BY: GORDON BURNSIDE
Negotiations were so tough, they went on for seven months," Cindy J. Rogers said. "The store's owners wanted to rent not to us but to small retailers. Finally we told them, 'Look, this isn't a speakeasy we're planning to run here.' Since then, they've become big supporters of our program."
Rogers, CEO of Geriatric Behavioral Health Services, St. Francis Medical Center (SFMC), Monroe, LA, was describing one stage in the evolution of a project that her employer and several partners had launched on behalf of senior citizens in their region. She discussed the project at the annual meeting of the American Association of Homes and Services for the Aging in Chicago in October.
Rogers's project is St. Francis Senior Plaza, a former discount store in downtown Monroe. Refurbished, the 39,000-square-foot building offers a wide variety of services to the older residents of a 100-mile chunk of territory including, besides northeastern Louisiana, parts of Arkansas and Mississippi.
Reconfiguring Care of the Elderly
By the mid-1990s, SFMC had become acutely aware of senior healthcare issues, said Rogers (the hospital was the first in the state to offer hospice and home care services). Proposed cuts in Medicare and Medicaid funding, on one hand, and the new emphasis on wellness and community health, on the other, had convinced SFMC's leaders that they must reconfigure its care of the elderly. In 1996 they convened a three-day strategic planning session on these issues. "We could see the senior wave coming down the pike," Rogers said.
St. Francis Senior Plaza was born at this session. Since the project was judged to be too costly for the hospital to handle alone, SFMC's leaders sought the help of two other local agencies: the University of Louisiana at Monroe (ULM) and the Ouachita Council on Aging (COA). After struggling to overcome a good deal of initial suspiciousness, the three groups agreed to work together on the plaza idea. (The project's founders also had to overcome some ancient rivalry between Monroe and West Monroe, its twin across the Ouachita River.)
Each partner had its own reasons for backing the project, said Rogers. SFMC wanted to expand its continuum of care and "raise its profile in the community." The ULM, site of the state university system's Institute of Gerontology, sought access to older people for its researchers and students. The COA was looking for larger quarters, more grant opportunities, and a closer relationship with the hospital (the two were already partners in the local Meals on Wheels). "Once we started talking about it, the plaza seemed to be the answer for all these different needs," Rogers said.
A former Wal-Mart store turned out to be the best site for the senior plaza. The building was on the route of the city's public transportation system and about midway between its poorest and most affluent neighborhoods. Rogers was sent to negotiate with the building's owners—a job that, as mentioned, turned out to be more strenuous than expected. But finally a contract was signed. And, after the partners spent $2.5 million (mostly provided by SFMC) to renovate the old store, St. Francis Senior Plaza opened in the fall of 1998.
The Plaza's Services
The plaza is home for a dozen services, some of which are charged for the use of their space. Operated as a specialized department of SFMC, the plaza is governed by hospital team leaders who meet regularly to collaborate on services.
St. Patrick's Partial Hospitalization Program St. Patrick's is the name SFMC gives its psychiatric hospital. Partial-hospitalization patients spend five to six hours a day at the plaza, five days a week. Meals are provided.
Ouachita Adult Day Healthcare Program This program furnishes daycare for seniors. A staff, recruited by SFMC but paid by COA, runs the program, teaching arts and crafts classes and leading other activities.
Geriatric Rehabilitation Services This program's staff provides speech, physical, and occupational therapy for seniors.
Community Case Management/Geriatric Assessment A team of nurses and social workers "aggressively" manages symptomatic illnesses in about 500 clients. Another 1,500 clients are members of a wellness program in which they attend diabetic or cardiac care classes, for example, and belong to aerobic exercise groups.
Home Care Services The staff of this program offers home health, home infusion, and hospice services. In the fall, they give flu shots to community seniors.
Secure Partners This is an SFMC-created Medicare supplemental insurance program. Counselors advise seniors on their insurance needs.
The Institute of Gerontology's Resource/Research Center Maintained by ULM and staffed by a librarian and gerontology students who serve as part-time employees, the center conducts research involving seniors who use the plaza's clinics. It also offers an elderhostel program and an employment service for seniors. Various ULM professors use the center to teach classes (in yoga, for example) to interested seniors; gerontology students teach them computer skills. The center includes a library, computer laboratory, TV-VCR room, and the institute's gerontology database.
Medwise Clinic This program, staffed by a physician and nurse who specialize in geriatric medicine, provides primary care to seniors.
Ouachita Council on Aging Activity Center Operated by the COA, this center offers classes in ballroom dancing, Cajun dancing, and other activities for seniors.
Alzheimer's Association This group counsels support groups for people who provide care for Alzheimer's patients.
Monroe City Schools The local school district, another new partner, sponsors GED classes for interested seniors.
Conference Rooms The plaza reserves two rooms for interested community groups.
Partnership Aids Stewardship
On average 200 seniors use the plaza every day, Rogers said. Approximately 20 percent come for medical services, the others for the nonmedical ones. Because the plaza is on the city bus line, it is easily accessible to local seniors. The COA has a fleet of vans and SFMC owns two; these are used to bring seniors in from the more rural areas. "It's not uncommon for a senior to come and spend the biggest part of a day at the plaza," Rogers said.
Along with its other benefits, St. Francis Senior Plaza helps the partner organizations steward resources. "Yes, the plaza is a place," Rogers said. "But the synergy created by its component programs is more important than the building. A project like this makes stewardship easier. Once you get past the hurdles — the jurisdictional and funding squabbles — you can ask: What is it I do that you can enhance? What do you do that I can maybe be the support piece for? A lot of lines have opened up in our community because of this project."
—Gordon Burnside