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About The Siuslaw news. (Florence, Lane County, Or.) 1960-current | View Entire Issue (Oct. 10, 2018)
SIUSLAW NEWS | WEDNESDAY, OCTOBER 10, 2018 | 5A FLORENCE from page 1A She showed the Wastewater Fund on page 12 of the report and relat- ed it to Public Works Director Mike Miller’s presentation on three up- coming utility projects. Money from that fund, as well as wastewater sys- tem development charges, will fund those projects. “One of the capital projects that was anticipated for the year is this sewer extension project. You can also see that we have not spent as much as we thought we would,” Reynolds said. “We thought we would have this project a little fur- ther along this year than it is actually playing out.” The council first heard about the Highways 101 and 126 Utility Projects in August, as city staff were already working on plans to extend water and wastewater facilities on the highways. Those projects are now coming together, with a public hearing scheduled for the forma- tion of a reimbursement district on Highway 101. “You can see that in the capital outlay, there is a budget for $1.199 million, and we’ve only spent about $380,000 in wastewater. By the time you get to the next year end, on June 30, 2019, you’ll see that project spent out based on the timeline presented to you,” Reynolds said. City Councilor Ron Preisler thanked Reynolds and city staff for their work on the project report. Mayor Joe Henry said, “We’re un- der budget, so that’s always a good thing.” After the planned public hearing on the reimbursement district, the bidding and construction timeline will be solidified on the three sepa- rate utilities projects, with construc- tion scheduled to take place early in 2019. “The (wastewater expansion) project that Mike spoke about will include five annexations of proper- ties that are looking to grow and add to our city, for both commerce and residence,” Reynolds added. “They see the potential, and there is a lot of excitement out there, on both sides of the highway. … Our city is grow- ing, and it is growing at a pace that makes sense for Florence.” In addition to these annexations, two other requests to join the city have come in, making it seven new properties annexing into the city. All the properties are going through the Planning Commission process. The City of Florence will begin the audit on the preliminary report this month, with the Florence City Council expected to approve the re- port in December. For more information, visit ci. florence.or.us. HEALTHCARE from page 1A “They’re just checkups to go in, see their vital signs,” Martin said. “See how everything’s going. Make sure the house is in good shape, if there are any problems I see.” If the program is successful, it could become a permanent fixture in the Siu- slaw Region. Other areas, such as Eugene, are closely monitoring the Mobile Inte- grated Healthcare program to see if it can be integrated into their own healthcare system. How the program chooses patients be- gins at a daily morning meeting at Peace- Health Peace Harbor, where patient dis- charge planner and medical social worker Mary Anne Carter goes over the roster of current patients with Martin. “We have a daily worksheet and we print out patients every day,” Carter said. “We have categories that are important to us, such as if they were readmitted. We try and focus on COPD (chronic obstructive pulmonary disease), diabetes, heart fail- ure. Those are the ones that seem to have the most return to the hospital, especially COPD. They’re at the home, they can’t breathe, they start to panic, they can’t breathe even more, they go into the ER.” Carter said that they do have a home health agency that can help, but its time is limited. “Chris is like a free agent,” Carter ex- plained. “He has the option to just go in there, sit and talk with them. Develop that rapport that makes them comfortable, so they don’t come rushing to the ER. Statis- tics have shown that patients who return to the ER frequently, it’s traumatizing for them. It’s really better to keep them at home, unless it’s an emergency. Of course you come to the hospital then. But an emergency room is very traumatic for an elderly person.” Martin added, “And some patients are afraid to go into the hospital because they’re afraid they won’t come out of the hospital. This way, I can go out there and talk to them in their home and assure them.” After Carter, Martin and other health- care professionals at PeaceHealth choose which patients are best suited for the program, the program inquires if the discharged patient is willing to meet with Martin. A visit from the Mobile Integrat- ed Healthcare Program is not mandatory, with patients having the final say if Mar- tin visits or not. “Sometimes they don’t want me to come out, and sometimes they do,” Mar- tin said. “It just depends. It’s frustrating at times, because I can help them, but they’re not accepting the help.” Carter explained that the patients who primarily use Martin’s services are very private. “The retirees worked hard to get where they are, and they’re very independent,” she said. “To depend on somebody is giv- ing up some of their freedoms, and they don’t give in easily. People think that we’re going to come into their home and take away rights, say, ‘You can’t live here.’ They really feel like we’re infringing on their in- dependence, and that we’re going to take it away from them. But, that doesn’t hap- pen with us.” Most who have opted for the program have ended up appreciating it. “It took us two months to see this one person,” Martin recalled. “She ended up loving it. She came in bragging about it at a community meeting.” While the group has yet to gather exact statistics on the program’s efficacy, anec- dotal evidence points to a drastic decrease in readmissions since the program began. “You can see the readmissions were higher last year than they are now,” Mar- tin said. “Having a true number, I can’t have that. I’ve had 400 visits, though.” It’s impossible to say if the program prevented 400 hospital visits, but if it had, the savings to the hospital could be worth millions, since the average ER visit costs $8-10,000, according to Martin. Four hundred ER visits could cost up to $4 million. Insurance companies save money in covering costs, and patients save money in copays. ONE DAY SEMINAR Basics of Selling on Amazon.com David saw the high cost of healthcare when he went into the ER for salmonella, which he nearly died from. “I was so sick,” he said. “I thought, you know, how much is an old guys life worth? I really thought that, especially when I got the bill later from the hospital. $178,000. I told Pat. She thought I was kidding. Seri- ously, I thought I wasn’t worth that at my point in my life. I was 75. “I’ve changed my mind now. I’m going kicking and screaming.” “A little undercover work” As Martin drove to David’s house for his checkup, he went over what an aver- age home visit consists of. “They’re usually anywhere from 20 to 90 minutes,” he said. “The first visit is al- ways the longest, as we go through their medications and make sure they don’t have questions about the medications. Why they’re taking it, how long they’re taking it. If they have any equipment, they can ask me how to use it, how to clean it. All of that takes a lot of time.” He also does a thorough inspection of the house, ensuring a safe environment: Handrails are secure, rugs are not slip- pery, make sure the steps aren’t creaking and crackling. “I’ve found smoke detectors that aren’t working,” Martin said. “Get those re- placed, talk to the fire department so they can go out there and get them replaced through a program they have. That’s up to 25 detectors that I’ve found. People don’t have fire extinguishers in their home, so I go out and get one, show them how to use it. Make sure they have food there, and that they’re eating the right type of food. Make sure the house is clean.” For subsequent visits, Martin does the usual round of checkups, taking the patient’s vitals, and answering any ques- tions. “When you’re in the hospital, there’s so much going on and you just want to go home,” he said. “And with everyone talking to you, it’s possible you still don’t understand. Or sometimes they forget to ask a question. They can ask me. If I don’t know the answer, I can get it.” Sometimes Martin visits a patient just once, but the majority see him four or five times. “There are some people that are prob- ably around 40 visits,” he said. “But when- ever I stop seeing them, they’re coming back to the ER. And so, we found that if I spend 30 minutes of my time, I can pre- vent them from coming to the ER when it’s not needed.” Right now, Martin is seeing anywhere from 45 to 60 patients, visiting around five a day. During his 10-hour shift, he also helps fill in the gaps in the healthcare system. “I’ve really helped palliative care a lot,” he said. “Really helping Home Health out when they’re falling behind. The Care Coordinators will call, having concerns with a patient that they can’t get a hold of. Or some lab was out of whack and they can’t get a hold of them. They’ll call me, and I’ll go out there and talk to them.” The vehicle he drives is rather nonde- script; one would never know a patient is getting a visit from the hospital. “The original plan was to show up in an ambulance, but people get panicked, wondering if someone is hurt,” he said. “It attracts too much attention. You have to do a little undercover work.” “Quite a little bond” Then it was back to the walking questions. David described walking down to the end of the street, his normal loop that runs about a mile. But he hadn’t been to the gym in a week. Then he started walking around as Martin watched. While he didn’t use his canes, he was still able to get up, but he was noticeably uncomfortable walking. “Even walking over here, you’re still off balance a little bit,” Martin said. When David first Martin, he could hardly get out of bed. David was in the ER the previous night and was still groggy in the morning. 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