Get Connected to Health

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By Terri Tresp, St. Mary’s County Library

Originally appeared in the spring 2009 edition of The Crab, a quarterly publication of the Maryland Library Association

When Lexington Park Library patrons in St. Mary’s County visit their library not only can they get homework help, book recommendations, movie entertainment, and computer instruction at their branch, they can even get relief from a sore throat.

Thanks to “Get Connected to Health,” a mobile outreach service of St. Mary’s Hospital, uninsured, low income residents can receive primary medical care every Monday between 1 and 5 p.m. in the library parking lot.

Health Connections, the hospital department responsible for the mobile service, has sent a van to community events for years with staff who offer health education and screenings, including blood pressure checks, total cholesterol and blood glucose.

It expanded its scope in November 2008 to offer primary care service. The van began making weekly visits to a community center in the area, but wasn’t getting much business. While the plan had always been to expand service to the Lexington Park Library, the Health Connections team decided to visit the library exclusively in hopes of being more visible to the community. The library is located on the same street as a fire station, an elementary school, several churches and a large residential neighborhood.

Library staff saw firsthand how helpful the van could be during one of its early visits. A patron participating in a computer class excused herself and went to the circulation desk and asked to call her husband. Staff member Kathy Roy noticed the woman did not look well and asked if she could help. The patron was diabetic and felt she was going to pass out. After the patron placed the call to her husband, Kathy escorted the woman to the van. Medical staff stabilized her until her husband arrived.

As of December 31, 2008, the outreach van had recorded 72 patient visits. Only 18 percent of those were returning patients. Of the patients seen, 58 percent had a chronic disease requiring the services of a primary care provider to control the disease. Hypertension and diabetes were the most common. About 20 percent of patients were sent for further diagnostic testing.

According to Health Connections Director Barbara Hak, the Lexington Park community has the largest concentration of population in the county, but has a disproportionate number of residents living in or near poverty which means they are uninsured. To compound the problem, St. Mary’s County, like many rural areas, is experiencing a physician shortage. This means many primary care providers are not accepting new patients, so the uninsured end up in the hospital’s emergency room for treatment.

“Get Connected to Health” staff members not only treat medical problems on the spot and prescribe medication, they also refer patients to other health facilities or social service agencies to foster continued care. There is a $15 fee required for each visit, but that fee will be waived for qualifying patients.

The van is staffed by a registered nurse, Renee Shively, and a volunteer physician, Dr. Patrick Jarboe. The facility includes two exam rooms, a wheelchair lift and a cardiac monitor. Flu vaccines for patients over 18 were made available this year. Some laboratory services also are available, including pregnancy and blood sugar testing. Analgesics are available, but narcotics are not kept on the van.

The van’s driver, Phil Caroselli, also assists with intake paperwork. Each week, he mans a table in a small conference room off the library lobby and meets with patients. Because the van has a small waiting area, patients are encouraged to take advantage of the library’s restrooms, café and reading material while they wait for their appointment.

Branch Manager Terri Tresp, who sits on the Get Connected to Health Advisory Team, initially was concerned the lobby would resemble a medical waiting room and perhaps make other patrons feel uncomfortable, but that has not been the case. Van staff members use cell phones to communicate with Caroselli to let him know when to send out the next patient.

The Get Connected to Health Advisory Team has applied for grants in hopes of obtaining funds for additional staff and to expand service, but to date has not been successful. However, local organizations such as the Local Management Board and Wal-Mart have made donations. In-kind support from organizations like the library is also essential. St. Mary’s Hospital is committed to maintaining the service and provides ongoing financial support to improve the community’s health.