ER visits plummet as United Way partners collaborate

About this story

Micki Chestnut is communications director for the United Way of Douglas County, which provides occasional features spotlighting local volunteers and charities supported by the United Way.

When you are homeless and uninsured, getting medical care for health challenges that can range from an infected cut to diabetes can be a formidable challenge.

Andy Brown, director of development at Lawrence Community Shelter, was stymied by how to ensure shelter guests received the health care they needed while also reducing the number of unnecessary trips they made to the emergency department at Lawrence Memorial Hospital.

“LCS guests were making frequent use of the emergency department for situations that maybe didn’t need acute emergency care,” he said. “And there were a lot of things that didn’t get treated until they did require acute emergency care. I was desperate to find a way to reduce the number of ER visits our guests were having.”

Brown toyed with setting up a medical clinic at the shelter, but before he worked to generate the considerable amount of sustained funds it would take to equip and staff a medical facility, he decided to bring the issue before the community partners working with the United Way of Douglas County on the health community impact goal. Every other month, this group of 15 nonprofit agencies meets together with United Way board members and program accountability volunteers to work on collaborative initiatives that serve more people more efficiently and achieve greater results.

Similar workgroups meet bimonthly under United Way’s community impact goals of education and self sufficiency. In total, 29 partners are collaborating across three goals to address the challenges that prevent people in Douglas County from achieving education, health and self sufficiency, the foundations of a good quality of life.

“The thing that is special about United Way is we get the opportunity to come in to the workgroup and say, ‘This is a problem we see in the community and we don’t know how to address it, so let’s brainstorm and figure out a solution,'” Brown said.

As he had hoped, the health workgroup came up with an innovative solution that has increased the number of shelter guests who receive ongoing preventive health care and decrease the number of unnecessary emergency department visits by more than 60 percent.

The plan was simple. Health Care Access Clinic offered to set aside a block of appointments two mornings a week just for shelter guests. Independence Inc. offered to transport guests to and from the clinic for their appointments. A United Way AmeriCorps member serving at LCS coordinates the appointments for guests, helping them schedule tests, fill prescriptions and get to follow up visits. United Way funds pay for the transportation costs incurred by Independence Inc. and for a portion of the medical care provided by Health Care Access Clinic.

Since its launch last February, the collaboration has had a significant impact on both the homeless guests who receive care and the collaborating agencies that provide the care. In 2013, 122 shelter guests received preventive medical care and the number of visits LCS guests made to the emergency department plummeted from 28 in the first quarter to 11 in the fourth quarter. As the guests establish a relationship with health care providers at Health Care Access Clinic, the partners hope they will continue to seek care at the clinic once they move from homelessness to self sufficiency.

And the collaborating agencies discovered how powerful of an outreach they can have when they work together to address a community challenge. “All of this came about because we were in the same work group with United Way,” said Shelly Wakeman, executive director of Health Care Access Clinic. “We aren’t done yet; we have lots of opportunity to help each other with our missions.”

“You really see that this whole process of collaborating has infused these agencies with a new way to think about their funding and their staff and their resources,” said Jill Enyart, co executive director of Independence Inc. “We have all these different pieces, so how can we put them together so they make sense and leverage the dollars in the community and have a really good outcome? This type of collaboration would not have happened without United Way.”

As the partners worked together to iron out the kinks in the new initiative, they saw the payoff in the lives of the homeless guests they serve.

“This collaboration just makes a ton of sense,” Wakeman said. “Many times there is co-morbidity with homeless people, like mental illness or substance abuse, that can feed into their not accessing care, even when it is available to them. Having the transportation removes a significant barrier. Homeless patients who come in are going to be well cared for and set up to manage their conditions as long as they are in our care.”