Illinois College of Optometry: 2007 – 2008

Vision of Hope Health Alliance patient receives an eye exam.

Lack of health care and health education are frequent barriers that keep people from seeking health care.

The Illinois College of Optometry and its clinical division the Illinois Eye Institute developed the Vision of Hope Health Alliance (VOHHA) to help people in need to address these barriers.  The objective of the VOHHA is to provide comprehensive eye care to uninsured, low-income adults and to connect these patients with primary healthcare providers when necessary.

VOHHA re-engages uninsured adults into the healthcare system, using primary eye care as a point of entry.

Programs like VOHHA are needed to address barriers that keep people from accessing healthcare.  The VOHHA program is in its fourth year of operation and has provided 3,121 people with important eye care services.  VOHHA has influenced both eye care and general medical care choices for low-income, uninsured adults and provided important services for partnering agencies in Chicago.   Support from the Washington Square Health Foundation and other funders have made the VOHHA program possible.

In November 2003, grants from the Washington Square Health Foundation and other local foundations enabled ICO and its partners to begin piloting the Vision of Hope Health Alliance (VOHHA) to coordinate the treatment and management of ocular and systemic disease among underserved populations.  The success of the pilot project positioned the VOHHA program for an application to the Local Initiative Funding Partners (LIFP) program of the Robert Wood Johnson Foundation (RWJF).  The Washington Square Health Foundation served as the nominating funding partner and led a successful site visit in April 2005.  In June 2005, ICO was named one of seventeen recipients (out of 295 initial applicants) of an LIFP grant from RWJF.  The grant provides up to $500,000 over four years in matching funds which will result in $1,000,000 dedicated to expanding the VOHHA program to serve people in need.  The most recent grant from the Washington Square Health Foundation helped to secure the matching funds for Year Four of the program.

There are many barriers that prevent people from seeking healthcare.  However, problems with vision may motivate patients to visit an eye care professional for eye glasses.  These visits provide opportunities for eye care professionals to educate patients about the importance of routine preventive eye and medical care and to make appropriate referrals.

“Sheri” was one such patient.  Sheri was working temp jobs, she did not have health insurance, and her position (and income) was unstable.  The glasses she owned were very old and had broken many times.  She knew that she didn’t see the best out of her glasses and that they looked horrible.  However, Sheri could not afford to buy new eye glasses.  She reached a point when she knew she had to obtain new eye glasses even if it meant that she went into debt.  Fortunately, Sheri was referred to and qualified for the VOHHA program.  Through VOHHA, she received an eye exam and eye glasses at no out-of-pocket cost to her and, since she didn’t have a primary care provider (PCP), she was referred to a partnering Federally Qualified Health Center (FQHC) where she could receive primary medical care at a reduced cost.  After her eye exam, Sheri was told her eyes were healthy.  However, at her primary medical exam, she learned that she had type 2 diabetes mellitus.  Sheri was surprised to find this out because she had no symptoms.  Currently, Sheri’s diabetes is under control.  Sheri is happy to report her health is very good and her vision is great!  Sheri is a smart woman but she was not educated about the importance of routine eye and general medical care.  When she came to VOHHA, she was worried about her glasses and willing to go into debt for new glasses.  Yet she was seemingly not worried about the health of her eyes or general health.  Through VOHHA, Sheri is now aware of the importance of preventive medical care and has been active in managing her diabetes.

“Ellen” faced a different set of obstacles.  Working as a live-in nanny and housekeeper, she earns room, board and $100 per week.  She knew she had problems with her vision but “pretended” to see because she was afraid she would lose her job if her employer knew of her vision problems.  Her employer, “Mary”, had noticed Ellen did not seem to be cleaning as well as she had in the past.  Another time, Mary found an object in her baby’s mouth and Ellen was unaware.  Mary talked to Ellen about these issues and Ellen finally admitted her vision problems.  Fortunately Mary was supportive of Ellen.  Through a friend, Ellen learned of and was referred to VOHHA.  She reported a lack of recent eye care and general medical care.  She was diagnosed with cataracts in both eyes, which caused her to suffer from significant visual impairment.  Since VOHHA does not cover cataract surgery, another charitable program was found through which Ellen obtained cataract surgery.  Ellen was also diagnosed with diabetes and hypertension at her general medical appointment.  After the cataract surgery, Ellen went to her employer in tears.  “It is raining,” she said.  Mary did not understand.  “Yes, it is raining,” she said.  “I can see the rain,” answered Ellen.  She could not remember the last time she had seen rain.  Ellen faced barriers not only due to the cost of healthcare but she feared she would lose her job if the truth about her vision were known.  Fortunately, Mary empathized with Ellen and her situation.  Ellen’s fear did not come true.  Fearing loss of employment is an obstacle that keeps some from accessing healthcare and receiving needed treatments.

This program was presented at the 2008 American Public Health Association’s Annual Meeting.  The PowerPoint presentation can be found here.