Health & Wellness 2013

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Sunday, February 24, 2013

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Enid News & Eagle

dealing with

UNKNOWNS

Despite changes in health care world, local hospitals doing well, chiefs say

By Jeff Mullin Senior Writer

In this, the third year under the Affordable Care Act, commonly called Obamacare, the brave new world of health care is becoming clearer, at least somewhat.

“I think there’s still some questions,” said Stan Tatum, chief executive officer at St. Mary’s Regional Medical Center.

“Certainly we have more answers as to its enforceability and constitutionality.”

“Some of the uncertainty has been removed,” said Jeff Tarrant, president of Integris Bass Baptist Health Center. “Is the act going to be repealed? No, that clearly is not going to happen.

“There’s still some unknown. Some parts of this you don’t know how they’re going to work until you implement them.”

The cost of not having health insurance One aspect of ACA is the expansion of Medicaid coverage, a provision states are allowed to opt out of after a Supreme Court ruling. Oklahoma has opted to opt out.

“That’s of significant concern to Oklahoma health care providers,” said Tarrant. “It’s of significant concern to a portion of our population, who, if Medicaid expansion were allowed to be implemented, would have health insurance.”

Oklahoma Gov. Mary Fallin rejected expanding Medicaid coverage that her administration said would cost the state some $475 million between now and 2020. The Oklahoma Policy Institute, however, says that figure is much lower, with the expansion potentially costing the state $28 million to $37 million per year in 2020.

The Affordable Care Act originally mandated states would expand Medicaid to cover people younger than 65 with income below 133 percent of the federal policy level. But last June the U.S. Supreme Court struck that down, giving states a choice in the matter.

Beginning in 2014, people whose employers do not offer health insurance will have the opportunity to purchase it directly in the Health Insurance Marketplace.

The largest remaining question concerning the Affordable better in relation to health care Care Act, Tatum said, is how many uninsured people will take providers across the country,” advantage of the opportunity the law offers to have some form said Tarrant. of health insurance.

Tatum said knowing St. “There’s a big part of me that really questions if they will,” Mary’s is going above said Tatum. and beyond quality Those who can afford it and who elect not to have health measures is gratifying, insurance will be subject to a fine beginning in 2014 under the but “it’s also constant so-called individual mandate. pressure and threat.

“The penalty itself may be quite a bit less than the cost of There’s lots of risks paying the insurance premium,” Tatum said. involved with losing And even if people take advantage of the government-spon- one percent of your sored insurance, the question becomes how many medical providers will refuse to accept it, as some decline to accept Medicare and Medicaid patients now, Tatum said.

“There’s a real question mark about will this really translate into access for these individuals or will they continue to use hospital emergency rooms because they can’t get a primary care physician?” Tatum said. “And Oklahoma’s been ranked the No. 1 state in the U.S. for a shortage of primary care physicians. If they don’t, it’s been a one-sided deal, and we end up los- Jeff Tarrant is president of Integris Bass Baptist Health Center. (Staff Photos by BONNIE VCULEK) ing a lot in the process.”

Tatum said hospitals could benefit if people who currently Medicare reimbursement,” which amounts to roughly $300,000 for St. Mary’s. are uninsured “do sign up for some kind of health insurance.”

“That’s probably been the biggest change for hospitals,” At present, Tatum said, if an uninsured person is treated at the St. Mary’s emergency room, “we are lucky to collect two Tatum said.

Medicare reimbursement is currently 7 percent below St. cents on the dollar.” Uninsured patients represent about 7 perMary’s costs. Medicare patients represent 60 percent of the hoscent of St. Mary’s business.

“We wrote off about $13 million dollars last year in unin- pital’s patients, Tatum said. sured (patient care),” Tatum said.

Increased cost of health care for health care

Just rewards with a side of risk

Stan Tatum is chief executive officer at St. Mary’s Regional Medical Center. (Staff Photos by BONNIE VCULEK)

One aspect of the Affordable Care Act directly affecting hospitals is Value-Based Purchasing.

“This was an effort by Medicare, primarily, to reward hospitals that are doing well from a quality standpoint and penalizing those who are not,” said Tatum.

Under ValueBased Purchasing, hospitals must report monthly to the centers for Medicare and Medicaid. Presently, one percent of the Medicare reimbursement for each patient is withheld and put into a pool, money that is then redistributed to hospitals based on their combined score of a number of quality measures, patient satisfaction measures and re-admission rates. That withholding will increase a quarter of a percent each year until it levels off at 2 percent.

“You can get back your one percent, plus you can get back even more if you’re doing extremely well on those measures,” said Tatum.

Currently, St. Mary’s is getting “a slight premium” from Medicare because of its quality score, while Bass likewise was “a slight winner,” Tarrant said. Only 44 percent of hospitals in Oklahoma are getting all or more of their one percent back, Tatum said.

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Like other employers, hospitals have had to offer group health insurance to the adult children of employees, up to age 26, under ACA. “Obviously there’s an expense associated with that,” Tarrant said.

In order to implement some aspects of ACA, Tarrant said, hospitals are having to find ways to cut costs. The measure offers a way to do that by offering incentives to providers to switch to electronic medical records.

“That’s one aspect of the bill that’s pretty major in terms of how we operate,” said Tarrant. “They’ve put some significant financial incentives that are strong encouragement for health care providers to take advantage of that. In terms of what we’ve done recently, in the last year and a half, that’s been a huge change for that.”

Integris Bass is almost 100 percent paperless when it comes to medical records, Tarrant said.

An expanding industry, meeting the challenges Moving forward, Tarrant said, hospitals face “challenges probably unlike any we’ve faced in the 30 years I’ve been doing this,” in large part because health care in the U.S. consumed about 18.4 percent of the gross domestic product in 2012. The U.S. economy was nearly flat in 2012, while the health care industry grew about 4 percent.

“That tells us as an industry we have an appetite as a country for health care that we can’t afford,” Tarrant said. “I hope we are closer as a nation to dealing with that reality.

“As a country our focus needs to be on, how do we eliminate unnecessary expenses and protect what people expect to be there for health care resources.”

Despite the challenges of the current health care climate, Tatum said, 2012 was a good year for St. Mary’s. The hospital hired 10 new physicians over the past year and a half, was rated in the top 18 percent in the nation by the Joint Commission, received an A rating for patient safety by the Leapfrog Group and was rated in the top 10 percent in the nation by Becker’s Hospital Review for low re-admission rate.

Integris Bass was likewise rated in the top 18 percent of the nation by the Joint Commission in 2012. In November, Carrie Willson of Integris Bass received an Oklahoma Hospital Association Spirit of Advancing Wellness Award.

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Page 3

at your

SERVICE

Health care facilities in Enid are out to prove ‘nursing home’ is an obsolete term these days

By Bridget Nash Staff Writer

Negative images that form in the mind at the words “nursing home” have been dissipating over the last decade, but the transition away from an institutional feel is far from finished.

“Nursing home. That term is considered obsolete. There are very few regular nursing home facilities anymore,” said Samantha Wegmiller, RN, BSN, NHA. Wegmiller is health care administrator for The Commons in Enid.

The Commons The Commons provides “aging services,” said Wegmiller, and the residents of The Commons and places like it are making decisions to move to such a facility before they are in need of assistance.

“They choose to come in as independent living individuals, and they just move through the tiers,” she said.

There often is a certain level a trauma when an aging citizen is forced to leave his or her home because of a need for care. That is why many are choosing to make the decision early, while they still are independent. Those citizens can make their home in a facility that offers aging services and never have to transition again.

Some would rather not live in an independent living facility, and places like The Commons recognize that.

Rehabilitation services are offered for those who want to stay long enough to be able to get well and return home.

“We have rehab for people going back home,” said Wegmiller. “That’s when you see (the system) really work.”

In addition to the different levels of service offered, The Commons and other facilities offer a different atmosphere than what was once normal for nursing homes.

“It is a hotel-style feel,” said Wegmiller.

The Commons offers spa service, complete with whirlpool, hair and nail services and light massage. They also have a gym residents may use for exercising, numerous activities for the residents and they serve meals “a la carte” 7:30 a.m. to 7:30 p.m.

“There is no tray line service anymore,” said Wegmiller.

The goal of the new aging services philosophy is to increase quality of life rather than let it diminish.

“It really is just delivering a set of services where it is no longer a nursing home feel, not institutional.”

And the changes are just beginning.

“It’s going to look different tomorrow in our business than it does today,” Wegmiller said. “It’s rapidly changing and that’s what’s exciting.”

Greenbrier Greenbrier in Enid also is taking part in important changes, including a remodel to accommodate residents and their quality of life and changing meal options so residents not only are better nourished but enjoy their meals.

“We work with Oklahoma Health Care Authority. It’s a

Shontae Outley, Greenbrier dietary staff member, serves Melba Best. Clients at Greenbrier may select a special meal each day or order from the regular menu. The staff follows the client’s dietary needs. (Staff Photos by BONNIE VCULEK)

program called Focus on Excellence,” said Brittany Conner, Greenbrier community relations director.

With Focus of Excellence, facilities can make changes to meet certain quality of life criteria and, when those criteria are met, receive additional funding. Making these and other changes over the past decade has made a mark.

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Residents of Greenbrier, no matter which level of care they need, are not living in an institution, they are living in a place that feels like a home.

Golden Oaks Golden Oaks is another large senior living community in Enid that is implementing programs changing the face

of nursing homes nationwide.

Golden Oaks also offers several tiers of senior living, from independent to assisted to nursing home care and even non-permanent care.

“We can offer short-term and respite care,” said Jill Hake, nursing center and skilled nursing administrator. “And we have on-site therapy — physical, occu-

pational, speech — and wound care.”

Golden Oaks staff have worked hard to change any hint of institutional atmosphere at the facility to residents to live in a facility that feels like a home.

“We’ve adopted culture change and a resident-centered approach,” said Hake.

Hake said Golden Oaks staff work to accommodate residents and allow them freedom to abide by their schedules while complying with individual doctor’s orders.

“This is your home, this is your life. You get to be in charge,” said Hake.

Golden Oaks offers numerous activities for residents and has a scenic walking trail, a lake with ducks and a swimming pool.

“My goal here is to take away that fear of nursing homes. It’s going to be OK. It’s going to be a home,” said Hake.

About two thirds of Golden Oaks nursing home residents come from adjacent Golden Oaks village.

The other third have transitioned from the independent and assisted living options.

“We have a lot of couples here,” said Hake. “Some of them, one spouse may live in the independent part and come over (to the nursing center) to visit every day. And some couples, they both live here.

“It is our goal,” she said, “to make their end years some of their best years.”

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Sunday, February 24, 2013

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Enid News & Eagle

a

calling MEDICAL

Health care classes are abundant, popular among students at Autry Technology Center

By Phyllis Zorn Staff Writer

Autry Technology Center offers a plethora of studies designed to launch students into the health care field.

Nursing Students can train to become licensed practical nurses and, if they choose, continue studies at Northern Oklahoma College for registered nurse certification and then go to Northwestern Oklahoma State University to obtain a bachelor of science in nursing.

But nursing is far from the only health care training at Autry.

The list of full-time courses includes dental assistant, health careers, medical administrative, medical assistant, respiratory care, surgical technology, radiography, MRI.

Her students learn about answering phones, customer service, scheduling appointments, billing, coding, insurance and transcription.

The 40 students enrolled in the program can take classes for half a day or a full day. It takes about 2 years to complete the program if they study half days, Davis said.

Surgical technology Kim McFarland, surgical technology instructor, said students learn a full array of techniques to assist in the operating room.

“We teach our students to pull their cases, set up a sterile field, learn the procedure so they can pass instruments and learn patient care,” she said. “They learn about laparoscopic procedures.

We really learn all the special-

Dental assisting Traci Gosney, dental assisting instructor, said the dental assisting program is 10 months. Students learn about fillings, x-rays, receptionist duties, alginate impressions, orthodontics and temporary crowns.

“It’s a lot of hands-on learning, to learn what they need to know to work with the dentist,” Gosney said.

“After spring break, the students have the opportunity to go out and get supervised work experience,” said Melissa Jenlink, marketing director for Autry.

“They actually get to work with the doctors,” Gosney said. “We get a lot of employment from doing that.”

Demand for the dental assisting program has caused it to grow from an afternoon-only program last year to a program with one set of morning students and another set of afternoon students. There are 30 currently enrolled in the program.

Business information Tera Davis, business information technology instructor, teaches courses in the medical administration program.

“I teach the front office skills,” Davis said.

Hayden Gulley (above) prepares instruments as Rikki Donnell and Alba Zuniga go through procedures during their surgical technology class at Autry Technology Center.

Matecha Richardson and Kristen Marsh (left) prepare a training mannequin for X-ray during a dental assistant class.

(Staff Photos by BILLY HEFTON)

ties — neuro, ob/gyn, orthopedic. My students are very well-rounded.”

Autry has agreements with with St. Mary’s Regional Medical Center and Integris Bass Baptist Health Center and Ponca City Medical Center for clinical experiences for surgical technology.

Enrollment in surgical technology and respiratory care are limited, and students are screened before being admitted.

Respiratory care Jim Grantz, clinical director for the respiratory care program, said students in the course are taught everything they can be taught about the heart and lungs during the two-year program.

“A lot of things I teach have to do with mechanical ventilation,” Grantz said Pharmacology, professional-

ism and customer service also are part of what students learn, Grantz said Deryl Gulliford, program director for the respiratory care program, said the students learn to assist patients with conditions like asthma, emphysema, cystic fibrosis, black lung disease, pneumonia, congestive heart failure and prematurity.

“Treating premature infants is one of the exciting parts of what we do,” Gulliford said.

“

U.S. U.S. NewsNews and World and Report World lists respiratory care as care one of Report lists respiratory as the care one oftop the health top health carejobs jobs in America, placing it 13th on the top 100 list.

“What else can you train for in two years that will generate a median salary of $60,000?”

Gulliford said.

Graduates of the respiratory care program have found 100 percent employment in the last two years, Grantz said.

The program admits 10 new students per year in a competitive process that includes interviews of potential students.

“It is academically challenging,” Gulliford said. “You do need to be prepared to study.

ACT scores make a difference, and high school grades do make a difference.”

Adult and career development health science classes at Autry cover medication aide and continuing education for CMA, emergency medicine, home health care, certified nurse aide training, medical administration, pharmacy technician, basic life support instructor updates, adult and child CPR and first aid.

What else can you train for in two years that will generate a median salary of $60,000? It is academically challenging. You do need to be prepared to study. ACT scores make a difference, and high school grades do make a difference.”

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Enid News & Eagle

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Page 5

NURSING a field of study

By Phyllis Zorn Staff Writer

Northwestern Oklahoma State University is one of three higher education facilities in Enid offering nursing instruction. Northwestern, Northern Oklahoma College and Autry Technology Center work together to help students advance their nursing education. Pictured (clockwise from top left) are Sheila Blalock, R.N., M.S., instructing NWOSU nursing students in Enid, Woodward and Alva from the Enid campus; NWOSU students (from left) Ryan Cooper, Titus Bakare and Frannie Landrigan perfecting their nursing skills at the Enid campus; and Cheryl Kent, interim director of nursing at NWOSU. (Staff Photo by BONNIE VCULEK)

Training to become a nurse is easy to find in Enid.

Autry Technology Center offers practical nursing education, Northern Oklahoma College offers registered nurse training and Northwestern Oklahoma State University offers bachelor of science degrees in nursing. In addition, the schools have agreements with one another to make it easier for nurses to move up to a higher level of education and receive credit for what they learned at the previous schools.

Autry Tech Autry offers a self-paced practical nursing program with 34 students currently enrolled.

The program combines clinical experiences and classroom courses.

Melissa Jenlink, marketing director for Autry, said it’s generally an 18-month program.

Students take certification tests to become licensed practical nurses.

“The practical nursing program is very flexible with the class schedule,” Jenlink said.

Nursing program hours are 8:15 a.m. through 9:30 p.m.

Monday through Thursday and 8:15 a.m. to 3 p.m. Friday.

Northern Jeanine Deterding, chairwoman of the nursing division for Northern Oklahoma College, said NOC’s program always is evolving, in keeping with the fact nursing is an ever-evolving field.

“We have changed our nursing schedule,” Deterding said.

“We now have clinical skills open three days a week instead

of two. We have gone to computerized testing instead of paper and pencil.”

NOC currently is working toward renewal of its accreditation from National League for Nursing Accreditation Commission. To remain in good standing, accreditation must be renewed every eight years.

NOC has 80 freshman and 80 sophomores in nursing studies this semester on all three campuses, with 23 freshman and 30 sophomores at Enid.

Northwestern At Northwestern Oklahoma State University, 75 students are studying nursing on campuses at Alva, Enid and Woodward, with 24 at Enid, said Cheryl Kent, interim director of nursing at NWOSU. The level of nursing education is driven by the students

themselves, Deterding said.

Students can get a two-year registered nurse degree and start earning good wages, then return to finish up the bachelor’s degree program later if that is what works for them.

“There is a push to have all nurses have their bachelor’s degree,” Kent said.

A bachelor’s degree opens doors to management positions and further education as nurse practitioners, Kent said.

NWOSU’s nursing program will expand to the University Center in Ponca City in the fall.

Classes will be offered via ITV for Ponca City students.

NWOSU also offers an RN to BSN online program that starts in July and runs two years.

The university is looking to begin the same program — with a fall start date — to accommodate more students, Kent said.

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Sunday, February 24, 2013

Enid News & Eagle

Page designed by: Violet Hassler

Care Team staff puts HOME in health care

By Cass Rains Staff Writer

Enid and area residents have many options for home health care assistance due to chronic illness, challenges of aging or recuperation after a hospital stay.

Home health agencies help individuals remain in their homes as long as possible by bringing nurses, therapists and other trained medical personnel in to provide services.

Once facet of home health care is private duty care. Unlike Medicare, a doctor’s order is not required to receive in-home assistance.

Private care can be compensated through private pay, respite vouchers, long-term care insurance or veteran’s benefits. CareTeam partners with Medicare and hospice agencies to provide a full range of care that allows families to keep their loved one at home.

“We provide personal care such as companionship, bathing assistance, homemaking tasks, transportation and dementia care,” said Sandy Griffin, office manger for CareTeam.

“This can be for as little as one hour to aroundthe-clock care.

“Even when patients require hospitalization or have to be admitted to a facility, families often ask us to be there to provide one-on-one care for their loved one.”

She said the family has the security of knowing all CareTeam members are licensed, bonded and insured and have passed stringent background checks.

“Our caregivers are required to undergo continuous training and our clients have the peace of mind knowing that all worker’s compensation and tax liabilities are covered by our company,” Griffin said.

CareTeam’s office serves Enid and the surrounding area.

“We can be reached 24 hours a day to answer any questions or concerns, as we never use an answering service,” Griffin said. “We can provide an in-home assessment at absolutely no charge or obligation and tailor our service to meet the individual needs and budgets of our clients.”

CareTeam is at 228 Kenwood and can be reached at (580) 237-0669. The company’s website, www.careteamhc.com, provides more information.

Care Team Home Health staff (above, from left) Melissa Arganbright, service coordinator; Sandy Griffin, office manager; and Shannon Bruey; R.N., review a client’s progress during a meeting at 228 Kenwood. Arganbright and Bruey (left) share ideas. The business provides prescribed in-home health care. (Staff Photos by BONNIE VCULEK)

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Sunday, February 24, 2013

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Page 7

QUALITY

it’s an issue of

Hospice facilities in Enid, area provide residents care when it’s needed most

By Cass Rains Staff Writer

Several area agencies provide hospice services to ensure quality of life for patients who are terminally ill or at the end of their lives.

Hospice service offers an alternative to aggressive treatments and provides emotional, and sometimes spiritual, support for patients and their families.

Circle of Love This year, Hospice Circle of Love is celebrating an important anniversary.

For 30 years, the facility’s staff and volunteers have helped terminally ill patients make every day count.

The not-for-profit organization was started in 1983 by a group of community leaders. They were familiar with the hospice concept and believed there was a need for such a service in this area.

Following several brown bag lunches, volunteers were trained, office space was donated and a nurse was hired. Six patients were served in the organization’s first year. One paid employee and several volunteers ran the operation.

In 1986, the organization was Medicare-certified.

Aides, social workers and counselors were hired. Over the years, chaplain and music therapy services were added. Today, Circle of Love has 26 employees and 32 volunteers.

Registered Nurse Lenora Beckwith, who has been with Circle of Love for 10 years, said she can’t imagine doing anything else.

“This is the best job I’ve ever had. Hospice is extremely rewarding because of the people,” Beckwith said. “Our staff is truly a team. We are here for the patient’s benefit.”

The hospice team provides a variety of services such as pain and symptom management, bed baths, counseling, pet therapy and spiritual and emotional support.

In addition, hospice supplies patients with medications and medical equipment related to their terminal illness. Hospice accepts Medicare and some insurance policies.

Circle of Love utilizes money from memorials and fundraisers to serve those who don’t have benefits at no charge.

The organization has donated more than $2.5 million in free care since it began in 1983.

“As a not-for-profit organization, we exist solely to support those in need,” Circle of Love Director Chad Caldwell said. “Our goal is to help patients make every day count.

“We really focus on quality of life.”

Hospice Circle of Love has served more than 4,000 patients throughout the last three decades.

“We feel honored to have helped so many patients and families at such an important time in their lives,” Caldwell said.

“I go in and just visit with the family and the patients to find out where they are spiritually,” he said. “A lot of time on my first visit we don’t even touch on religious things. We talk about family and the patient’s life.”

He said as a chaplain, he helps gather information about the patient, and if they have spiritual needs not provided by their church he helps guide them.

“It’s more about comfort care,” Stone said. “If it’s words of comfort they need, we provide that. If it’s medication they need for comfort, we provide that.”

Hospice care doesn’t just focus on the patient it focuses on the family.

“A lot of people are reluctant to put a loved one on hospice because they’re afraid it signals the end,” he said. “Anything we do does not make the end come sooner. It’s going to come at the same time. We provide care and comfort in the final months of life.”

Stone said there always will be a stigma around hospice care, especially around the holidays.

“A lot of time we can provide comfort, and sometimes the comfort we provide can prolong life and give families time for closure,” he said. “We try to bring them together at the end.”

Ross Health Care Ross Health Care is one of the state’s largest homecare organizations with offices in Enid, Oklahoma

Carter Healthcare Carter Healthcare Inc. also provides hospice services for communities surrounding its Enid office, as well as patients in Enid. “ W e h a v e nurses stationed through out the various counties that help us provide quality care to patients in the outlying areas such as O k e e n e , Fairview, Blackwell,” said Tina Morton, director of marketing and licensed clinical social worker. “Part of the beauty of working in our field is we start where we live and head out from there.”

She said Carter provides registered nurse and licensed practical nurse teams trained in symptom management, as well as home health-aide services.

“Our goal in 2013 is to really reach out more in the Enid community and surrounding areas so they have a better understanding of Carter, in particular the services Carter can provide,” Morton said.

She said one of Carter’s goals is to improve the understanding of what hospice can do for patients and families.

“We are just the highest level of home care insurance will afford a family,” Morton said, “especially when they don’t want to pursue aggressive care.”

Chaplain Ron Stone has worked with Carter for almost six years. Medicare requires a spiritual adviser in Hospice work, but Stone said he fills multiple roles for patients as a chaplain.

Ron Stone (above), the chaplain for Carter Health Care for almost six years, visits clients in their homes. (Staff Photo by BONNIE VCULEK) Hospice Circle of Love Nurse Aide Janet Burgess (left) poses with patient Joy Hager. The organization has served in Enid since 1983. (Photo provided)

“A lot of times we just ... provide a listening ear,” Stone said. “I find that I get into a lot of homes that some ministers don’t have the opportunity to get into.

That provides spiritual care as they need it.”

Stone said he’s been involved in church ministry for 22 years.

“I had a friend who was a hospice chaplain in the same position I’m in right now,” Stone said. “After hearing him talk about that a couple of times I asked him what I had to do to get into that.”

Stone joined Carter Healthcare Inc. as a chaplain in Bartlesville and later transferred to the Enid office.

“Things just worked out,” he said. I kind of fell into the position, a position I feel like God was preparing me for for 22 years.”

Stone said he wants people to know hospice care is about comfort for the patient.

City, Chickasha and Lawton.

President Hank Ross said the organization has been in Enid for about eight years.

“We offer hospice care seven days a week, 24 hours a day,” he said.

Ross said hospice care can last anywhere from a few days to years, depending on the patient. He said those who typically receive hospice care are those who are terminally ill and have a life expectancy of six months or less.

“The biggest complaints we get in hospice care is people said we wish we’d known about it earlier,” he said. “Hospice care is not about giving up, it’s just a different level of care. We address a vast majority of issues not just for the patient but for the family.”

He said hospice care is a benefit covered 100 percent by Medicare, but about two-thirds of those eligible do not use it.

“Only about 35 percent of people who have the hospice benefit through Medicare utilize it,” Ross said, adding he expects that number to rise. “It’s a fastgrowing part of Medicare benefits.”

He said he thinks hospice care is an area of service that will continue to grow.

“It’s the best level of care for the patient at that time,” Ross said. “We don’t want people to die in pain. We give them the comfort level they deserve.

“We need help coming into this world, and we need a little help going out.”

Page 8

Sunday, February 24, 2013

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Enid News & Eagle

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Page 9

a

COMMUNITY effort

Clinic offers help for the uninsured in Garfield County

By Phyllis Zorn Staff Writer

On a recent Tuesday evening, 15 people waited outside the door of Enid Community Clinic for the 5 p.m. opening. Five minutes after the door was unlocked, 30 people were in the waiting room.

One of them was 47year-old Andrea, who didn’t want to give her last name.

She and her husband rely on Enid Community Clinic for treatment of their diabetes, as well as Andrea’s lung disease, because neither has health insurance. Her husband is unable to work and is in his third round of applying for disability. Andrea works for a fast food restaurant.

“I just can’t afford it because I make minimum wage,” she said of her insurance options.

Andrea and her husband take five prescriptions each.

“I take three they send to Scheffe,” Andrea said.

Those medications cost less than $5. They get the other prescriptions, which are much more expensive, from the clinic.

In addition to Tuesday evening, when patients can see a physician, there is a nurse-led diabetes education clinic on Thursdays.

Patients can consult with a nurse between 9 and 11 a.m. most Thursdays.

It also is a service Andrea and her husband use.

“They even have a dietitian to help you,” Andrea said.

Janet Cordell, Enid Community Clinic coordinator, said the driving purpose in making the nursing clinic available is that it gives the clients more time with a medical provider.

“You can effect change if you develop a relationship,” Cordell said. “We don’t have time to develop relationships on Tuesday evenings.”

Cordell said on Tuesdays the clinic sees 50-60 patients, many of whom have chronic conditions such as diabetes, COPD and the like.

The clinic dispenses maintenance prescriptions for patients with chronic conditions so they do not have to see a physician so often.

Cordell said she notices a trend among the patients.

“We’re seeing a lot more people who are newly poor,” Cordell said.

“They’ve always had insurance or always had a doctor.”

The clinic doesn’t try to duplicate services.

They don’t provide pregnancy tests or birth control services, prenatal care, mental health services, immunizations, physicals or anything a patient can get elsewhere for free.

Nor does the clinic provide dental services, though that’s not for lack of need.

“One of the biggest needs is dental care,” Cordell said.

“They can’t do everything, but they do what they can,” Andrea said.

In order to be eligible for treatment at Enid

“

You can effect change if you develop a relationship. We don’t have time to develop relationships on Tuesday evenings.

We’re seeing a lot more people who are newly poor.

They’ve always had insurance or always had a doctor.”

Janet Cordell, Enid Community Clinic coordinator

Community Clinic, the patient must: • have no health insurance.

• have income no more than 185 percent of the federal poverty level.

• be a Garfield County resident.

They need to bring proof of address and income for the entire household and two copies of their federal income tax forms for each earner.

The clinic runs on volunteers. On any given Tuesday evening there are several nurses and nursing students, two physicians, medical students or residents and an interpreter or two.

Janet Cordell (above, left) goes over a chart with Joyce Pitt, an interpreter, at Enid Community Clinic. Ana Ledesma, PNS, takes the pulse of Roseline Mottelang (right) at Enid Community Clinic, which provides clinic services Tuesday and nurse clinic Thursday.

(Staff Photos by BILLY HEFTON)

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Sunday, February 24, 2013

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Enid News & Eagle

the

CHALLENGES of rural health care

Communities continue to find ways to keep health care facilities open, services available

By James Neal Staff Writer

As the nation’s health care industry adjusts to implementation of Patient Protection and Affordable Care Act, or so-called “ObamaCare,” some of the greatest challenges and changes may be seen in delivery of health care to rural areas.

Autonomous rural hospitals, already in decline before 2010, are increasingly moving toward affiliation with larger, corporately-held hospitals to better manage the bureaucratic requirements of new federal health care mandates.

Changing models Jeff Tarrant, president of Integris Bass Baptist Health Center, already is familiar with the model of rural clinics connected to larger metro hospitals.

From Enid, Integris staffs and manages clinics in Garber, Hennessey, Medford, Waynoka, Cherokee and Caldwell, Kansas.

Tarrant said some of the affiliated rural clinic staff work fulltime at their clinic location, while others split their time between Enid and the remote clinics.

He said staffing rural clinics is “based on the size of the community and the need for our presence.”

Integris also works out of clinic space in rural hospitals, as it does at Seiling Municipal Hospital.

The challenge for any rural health care provider, Tarrant said, is in filling the patient volume needed to meet staff and facilities overhead.

“That issue is typically related to community size, and with a clinic in a community the size of Waynoka — that’s a wonderful service and it’s a wonderful community, but there’s a fixed overhead expense just to have that facility open, and it’s a challenge.”

Tarrant said many communities, like Waynoka, would not have local health care without affiliated clinics.

“That’s a great example of a community that, without that clinic being there, people would have to travel quite a ways to receive care, and we see that as an extension of our mission.”

Tarrant said challenges of patient volume in rural areas can be overcome by tailoring services to community needs. He said that kind of creative efficiency becomes more necessary as the federal health care law reaches full implementation.

“I’d like to say (the future of rural health care) is as bright as ever, but the tone for health care across the country is that things don’t get easi-

er from here,” Tarrant said. “They’re going to get tougher. I hope that’s a message to our industry that we need to operate more efficiently. I would be shocked if we don’t see some evolution of how things have traditionally been done.”

Tarrant said that evolution in rural health care likely will entail most unafilliated rural hospitals seeking affiliation with larger providers, in order to benefit from larger administrative structures and stronger purchasing power.

“In terms of gaining efficiencies and economies of scale, having an affiliated provider can help make those hospitals a more financially viable option,” Tarrant said. “I think we will see more of that affiliation, and smaller hospitals will look for affiliation to gain that economy of scale.”

An exam room (above) and newly remodeled entrance (left) are seen at Great Salt Plains Health Center in Cherokee. GSPHC operates clinics in Cherokee and Medford with assistance of Health Resources and Services Administration Health Center Program grants, which provide partial compensation for providing health care to uninsured and low-income families. (Staff Photos by BILLY HEFTON)

“As a small hospital, it’s hard to do that.”

Tough shoes to fill

He said affiliation isn’t something that should cause concern for rural residents.

“If that (affiliation) solidifies the delivery of health care in some of the communities in northwest Oklahoma, I think that’s something even the communities should celebrate,” Tarrant said. “The loss of autonomy is a lot less onerous than the potential loss of health care.”

Administering duties Roger Knak, CEO and administrator of Fairview Regional Medical Center, said the transition to affiliation is necessary because of payment structures and increased administrative overhead associated with new federal health care mandates.

“The days of the true, stand-alone small hospital are coming to a rapid close,” Knak said.

Those days came in January for Fairview Regional Medical Center, when the board of the previously unaffiliated hospital voted to sign and affiliation agreement with St. Anthony Hospital of Oklahoma City.

Knak said Fairview Regional Medical Center will retain its name,

local board control and essential autonomy but will receive “strategic support” from St. Anthony in administrative support and health care planning.

“It’s really hard for a small, community hospital to do all those things,” Knak said.

He said the partnership with St. Anthony Hospital will “allow them to take care of more of the federal health care mandates for us, and give us stronger physician alliances to help keep our physicians up to date with the changing world around us.”

Okeene Municipal Hospital also is seeking stronger affiliation, strengthening an already-existing agreement with St. Anthony Hospital.

Shelly Dunham, CEO of Okeene Municipal Hospital, said the hospital has had an affiliation agreement with St. Anthony Hospital for five years.

She said she and the hospital’s board are “looking at a different agreement to tighten that affiliation.”

“Small, rural hospitals without an affiliation just can’t continue to survive with the health care reform law and the call for ACOs (accountable care organizations),” Dunham said.

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Aside from the adjustments in affiliation brought on by the new federal mandates, Dunham said an ongoing challenge is recruiting physicians to serve in rural areas.

She said one of her physicians is retiring in March, leaving a space that is increasingly difficult to fill.

“It’s not easy for a small community to recruit a physician,” Dunham said. “We’ve been working with a recruiter, but that’s a lot of money to pay the recruiters, and it’s a challenge.”

Tim Starkey, CEO of Great Salt Plains Health Center, also said physician recruitment is his biggest ongoing challenge.

GSPHC operates two clinics, in Cherokee and Medford. Both clinics operate with the assistance of Health Resources and Services Administration Health Center Program grants, which provide partial compensation for providing health care to uninsured and low-income families.

“It’s just tough to get doctors to come to rural communities,” Starkey said. “It’s definitely a competition between communities, and the small towns just lose out sometimes.”

Starkey said he has been working with a recruiter for six months to attract a physician to the GSPHC clinic in Medford, but the position remains open.

Starkey said it is easier in rural areas to recruit nurse practitioners and physician assistants, “but rural folks want to see a doctor in their community.”

Overcoming obstacles Despite the ongoing challenge of recruiting doctors, Starkey said GSPHC is considering expanding its

grant-funded clinics to a third community.

He said the GSPHC board has considered several communities, but nothing has been finalized, and GSPHC is in the early stages of applying for the extra grant.

“We’re applying for the grant, but it’s very competitive, and only 25 sites will be selected nationwide,” Starkey said. “The likelihood of us getting funded is fairly low at this point. We think it’s worth going ahead and sending in the application in case there’s more funding down the road.”

Starkey said GSPHC will look for a community not already being served by primary health care services, if they receive the additional grant funding.

“It’s really about working with the local communities,” Starkey said. “Some communities already have primary care practices. We’re looking for communities where we can go in and not compete with other providers already in the community.

Our mission is to serve communities that have lost their hospital, or don’t have a hospital in the rural areas.”

Opportunities out there As rural health care providers continue to adjust to changing federal health care mandates, changing affiliations, and changes in available funding, some see a bright spot on the other side of all the change.

“Health care is sitting in a scary place right now, but it’s also a great opportunity,” Knak said.

He said the new health care structure’s increased emphasis on prevention “moves us from sick care to health care.”

“That’s what we need to get more into the market of,” Knak said, “is making our community healthier, so they don’t need as much health care.”

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Enid News & Eagle

Sunday, February 24, 2013

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Page 11

the IRTH of a new focus

B

Garfield County Health Department wants healthier residents from start

By James Neal Staff Writer

The effort to build a healthier community begins before birth. That’s the focus of a new initiative at Garfield County Health Department aimed at reducing the county’s disproportionately high rate of infant mortality.

Maggie Jackson, a health educator at Garfield County Health Department, said infant mortality in Garfield County has averaged about 12 deaths for every 1,000 live births over the last five years, significantly higher than Oklahoma’s five-year average of 8 per 1,000, and twice the national infant mortality rate of 6 per 1,000.

According to health department figures, the top five factors contributing to infant death in Oklahoma are: • congenital malformations, or birth defects.

• disorders related to premature birth or low birth rates.

• Sudden Infant Death Syndrome (SIDS), including sleep-related deaths.

• maternal complications during pregnancy.

• infant injury, including abusive head trauma and shaken baby syndrome.

A sleeper suspect Jackson said reducing the risk for infant mortality in Garfield County requires education, prevention and changing the overall community environment to make Garfield County healthier for residents of all ages.

One of the simplest changes, Jackson said, is in following safety guidelines when putting babies down to sleep to avoid the risk of SIDS. “There are avoidable factors contributing to babies dying of SIDS, such as sleep position, being suffocated by sleeping with adults or by having too many blankets or toys in the crib, or by falling off a sleeping surface,” Jackson said.

“Culturally, your mom will pass down to you ‘This is how I put you down to sleep,’” Jackson said. “It seems soothing and nurturing to comfort a baby by having them sleep in your bed, but that can be detrimental.”

She said babies should be

placed on their backs in a crib located close to the parents’ sleeping area, without toys or blankets in the crib.

Jackson said babies should not be swaddled in blankets to put down to sleep, but should instead wear a sufficiently warm “onesie.”

Jackson said parents should avoid overdressing babies for bed, as overheating increases the risk of SIDS.

Community factors Aside from preventing SIDS, there are a number of health factors specific to pregnancy that affect the county’s infant mortality rate, including lack of folic acid during pregnancy, gestational diabetes and hypertension.

But, there is a longer list of health factors that affect the community at-large and contribute to infant mortality when women carry their health issues into pregnancy.

Jackson said those include maternal tobacco use and tobacco use in the home after birth; poor maternal diet and nutrition; unhealthy eating habits; and obesity.

Overcoming those environmental risk factors is the long-term solution to lowering infant mortality in Garfield County, Jackson said.

Funding education Toward that end, the county recently was awarded a $20,000 Preparing for a Lifetime grant from Oklahoma State Department of Health.

The program is a state initiative to provide women and families the education and resources needed to achieve healthier outcomes for their babies.

Jackson said Garfield County Health Department will use the grant to provide educational materials on topics such as prenatal health, breastfeeding, SIDS prevention, tobacco cessation and other topics related to pregnancy and infant health.

She said the grant will enable the county health department to obtain educational materials “culturally appropriate” for the health department’s clients.

MAPPing a plan The health department also will address infant mor-

A parent (top) caresses a plush bear inside an empty crib. Jalene Jackson’s hands (above) form the shape of a heart around her infant son’s feet. Abel is the youngest

of four Jackson children. Garfield County Health Department has taken aim at reducing the infant mortality rate in Garfield County. (Staff Photos by BONNIE VCULEK)

tality through its broader initiative to improve health outcomes in the county, Mobilizing for Action through Planning and Partnership (MAPP).

MAPP is a coalition of more than 20 community partner agencies in Garfield County, in the health care, treatment, prevention and social service fields.

MAPP began building a comprehensive plan to improve the county’s health last year. The process began last June with a public listening session, then entered a process of identifying key areas of public health in the county that could be impacted with available resources.

The MAPP coalition recently selected its top six areas of emphasis in the county: • tobacco cessation • nutrition and physical activity

inventory of the county’s strengths and weaknesses related to the six selected areas of emphasis.

During that process the health department and MAPP coalition will continue to host public events aimed at promoting healthier lifestyles.

The next of these events will be the annual “Kick Butts” tobacco cessation and prevention campaign, sponsored by the Garfield County Tobacco Free Coalition.

Kick Butts will begin March 17 with a kickball tournament at Meadowlake Park.

Teams of at least five members will compete for prizes and bragging rights.

Teams and individuals also will compete to see who can pick up the most cigarette butts in the park.

Prizes from the March 17

• infant and child health • domestic violence • chronic disease • access to health care and mental health services Jackson said by addressing those areas, the health department and its MAPP partners hope to not only reduce infant mortality in Garfield County but promote lifelong healthier outcomes.

Taking it public “There are different levels of prevention,” Jackson said, “and the primary prevention is changing the environment in our county.

We want to reach all levels of health and change the environment in our county to make it a healthier place to live.”

The next step in the MAPP process will be to conduct a lengthy “Forces of Change Assessment,” an

event will be presented March 20 during an awareness day planned at Oakwood Mall.

The March 20 event also will feature a youth poster contest focused on reducing tobacco use in the community.

The health department also will host the “Walk This Way” competition beginning April 13, with teams competing to see which team can log the most miles walked during a six-week campaign.

Jackson said the goal of the Walk This Way competition is to get each team member to walk at least 30 minutes per day and promote healthy exercise habits that will last long after the competition.

Jackson said more details on the Walk This Way and Kick Butts events will be available soon.

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Sunday, February 24, 2013

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Enid News & Eagle

a

DOCTOR in the house

St. Mary’s Regional Medical Center patient access services staff assists clients as they arrive at the hospital. (Staff Photo by BONNIE VCULEK)

St. Mary’s looks inside in order to implement changes in community health care offerings

By Robert Barron Staff Writer

St. Mary’s Regional Medical Center will spend 2013 improving its coverage and simplifying record-keeping, said Stan Tatum, hospital administrator.

Tatum said the hospital is pursuing a restart of its University of Oklahoma Family Residency program. The hospital had one from 1976 until 2008. He predicted Enid and the surrounding area will obtain new primary care physicians through that program.

Tatum said it would be one of the secondary programs of the hospital that would be key in an effort to try and respond to the shortage of primary care physicians.

“Oklahoma is the number one state in shortage of primary care physicians,” Tatum said. “(State) Governor (Mary) Fallin has listed it as a priority.”

One major improvement the hospital will make in 2013 is internal, with a new electronic health records system. Installation of the patient information system is scheduled this week, Tatum said.

Chief Nursing Officer Doug Coffey said the system will consolidate information into an overall record, providing more access to providers. It is designed to help implement best practices for patient care, Tatum said.

“Our goal is to get patients better and healthier,” Tatum said.

By integrating all of a patient’s information into one system treatment is safer. If there is a mismatch of drugs or other problems the system will find it. It also provides better affordability of care. All information will remain private, he said.

Tatum said the health care industry is behind other industries in capability and is in the process of catching up.

Focusing on care St. Mary’s recently announced a new hospitalist program. That process will enable the hospital to take pressure off doctors by having the hospital’s physicians, or hospitalists, concentrate care on those seriously ill.

“Patients who come into the hospital are very sick. To have someone whose sole focus is treating inpatients, they receive better and more timely care,” Tate said. “It will be a big benefit to the hospital and our patients.”

Physician recruitment is always a primary goal, Tatum said. He considers the hospital fortunate because it has recruited 10 physicians in the past 18 months. Some Enid physicians are nearing retirement age, plus Enid is growing, and St. Mary’s is definitely targeting primary care physicians and specialists. Primary

Caring Makes a Difference

care and neurologists are a huge Affordable Care Act, or ObamaCare, as part of an overall goal to need, and doctors practicing in areas puts a focus on continuum of care. increase care in rural areas, Tatum In the past, care often stopped said. of pulmonary and general surgery, orthopedics and pediatrics also are when the patient was discharged.

The hospital industry is changNow the hospital will be penalized ing to value-based system to meet in high demand.

The hospitalist program helps in if readmittance rate goes above a federal government quality critethat regard, because it offers those level set in the new law, Tatum said. ria. who do not have a physician peace of mind when it comes to being treated in-patient.

Krista Roberts, chief operating officer, said one of the most common queries from individuals new to the community is access to primary care physicians.

With hospitalists, St. Mary’s can be more productive and see more patients. The traditional model of primary care is becoming nontra- Stan Tatum, chief executive officer at St. Mary’s Regional Medical Center, poses in the hospital. (Staff Photo by BILLY HEFTON) ditional, Roberts “We make sure our patients get said. St. Mary’s is planning to conIt’s part of the process, Tatum tract with a company that employs followup care that is timely,” he said, of ensuring quality care, hospitalists and covers hospitalist said. which St. Mary’s has offered for For example, when a person with years ... and has the awards to services 24 hours a day, she said.

Many patients who come to the congestive heart failure is dis- prove it.

During 2012 St. Mary’s emergency room do not have a pri- charged physicians must continue to mary care doctor. The hospitalist monitor fluid retention and fol- received a number of national will act as that patient’s physician lowup on that patient’s needs before awards from hospital rating while they are in the hospital and he or she has to return to the hospi- groups for patient safety, low readmission rates for primary patients. will recommend a local physician tal, he said.

They also were cited for a commuwhen they leave. They are also dis- A changing future nications system developed by St. cussing how they align past acute care services to prevent recidivism St. Mary’s plans to place two Mary’s staff and received a top physicians in Kingfisher, through quality award for the second year to the hospital, Tatum said.

The Patient Protection and St. Mary’s Physicians Association in a row.

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Enid News & Eagle

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Page 13

the

IMAGE of health care Integris Bass sinks millions into upgrading equipment, improving facilities and helping build the local economy nature of medical progress.

They soon will replace its medical catheter lab for a cost Integris Bass Baptist Health Center is gearing up for a busy of more than $1 million.

Integris plans to replace its 2013 and is taking steps to stay close to the community health nuclear imaging department needs, said Jeff Tarrant, hospital administrator.

“This community needs additional primary care providers. at a cost of another million.

I hope there is a day when we don’t have to say that,” he said. The hospital also plans to “It is difficult to stay current with the need because there are spend $56 million on capital a number of primary care physicians leaving their practice, acquisition this year. many because they are nearing retirement. The Integris Urgent “If you don’t keep that current, you can’t maintain the quality of servI wish we had primary care physicians waiting for ice,” Tarrant said. “These patients.” expenses never Jeff Tarrant, administrator, Integris Bass Baptist Health Center go away.”

In addition Care Clinic has seen much growth in the type of people who to those plans, the hospital will get a facelift and see come in who are sick and have no primary care physician.”

Tarrant said that is not what the facility is designed for, but some improvements to the exterior of the building. people are seeking medical care wherever they can.

“I wish we had primary care physicians waiting for patients. Tarrant said renovations will If you call a physicians today for an appointment the earliest extend to all three buildings so that all three look like they you can see one is mid-April,” Tarrant said.

Integris will add three residents graduating this year, and are part of the same facility.

In 2003, the hospital comTarrant thinks two will commit to staying at Integris to practice.

Integris Bass has a medical student program affiliated with pleted an $8.2 million expan- Integris Bass Baptist Health Center has installed a new MRI system in its newly remodeled imaging center. Vicky Godding, direcOklahoma State University. He said it is not difficult to recruit sion project that tripled the tor of radiology, played a key role in design and upgrade of the hospital’s imaging equipment. (Staff Photo by BONNIE VCULEK) doctors to Enid. The hospital is looking for someone with rural size of the Emergency Department and included a new Women’s Center, but Integris generation reaches retirement age. or midwest background who is family oriented.

Enid has become a health care destination and is a natural fit.

“Those are the right conditions and with those we have won- was only getting started then.

Aging is a key element in hospital growth. Garfield County Health care is also an important part of the local economy. derful success,” he said. “It’s very expensive to recruit and start Tarrant said he believes Integris is poised for future growth as a practice.” has an aging population, Tarrant said.

Technically, the hospital is preparing to go online with a new “When people age they leave the work force and typically health care needs continue to grow.

“We have created opportunities going forward that as the MRI system. The old one is six years old and the equipment become patients. You can plan for that,” Tarrant said. The numcosts millions of dollars to purchase. Tarrant called that the ber of retirees has increased in recent years as the baby boomer environment gets tougher that will always be opening doors.”

By Robert Barron Staff Writer

“

Page 14

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Sunday, February 24, 2013

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Enid News & Eagle

“

We are doing a lot of trauma assessment with kids who have been through trauma.”

Rebecca Kroeker, MHR, LPC, RPT-s, ATS Counseling-Focus Institute Director

Chelsey Speakman (left), a behavioral health and rehabilitation specialist, reads to several children at Choices Institute. Casey (below), a Calico feline owned by Joyce Bean, checks out a visitor’s camera lens during a session at Choices Institute. The cat loves the extra attention and helps provide calming moments for clients.

(Staff Photos by BONNIE VCULEK)

medicine for the

MIND

Enid and area residents have many options in the field of mental health

By Bridget Nash Staff Writer

When our bodies don’t feel exactly like we know they should there are many things we do. We exercise or watch what we eat or go to the doctor to find out what’s wrong.

When our mind, our true self, is overwhelmed or hurt or confused, we often just try and tough it out but, the truth is, sometimes we need a little help.

Enid has many mental health options available to people of all ages and needs.

ATS Counseling-Focus Institute is one of Enid’s many options for counseling and therapy.

“We try to place people’s needs with the therapist who will best meet their needs,” said ATS Counseling Director Rebecca Kroeker, MHR, LPC, RPT-s.

ATS Counseling offers a variety of services for children, adolescents, adults, couples and families.

ATS Counseling has 42 employees with varying specialties who are trained and eager to help people through anything they may be facing.

“Because we have such a

are required to be, Kroeker said that is not always the case. About once a year, she said, someone voluntarily enrolls in the program, recognizing abusive tendencies within themselves and willing to correct them.

Growing Hope Network also offers its Compassions Workshop for fathers with aggressive tendencies.

Choices Institute is another option in Enid for those seeking counseling or therapy.

“We offer day treatment options as well as traditional,” said Ellen Huffmaker, board certified psychiatric nurse practitioner.

Choices Institute day services are for children with greater needs, and the facility’s traditional treatment option is for people of all ages who want the traditional once-a-week session.

There also is an option offered that falls in between day treatment and traditional. Choices Institute offers modified traditional sessions to help children learn socialization and to re-direct their emotions.

Choices Institute soon will add what Huffmaker calls an exciting new service to its list.

“We will be offering some medication management in the future,” said Huffmaker. “That is a need in Enid.”

large staff, we’re really able to individualize people’s care,” said Kroeker.

Recently ATS Counseling has been helping more children who have been through emotionally difficult events.

“We are doing a lot of trauma assessment with kids who have been through trauma,” said Kroeker.

ATS Counseling began in Enid in 2006 and has grown tremendously. There are now ATS Counseling facilities in Enid, Oklahoma City, Stillwater, Ponca City and Hennessey.

Kroeker also is involved in Growing Hope Network, an organization that works in offender re-entry.

“Part of it is working with batterers and domestic violence,” said Kroeker. “We have been certified in the attorney general’s program Batterers Intervention Program.”

Kroeker said the state of Oklahoma requires anyone convicted of domestic violence complete 52 weeks of Batterers Intervention Program.

While nearly all offending participants in the Growing Hope Network program are there because they

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Youth and Family Services also offers numerous programs for children, adults and families.

Other mental health options in Enid include End Point Counseling and Integris Bass Baptist Behavioral Health.

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Enid News & Eagle

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When a person is diagnosed with a disease or condition, whether it be life-threatening or simply life-changing, it is natural to feel isolated and alone.

One of the goals of the many support groups available in Enid is to firmly dispel that notion.

Both Integris Bass Baptist Health Center and St. Mary’s Regional Medical Center offer a number of support groups dedicated to those dealing with any number of conditions, from diabetes to Parkinson’s, from cancer and cardiac rehabilitation to fibromyalgia and lupus.

The meetings are a mixture of the social and informational, said Amanda Stinnett, an exercise physiologist at St. Mary’s who is involved with the hospital’s cardiac support group.

“The biggest benefit is probably moral support, knowing that they can come and they can speak with other patients who have gone through the same thing and they don’t feel so alone in their journey, getting through and healing from their procedures,” she said.

“It’s a pretty hard thing to go through, and it can be traumatic, and it’s life-changing.”

speakers come in,” said Lenherr.

Support group members get a lot out of the experience, but so do the facilitators.

“The best thing is just seeing the smile on their faces when they realize they’re not in this alone, that

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to the support group reported less fatigue, less pain, and the emotional benefit that they felt more hopeful,” she said.

“On the medical side of it they also outlived the other

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The group meets at 4 p.m. on the third Thursday of every month at Central Christian Church and is facilitated by the Rev. Don Johnson.

Enid-area support groups are listed in the Datebook section of the Enid News & Eagle’s Sunday edition or under the Lifestyles section at enidnews.com.

For a list of support groups at Integris Bass, call Luetkemeyer at 548-1110.

Information on support groups at St. Mary’s is available at www.stmarysregional.com/community-information/supportgroups.

For information about Enid Spiritually Based Cancer Support Group, contact Johnson at 4022612.

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varies accordingly to what they whether or not they affected health group by an average of 18 months.” (the members) are interested in.

First-time support group particioutcomes. The group studied 80 “Mostly it’s food. There are a lot breast cancer patients whose dis- pants often enter the meetings with a of food questions touch of apprehension, Luetkemeyer because that makes a said, but that quickly fades. big difference in “It has been rewarding, too, to see managing their disthe friendships that form in those ease.” groups,” she said. “A lot of times Ruiz facilitates the folks will enter that room for that group, she said, but first meeting the members aren’t and not know shy about sharing a soul around their own experience the table, and The biggest benefit is probably moral support, with diabetes. a year later knowing that they can come and they can speak “They like to they’re all with other patients who have gone through the share about their life chatting, same thing and they don’t feel so alone in their with diabetes,” she they’re fast journey, getting through and healing from their said. “They try to friends. It’s help each other.” been a really procedures. It’s a pretty hard thing to go through, rewarding The goal is to help and it can be traumatic, and it’s life-changing.” thing to be a patients better cope part of. with chronic diseases Amanda Stinnett, “I think like diabetes. an exercise physiologist at St. Mary’s Regional Medical Center that’s the “Even though biggest benewe’re their support fit, that feelteam and they can call us for questions, they have to ease had already metastasized. Half ing of support and knowing that live with it every day,” said Ruiz. the group went to support group you are not alone.”

“Our idea is to give them the meetings daily, while the other Reluctant participants knowledge so they know what to group didn’t. do.”

“They found the group that went Depression often sets in after a person is diagnosed with a lifechanging condition, Luetkemeyer said.

“When you can share your experiences with other people who are in that same situation, it is helpful for everyone,” she said.

The support groups also benefit caregivers, as well as those dealing with life-changing conditions.

“We also deal a little bit with care-giving support in each of our support groups,” she said. “It’s important for a spouse or caregiver to know what lies down the road.”

Sometimes patients are reluctant participants in support groups, at least in the beginning, said Stinnett.

“My favorite is when we have a patient come in who just does not want to be here, at all,” she said.

“Once they start coming they realize how relaxed we are and how friendly our patients are. It’s like a switch, they want to come, they want to be there.”

“It’s good to know you’re not the only one hurting in a certain place or you’re feeling dizzy from low blood pressure,” said Jessica Lenherr, a registered nurse involved with the St. Mary’s cardiac support group. “To share that with someone else kind of helps release some of that stress, which is a big thing after heart surgery.”

Anita Luetkemeyer, who serves as director of public relations at Integris Bass, Anita Luetkemeyer (top) responds to a question about different support groups at Integris Bass Baptist also facilitates the hospital’s Health Center. Amanda Stinnett (above, right), an exercise physiologist, describes the support she and Parkinson’s and fibromyal- Jessica Lenherr (left) provide cardiac rehab patients at St. Mary’s Regional Medical Center. Patti Ruiz, gia/lupus support groups. (right) RN and program coordinator for the diabetic support group at St. Mary’s Regional Medical She said the benefit of sup- Center, answers a question during an interview. (Staff Photos by BONNIE VCULEK) port groups is two-fold.

Evidence of results “Just by definition, support they do have us here to help sup- Evidence of results group, you have the emotional com- port them,” said Lenherr. “Seeing Luetkemeyer has no clinical ponent,” she said. “Where people are that patient come in in a wheelbackground and no experience bonded by a common illness and by chair, not being able to walk 100 with Parkinson’s, fibromyalgia or sharing their experiences they feel yards, and they leave without the lupus, but she is a cancer survivor. more hopeful, less depressed, more wheelchair, they leave being able “I have found that some of my prepared to deal with the conse- to walk a mile.” experiences when I dealt with that quences of their disease. (cancer) have overlapped,” she Food for thought “The other primary benefit is said. “There are some things we all education and disease managePatti Ruiz, program coordinator share when we are facing a chronic ment. A lot of times our programs for the diabetes care center at St. condition. So I am able to bring focus on medications that are spe- Mary’s, said the hospital’s diabetes some my own personal experience cific to that condition or nutrition.” support group concentrates on to the group.”

The St. Mary’s cardiac support nutrition and exercise.

While preparing for a group, for instance deals with heart “Nutrition is one of the pillars of Parkinson’s support group meeting, facts, exercise and cholesterol, diabetes care, that and exercise,” Luetkemeyer said she came across among other topics.

Ruiz said. “We just try to cover all a Stanford University study that “We have a whole array of the different areas at some time. It focused on support groups and

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Local groups making sure those who face life-changing conditions are not in it alone

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