Ilene Lindsey was just 45 years old when her health problems began:
spinal stenosis, a major heart attack, black foot, diabetes, and
Ramsay Hunt syndrome, a rare complication of shingles that causes
facial paralysis. The illnesses began 15 years ago and just kept
coming, one after another. Lindsey and her husband, Carey, would
barely have time to recover from the stress of one when another
They ran a restaurant and lounge called Little Bit and More in
Story City, but a few months into Ilenes health crisis, they
lost it to bankruptcy. Then Carey, who had worked as a bricklayer
before opening the business, spent several years doing electrical
work on a contract basis and trying to pay for private health insurance.
They couldnt keep up.
"Every time Ilene went into the hospital with another problem,
our premiums would go up," Carey says. "I was constantly
worried about her and about how to pay for all her prescriptions."
Sometimes Ilene tried to talk Carey out of buying the medication
she needed because, she says, it didnt make sense to use all
their money for pills when they barely had enough to eat. But he
was devoted to her, often going into debt in order to pay for her
A year and a half ago, everything changed for the Lindseys. Thats
when Carey, desperate to find assistance before he and Ilene lost
everything, heard about the Indigent Patient Care Program (also
known as the "state papers program") at University of
Iowa Hospitals and Clinics.
This program works in partnership with the state of Iowa to ensure
that chronically ill and indigent Iowans receive health care. Every
Iowan who receives state papers as part of the Indigent Patient
Care Program is eligible to receive medical and surgical services
at the University at no personal cost. State papers are awarded
according to the guidelines of county general assistance offices
in each of Iowas 99 counties.
Each year, about 3,500 patients receive services at University
of Iowa Hospitals and Clinics on the state papers program. Many
receive personal assistance from a case manager with the Care Management
Program, a service provided under the auspices of the Indigent Patient
Care Program. Through the program, nurses coordinate patient care,
assist in setting up multiple appointments, and provide links to
resources when questions about medical or pharmaceutical issues
arise. This program even arranges transportation to and from University
of Iowa Hospitals and Clinics for indigent patients and has successfully
increased patient satisfaction and outcomes while reducing resource
utilization. Its worked wonders for the Lindseys.
Both Lindseys qualified for the Indigent Patient Care Program through
Story Countys General Assistance Office. Because Ilenes
medical needs are so complex, she was referred to the Care Management
Program. Carey says access to quality medical care has relieved
them of their greatest stress. But the relief isnt just due
to the financial help they receive. What matters even more, he says,
is the way the Care Management Program delivers service to its clients.
"When we first came to the University hospital on state papers,
I thought everyone would be looking down their noses at us,"
Lindsey says. "But weve never ever seen a hint of that.
These people greet us at the door like we just handed them a million
dollars. And thats everyone: the receptionists, the nurses,
and the doctors."
If they had to thank just one person for the change in their lives,
though, it would be Joyce Powell, a case manager with the Care Management
Program. Powell, an advanced nurse practitioner, keeps track of
Ilenes health conditions and has been instrumental in managing
conflicts between the nine medications Ilene must take each day.
Powell also communicates with Ilenes many providers and makes
recommendations to treat the constant pain resulting from her spinal
Carey and Ilene Lindsey have been married for 46 years. Thanks
to the Indigent Patient Care Program, he says they now have a shot
at celebrating their 50th anniversary.
"You have no idea what its like to fight so hard and
worry so much and then find out, all of a sudden, that this program
exists," he says. "Ive been meaning to write to
Governor Vilsack to tell him about our experience here. I want to
see the people who are holding this project together get some recognition