The COPE Program
A Nursing Success Story

One of VNASC’s six goals for the 2004-2006 strategic plan has been to assess the health care needs of the disenfranchised members of our communities and start one new program that addresses identified needs. To begin this needs assessment, a team was formed in February 2004. The team and resulting program have become known as the Community Outreach Program Effort (COPE).

	Wellness Nurse Cheryl Kyne is COPE’s familiar face at the Community Meal Center.

From the start, it was determined that a survey of the area’s disenfranchised population would be paramount to begin any new service for this population. The team first defined what groups made up the disenfranchised population. Some of the groups identified included: single mothers, victims of domestic abuse, new immigrants, persons with low income, the homeless, persons with mental illness, and persons with HIV. In February 2004, a successful James P. & Mary E. Shea Grant application was made, which sought funding to support health screening and education activities in the community among the disenfranchised population in order to facilitate a survey process.

In March 2004, phone surveys of other health & social service agencies were completed to elicit information about the most pressing and inadequately addressed community health needs. As a result, some common themes emerged. The most frequently cited pressing community health needs with inadequate coverage included: dental health, maternal-child health, asthma, nutrition/obesity, mental health (adults and children), and preventive education.

In April and May 2004, the team developed survey questions for individual interviews with members of the community. In June 2004, the first draft of the COPE survey was completed. It was trialed in early June with 11 surveys completed without difficulty. Also in June, health screening and education activities focusing on the disenfranchised population in New London began with funding by the Shea Grant.

Formal surveying began in early August 2004 with 111 surveys completed by September 1, 2004. Sites for formal surveying included the Community Meal Center and two sites on State Street. The survey showed that 72.1% of survey participants would utilize health education and care if made available in a community place. Throughout the winter of 2004/2005 the VNASC wellness nurse made scheduled visits to community sites in New London with the goal of becoming a familiar face to the disenfranchised population. Also during this time, the COPE Team developed nursing protocols to be used by the wellness nurse that would guide her decision-making with clients.

The end result of the COPE Team’s efforts is a regularly scheduled nursing clinic at the Community Meal Center in New London. The program is being funded for the first year through a generous grant from Liberty Bank Foundation, Shea Foundation and Community Health Access Management Program (CHAMP). In the first four months, 124 clients have made more than 300 visits to the VNASC wellness nurse. These office hours are advertised only by word of mouth and by a sign posted at the meal site.

Of the 5 to 15 clients seen per session, most are receiving nursing care for multiple medical problems or conditions including diabetes, alcohol abuse, pregnancy, smoking, wounds, asthma, high blood pressure, arthritis, depression, heart disease, and seizures. These clients may also receive smoking cessation instruction, diabetic and diet teaching and, most importantly, assistance with accessing other resources such as the L&M Hospital ER for urgent care, Community Health Center New London for primary care, CHAMP for pharmacy assistance, Thames Valley Council for Community Action, Catholic Charities, and the Jewish Federation. The wellness nurse has also worked with MALTA (a mobile ministry) and the New London Homeless Coalition.

The sessions are scheduled for every Monday, 11:30 am-1:30 pm and every Tuesday, 4:30-6:30 pm, in a private office space at the meal site, enabling clients to meet with the nurse on a one-to-one basis.