Project Access is a program that has been successful enough to reach maturity. Which means, of course, that there are new challenges that must be met in order to continue the mission of bringing quality health care access to the working poor.

With uncertain times ahead, enormous pressures will be put on our health care system. Even government programs may feel the squeeze. “A lot of states are going to be either restricting eligibility or, for one reason or another, there’s going to be a lot of folks that don’t quite fit into any set government programs,” warns Peter Stern, executive director of the Prescription Network of Kansas. “So there’s an obvious need for a different sort of safety net that’s funded by various sources.”

That’s why a program such as Project Access is even more critical than ever.

“We’re continuing to focus on expansion. We’re now conversing and collaborating with dentists and hope to help facilitate the provision of coordinated dental care for the uninsured in our community,” asserted Central Plains Regional Health Care Foundation president, Dr. Chris Moeller. The process is the same as for physician participation, whereby dentists who express an interest in donating services can provide basic emergency dental care. According to Project Access director Anne Nelson, “We are working with area dentists to develop this project in 2003.”

In another area, Project Access has also contracted with Via Christi’s Health Connection Program to field calls from enrolled patients. It’s called the Call-A-Nurse project. Through this project, patients are urged to call with questions when their physicians’ offices and clinics are closed. This serves as an educational tool and is one approach Project Access utilizes to redirect patients away from using hospital emergency departments for primary care needs.

Likewise, Project Access has created patient education programming, designed to help patients better manage their conditions and learn how to communicate with, and appropriately access, the health care system. By providing educational information and resources, people can begin to make better decisions about their health and, in the process, develop an internal locus of control for behavior. With this kind of education, Project Access hopes to see generational changes in this patient population. According to Ms. Nelson, “children watch how parents make decisions and they grow up to repeat their parents’ actions. If someone was raised to access health care only during acute episodes and only through emergency rooms, they’ll need to be taught how to correctly access primary care providers.”

Project Access has also contracted with the Via Christi Marcus Consumer Health Resource Center in Wichita to provide timely materials to all patients and providers within various Project Access programs. Useful information on a wide variety of topics — anything from surgical procedures and proper medication usage to managing blood sugar and lowering blood pressure, preventing preeclampsia, etc. — is researched, compiled, and put into a format that respects literacy, language and culture.

Project Access continues to help prevent further misuse of hospital emergency departments with its Case Management Project. Its purpose is to assist high-utilizing ER patients (also known as “frequent fliers”) by helping them connect to community resources and primary care providers. Since ER physicians are trained to manage urgent, acute conditions — which makes ERs a poor way to meet primary care health care needs — it’s in the best interest of the patients to have a designated medical care home. This project was also designed to provide some much-needed relief to area hospitals since utilization of the ERs by the uninsured has increased in record numbers. “The hospitals offered to participate in Project Access early on by donating inpatient and outpatient services,” reminded Ms. Nelson. “So it was important for us to help them by bringing something to the table in return.”

As part of the Case Management Project, Project Access funds four Case Management Teams. Located at the four major hospitals, each team consists of a nurse and a social worker. These case managers help remove barriers like transportation, literacy, inexperience with the system, a lack of knowledge about health conditions, etc., that can prevent a patient from connecting to primary care physicians. Case managers make home visits and remain in phone contact with patients. High-utilizing ER patients (defined as those with three or more ER visits within the last year) who are uninsured and who live in Sedgwick County are eligible for the program.

“We track activities, patient and program outcomes (including health status, productivity, locus of control, pre- and post-ED [Emergency Department] utilization numbers and charges, etc.) with an outstanding Microsoft Access database that we’ve developed,” declared Ms. Nelson, adding that “this is a large project with many positive, early results — including a significant reduction in ED utilization by this population.”

And speaking of tracking, Project Access also has a Patient Enrollment And Tracking System Project. “We’ve been working with the six low-cost community clinics to connect them via computers and a common enrollment database,” said Ms. Nelson, adding, “there would then be a database in place to track patients who might be accessing care at multiple sites. It will also assist us in gathering accurate and timely statistics needed when writing new grants — to bring additional funding resources into the community.” Right now, each clinic operates individually, which makes it more difficult to coordinate care and gather accurate statistics.

Finally, in the ongoing quest to learn about treatment patterns, charges and services associated with the uninsured, Project Access has contracted with the University of Kansas School of Medicine-Wichita (KUSM-W) to implement a community-wide hospital study of all patient data relating to uninsured and Medicaid patients over the previous three years.

This is the first time the hospitals have partnered in a study like this. And now they’ll be able to use this information in planning their processes to better serve patients, reduce inefficiencies, and lower costs. The data has already been compiled and downloaded, and the KUSM-W staff are now analyzing it.

It doesn’t end there, though. Still to come is another study, to be conducted in 2003, which will also include the 12 residency programs.

Which demonstrates just how the staff at Project Access keep pressing forward.

Indeed, it’s a good thing for Wichita and Sedgwick County that they do. As more and more people in the health care field discover that the issue of the uninsured has become a workforce issue, the value of Project Access can only increase. Its experience in partnering for success makes Project Access the right choice to, according to Ms. Nelson, “partner with the business owners of the community to ensure a long-term, healthy workforce.”

Certainly an important aspect when one considers that, in the years ahead, a community with a healthy workforce can better do its part to help strengthen the economy.

All of this serves as a reminder of how important it is that everyone “step up to the plate.” It’s not always easy. And there are unquestionably many challenges ahead. (Unfortunately, one of the dangers that lie ahead is that Project Access could be seen not as a safety net program based upon volunteerism, but as a substitute for individual health insurance coverage.)

Nevertheless, Project Access, by fulfilling an ever-growing need in our society, has shown how it can be done. As such it deserves our recognition and our support for its enduring success.