberland and Kennebec Counties, was to move away from what is known as a drug formulary.
Rather than simply providing coverage for a long list of pharmaceuticals, MacDonald sat down with a group of doctors and asked them a simple question: “If you were in a third world country- what are the basic meds you’d need?” From this question, they compiled a list of 11 acute medications that are aimed at providing necessary care for common ailments.
“It is not that it is a panacea for [patient] problems, but if I can get someone medication to help their heart murmur, their asthma, their high blood pressure, then I will,” said MacDonald.
MacDonald postulates that if people receive better primary care, have access to the medications they need, and have support through CarePartners Plus to advocate on their behalf, hopefully they will not visit the emergency room as frequently, and will ultimately prove that programs such as this are not only sustainable, but can save money.
The grant will run for three years, at the end of which, MacDonald hopes to “present to the hospital raw data that proves that keeping this population healthy strengthens the community, the hospitals, and improves peoples’ lives.”
CarePartners Plus relocated only a couple of months ago to Belvedere Road in Damariscotta where they have been gathering data as they have progressed in gaining more participants in the program. If the CarePartners Plus program proves viable and successful, it will be used as a model for other programs throughout the state.
MacDonald hopes to see the program grow in the future, offer more community educational programs on healthcare, gain involvement from local dentists involved to offer some sort of basic dental coverage, keep doctors appraised of the current generic drugs available, and really fulfill the goal of “whole patient care.”
Nevertheless, according to MacDonald the priority is always the patients “The goal is to grow thoughtfully and take care of people,” she said, “I am really passionate about this and I really believe in this program.”
