Ky. program a model for improving rural access

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

As part of his series on rural health, the Wisconsin State Journal‘s David Wahlberg traveled down to Appalachian Kentucky to see how state-funded “navigators” had helped improve access to health care in the region with the lowest life expectancy in the nation. There, they help guide the rural poor through the byzantine system and toward free or low-cost care. They’re part of a program called Kentucky Homeplace.

…lay workers live in the communities they serve, which includes most of Appalachian Kentucky. The workers, who receive basic medical training and earn about $25,000 a year, make home visits and address a variety of needs, such as finding low-cost prescription drugs, arranging transportation to doctor’s offices and helping patients follow up on medical tests.
They also make sure homes have heat and running water — and people have food and clothing.

The lay workers get 40 hours of training, and specialize in navigating the local culture and translating medical terminology into words and concepts the locals find more familiar. Their primary role is helping residents find more affordable prescription drugs. According to one of Wahlberg’s sources, “The program, which operates on $2 million in state money a year, helped clients get $28 million worth of free or discounted medications last year.”

The program, started in 1994, “has linked tens of thousands of rural Kentuckians with medical, social and environmental services they otherwise might have done without,” according to the National Rural Health Association, which named Kentucky Homeplace its outstanding rural health program of the year in 2008.

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