Duke nurse practitioner Colleen Wojciechowski takes Andrew Whitley's blood pressure as part of "Just for Us," a program that provides in-home medical and mental health services to low-income North Carolina senior citizens. Recently named "N.C. Nurse Practitioner of the Year" for her work in the program, Wojciechowski visits Whitley every month to coordinate his treatment plan and ensure he receives the care he needs to stay healthy.
In 1925, James B. Duke willed $4 million to establish Duke Hospital and its medical school to improve health care in the Carolinas, then a poor region lacking in hospitals and health care providers.
In the decades since, Duke has devoted itself to bringing high-quality health services to needy individuals across the region. That might mean caring for an unemployed accident victim, or donating a lifesaving operation to a child whose parents are uninsured. Or it may mean providing health services to a whole community—as in the case of "Just for Us," one of the newest ways Duke is helping low-income North Carolinians access needed health care.
Launched in 2001, Just for Us brings low- or no-cost health services to medically fragile elderly individuals living in Durham public and subsidized housing facilities. Administered by Lincoln Community Health Center and the Duke Division of Community Health--a collaboration between Duke's School of Nursing and Department of Community and Family Medicine—the community partnership brings medical professionals from Duke, mental health specialists from The Durham Center, and Durham County social workers into residents' apartments to provide services and coordinate care. Other partners include the Durham Housing Authority and Durham Hosiery Mill (which provide free office space).
Many of the program's 300 participants have multiple medical problems and chronic diseases, but often didn't receive the treatment or monitoring they needed, according to medical director Kim Yarnall, MD. Through Just for Us, they now receive in-home services ranging from physical examinations, medication management, and mental health care to help arranging appointments and transportation to see specialists.
That personalized attention is working wonders. Since the program started, data show that many of the residents with hypertension and diabetes have gotten their chronic conditions under control, hundreds of emergency room visits have been averted, medication management has improved, and many patients who previously had no primary care physician now do. Administrators hope the program will serve as a model for financially sustainable care coordination programs across the state and the nation.
More than a success story, Just for Us is an example of Duke University Health System's innovative approaches to meeting societal health needs, says William J. Donelan, executive vice president and chief operating officer of DUHS. "Duke has a tradition and long history of providing medical care to the needy of the state of North Carolina dating back to 1930," he says. "While there are limits to the amount of charity care that DUHS, as a private institution, can provide, we remain firm in our service commitment, even as we push for national solutions to the gaps in access to medical care."
For more information about Just for Us, call 919-956-5386.
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