From Kentucky, USA:
I am a diabetes educator and can refer patients in need to indigents from anything from medicines to syringes except strips. What is an indigent patient supposed to do for a regular supply of blood glucose monitor strips? Too many adults fall between the cracks of no income, no insurance, and no medical card. Our local health department has a program for children, but help for adults is limited at best. It's frustrating at times.
This question was referred to several members of the Diabetes Team, who have each given an answer:
Answer from Dr. Quick:It's one of the most frustrating aspects of my office practice: plenty of insulin and pill samples, plenty of handouts, even free meters, but finding strips seems nearly impossible.
Our state's ADA voted funding for emergencies for indigents; but it's one-time only.
The next Medicare proposal from the President apparently includes more about coverage of diabetes education (and hopefully supplies) (I heard a bit of a boring presentation by someone to some Congressional committee the other day on C-Span). Wonder if it'll pass, or get lost, and whether it'll help?
Answer from Stephanie Schwartz, diabetes nurse specialist:Try mandating HMO/insurance/Medicaid coverage of Durable Medical Supplies for diabetes, including strips, through your state legislature: New York (and perhaps other states?) did.
Answer from Tom Bartol, Family Nurse Practitioner:I have been working in a community health center with low income/indigent folks. There were a couple of ways I worked around this.
First, I had people who were doing once daily testing and were not making medication changes do their monitoring just two days a week but 4 times a day on those two days. This was much more useful than just once daily testing yet used about the same amount of strips.
The other thing I did was go to some of the churches in the wealthier parts of town, where the indigent don't live. I told them of the dilemma and many were looking for a way to "help the poor" as they had few in their area. This was a way where they could know their money was going to good use. I requested a monthly commitment, say of 25, 50 or 100 dollars a month. If you can get 10 churches to give you $25/month that is $250 per month and so on. This way I can budget the money.
I worked with a local pharmacy and we came up with a sliding scale voucher system. For the majority, even of indigent folks, I didn't want to give them away for free. Something they pay for they will see has value and won't be wasted. Monitoring must be important not to me but to them. So, they paid between $10.00 and full price for strips and I used the church money as far as it would go.
Before doing that I had looked near and far for sources of strips for the indigent and just couldn't find a regular supply. The companies would give me some from time to time but I couldn't depend onaohem regularly. The churches, though, became regular. I waould send them quarterly reports and most would pay me quarterly.
Just an idea. Good luck!
Original posting 30 Jan 97
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