story and photo by Traci Chapman

As healthcare becomes more complex and treatment more expensive, patients of all ages and conditions have found themselves in a no man’s land where they find more questions than answers.
That’s where care management can lift the mists obscuring the answers those patients – and their families – are searching for, helping them improve their health, while avoiding at least some of the stressors that come with high medical bills and navigating the healthcare system.
What is care management?
Case managers are tasked with helping patients, caregivers and families find the most effective way to manage health conditions, while also focusing on potential medical cost savings. Several studies found in the U.S. National Library of Medicine, overseen by the National Institutes of Health, concluded care management can improve patients’ quality of care in the long-term, as well as positively impacting the cost of that care.
University of Oklahoma Health Sciences Center Fran and Earl Ziegler College of Nursing’s Care Management program has been providing community-based healthcare management services since 1995.
Seniors and Disabled Patients
OU’s Nursing Care Management program provides care management services to patients of all ages, conditions and income levels. For Karissa Maddox, RN, BSN, CMC, many of the people she’s spent the last 15 years of her career treating and guiding through the healthcare maze are seniors, elderly and disabled individuals who are deemed ADvantage-eligible by Oklahoma Department of Human Services. Maddox is also the program’s private care management services supervisor.
Oftentimes, multiple doctors treat patients, who also might be facing a myriad of conditions. That’s where a case manager comes in, serving as a central information hub and helping to coordinate care, Maddox said.
“It just relieves the stress and helps the family try to live a normal life, especially if loved ones live at a distance,” she said. “We are often the ‘professional advocate’ helping manage care – while communicating with family members and providers, in addition to coordinating all health care needs.”
OU Nursing case managers first provide an assessment, allowing them a comprehensive look not only into a patient’s medical issues, but also other challenges facing that patient – and their family. As hospital stays get shorter, Maddox said these assessments are crucial, providing the proper care plan and a bridge to medical providers, while also allowing patients to save money.
“You see the education you provide, the stability you provide – and being an advocate for them is huge,” she said. “Sometimes people don’t have anybody else to speak for them.”
OU Nursing Care Management has four office locations in Oklahoma City, Tulsa, Lawton and Elk City, providing services across Oklahoma to patients and their families.
Maternity Coaching and Education
OU Nursing recently unveiled new services geared specifically for pregnant women and new or expectant parents. This service provides supportive coaching and education to clients to help with the life transitions that come with the addition of a new baby, their communications with health care providers — also helping them to determine the best resources for their individual needs.
“The focus is on the client and personalized according to what is most important to her,” said Margaret Back, RN RLC, ANLC, maternity coach and consultant. “The tailored plans and education materials prepare the client to anticipate changes and to minimize the stress of transitioning through the stages of pregnancy and the ‘4th Trimester’ of life with a new baby.”
Services also benefit anyone feeling overwhelmed or uncertain about maternity health-related issues, Back said. “New or single parents working through the transition back to work and adoptive parents or grandparents caring for their grandchildren can also find support, guidance and assistance,” she said.
While services offered by Maternity Coaching and Education are not a substitute for a doctor, midwife, lactation consultant, childbirth educator, therapist or doula, those will be accessible to participants, Back said. It offers Bump to Baby & Beyond Bundles, as well as a la carte options, all designed for flexibility and to address the changing needs of individuals and families, both during pregnancy and after childbirth.
“I am very excited about the opportunity to share the knowledge and experience I have acquired during the past 30 years as a nurse,” said Back. “I truly enjoy helping expectant mothers and new parents navigate through the exciting but sometimes overwhelming transition to parenthood and newborn care.”
Teri Round, MS, BSN, RN, NE-BC, executive director of clinical operations, cited OU Nursing’s multi-faceted approach to care management, which allows patients to move through every chapter of their life – and healthcare – with support and guidance.
“We have been in the business of providing care coordination for more than 20 years – Our case managers are experienced professionals who are able to care for others across their lifespan, but who specialize in the care of seniors and helping them age in place,” Round said. “We have developed other business lines, which work to support care transitions using CTI, an evidence-based model that helps individuals control their chronic conditions at home versus hospitalization or ER; with OU Physicians in the Bedlam L Clinic, in a team effort to improve quality of life in those with little or no insurance and chronic conditions; private care management performing all of the above; and maternal-child health, our newest addition to our group of services.”
For more information or a professional consultation for private care management, contact Lisa Macias at 866-416-4980 or via email at lisa-macias@ouhsc.edu.

By Darlene Franklin

Fifty books in with her latest novel, “Mermaid’s Song,” historical author Darlene Franklin is still going strong and looking forward to another fifty titles.
“I love finding a historical tidbit and teasing it into a story,” Franklin said. “I love growing a story from a character, an idea, a setting, an event. There is never enough time to tell them all.”
Franklin recently celebrated her Jubilee title, “Mermaid’s Song,” with 500 supporters joining her in an online Facebook gathering July 10.
The well-received story is an imaginative retelling of Hans Christian Andersen’s classic fairy tale, set on the shores of historic Maine with a shipwrecked Acadian beauty and her rescuer.
Franklin’s storytelling career took off in 2005 with “Romanian Rhapsody.” Her first historical novella, “Dressed in Scarlet,” finaled for the 2008 American Christian Fiction Writers Book of the Year award as part of the Barbour novella collection, “Snowbound Colorado.”
“That gave me the courage to continue, and the market was wide open,” she said.
While relishing the afterglow of celebration, Franklin is committed to five additional novellas over the next year and will be contributing devotions to an upcoming nonfiction collection.
“At the moment, I’m writing this year’s Christmas romance, ‘The Christmas Child,’ to be released by Forget Me Not Romances this September,” Franklin said. “Apart from that, the door is wide open. I’m looking at writing a single-author devotional book, and maybe contemporary romance or a cozy mystery.”
When not writing best-selling fiction, Franklin pens a column for Book Fun Magazine, “The View Through My Door,” her unique perspective on life from a nursing home. Franklin’s titles are available at online retailers as e-books and in print. Her complete list of fifty, as well as dozens of collections to which she contributed, can be found at https://www.amazon.com/Darlene-Franklin/e/B001K8993A.

In the culmination of a three-month environmental effort, the numbers are in, and the hard work of Oklahomans has proven to pay off once again.
For the fifteenth consecutive year, Keep Oklahoma Beautiful (KOB) took part in the nation’s largest cleanup, sponsored by Keep America Beautiful. Volunteers from all over America participate in the Great American Cleanup (GAC), and each year, Oklahomans do their part to keep the state beautiful. Since 2010, Oklahoma has had 100 percent county participation, and this year was no exception. From March 1 to May 31, over 46,000 volunteers and participants fought dirty to keep Oklahoma clean.
Organizations that register for the GAC in Oklahoma receive free trash bags, gloves, vests, water and more. In addition, 36 organizations received cash grants and 11 received equipment grants.
Since 2002, the GAC in Oklahoma has collected over 214 million pounds of litter and debris. Just this year, Oklahoma communities cleared over 3,500 miles of roadways, shorelines and hiking trails. Nearly 192,162 pounds of hazardous waste and electronics and 13,142 tires were collected, helping to protect our environment as well as keep it clean.
The Great American Cleanup is far more than a cleanup effort, however. Communities across the state participate in beautification projects, planting gardens and restoring buildings. This year, communities planted over 7,300 flowers, seedlings, shrubs and trees and painted or renovated 35 buildings.
GAC events have the power to bring communities together, with over 700 groups teaming up this year. 4-H clubs, civic organizations, FFA programs, businesses, chambers and municipalities worked together with the unified goal of keeping Oklahoma clean. The collaboration is 100 percent statewide, and Keep America Beautiful has recognized KOB several years in a row for their complete county participation.
“The KOB GAC is our signature program for which we are recognized nationally for having at least one community in all of our 77 counties participate,” said Jeanette Nance, KOB Executive Director. “It speaks volumes when we can be the facilitators for communities to come together for a beautiful cause.”
The GAC in Oklahoma not only makes municipalities more beautiful, but also unites community members.
“Community cleanups are a really fun way to volunteer,” said Wanda Gray, coordinator for the INCA-RSVP cleanup in Tishomingo. “What’s better than spending a couple hours with family, friends, and neighbors making your home a better place? Our volunteers are uniting through community service, responsibility, and sharing of the natural environment to help drastically improve the quality of their communities.”
This annual program in Oklahoma strives to strengthen communities, all while keeping this state more eco-minded and environmentally friendly. KOB maintains the belief that unity through community improvement has the power to make positive change. “For us, the Great American Cleanup is so much more than a series of litter pickups or community improvement projects,” said Brenda Russell, with the Twin Cities Revitalization Project. “It is our opportunity as a community to come together and truly showcase that we as a whole are greater than the sum of our parts.”
Keep Oklahoma Beautiful is a statewide nonprofit with a mission to empower Oklahoma citizens to preserve and enhance the state’s natural beauty and ensure a healthy, sustainable environment. To learn more about their programs, visit keepoklahomabeautiful.com.

Whether it’s climbing into a combine to harvest the wheat or walking into a congressional meeting to discuss farm policy, Francie Kucera Tolle remains focused on one goal—“It’s the legacy of it.”
Rather than a legacy of how Tolle will be remembered, this is one centered on how others will value and appreciate agriculture as a result of her family’s stewardship.
Having been born on a family farm and now farming with her husband Chuck, Tolle knows the importance of agriculture. She has been a resident in Grant County her entire life and laughed as she reminisced growing up on a farm with her three sisters.
“My dad brought a bottle calf home one time and we thought it was the greatest thing ever and asked for a few more. The next day we had 30 bottle calves and would be mauled when we got to barn,” said Tolle. “A year later we wanted some feeder pigs and my dad brought home a whole truck load. Next, we thought we would like some sheep and our dad said, ‘Really?’ We changed our minds pretty quick.”
Tolle spoke about the daily life lessons that were learned among the cattle and in the wheat fields. The greatest of these was work ethic and faith.
“You have to have faith because there is no telling what the weather will be,’’ said Tolle. “You use your work ethic and do everything you can but in the end you have to have faith.”
Growing up, Tolle did everything the hired hands did on the farm, saying it was expected of her and her sisters. She started driving the combine when she was 12 and basically lived in the barn with the stocker cattle during the winter. She went on to college with no plans on returning home. But as fate would have it she started dating a local farm boy and married him in 1990.
“I didn’t really have plans on marrying a farmer,” laughed Tolle. “I was a business major and liked marketing. But then I started dating Chuck and I came back to agriculture pretty quick.”
They moved and started their own operation in 1992 in Grant County with a quarter of land, mainly growing wheat and running a cow-calf and stocker cattle operation. Their little operation began to grow as Tolle had two boys, Clint and Cole.
Tolle laughed and said her boys never wanted to drive the combine growing up because that was her thing. Now her boys are growing up and making their own legacy. Clint is married and will graduate college soon, with plans on returning to the farm. Cole just graduated high school and is beginning embark on his college journey studying construction management.
In addition to raising two boys and operating a farm, Tolle also works tirelessly to carry on the legacy of her dad, who taught her the importance of agriculture through policy.
“I got my love for policy from him,” said Tolle. “He never went to college but he was the smartest man I ever knew.”
It was not uncommon for Tolle and her father to be talking about world trade, farm policy and commodity markets. This sparked her interest and she began her work in farm policy in 2003 as Director of the Oklahoma Wheat Growers Association.
From here, many doors began to open for Tolle as she served as Agricultural Liaison to Congressman Brad Carson, Director of Agritoursim, Legislative Policy Analyst for the Oklahoma Farmers Union/American Farmers and Ranchers, State Director of Farm Service Agency and is now currently the Regional Director of the Risk Management Agency serving Oklahoma, New Mexico, and Texas.
When asked about her most rewarding experience, there was no hesitation as she recalled the implementation of the Livestock Forage Program, which resulted in paying over a billion dollars to farmers and ranchers in Oklahoma affected by the three year drought.
“I saw people literally cry because they were saved… I will never forget. That was pretty impactful,” said Tolle.
Although she stays busy with policy and farming, she never forgets why she does it. Tolle is proud to say that she is only the second generation born in the United States.
“It’s the legacy of it. My grandparents came here for this reason. Here I am fulfilling the dream they had. I don’t want it to die,” said Tolle.
Again, even though Tolle has left a legacy in what she does, this was not her goal in an individual sense. Instead, she hopes that through her work, people will know and understand the complexity of farming and in agriculture in general.
“It’s not easy,” said Tolle. “Yes it is rewarding but it is the hardest job you will ever do. If you don’t love it, you won’t do it. There is not another job where you work as hard as you do with farming.”
Tolle is also quick to give credit to her husband for all of her success saying he is extremely supportive of everything she has done. Even with all of her accomplishments, her greatest one is building a legacy with her husband to make sure that others will value and appreciate agriculture as a result of their stewardship.
“My goal is to leave a legacy,” she said.