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Safety Net

A county’s difficult question: How to save its local hospital?

Elbert Memorial Hospital needs funding from the county in order to remain open.

Elbert Memorial Hospital needs funding from the county in order to remain open.

Elbert Memorial Hospital has served its northeast Georgia county for more than 60 years.

But the future of the hospital is now unclear. Its fate will hinge on the coming days and weeks.

Elbert County commissioners are holding public hearings this week and next on a proposed one-mill property tax increase for one year to raise about $500,000 to offset the Elberton hospital’s costs for indigent care.

Without the money, the 52-bed hospital will close, officials warn. That would eliminate more than 200 jobs, and residents would have to travel more than 30 miles to the nearest hospital. A closure would jolt the mostly rural county’s economy.

Elbert Memorial lost $1.5 million in its last fiscal year, CEO Jim Yarborough said Tuesday. “Our concern is that charity care and bad debt are trending upward,” he said. Yarborough calls the financial crunch facing many Georgia hospitals “a silent epidemic.”

The hospital’s predicament demonstrates how counties and hospitals depend on each other financially, and how revenue pressure on each is creating an unprecedented squeeze.

“Counties are in major turmoil deciding whether they want a hospital or pick up the garbage,’’ said Jimmy Lewis, CEO of HomeTown Health, an organization of rural hospitals in the state. Meanwhile, he added, “The general cash position in most rural hospitals is extremely dire.’’

Hospitals are facing lower reimbursements from government programs and private health insurers, along with high levels of uninsured and underinsured patients.

But another key issue is Georgia’s decision not to expand Medicaid, hospital execs say.

Gov. Nathan Deal and Georgia’s legislative leaders, citing costs, have decided not to expand Medicaid as outlined under the Affordable Care Act.

Expansion “would help significantly,’’ Yarborough said. “It would create a paying source” from uninsured low-income patients, he added.

The Elbert County predicament comes in the wake of five hospitals closing in Georgia in the past two years. Four were in rural areas. And several other hospitals around the state are struggling just to stay open.

Debra Nesbit

Debra Nesbit

“If this disturbing trend continues, we’ll have major access-to-care issues for hundreds of thousands of Georgians throughout the state,” Kevin Bloye of the Georgia Hospital Association told GHN recently. “It will also have devastating financial consequences to areas that lose their local hospital which serves as a major economic engine.”

Meanwhile, hospitals’ requests to counties for help are more urgent now, said Debra Nesbit of ACCG, which represents county governments in Georgia. “The counties are really struggling with that.”

“Hospitals are saying, ‘Give us money or we are going to shut the door,’ ’’ Nesbit added. But with property appraisals decreasing, she said, counties have financial problems of their own. “They may not have the resources, particularly in rural areas.”

Most counties are supporting their hospitals financially, Lewis said.

Reimbursement reductions for hospitals “translate into an unfunded mandate onto the county,” Lewis added. “Rural unemployment rates are so high there’s no millage capacity to support the unfunded mandate.”

Some counties are pursuing new avenues to keep their hospitals upright. Recently, Habersham County in the northeast Georgia mountains agreed in a deal with the
local hospital authority to make monthly bond payments on Habersham Medical Center’s $37 million debt. The county will eventually take over the assets of the facility.

Newton Medical Center

Newton Medical Center

In Newton County, east of Atlanta, 97-bed Newton Medical Center recently requested a property tax increase to offset indigent care costs. It would have resulted in about a $600,000 funding increase, said Troy Brooks, assistant administrator of fiscal services for the hospital. But he said the county has already set the budget and did not include the funding that the hospital requested.

The hospital isn’t in danger of closing, Brooks indicated. Last year the hospital posted its first positive margin since fiscal 2008, which Brooks attributed to the nearly $2 million in funds related to the Electronic Health Record initiative in the Affordable Care Act.


Rocky times in the rock hills


Elbert County takes pride in its granite industry, and Elberton calls itself “The Granite Capital of the World.”

But its overall economy is less solid.

About one in four residents has no health insurance, according to the 2014 County Health Rankings, produced by the Robert Wood Johnson Foundation and the University of Wisconsin. The report also shows the Elbert County unemployment rate is higher than the state average, and that about one in three children live in poverty.

Elbert County

Elbert County

As the Elbert County commissioners hold public hearings on the tax increase, Elbert Memorial’s website sums up the situation: “This financial relief is needed to keep our hospital from closing, which would result in a devastating economic loss to the community and leave Elbert County residents without local access to health care services.”

Yarborough said he’s “very hopeful and optimistic” about the financial help. Still, he noted that in the current hard times, “there is a portion of citizens that are not in favor of a property tax increase.”

Elbert Memorial has an affiliation and management agreement with AnMed Health in nearby South Carolina, which has helped the hospital. Nevertheless, the charity care and bad debt for Elbert Memorial Hospital grew to nearly $4 million in its last fiscal year.

The request to the county commissioners is for funding the charity care of Elbert County residents. “They don’t have a mechanism to pay,” Yarborough said. “The ER always has to take care of you.”

The county commissioners will take a final vote on the tax increase after the public hearings. Commission Chairman Tommy Lyon said if the hospital closes, the county will have to add another ambulance and crew to transport patients to hospitals in Athens or in Anderson, S.C. – a step that would cause the budget to be in deficit.

“We’re in a very dire situation,’’ Lyon said, according to an Elberton Star article.

A recent report by the Urban Institute said Georgia’s decision not to expand Medicaid will cost the state’s hospitals $12.8 billion in lost reimbursements over a 10-year period. Medicaid expansion – making more low-income people eligible for the program – would ensure some reimbursement for hospitals that treat these people.

Hospital executives aren’t saying expansion is a complete cure-all. In Georgia, said Yarborough, Medicaid pays only 85 percent of the cost of a covered patient’s medical services. “We lose 15 cents on every dollar,’’ he said.

Still, Yarborough noted that for a hospital, getting “85 cents on the dollar is much better than zero cents on the dollar.”

Brooks of Newton Medical Center said, “I am hearing that hospitals in those states that did expand Medicaid have seen noticeable improvement because of it.”

Nesbit of ACCG recognizes the political realities in Georgia. “Clearly, Medicaid expansion is off the table right now,” she said.

“We don’t have a position on Medicaid expansion,” Nesbit said, though she added, “We want all Georgians to have access to health care.”

“We are continuing to look at the situation, look at creative ways to expand some health care access.”

Elberton Georgia, Granite Capitol

Elberton, in northeast Georgia, takes pride in its famous granite industry.

Faithful recruiters: Two from Catholic order joined ACA effort

Cecelia Smaha (seated) and Sr. Joan Serda at a Get Covered America event in Atlanta

Cecelia Smaha (seated) and Sr. Joan Serda at a Get Covered America event in Atlanta

The volunteer army in the Affordable Care Act enrollment effort included two older women stationed regularly at a Macon Kmart.

Sister Joan Serda and Cecelia Smaha, a layperson associate of the Sisters of Mercy, talked to hundreds of local residents about the health care law in the months leading up to Monday’s enrollment deadline.

The two say they volunteered for the Get Covered America campaign because their organization’s mission includes helping people living in poverty who lack education and health care.

“I feel terrible that so many people don’t get health care,’’ said Serda, 76, who has been a nun since 1956. She’s a retired educator, so the role of informing people about their insurance choices was a natural fit.

She and Smaha set up a table at Kmart, answering questions about the ACA and talking about coverage, and gathering names of people who wanted further help. They also did education sessions at local Catholic parishes.

James Ramirez, the Get Covered America official who oversees Macon, says Serda and Smaha made a huge impact in the education effort.

“They are probably the most passionate, dedicated people I have seen in my experience, willing to sacrifice their time and energy to make the world a better place,’’ he says. “There is no way we could have made this much impact in Macon without their help.”

Hours after the midnight Monday deadline for sign-ups, the White House announced Tuesday that more than 7 million Americans were enrolled in the health insurance exchanges.

The two Macon women didn’t help people sign up directly. They were not “navigators,’’ specially trained counselors hired to help people enroll in the insurance exchange.


Divisions among Catholics

Still, they say, there was a lot of education to be done about the complicated law, which has many critics and is not well understood by many Americans. The state’s Republican political leadership remains united against the Affordable Care Act, also known as Obamacare.

Sr. Joan Serda at Kmart in Macon

Sr. Joan Serda at Kmart in Macon

The hardest thing to explain to opponents of the law was that the ACA helped the working poor, Smaha says.

“This is not a freebie,’’ says Smaha, 71, who has been a lay associate of the religious order since 2000. “Some people [signing up] had two or three part-time jobs.’’

None of the ACA opponents who talked to them were “really rude,’’ Serda says.

“We had a few people who came to us and discussed their opinions,’’ she adds. The two say they acknowledged to the skeptics that the ACA isn’t perfect, that it could be improved. “No one was ugly’’ in the way they disagreed, Serda says.

Some of the law’s provisions have been opposed by the U.S. Conference of Catholic Bishops. The group set out a position that supported the expanding of insurance coverage to millions of Americans. But the bishops also opposed final passage of the ACA because of concern that it would expand the role of the federal government in funding and facilitating abortion and plans that cover abortion.

The bishops also oppose the ACA requirement to offer insurance coverage for contraceptives. A Catholic religious order, the Little Sisters of the Poor, has fought in court against a contraception coverage mandate for people it employs.

A spokeswoman for the bishops noted Wednesday that while they have opposed certain provisions of the ACA, they have not joined in efforts to repeal the law.

Serda and Smaha do not appear overly concerned about these stands by the bishops and some other Catholics. Their order, the Sisters of Mercy, on their website said they supported the passage of the ACA out of a conviction that people have a right to health care.


Two outspoken women

Serda and Smaha say their biggest challenge was not having a navigator at Kmart to help people apply for coverage. Kmart didn’t allow it, they say. “We would have gotten a lot more people,’’ Serda says.

A spokeswoman for the company said in an email to GHN that the role of the insurance navigator is to help consumers prepare electronic and paper applications and enroll in coverage.

“This may have been why the navigator was not able to assist,’’ the spokeswoman said. “No computers were on site nor were any enrollments being processed.’’

The two women say they’re unhappy with the decision by Gov. Nathan Deal not to expand Georgia’s Medicaid program. Expansion of Medicaid is outlined under the ACA but is optional for states, and several are not doing it. Deal, backed by fellow Republicans who control the General Assembly, says Georgia can’t afford to do it.

If Medicaid expansion were carried out, it would extend coverage to hundreds of thousands of uninsured Georgians, who are making below 100 percent of the federal poverty level but don’t qualify for subsidies in the insurance exchange.

“So many people have been caught in the gap,’’ with neither Medicaid nor subsidies, Smaha says.

The two women don’t know how many of the people they talked to eventually enrolled in coverage.

“I think it was worthwhile because we helped some people,’’ Serda says.

Ramirez of Get Covered America has a stronger view. He says Serda and Smaha “have been central to our success statewide, but definitely in Macon.”


Insurance ‘navigators’ feel like they’re swimming against the tide


Protesters in Coweta County rally against the UGA navigator program in November. Photo courtesy of  the Newnan Times-Herald.

Back in December, with the deadline approaching for people to enroll for Jan. 1 coverage in the new insurance exchange, an event was scheduled to inform Greene County residents about the program.

The event was to feature a health insurance “navigator,” a person trained and licensed to inform people about the Affordable Care Act and guide them through exchange enrollment. This particular navigator, Kimberly Jenkins, was one of a dozen working under a federal grant to the University of Georgia.

Greene County would seem to be a promising venue for such an information session, since 19 percent of its residents have no health insurance. “A lot of people could benefit in this community,” said David Daniel Jr., the county’s extension agent for agriculture and natural resources.

But this particular gathering did not work out as planned.

Daniel said he tried to distribute flyers for the event in many locations — including a hospital, a drugstore and many medical offices — but the only place that agreed to put one up was the Greene County Public Library.

“I left them with a couple of doctors’ offices, but no one put them out,” Daniel said. “It’s kind of understandable. It’s still one of those issues that no one wants to touch. With things being the way they are now, everybody’s got to be politically correct. No one wants to go out on a limb to make it work or to help it work.”

And if that lack of response was not annoying enough, the session had to be called off at the last minute because Jenkins became ill. It has not been rescheduled so far.


Many people skeptical of Obamacare


The misfired effort in Greene County was partly a matter of bad luck, of course. But the whole incident seems to sum up the roadblocks that navigators face in Georgia. The ACA, also known as Obamacare, is complex and controversial. People who are trying to raise awareness about it are in an uphill battle.

The problems for the navigators began early, with the bungled October 2013 debut of, the federal exchange website. Navigators were supposed to help people use the exchange, but most Americans could not get access to it. Repairs on the site took weeks.

At the same time, a controversy over policy cancellations led to a nationwide wave of bad publicity about the ACA in general. Many people became wary of having anything to do with Obamacare.

Photo of the Georgia Capitol BuildingAnd in Georgia, members of the Republican-led political establishment have remained firmly opposed to the ACA. They fought the health law before it was passed, tried unsuccessfully to repeal it and supported legal challenges to it. In the General Assembly, GOP lawmakers are now seeking to bar the public state universities or colleges from helping to implement it. (That would appear to eliminate the UGA navigator program.)

Health and Human Services Secretary Kathleen Sebelius, visiting Atlanta on Monday, defended the navigator work, saying of the UGA program: “I can’t imagine a more important job than letting people know what the law says, and what their rights and benefits are.’’

Navigators themselves have become a focus of ACA opponents. Late last year, an ACA information session in Coweta County was the target of a protest by Georgians for Healthcare Freedom and the Coweta Tea Party. Some protesters carried signs reading “Navigators get out.”

Though the Coweta demonstrators were few in number and peaceful, the safety of navigators is a top concern, said Sheri Worthy, the principal investigator for the grant that funds the UGA navigator program. Since the protest, the UGA faculty members who supervise the navigators posted in rural areas have decided to cut back on big, open events and concentrate on individual enrollment.

“We really refocused our efforts to work with individuals and doing small, focused events in trusted venues,” Worthy said last month during a presentation on the UGA campus.

All told, UGA’s 12 navigators have held 365 educational activities in communities throughout Georgia.


Enthusiasm for the mission


Jenkins, the navigator whose illness forced the cancellation of the Greene County public information session, said she is trying to reschedule it, and hopes to work next time with St. Mary’s Good Samaritan Hospital in Greensboro.

County official Daniel, who distributed flyers the last time, said he is still trying to determine the “most efficient way to get information out in a timely manner.” A newcomer who has been on the job for only seven months, he acknowledged that printed notices may not be the way to go.

Greene County resident Mary Miller said she gets most of her news from local newspapers such as The Breeze and Lake Oconee News. She said she did not hear any talk about the planned event in December and did not see any advertisements for it.

But she’s familiar with the ACA effort. “I’ve heard talk about it at work,” said Miller, a real estate agent who has insurance. “There’s certainly word around that they are trying to get people to sign up for it.”

Jenkins is responsible for disseminating health care information to about 100,000 people living in 12 of Georgia’s 159 counties. She tries to visit a county once or twice a week and devotes the rest of her time with to individual appointments with people trying to get insurance through An appointment typically lasts one hour as she walks the person through the application and answers any questions.

It’s a slow process, but Jenkins said she is making it work by visiting several counties in one day and spreading the word wherever people gather. She regularly attends churches in the community and enrolls people after services.

“I’ve enjoyed it,” Jenkins said. “Just being able to help and meet different people.”

Becoming part of the existing “community system” is crucial to reaching rural people, according to Sharon Gibson, the cultural trainer for the navigators. She instructs navigators to work with the leaders in the community and the popular groups that already operate there.

The hostile response to the ACA, made worse by the implementation problems last fall, has been a hurdle for Jenkins. She said people are often skeptical until they see the premiums for health coverage.

“Once they see the prices associated with the claims, they are generally happier, so I urge them to do the application,” she said.

Georgians can sign up for health insurance until March 31, when 2014 enrollment closes. The navigators and extension agents are working to sign people up by the deadline. After that, they will continue to educate people about health insurance in general.

“It doesn’t matter who they are — white, black, Latino — people in rural communities are wary of change,” said Gibson. “There’s a lot of TV and radio and that’s confusing. A lot of what our navigators do is address misconceptions.”


Lindsey Cook is a senior at the University of Georgia,  studying journalism, computer science and new media. She is an AP-Google scholar and her work has appeared in The Washington Post, The Atlanta Journal-Constitution and Online Athens.



Hospitalists: The specialists whose patients all have beds

Nurse practitioner George Mackel (right) is one of the first hospitalists at Morgan Memorial Hospital

Nurse practitioner George Mackel (right) is a member of the hospitalist team at Morgan Memorial.

Morgan Memorial Hospital in Madison got tired of having so many patients who were just passing through.

Too often in the past, the hospital has stabilized newly arrived patients, only to see them quickly bundled off to Athens for further treatment.

Ralph Castillo, the administrator for the 25-bed hospital in one of the most famously beautiful communities in Georgia, thinks he has the solution to this stopover problem.  He has launched a program that he says will save lives and keep more patients in Morgan County, closer to home and family.

Castillo introduced a team of hospitalists – mainly physicians who specialize in the care of patients who are admitted to a hospital.

Morgan Memorial has brought in a hospitalist group of nine physicians and five nurse practitioners/physician assistants who manage and coordinate all aspects of a hospitalized patients stay while working closely with a patient’s primary care physician– from admission until discharge.

The idea, Castillo says, is to increase patient and physician satisfaction. Every day, a hospitalist comes in very early, catches up with the nursing staff on any overnight developments, and tends to about 10 patients in an eight-hour shift.  That’s about 60 percent of Morgan Memorial’s inpatients on an average day.

Previously, all six of Madison’s primary care doctors came to the hospital to see patients who had been admitted.  Castillo said having hospitalists at Morgan Memorial enables doctors in the community to see more patients in their offices, while inpatients have a hospital-based doctor to respond quickly and expedite their recovery.

A new idea for a small town

Most people around Madison don’t even know what a hospitalist is.  But that’s probably true of most people around the country.

“Hospitalist” is a relatively new medical specialty, one rooted in a California experiment that began in 1992.  The term “hospitalist” was coined four years later in a New England Journal of Medicine study.

Morgan Memorial Hospital

Morgan Memorial Hospital

Studies conducted in Minneapolis, Long Island, N.Y., Los Angeles and other urban areas indicate that hospitalist programs can decrease the average length of hospital stays by up to 35 percent.  In Georgia, hospitalists have been around for a while in larger, regional hospitals.

But almost no data are available anywhere about hospitalist programs in small or rural facilities.

Because the service in Madison is only a few months old, its impact on patient care remains unclear.  And there are skeptics.  Not every local doctor has agreed to cooperate, and pharmacists are worried that working with hospitalists could make their job harder.

Morgan Memorial does not directly pay the salaries of hospitalists.  They are part of an Integrated Care Program (ICP), a bundle of inpatient and emergency department services that cost the hospital $800,000 to $900,000 annually.

Since the hospitalists went to work at Morgan Memorial about four months ago, the average number of  inpatients is higher by one to two per day.

“There were more patients leaving our ER room than they needed to,” Castillo said, “and having a hospitalist here enabled us to keep more patients here for the routine medicine rather than automatically shipping them to Athens.’’

Castillo said the hospitalist program also makes life better for primary care doctors in the community, giving them more free time.  “I’ve got one physician in particular – he’s been able to travel outside the state of Georgia more often than he had in the past,” Castillo said, “and he’s also been able to actively participate in both of his children’s extracurricular activity.”

Benefits vs. drawbacks

Four of Madison’s six primary care doctors have agreed to hand off acute care patients to the new specialists at Morgan Memorial.

One is Dr. Dan Zant, a family practice physician who’s also chief of staff at the hospital.

“It helps me be free to tend to my patients in the office,’’ Zant says. “It’s helped me expand my hours to see more patients.’’ And after hours, he says, the hospitalist program allows him “to turn it off and enjoy some family time.’’

Dr. Miguel Cossio – known as “Dr. Mickey” to his patients – is one of two who have not.  He says he feels strongly obligated to continue seeing his patients when they are hospitalized.

“It’s like you have a friend,” he said of the patient-doctor relationship.  “When times are good, everyone’s your friend…but a true friend is there in the good times and the bad.”

Though Cossio says he has “no opinion one way or the other” about the hospitalist program, he made clear that has no intention of switching over to it.

Local pharmacist Elise Lang, who practices at Thrifty Mac, worries that the hospitalist program will make it harder for pharmacists to stay in the patient care loop.

The Affordable Care Act, she said, has already increased paperwork for folks in her profession, especially when ventilators or other medical equipment are needed.  In such situations, pharmacists need more information from the treating physician.

But hospitalists, who see only inpatients, don’t necessarily have every patient’s complete medical records on hand when the pharmacist calls, Lang said.

And sometimes these physicians are harder to reach than office-based doctors.  “They don’t keep regular business hours,” Lang said.

Other area pharmacists say they’ve faced the same issue when trying to fill orders for patients hospitalized at larger facilities with hospitalist practices, including Athens Regional Medical Center.

The full costs and benefits of Morgan Memorial’s hospitalist program remain to be seen.  Most hospitals don’t see the positive effects until at least a year of services, experts say.

“At the end of the day,” said Castillo, “we want the patient well and on their way, just like the primary care physician wants the patient well and on their way.”


Lee Adcock is a first-year health and medical journalism student at the University of Georgia. She is also a music critic for various media outlets.


Health leaders teach people like themselves how to live better

Barbara Haynes, a community health partner, works in the kitchen during a party at Shiloh Baptist Church in Athens.

Barbara Haynes, a community health partner, works in the kitchen during a party at Shiloh Baptist Church in Athens.

Every Sunday morning, Shiloh Baptist Church in Athens fills with about 125 members who have come for preaching, prayer and song.

The services nurture the spiritual well-being of the congregation. And then, after church lets out, Shiloh member Barbara Haynes is there to tend to their physical health.

Each week, Haynes promotes more exercise and healthier eating to help church members ward off obesity and diabetes.

“We had this thing of ‘the sweeter the better’ and ‘the saltier the better,’ ” Haynes said. “Now we know better.”

Often, Haynes is in the church kitchen cooking up new versions of familiar foods, using healthier seasonings than she and the other church members grew up with.

During a family picnic once or twice a year, Haynes joins forces with health professionals to screen church members for high blood pressure, elevated blood sugar levels and other problems.

Shiloh Baptist is a small, predominantly African-American church in east Athens, drawing members from throughout the city and some outlying areas.

“We have a lot of people who have health problems,” Haynes said, “and [they sometimes] don’t take it seriously.”

Haynes, 60, who is retired and spends most of her time volunteering, uses her status as a church member — and in many cases, as a friend — to get people to pay attention and perhaps ward off preventable ailments.

Haynes did not learn her medical skills in college. She learned how to quiz people about their health worries and screen them for common problems in a five-week training course managed through the Athens Health Network, an organization that aims to narrow health disparities.

Graduates of the course are designated “community health partners,” and they put their skills to work in churches, workplaces and Head Start Programs, and among neighbors and families. Since 2012, 52 people have completed the training.

Gudelia Almazan, a social worker for Easter Seals North Georgia, checks Ismelda Santos' blood pressure.

Gudelia Almazan, a social worker for Easter Seals North Georgia, checks Ismelda Santos’ blood pressure.

Haynes signed up because she wanted to be a leader in her community, someone who spreads information about staying healthy, a person doing battle against premature illness and death.

That’s important, Haynes said, because many of her friends and neighbors don’t get regular check-ups from a doctor.

“Some of them, if they don’t get sick, then they never go to the doctor,” she said.

That lack of medical screening could allow a problem like high blood pressure, obesity or high cholesterol to get dangerously worse before anything is done about it.

“To have someone monitor them, it will help them get the help they need without going to the doctor” as frequently, she said.

Mercy Health Center, a faith-based medical resource center, started the Community Health Partners training in Athens, and two years ago the Athens Health Network took it over.

Nurses and pharmacists are among the instructors, and participants learn about a range of chronic conditions, infectious diseases, reproductive health and nutrition.

They learn basic skills, including how to measure and interpret blood pressure results and perform simple blood tests.

Because the program is geared to people with lower incomes, the health partners learn about what kind of care is offered at the Athens clinics and who is eligible.

The course is free to those who want to participate in the program.

“They become health experts,” said Laura Alexander, the new executive director of Athens Health Network. “They become resources for people to go to with questions.”


Idea catches on worldwide


This is known as a “lay health educator model,” an approach used around the world and with great effectiveness. Trained community members disseminate health information, keep their eyes open for emerging public health problems and report them.

These trained lay people often understand better than medical professionals why residents of their communities resist changing their health habits.

“Lay health educators bring a good sense of what those barriers are and how to change them,” Alexander said.

A 2007 report by the World Health Organization highlighted the effectiveness of lay health educators, especially those who are well trained and integrated into their communities. The report said this model can be especially effective in promoting child health.

Through a federal grant, a Head Start program run by Easter Seals North Georgia is reaching children and their families using this model.

Easter Seals staff members took Athens Health Network’s training course over the summer. Now they’re putting what they learned to work with children 3 to 5 years old. The kids come from about 1,300 low-income families in Barrow, Madison, Jackson and Walton counties.

As part of the Easter Seals program, social workers screen students for signs of trouble and talk with parents about health issues.

Before the training, Easter Seals staff had already taught families about nutrition, exercise and a healthy lifestyle, but the Community Health Partners training bolstered the “awareness and confidence of the social workers,” said June Gray, health and nutrition specialist for Easter Seals.

Four-year-old Juan Santos of Winder, a student in the program, suffers from asthma. And the problem is made worse by his attention deficit hyperactivity disorder. “He’s so active,” said his mother, Ismelda Santos.

But Santos said the staff there taught her how to manage Juan’s asthma. They’ve also helped her manage her own high cholesterol.

“They are very helpful if you have a need,” Santos said.

The Community Health Partners program has made a big difference in how staff members advise parents about the health of their children and families, said Kizzy Wingfield, family services supervisor for Easter Seals North Georgia.

Wingfield said the training has helped her manage her own health better, especially when it comes to reducing work-related stress and eating more healthful foods.

“It not only empowers me and my personal well-being, but it also empowers me to help my family and my community,” Wingfield said. “It’s a domino effect of everyone being informed of preventative care.”


Aaron Hale is a former government and public safety reporter. He currently is a first-year graduate student in the health and medical journalism program at the University of Georgia.

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