Progress16: Heath & Retirement

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‘Just getting started’ Medical community continues to expand in Athens, county

By Kathi Nailling STAFF WRITER

In a city with a population around 12,000 Athens has become a unique medical community. From primary care physicians to cardiologists almost all medical issues can be treated within the community.

In 1979 Dr. Douglas Curran arrived in Athens along with Dr. Kenneth Lemmon and Dr. Jim Cox to start a primary care physician's practice that has lasted 37 years.

The medical practice has grown from the three doctors to 13 doctors with locations in Athens and Gun Barrel City.

“I think there may have been eight or nine doctors total in Athens when we arrived,” said Curran. “That would include the three of us.”

Curran thinks now there are close to 20 primary care physicians in Athens. Family physicians comprise just under 15 percent of the U.S. outpatient physician work force, yet they perform 23 percent of the visits that Americans make to their physicians each year Dr. Curran said the three doctors drew a circle around the outskirts of Dallas to locate where they would set up practice. Athens won.

“Athens was on the edge of exploding,” said Curran. “They were talking about expanding the old county hospital. It was exciting times in the medical field. We wanted to be part of it.”

Curran said he has sat back and watched as doctors and specialists have arrived in

Dr. Douglas Curran was one of the first to arrive in Athens. Now the number of physicians has doubled.

See EXPANDING, Page 4

Inside

Senior assisted living communities are on the rise in Athens • Page 3

Dr. Gary Williamson, chief medical officer and founder of Disciples Clinic, and Layton Holt, administrator from 2009-2014.

Standing in the gap

ETMC offers vast array of service in Athens and Henderson County • Page 6

for health care Disciples Clinic continues to grow despite national changes

By Chad Wilson EDITOR

The Affordable Care Act, more commonly known as 'Obama Care,' has affected millions, but the Disciples Clinic in Athens is one business that has not felt the impact.

The Disciples Clinic of Athens was created and incorporated in August 2008 as a charitable, nonprofit 501(c)(3) organization. The clinic opened for its first patients on January 5, 2010.

The vision of Gary Williamson, a practicing physician himself, the clinic occupies the former

“It has become a non-denominational, faith-based organization and from what all I can find, it is the most successful, most prolific organization of its type that has ever been in Henderson County.”

– Dr. Gary Williamson, Disciples Clinic founder Primera Iglesia Bautista Church at 604 York Street in Athens and consists of three examination rooms, a procedure room, a pharmacy/laboratory room, offices, chapel and two complete dental operatives.

Talk of the Affordable Care Act caused a moment of concern for

Williamson and the volunteers at the clinic before they realized how little the massive change in health care was going to affect their operations.

“We were really worried that it would cause a problem for us for some reason,” he said. “Many of our patients acquired the basic

health insurance through the Affordable Care Act but quickly found out that there was like a $5,000 deductible that they couldn't afford. A lot of them came back to us. We made a deal with them that if they want to keep their in-

See CHANGES, Page 4

In search of a good night’s sleep? Athens is home to the answer • Page 8

Special Section

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Assisted Living

BOOM Assisted living facilities booming in Henderson County

By Joe Elerson STAFF WRITER

If you've driven through Athens recently, you may have seen a fourth assisted living facility being built along Wood Street in Athens.

But what is causing the latest boom in assisted living facilities across our area?

According to Jill Lentini, operations manager for the new Country Place Senior Living it is the location.

“We decided a few years ago to come into Athens mainly because of the rural small town,” Lentini said. “That is really our niche market. We are a boutique style 24-suite residence. Athens really seemed like an ideal place for us to call home.”

She said when it comes to having four assisted living facilities in Lakeland House, Oak Wood Place Senior Living, Arabella and Country Place, they have a special bond with their residents.

“We really pride ourselves in becoming a part of the community. The people who we staff are local and we really wanted our residents to experience a microcosm of the life they had outside of our residence,” Lentini said. “Being cared for by their peers or their peers, children or people in the community is one way we can give back. Our residents get personal attention from our staff.”

The Assisted Living Federation of America defines

assisted living as a long-term care option that combines housing, support services and health care, as needed.

Assisted living is designed for individuals who require assistance with everyday activities such as meals, medication management or assistance, bathing, dressing and transportation.

Some residents may have memory disorders including Alzheimer's, or they may need help with mobility, incontinence or other challenges. Residents are assessed upon move-in, or any time there is a change in condition. The assessment is used to develop an Individualized Service Plan.

Blake Daniels is the owner of Oak Wood Place Senior Living and said this type of living gives Athens residents some of the same freedoms they have been accustomed to in the past.

“Assisted living here has given Athens another option for parents and grandparents to continually feel like they have that freedom of choice,” Daniels said.

“When they lived at home, they were able to choose when they wanted to eat, choose when they wanted to go to town, if they wanted to take a walk or watch TV. Assisted living still tries to incorporate that where they have that freedom of choice. We help them a little bit when they forget or need assistance.”

Daniels said in 2000 when they

Four assisted living communities are located in Athens. opened Oak Wood Place, there were only two assisted livings in the area with Lakeland House being the other one.

“We had six or seven nursing homes so there was a need for it.

The closest place you could go for an assisted living was Tyler or Dallas,” Daniels said. “I think the need for an assisted living and the need for that style of just helping residents take care of their basic necessity needs was a need. We call them ADL's (Activities of

Daily Living), which are getting dressed, managing their medicines if they need it, reminders to go to the doctor, reminders about coming to eat.”

With the recent additions of Arabella and Country Place, Daniels said his is the only one in the area that is family owned and operated.

“I am family owned and operated and can be here at 2 a.m. or 2 p.m. The other assisted living facilities are corporate owned,”

Daniels said. “It is a big deal to me that every single person here I hired locally. It meant a lot to hire local people and keep it where the money stays here in this area.”

When it comes to the future progress of assisted living facilities, Lentini said at Country Place Senior Living, they are looking to expand throughout the state since they have 55 sites they are looking at right now.

Daniels said his future plans for growth will hopefully include a Memory Care Unit, which helps with mild to moderate dementia sufferers.

“We want to get the Memory Care Unit, which is the next biggest step. We have one other assisted living that has that which is Arabella,” Daniels said.

“Memory Care is a locked unit since they are flight risk and forget where they are. That is our next project which will stand alone. I want to get this going within a year if not less. We have expanded and are currently expanding that area in our new building.”

Before you start your search for senior living options, ask yourself key questions about what you are looking for, what you need to know, what your ideal outcome would be a year after move-in, how you will deal with the cost of living in a senior living community, and how you will make the distinction between price and value.

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Health & Retirement

Changes in health care have not changed clinic’s mission Continued from 1 surance for catastrophic coverage, we would continue to see them. We do not accept insurance or any government funds, we strictly operate on private donations and volunteer services.”

On Aug. 1, 2012 the clinic qualified almost 900 patients while working with more than 7,500. In a few short years since, the clinic now has 1,400 qualified patients.

“Originally we planned to be able to serve about 500 people, we now serve over 1,400,” Williamson said. “I originally envisioned this as being in a couple of Sunday School rooms on a Saturday once or twice a month. It quickly became apparent that it was way bigger than that. It has become a non-denominational, faith-based, organization and from what all I can find, it is the most successful, most prolific organization of its type that has ever been in Henderson County.”

The Disciples Clinic is a primary care clinic which provides a "medical home" for patients by offering outpatient treatment for illness and injuries, health maintenance for chronic conditions, preventive health care and diagnostic service.

As a part of its basic services, the clinic offers complete laboratory testing and analysis, low cost prescrip-

Pictured is a scene from the Disciples Clinic grand opening in 2012. tion service, mammography, pap smears, x-rays electrocardiograms, nutritional and diet counseling, as well as diabetic testing and treatment.

“We do a lot of things outside of the clinic. We help people to acquire surgery and consultations among other stuff,” Williamson said. “The

whole purpose of the clinic is to help those who are trying to help themselves.

Either the husband or the wife must be working. We will see both the husband and the wife, if either of them is working at least 20 hours a week.”

Qualifications for the patients include: Henderson County residency, work at

least 20 hours a week, have no insurance including Medicare or Medicaid, between the ages of 19 and 64, total household income less than 200 percent of poverty level and pay a minimal co-pay based upon your income.

“We have had a steady flow of patients. We may get to a point where we

need to open another day but right now we are handling it with two full days and a half-day each week,” Williamson said. “We hope to eventually have an executive director who can be there at all times and maybe open the clinic another day each week. For right now, the demand is being satisfied with what

we have.”

The clinic is a nonprofit corporation supported by donations and grants.

A staff of volunteer physicians, dentists, medical professionals and support personnel provide services at a nominal cost based on the patients ability to pay.

“I have been very pleased with the participation of medical professionals in the community. We have nine providers that come and help cover shifts each month,” he said.

While service has grown each year, including 1,401 office visits in 2015, the biggest hurdle in reaching the community is getting the word out about the facility.

“One big problem we have is people not knowing about it. The target population we have are those who are working, but can't afford health insurance,” Williamson said. “We are trying to do outreach programs to talk with factories and fast food restaurants here in town. Most of our referrals are by word of mouth. I wish there was a more efficient way to connect with those who need us.”

The clinic is open on Tuesday and Thursday from 9 a.m. to 12 p.m. and 2 p.m. to 5 p.m. Saturday hours are from 9 a.m. to 12 p.m. For information, call 902-677-3604, or visit, www.disciplesclinic.org.

Expanding medical community a postive sign for Athens Continued from 1 Henderson County. “Athens is now just getting started.”

“Back when we started, family docs in rural Texas did everything.” Curran said.

Doctors in rural areas receive patient cases they might not normally come across in medical school or during their residency.

Because a rural physician is known as a "jack-of-all-trades," the physician will see a broader scope of illnesses.

Since a specialty hospital or clinic was inaccessible to the patient for geographic reasons, local physicians became proficient enough to provide a wider variety of services that might be passed off to a specialist if practicing in a big city.

With hospitals and healthcare providers across the U.S facing a shortage of qualified medical professionals, Athens tends to be the exception.

Curran said he considers it great to be able to grow with Athens and be part of the continued growth.

“We have some of the best physicians in Athens,” said Curran.

Another big facet to Henderson County is cancer treatment. Athens HematologyOncology has been treating cancer and blood disorders in Tyler since 1985.

The hematology-oncology clinic opened a location in Athens, and is now expanding to the Cedar Creek Lake area with an office in Gun Barrel City.

Fred Ernest, administrator

KATHI NAILLING/STAFF

The old Wulf Outdoors building is hardly recognizable now as it will soon open as Fresenius Medical Care. with AHO said, “We open locations where we think there is a need. Gun Barrel had a population with just such a need. We will start the Gun Barrel clinic small and grow it as needed.”

Ernest said some people are not aware of the quality of doctors that can be found in Henderson County.

“Some of our doctors were trained at M.D. Anderson and the Mayo Clinic. These are very good doctors,” he said.

Curran agrees that some of the best doctors can be found in small towns such as Athens, “You can't hide in Athens, you are part of the community.”

“If you’re not good and care about your patients you won't last,” said Curran. “You have to

be available.”

Curran believes a relationship with his patients is a necessity to good medical care.

“The residents of our county should feel very blessed,” said Curran. “There is a beautiful hospital and the county now supports many physicians.”

The hospital Dr. Curran refers to can trace its roots to the Henderson County Memorial Hospital. During the mid 80s the county hospital reached out to other health systems to find a partner who would help the facility improve and stay up-to-date.

East Texas Medical Center was selected and in 1986 the hospital on Palestine Street was opened.

In 2010 the hospital undertook a $32 million construction and ren-

ovation project.

While the architecture of ETMC may be impressive, the hospital itself offers an array of diagnostics, including a 64-slice CT scanner, MRI, nuclear medicine, digital mammography, ultrasound and X-ray.

Today this hospital provides Henderson County residents with a host of inpatient and outpatient services including a 24hour emergency department designated a Level IV trauma center by the State of Texas and serves as home base to one of ETMC’s Air 1 helicopters.

ETMC also provides a variety of other medical programs.

ETMC Cedar Creek Lake in Gun Barrel City houses a 24-hour emergency center, internal and family medicine clinic, rehabilitation center and an ETMC Olympic Center serving residents in western Henderson County. ETMC Home Health and ETMC EMS serve all of Henderson County.

The ETMC Cancer Institute operates a facility in Athens providing residents with an option for radiation therapy close to home.

Athens and Henderson County have come a long way since 1979 when Dr. Curran and his three colleagues arrived in Athens to open a medical practice.

Athens now has become home to specialities such as physical therapist, chiropractic, surgeons, cardiologist, podiatrist, urologist, gastrointestinal, cardiovascular, women's health care, ear nose and throat, neurology, dermatology, oncology, hematology, ophthalmologist, orthopedics,

pathology, pediatrics, radiology, sleep disorder, oral surgery and kidney dialysis.

Still there are specialities not yet available in Athens such as pulmonary or critical care. For these a patient still will visit the Tyler hospital to be treated.

Rural people and rural communities such as those found in Henderson County are faced with many of the same health issues and challenges confronting the rest of the nation – exploding health care cost, large numbers of uninsured and underinsured, and an overextended health care infrastructure.

Many areas in the United States suffer from a lack of access to comprehensive, high-quality health care. It has been estimated that approximately 65 million Americans live in communities with shortages of primary care providers – of which nearly 50 million live in rural areas.

With the medical industry’s continued growth, Henderson County still has a shortage of primary care clinicians.

Primary care means frontline care, and it can come from doctors (family physicians, internists, or pediatricians), physician assistants, or nurse practitioners. Primary care clinicians are the quarterbacks of patient care.

Athens has been successful in the health care industry because it started with a good primary care and continues to grow its medical community.

Many doctors such as Curran are choosing Athens because “it's a great place to raise a family.”

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ETMC has you covered Vast array of services offered in Athens and throughout the county Special to the Review Since the mid 1980s, ETMC Athens has been serving the healthcare needs of the people of Athens and Henderson County.

ETMC Athens is a full-service hospital featuring 127 beds and a qualified, compassionate team of nurses and allied professionals focused on you.

For patients in need of more specialized care, we offer our intensive care unit, which features 10 spacious patient rooms and the latest in monitoring services.

Surgical services The surgery department continues to grow. In 2015, nearly 4,500 surgeries were performed and two new surgeons joined the staff – Andrew Lehr, MD, board-certified otolaryngologist, and Nicholas Medel, DDS, MD, oral maxillofacial surgeon.

Other specialties offered include orthopedics, general surgery, urology, obstetrics and gynecology, podiatry, pain management and ophthalmology. A large number of laparoscopic procedures are performed at ETMC Athens.

The department features six operating rooms and a recovery unit with nine beds.

Our day surgery unit has 16 beds. All outpatient registration and pre-surgical testing are handled on the same floor for easy in-and-out access with an emphasis on privacy.

Our ETMC orthopedic surgeons, Dr. Kevin Fain and Dr. Matthew Rudolph, handle issues ranging from setting broken bones to repair-

ing damaged joint tissue to joint replacement surgeries.

ETMC Athens is equipped with a Spider arm positioner and HANA (hip and knee arthroplasty) table, equipment that lets the surgical team position the patient’s limbs for improved access, safety and comfort. The HANA table is particularly useful in hip-replacement surgery using the less-invasive anterior approach, which usually results in a faster recovery.

Labor and delivery Nearly 900 babies made their entrance into the world at ETMC Athens in 2015. The good news for Henderson County families is there is room for more.

ETMC Athens boasts eight spacious LDRP (Labor, Delivery, Recovery and Postpartum) rooms providing a comfortable environment for birthing moms and their families.

This concept allows most women to complete their hospital stay in one room.

Our nursery has 15 bassinets and modern security features to give new families peace of mind.

Emergency care Designated a Level IV trauma center by the State of Texas, our emergency department features 21 exam rooms, many with windows, and two trauma rooms. Our ED is staffed round the clock by board-certified physicians and nurses with advanced trauma training.

Additionally, an ETMC Air 1 heli-

copter is stationed at ETMC Athens to provide critical care transports when needed.

Primary care The ETMC First Physicians clinic in Athens is open Monday through Friday from 11 a.m. to 7 p.m. providing primary care for patients with appointments and walk-ins. The clinic, located at 2000 S. Palestine, Suite 100, behind the hospital, provides an alternative for people without primary care physicians who might otherwise look to the hospital’s emergency department for non-urgent care. To schedule an appointment, call 903-676-5580.

Diagnostic services Our array of highly sophisticated imaging technology includes two 64slice CT scanners, MRI, mammography, nuclear medicine, X-ray, ultrasound and bone densitometry.

Our fully equipped laboratory, accredited by the American College of Pathologists, operates 24 hours a day, seven days a week, ensuring your tests are completed in a convenient and timely manner.

Other services ETMC Athens also offers a gastrointestinal lab, pain management services, lithotripsy for kidney stones and diagnostic cardiology services, such as cardiac stress testing and cardiac ultrasound.

For more complete information on the services offered at ETMC

Athens, visit etmc.org/athens.

The ETMC Cancer Institute in Athens, 1801 S. Palestine, offers top-quality radiation therapy services for patients in the western part of our service region. ETMC purchased the center in 2009. The facilities were remodeled and re-opened in January 2011 featuring a state-ofthe-art dual energy linear accelerator, which allows patients to receive more precise radiation treatments with fewer side effects.

In September, board-certified radiation oncologist Bruce Ellerin, MD, began working full-time at the Athens cancer center. The addition of Dr. Ellerin allows more patients to be treated at the Athens facility.

Dr. Ellerin earned a bachelor’s degree in government from Harvard University. He earned his doctor of medicine from the University of North Carolina School of Medicine in Chapel Hill.

He completed internships in anesthesiology, internal medicine and pediatrics at UNC hospitals, and completed his residency in radiation oncology at Weill Medical College/New York Presbyterian Hospital in New York City. He is certified by the American Board of Radiology.

ETMC services extend beyond Athens to the lake area at our outpatient center, ETMC Cedar Creek Lake.

ETMC Cedar Creek Lake is a state-of-the-art facility offering 24hour emergency care, supported by diagnostic radiology and laboratory services, physicians’ clinics and an ETMC Olympic Center.

The facility boasts a Phillips High Field Open MRI scanner, making testing easier for larger-sized patients or those who deal with claustrophobia. Other imaging services available include 64-slice CT scanner, mammography, X-ray, ultrasound and bone density screening.

The ETMC Olympic Center at Cedar Creek Lake offers physical, occupational and aquatic therapy, along with cardiac and pulmonary rehab.

It is also a fitness facility featuring cardiovascular training equipment, free weights, strength training machines, group fitness classes and an indoor saltwater pool.

The ETMC First Physicians clinic at Cedar Creek Lake provides primary care for the whole family through its team of providers: Dr. William Giles, internal medicine; Dr. Susan McMullen, family medicine; Danny Fillip, physician assistant and Janet Smith, family nurse practitioner. To schedule an appointment, call 903713-1580.

For more information on ETMC Cedar Creek Lake, visit etmc.org/cedarcreeklake.

ETMC Home Health, with offices in Athens and Gun Barrel City, is the largest hospital-based home health care service in the region. Home health care delivers an extension of hospital care for people who are recovering, disabled or chronically or terminally ill and in need of medical, nursing, social or therapeutic treatment.

For more information on the services offered by ETMC throughout East Texas, visit etmc.org.

Home health care industry is on the rise

By James Robertson SPECIAL TO THE REVIEW

Gone are the days where spending our remaining time on this Earth in a hospital bed or nursing home is our only option.

In recent years the Home Health and Hospice industry has exploded, giving most Americans a granted final wish, to pass in peace and dignity in the comfort of their own home.

Leading experts from the National Hospice and Palliative Care Organization say that 90 percent of Americans prefer to spend their final days at home.

The importance of home health care and hospice is no different in our community here in Henderson County than it is in communities across the country.

“We're seeing an aging population,” said Oran Ferrell III, owner of Genesis HomeCare in Athens. “It's aimed at patients who are defined as homebound. That means patients who should not be driving, that's not an absolute requirement but if they do drive on occasion to pick up medicines or go to church, things like that don't disqualify them. They do have to be referred by a physician based on their needs.”

Ferrell bought Genesis HomeCare when he was 64 years old with the perspective of a growing population that needs care and is

Genesis HomeCare is one of several home health care businesses in Athens. aimed at patients who are homebound.

Since 2011 a tidal wave of 77 million baby boomers started to become eligible for Medicare.

Medicare will not pay for nursing home services but Medicaid will give assistance to patients who have assets lower than $2,000.

The boom in home health is projected to lower medical costs for the nation as a whole.

The Centers for Medicare and Medicaid Services has projected that over the next decade rates of health care spending will rise at lower rates than in the past.

However, between 2010 and 2050 the population of people over the age of 80 will nearly triple. This is where home health and hospice makes the biggest impact.

“We hope that we can improve their status and their health condition and that they'll return to a healthier

lifestyle as they were before,” says Ferrell.

“Because people are aging at the rate and to the extent they are, a lot of patients on home health care we are looking to maintain their health instead of seeing it decline.”

Top players and policy makers in the medical in-

“Because people are aging at the rate and to the extent they are, a lot of patients on home health care we are looking to maintain their health instead of seeing it decline.”

– Oran Ferrell, III

dustry are expecting the demand for home health to increase over the coming years.

In 2008 home health contributed a 7 percent share of Medicare and increased to 8.8 percent in 2011, according to data from the Kaiser Family Foundation.

For Ferrell the experience at the end of life afforded to patients by Home Health and Hospice service hits home, as it does for most people who have utilized the services provided by it.

Both of his parents, who lived into their nineties were on a home health service.

“They lived long and healthy productive lives and in the end their bodies just began to give out,” said Ferrell. “Their plea was always, I don't want to go to the hospital and I definitely don't want to end up in a nursing facility. That's what you hear from people crying out in the community. We're helping them stay home.”

The growth of home health care is evident, especially in Henderson County communities.

What the future holds for the service is not set in stone but more growth is expected.

Its aim is not to replace hospitals or nursing homes but the concept of getting healthier and passing away at home is ideal for a growing number of people.

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Three cities certified for retirement Athens, Chandler, GBC featured as top destinations for seniors From Staff Reports Henderson County is a popular place to retire according to the GO TEXAN Certified Retirement Community Program.

According to the website retireintexas.org, Henderson County is home to three certified retirement communities. There are only 31 in the entire state.

Those communities are Athens, Chandler and Gun Barrel City.

The GO TEXAN Certified Retirement Community Program is a certification and promotion program provided by the Texas Department of Agriculture.

To become a certified retirement community, each community must complete a rigorous application process including a retiree desirability assessment.

The GO TEXAN stamp of approval ensures each certified community has demonstrated through its application that it can meet the living, employment/volunteer, health, entertainment, ed-

ucation and safety needs of its citizens and visitors - all the things that make Texas a great place to retire.

Each city is featured on retireintexas.org with brief information on what makes the community desirable for retirees.

Athens is featured on the site as a city “where historic brick storefronts and a beautiful courthouse speak of the history of this East Texas county seat. The square is still the hub of activity with businesses surrounding the courthouse, just as they did in the early years. Fall brings a harvest of color with pumpkins, gourds, pine straw and a variety of mums. The town has an array of lights and decorations during the yuletide season.”

According to the site, Athens is surrounded by a number of lakes making it a boater's and fisherman's paradise.

The East Texas Arboretum delights nature lovers and hikers while the Texas Freshwater

Fisheries Center boasts 300,000 gallons of aquaria along with other exhibits at the freshwater fishing museum.

Other key attractions mentioned in Athens are the Henderson County Performing Arts Center, Henderson County Fairpark Complex, Trinity Valley Community College and the Cain Center.

Events mentioned in Athens are the hamburger festival and fiddlers contest.

According to the site, Chandler is a city with a balance of past, present and future; priding itself on hometown family values.

“Our residents enjoy a friendly, faith-centered community with

caring and committed community leadership, exemplary schools, and a superior police and volunteer fire department,” the site reads.

Lake Palestine and the Neches River offer great fishing and recreational opportunities in Chandler.

Outstanding medical facilities and shopping in nearby Tyler are just a few minutes away.

Local restaurants offer delicious, quality food and Tyler Pounds Field Airport is only seven miles away.

The three city parks offer great entertainment for the family such as baseball, catch-andrelease fishing, walking trails, horseshoe pits, and picnicking.

Parks in the city include Winchester, McCain and River.

The Chandler Public Library offers programs year-round for readers of all ages. The Chandler Museum offers a look back at the history of the area.

“We take pride in our local schools, churches and clean, safe neighborhoods,” it reads.

Many local events such as the Chandler Pow Wow, the Chandler Chili Cook-off, the Chamber of Commerce Golf Tournament, Cruise Nights, Chandler Car

Show, Holiday in the Park, mud run and the Chandler Classic, Heart of Chandler and Chandler Challenge Horseshoe Tournaments are enjoyed by all.

Sitting about an hour from both Tyler and Dallas, Gun Barrel City is featured as a place to “stay home and enjoy the peace and quiet and the relaxing atmosphere away from the hustle and bustle of the big city.”

Cedar Creek Lake is featured on the site as one of the main attractions to the city where people enjoy fishing, sailing, boating, and every type of water sport imaginable.

The site reads, “According to the Cedar Creek Chamber of Commerce, many of Cedar Creek Lake's residents are commuters, traveling to the Dallas area to work. They proclaim the hundred mile round trip well worth the serenity they experience upon returning home to the lake at the end of the workday. The shoreline of Cedar Creek Lake is also a popular spot for "week-enders" who have purchased vacation/weekend homes that they can enjoy year round.”

GBC is the second largest city in the county. Athens is the first while Chandler is third.

Vital services for low income families

By James Robertson SPECIAL TO THE REVIEW

Families with low income need not be discouraged about where to turn for medical assistance.

Henderson County has a program in place known as the Indigent Health Care program.

Under this program, residents of the county who do not qualify for assistance under other state or federal programs can still receive health care services.

Created by the Texas Legislature under Chapter 61 of the Health and Safety Code the Indigent Health Care program was created in 1985 with the intent to ensure needy Texas residents had access to necessary health care.

One hundred and forty three

counties across the state have this program in place.

Requirements for eligibility include being a resident of Henderson County and having little to no income.

Eligibility is also dependent on resources and several household factors, such as a person living alone or two or more persons living together where legal responsibility for support exists, excluding disqualified persons.

A disqualified person is one who receives or is categorically eligible to receive Medicaid.

A household is eligible if the total countable household resources do not exceed $3,000 when a person is aged or disabled or $2,000 for all other households. A household’s net income can’t ex-

ceed 21% of the Federal Poverty Guideline. For instance, if one person lives in the household, their income cannot exceed $206.

However, counties may choose to increase the monthly income standard to a maximum of 50% of the Federal Poverty Guideline and still qualify to apply for state assistance funds.

Other examples of income standards include a two person household cannot exceed $279, three person household not to exceed $352, four person not to exceed $424, and a five person household not to exceed $497.

Basic health care services provided by the program include physician services, annual physical examinations, immunizations, medical screenings, lab and

x-ray services, family planning services for controlling fertility and achieving optimal reproductive health, prescriptions, and inpatient and outpatient hospital services, to name a few.

Optional services include dental care, diabetic medical supplies and equipment, durable medical equipment, emergency medical services such as an ambulance to a hospital, home and community health care provided they meet Medicare/Medicaid requirements and are provided by a certified home health agency, vision care, occupational therapy such as a rehabilitation facility, and physical therapy along with several other services.

A full list of offered services can be found online at

www.dshs.state.tx.us/cihcp.

Residents of Henderson County must apply through an application, provide needed information, and then attend an interview.

The program is funded by the taxpayers of Henderson County.

CIHCP is run and administered by an employee of the county. Eligibility is determined by this person after the conducted interview.

This employee is also responsible for processing all bills for payment.

For more information or to speak with someone about eligibility, contact the Texas Department of State Health Services Primary Health Care Group at 512-776-7796.

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Restful sleep is possible Athens is home to area’s only sleep-disorder clinic

By Jeff Riggs ASSOCIATE EDITOR

Health problems generally have many doctors and hospitals that attempt to cure that problem.

There is one, however, that is relatively new in its recognition, and which has few who are qualified to treat it. That's sleep disorders.

Athens can have self satisfaction knowing it has one of the few sleep disorders specialists in the state, and the only one for a large part of East Texas.

Ronald D. Cates, MD, PA, who is also a diplomate of the American Board of Sleep Medicine, owns and operates the Athens Center for Sleep Disorders in Athens.

Cates said he helped organized a new science of sleep studies, which came to light in the 1970s or early 1980s. That's when sleep tests became available to the public.

“I started in sleep disorders in 1990 in an office near the old hospital in Athens,” Cates said. “In 2002, I came over here with a fellowship in sleep studies in Dallas, and I was accredited in 2003. And this is the first free-standing sleep center in East Texas.”

He said there are about 88 known sleep disorders, with sleep apnea being primary because it does kill people.

A website dealing with sleep apnea explains that it is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.

Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.

Sleep apnea usually is a chronic condition that disrupts your sleep. When your breathing paus-

JEFF RIGGS/STAFF

Dr. Ronald Cates, standing, started his practice in Athens in 1990. He moved to his current location in 2002. es or becomes shallow, you’ll often move out of deep sleep and into light sleep. As a result, the quality of your sleep is poor, which makes you tired during the day. Sleep apnea is a leading cause of excessive daytime sleepiness.

Sleep apnea often goes undiagnosed. Doctors usually can't detect the condition during routine office visits.

Also, no blood test can help di-

agnose the condition. Most people who have sleep apnea don't know they have it, since it only occurs during sleep.

A family member or bed partner might be the first to notice signs of sleep apnea. The most common type of sleep apnea is obstructive sleep apnea.

In this condition, the airway collapses or becomes blocked during sleep.

This causes shallow breathing

JEFF RIGGS/STAFF

An employee of Athens Center for Sleep Disorders examines the CPAP masks.

or breathing pauses. When you try to breathe, any air that squeezes past the blockage can cause loud snoring.

Obstructive sleep apnea is more common in people who are overweight, but it can affect anyone. For example, small children who have enlarged tonsil tissues in their throats may have obstructive sleep apnea.

According to Cates, “It strikes about three percent of children, and gets worse with age. About 50 percent of adults have it after menopause. It is worse for women. Of the entire group, six percent of adults suffer severe sleep apnea.”

Cates said about 30 percent of adults who have sleep disorders also have sleep apnea.

“Many snore, but when it becomes a concern is when we do not rest well,” he said.

Cates said that people often will not admit they have sleep disorders since they do not detect it themselves.

“People swear they have no problem,” Cates said.

“Physicians that direct them to us because of their sleep disorders say the patients are gripey or grumpy. Sleeping is a perception.

What you are is normal to you.

The body heals during sleep.

Sleep apnea prevents sleep.”

Cates added that it is “never normal to fall asleep during the day,” if you believe you slept during the nighttime hours. Cates said certain risks of health problems quadruple with sleep apnea.

Among these are weight gain, hypertension, diabetes, heart attacks by blocked arteries and strokes.

“Many people with sleep apnea are involved in car wrecks, because of their poor judgement and slow reflex,” he said.

Cates said the U.S. Department of Transportation states that 50 percent of traffic accidents with fatalities are related to sleepiness, and not alcohol.

The Athens Center for Sleep

Disorders website states that sleep disorders include, but are not limited to the following: • Breathing disorders– Sleep breathing disorders include some of the most frightening and lifethreatening conditions you or a loved one can experience.

Snoring is an extremely common and treatable breathing disorder.

• Restless leg syndrome People experience restless legs in many ways, but all describe the feeling as an unpleasant "creepy, crawly" sensation when they are sitting or laying still, especially at bedtime.

• Insomnia – Insomnia is the inability to fall asleep or remain asleep. Trouble falling asleep or staying asleep plagues many adults. Insomnia will affect your waking and sleeping hours.

• Excessive sleepiness – Narcolepsy is defined as constant sleepiness and the tendency to sleep at inappropriate times. Its impact on a person's life can be significant and even disabling.

• Nighttime sleep disorders – Almost 40 percent of all children will sleepwalk at some time, with peak occurrence between 3 and 7 years. Sleep walking often runs in families and most children outgrow it by adolescence.

Sleepwalking can also be associated with night terrors.

• Circadian rhythm – Delayed sleep phase syndrome (DSPS) is a disorder in which the person's sleep-wake cycle (internal circadian rhythm clock) is delayed by two or more hours.

Athens Center for Sleep Disorders has morning, lunchtime and afternoon appointments. It is handicapped-accessible.

They accept and file most private insurance plans, and accept Visa, MasterCard, AMEX, checks and cash. Athens Center for Sleep Disorders is located at 704 S. Palestine St., Athens. Their telephone number is 675-1717. Visit them also at www.AthensSleepCenter.com