CARING FOR ALL
ETHAN steps in to help communities
By GEORGIA PURDY

PAT HENSHAW AND DANIEL BERRINGER, dental students from the University of Texas Health Science Center in Houston who work through ETHAN to provide service to the community.

East Texas Health Access Network (ETHAN), located at 117 West Houston Street, offers citizens of a five-county area access to a broad range of health and healthrelated services. But this nonprofit organization which now has 19 employees and a host of partners began with one staff person and one volunteer.

In 1998, Carlene Womack lost everything- her husband, her savings, her home, her vehicle, and her job. Womack had been a legal assistant and had also owned a bookkeeping service for 17 years.

"In 1998, my husband died after a five-month stay at St. Luke's in Houston, waiting for a heart transplant," Womack said. "For the two preceding years, we spent every dime we had on his care- sold our house, our vehicles. I even went to Mexico to buy his medicine. When that five months hit, I had to quit work."

In order for a patient to be considered for a heart transplant, the family must show strong support and so she had to go there to be with her husband no matter how long the wait.

MARIA MARTINEZ, left, and Steven Bui work on a patient through ETHAN's dental clinic.The pair are students with the University of Texas Dental School - Houston.

"I met other families in the same boat," she said. "They were savers like us. They had worked and saved for retirement but like us, they lost everything. I met a family in ICU who had been eating peanut butter and crackers for a week because it was all they could afford."

Womack's husband died during the surgery and she was left virtually homeless. She returned to Jasper broke, lived for a time in her husband's grandparents' home and went back to work as a legal assistant.

The hospital bill for her husband's care was $654,000 and that did not count physicians' bills. When she went to the hospital to meet with a financial counselor about how to pay those bills, she learned that there were resources to help her.

"I learned that there was an endowment fund available because my husband died during the transplant," Womack said. "I also found out that there were other resources to help meet the bills families incur when they have long hospital stays. I asked why people aren't informed. I was told, 'You have to ask.' Some of the families I met had been at the hospital for a year. Before a heart transplant is considered, families are interviewed and they must show strong family support. That's why they stay. They must."

By December 1999, she knew she didn't want to stay in her legal assistant position. She prayed about it and scanned the newspapers. When she saw an ad in the Jasper Newsboy for a community

coordinator to establish rural health networks, she knew that is what she wanted to do.

The program, originally funded by a grant from the Robert Wood Johnson Foundation, was to improve access to health care and related services. Womack knew from experience that access, the information needed to obtain service, was critical for many citizens.

From that single step, ETHAN was born, and for the first three and a half years she, with her father as the only volunteer, began the process of putting together a collaborative of partners to give citizens, access to vital health-related services in a five-county area that includes Jasper, Newton, Tyler, Sabine, and San Augustine.

Womack is Executive Director for this unique program that offers a broad range of programs.

Jana Herrin and Irma Dowden are two ETHAN team leaders. Herrin works in administration and Dowden is a community health worker and optician. They describe ETHAN as a hub with many partners.

"Basically, we try to help people without insurance," Herrin said. "We do what we can to find them the resources they need and to point them in the right direction."

ETHAN personnel first do a three-page intake that includes proof of income.

"We do an extensive intake that is then put in our database," Dowden said. "Then we do a benefit check. The client may qualify for a low-income subsidy or we may be able to help them with Medicare Part D, for example. After the intake, we can help them get the services they need."

Their enthusiasm for the services in progress is evident as they explain the numerous components.

"We do referrals for services people need, but we also offer many, many programs," Dowden said. "For example, we collaborate with community partners and offer free health education classes."

Both Herrin and Dowden emphasize that many people don't know enough about diseases such as diabetes, heart disease, asthma, and high blood pressure; therefore, they need help in learning how to manage their health problems.

"We also try to keep people out of the emergency room," Herrin said. "Hospitals reports seeing the same people three and four times a month. When people use the emergency room as their primary care, it is a drain on the economy- a drain on hospital resources."

They call this program Care Partners. ETHAN has a number of community health workers who provide referrals and assistance to those who use the ER for chronic health problems or illness that doesn't really qualify as an emergency.

"We have a lot of clients who abuse the emergency room," Dowden said. "We case manage. We find them a doctor. For example, we might see a Medicaid patient who goes to the ER in lieu of a doctor. They may have high blood pressure, for example. They may try to stretch out their medication because they can't afford the cost of the prescriptions. We help them find a doctor and get help with medicines. We are also trying to train doctors to make a spot in their schedules to see people who can't wait for an appointment two or three weeks."

ETHAN also provides dental service. They have a contract with the University of Texas Health Science Center at Houston, Dental Branch.

A team of dentists brings once a month clinics at various communities in the fivecounty area ETHAN serves.

"One service we are really proud of is the mobile dental clinic," Dowden said. "They come once a month to a different community. Clients must make an appointment and there is a $20 fee because this is an expensive program for us. They see 32 patients who don't have dental insurance and the fee for service is based on household income."

Dowden is a certified Community Health Worker and an optician.

She is especially proud of the Optical Shop.

"I'm also a member of the Evening Lions Club, one of our community partners," she said. "Vision, especially for children, is a Lions Club mission. Our optical program provides exams and glasses for people who can't afford glasses. We even go into nursing homes. So many elderly people have poor vision. They spend their time watching TV or reading, so why shouldn't they be able to see? We can do vision screening and provide eyeglasses. We work closely with a top lab and our frames are beautiful."

The new kitchen under construction has a retro look- red walls, white cabinets and trim, and a black and white tiled floor. They've dubbed it the Heart Throb Cafe' and there they will teach clients with heart disease, diabetes, and high blood pressure how to cook healthy meals.

ETHAN has many partnerships- local community groups, churches, homehealth agencies, the Jasper- Newton County Health District, Christus Jasper Memorial Hospital, physicians, pharmacies and pharmaceutical companies. Together, they provide numerous services. Depending on income, some are low cost, some free, and some are based on a sliding scale.

Their prescription assistance program, for example, helps patients obtain medications from major pharmaceutical companies. It is designed for those who meet income guidelines and are uninsured for prescriptions.

With all of the programs they offer, nothing makes these ETHAN employees' eyes light up like the mention of Medical Camp.

Health-care personnel screened for a variety of problems: hypertension, vision, diabetes, cholesterol, and even had foot and dental exams. Then, the physicians went over the findings with each patient.

Prior to 2006, ETHAN handled approximately 5,000 clients a year.

After Hurricane Rita, the number doubled.

"In 2006, we saw 10,000 people," Womack said. "Some lost their jobs because of the storm, some had damaged homes and little or no insurance, some temporarily lost jobs that didn't start up again for months. Many of the uninsured are elderly people."

Womack insists that ETHAN is not about her. It is not about one person, but a group of employees that has now grown to 19 plus a large group of volunteers who care about the needs of others.

Their holistic approach which enables them to provide a broad range of programs mimics Womack's first volunteer- her father who saw a need and filled it.

"My dad was the type of person who, when delivering equipment, he saw there was no food in the house or the client had little furniture except a ragged couch, would get those things donated and take it to them."

Her father volunteered until his death.