Part 2: Access

1. Part 2: Access • Communication • Physical • Medical Equipment

2. Hassle Factors

5. Access Prong 1 • Right care • Right place • Right time

6. Access Prong 2 • Right physical & equipment access: • To get to • Into • Through facilities & • Onto equipment

7. Access Prong 2 • Right communication access: • To get, understand & use information • To communicate using any needed auxiliary aids & services

8. PracticeSituations

9. Break up into groups • Choose a reporter / recorder to speak for group • Discuss & list what issues may need attention?

10. Latisha age 68, wheelchair user • A prior FFS patient, is in for 1st MMCO primary care appointment • African-American with multiple chronic conditions • (obesity, diabetes, hypertension, coronary artery disease, & rheumatoid arthritis) affecting mobility & vision • Over many years she has been labeled a “noncompliant” patient because she continually ignores prescribed diets & does not reliably take prescribed medications. • She has been lectured repeatedly about these problems.

11. Latisha age 68, wheelchair user • A prior FFS patient, is in for 1st MMCO primary care appointment • African-American with multiple chronic conditions • (obesity, diabetes, hypertension, coronary artery disease, & rheumatoid arthritis) affecting mobility & vision • Over many years she has been labeled a “noncompliant” patient because she continually ignores prescribed diets & does not reliably take prescribed medications. • She has been lectured repeatedly about these problems.

12. Maria • Maria, age 60, a prior FFS patient, • She is blind as is her husband Mario • She is hard of hearing • Maria, a new MMC patient, arrived by bus with Mario for her 1st primary care appointment. • She needs a series of tests (including a colonoscopy & endoscopy) over next 6 months involving: • Complex pre-test preparation • follow up at home

13. Maria • Maria, age 60, a prior FFS patient, • She is blind as is her husband Mario • She is hard of hearing • Maria, a new MMCO patient, arrived by bus with Mario for her 1st primary care appointment. • She needs a series of tests (including a colonoscopy & endoscopy) over next 6 months involving: • Complex pre-test preparation • follow up at home

14. Kaisy • Age 42, deaf since birth • A prior FFS patient, is by himself in for 1st MMCO primary care appointment • He points to his stomach at the receptionist window • He is a heavy smoker

15. Kaisy • Age 42, deaf since birth • A prior FFS patient, is by himself in for 1st MMCO primary care appointment • He points to his stomach at the receptionist window • He is a heavy smoker

16. Cho • Age 50, she uses a walker. • A prior FFS patient, coming alone for first primary care appointment. • Her speech is very difficult to understand due to cerebral palsy. • She has a mild intellectual disability • When making her appointment the receptionist thinks Cho said that she felt a lump in her breast.

17. Cho • Age 50, she uses a walker. • A prior FFS patient, coming alone for first primary care appointment. • Her speech is very difficult to understand due to cerebral palsy. • She has a mild intellectual disability • When making her appointment the receptionist thinks Cho said that she felt a lump in her breast.

18. Discussion Questions: • What are the: • Identified or implicit functional limitations? • Health and healthcare disparity issues? • Are there access needs? • Communication • Physical • Medical equipment • Other • How will you determine what is needed? • Are there policies, procedures and processes that need to be clarified or put in place by the plan or provider?