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Sky Lakes Care Management Outreach Program

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Sky Lakes Care Management Outreach Program

Hospital news | Wednesday, September 10, 2014

Contact: Thomas Hottman

Program is now serving patients referred from Cascade Health Alliance

H&N Staff Reporter

A new program through Sky Lakes Medical Center and Cascade Health Alliance hopes to help improve the health of the community.

Molly Jespersen of Care Management Outreach Program Molly Jespersen, the director of non-emergency medical transportation at Sky Lakes, said the Care Management Outreach Program will help remove barriers to health for clients, and she hopes the program will lead to a healthier future for both individuals and the community as a whole.

"Transportation is a huge barrier to health, among others like health literacy, social support, access to nutritious food, access to safe places to recreate and affordable housing. We're seeking to remove these barriers to health," she said.

Community health workers

The program employs three community health workers, who work directly with patients to address those barriers, Jespersen explained.

"The idea is to serve as the "vehicle" to transport clients from where they are in health today to where they need to and want to be, and we're here to help navigate along the way," Jespersen said. "Part of that could be literally driving a client from one address to another. But this program is much more than that."

She sees the community health worker as a bridge between the patient and the medical community.

Many roles

While a community health worker could drive a client to a doctor's appointment, the pharmacy, or another health location, they also can make sure the client understands and follows their medical treatment plans, offer health education such as understanding medical terms, work with dietitians to ensure clients know what a healthy meal is and how to cook it, provide social support, and more, Jespersen said.

For example, a community health worker could help a client achieve safe housing if they use a walker and are prone to falls around their home by making sure their paths are clear of cords that could be easily tripped over, Jespersen explained.

"If we can remove that barrier we can help people live a healthier life," she said.

New in the position

Jespersen, who previously worked for Klamath County Public Health, took on her new job at the hospital in April, while the community health workers started in July. The program took on its first patient in August.

Right now, the program is serving patients referred from Cascade Health Alliance, but Jespersen hopes to open it up to more patients through other Sky Lakes departments and community partners. Their patients now are the most vulnerable members of society, like those with chronic disease or with frequent hospital readmissions, she said, but the program has the potential to grow to serve the whole community.

"What's exciting to me is that we're really starting to understand that health doesn't happen in the hospital, it starts at home," Jespersen said.

PHOTO: Molly Jespersen is working as Sky Lakes Medical Center's director of non-emergency medical transportation.