Lee County health care future plotted
Mental health, drug addiction treatment most critical need
BY EVAN WILLIAMS ewilliams@floridaweekly.com

NATHAN

A lack of mental health care, including addiction treatment, is the number one concern for Lee County medical providers, according to Lee Memorial Health System CEO Jim Nathan and The Community Health Visioning 2017 Steering Committee.

The group of administrators met last week and reviewed eight most important health care needs they identified last year. They reviewed progress made toward stated goals, like the opening of an addiction triage center; and talked about challenges, such as the growing ranks of the uninsured.

The committee also discussed creating a "community scorecard" to objectively grade LMHS on its care and measure what health care needs are most pressing in future years.

Local doctors and health professionals sat on the steering committee, but there were also heads of local banks, colleges, insurance companies, developers, charitable organizations, realtors and a lawyer.

"It's truly impressive to be able to see — even with this horrendous year — what collaboration does for this community," Mr. Nathan said.

COURTESY PHOTO Lee Memorial Health System's new Gulf Coast Hospital is set to open in the Spring.

Here are the eight health care issues LMHS and Lee County leaders are focusing on in the next decade, in order of importance, and a sample of what was discussed:

Behavioral Health

 

LMHS expanded mental health care and addiction services last year, but needs more doctors and long-term funding to address the county's mental health crisis. Committee members also said the local community needs to better understand that mental illness and addiction are "legitimate medical conditions."

"It's a treatable disease," said Brian Lucas, vice chairman of the Bonita Bay Group and a chairman on the Mental Health and Addiction Coalition. "It's not the crazy guy on the corner; it's the guy sitting next to you."

Mr. Lucas noted the new addiction triage center is helping 40 or 50 new patients every month who have addiction problems. Many were sent there instead of being arrested.

"These are people that would either be in the jail or in the ER, but they're getting real treatment," Mr. Nathan said.

Some of the next steps for behavioral health will be to get the Triage Center operating 24/7,and finish construction of and launch The Pavilion at HealthPark by 2009, which will make room for more beds and psychiatrists.

Primary care alternatives

 

Thirty percent of Lee County residents don't have medical insurance.

And records show about half of LMHS patients are either uninsured or unable to pay out-of-pocket expenses after their insurance deductions.

Many don't have a family physician, and make ER visits at an enormous cost for care that should be handled elsewhere and less expensively. One in four patients who visit an ER in Lee is uninsured.

"Now we have more out-of-work uninsured," said Lalai S. Hamric, CEO of Family Health Centers of Southwest Florida, Inc.

Some alternatives for the uninsured or underinsured include the establishment of the Dunbar United Way House and the opening of the East Fort Myers United Way House.

Still, health care providers in Lee who increasingly give care without receiving compensation are losing millions.

Busy physicians or have trouble meeting patients' work schedules; and many who can't afford insurance also face transportation issues.

LMHS plans to expand neighborhood-based clinics and study how to finance care for the uninsured.

Electronic medical record

 

If an overarching system of medical records was created, doctors could get patients' lab results and prescriptions from anywhere in the world online, and share them easily with other doctors or organizations in the community.

And patients who go to different locations for treatment would benefit from a smoother, more seamless process.

Challenges the innovation will face include privacy and confidentiality issues, and funding.

Workforce shortage

There is a lack of health care professionals in Lee County.

 

"This is not a physician-friendly marketplace with heavy Medicare, Medicaid and uninsured," said LMHS CEO Mr. Nathan.

The good news is, Edison State College has the largest capacity for educating RNs in the nation; and Florida Gulf Coast University also has new options like the Doctor of Physical Therapy Program and the Acute Care Nurse Practitioner option.

Still, the Florida Center for Nursing predicts a shortage of 52,000 RNs statewide by 2020, and said the most severe shortage will be in Southwest Florida.

And numbers of doctors — primary care and specialists — are dropping even if they were educated in Southwest Florida schools, due to more residency slots being available elsewhere.

Mr. Nathan said the area should strive to make graduating doctors and nurses feel welcome.

Public awareness of services

 

Anne Rose, director of business development, LEE PHO, talked about getting medical news to the community.

Sometimes it's hard to get people interested in it, unless they get sick.

"We want to know about (health care) when we need it," she said.

Preventive health care

 

"What else do you need?" That's the question Community Cooperative Ministries CEO Sarah Owen directs toward every person who comes for a meal at The Soup Kitchen on Martin Luther King Jr. Boulevard.

When someone is in need of food, she said, it follows that they have a complex set of problems, including health care and housing. That's why next door to The Soup Kitchen, the needy have access to a wide range of services at the Dunbar United Way house, like mental health care, job assistance and other things.

There, other community organizations have partnered to ask that question, "What else do you need?," including LMHS, National Alliance on Mental Illness, Hope Hospice and Lee County Human Services.

Similar programs that work together in one place to address a wide range of issues are opening in East Fort Myers and are in the planning stages for North Fort Myers.

Chronic disease

 

Accomplishments include the Children's Hospital Child Advocacy Program, which has taught Mission Nutrition to more than 2,900 fourth- and fifth-grade students in 2007, to impact childhood obesity.

Focus on quality

 

LMHS improved its medical service in many areas last year, including: increased awareness of hand hygiene, reduction of urinary catheterassociated infections and educating physicians on the appropriate use of blood.

Challenges doctors face includes constantly changing clinical evidence.