Lori Thornton knows the nurses at the Oglethorpe County health department want her to quit smoking. She has already lost weight and improved her...

Lori Thornton knows the nurses at the Oglethorpe County health department want her to quit smoking. She has already lost weight and improved her diet through a state public health program that helps low-income and uninsured Georgians manage their high blood pressure.

“If it wasn’t for the health department, I would not seek any help,” Thornton says.

But the program that paid for Thornton’s care, known as SHAPP, or Stroke and Heart Attack Prevention Program, ended Sept. 30. Now, more than two months later, only six of the state’s 14 districts that originally offered the program have found ways to continue it. The districts, which each serve several counties, include those headquartered in Athens, Albany, Augusta, Dalton, Dublin and Savannah.

SHAPP provides patients with free or low-cost medication, weight loss counseling and care management. In some counties, consistent weight loss brings patients deeper discounts.

“The work will continue to be addressed in different budget streams around the state,” says Connie Smith, spokeswoman for Georgia’s Department of Public Health. So far, one state position has been cut due to the elimination of the program.

At its peak funding in 2006, SHAPP served more than 17,000 Georgians, but that number fell yearly due to steadily declining funds.
“The real question is not that funding has been cut for this program,” Smith says. “The question is: Which organizations in these communities can pick up and provide the same services?”

Donna Benton, adult health coordinator of the Athens-based Northeast health district, said three existing community clinics in Clarke County could treat low-income patients with high blood pressure, but those clinics are overloaded with clients already.

A matter of life and death

In the Northeast district, SHAPP participants have always been required to pay $30 per visit. This fee is what’s now allowing the district’s county health departments — including Oglethorpe, where Thornton gets care — to continue the program for the time being.

“Cardiovascular disease is the No. 1 cause of death in our district beginning at age 30,” says Dr. Claude Burnett, director of the Northeast district. He adds that preventive programs like this one cost less than what taxpayers spend on hypertension-related hospitalizations covered by Medicaid and Medicare.

High blood pressure, because of its lack of symptoms, often goes undetected in people who cannot afford regular medical care.

But in hard economic times, even beneficial government programs like SHAPP come under the scrutiny of budget cutters.

“We believe there is a need to continue the program,” says Benton. “We are saving lives every day. We are teaching our patients lessons for the long haul.”

Looking for funds elsewhere

Benton estimates that the Northeast district’s current supply of blood pressure medication will last through June 2012. After that, she’s unsure if money will be available to buy more.

Last year, 77 percent of patients enrolled in the program brought their blood pressure under control. According to national statistics, only about one-third, or 34 percent, of Americans with high blood pressure keep it under control.

Diane Orenstein, a researcher at the Centers for Disease Control and Prevention in Atlanta, said in an email interview that Georgia’s blood pressure program is cost-effective.

Smith, of Georgia’s Department of Public Health, said money for the program could come from another source of federal funding that is currently under debate.

In the meantime, some districts will try to sustain their programs for as long as possible with funding from other channels, but the future of the program is bleak.

For now, Thornton will continue to see her nurses in Oglethorpe County for her high blood pressure as long as she can.

“They make me feel successful and keep me motivated,” Thornton says.

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Kathleen M. Raven

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