ACCESS TO CARE

1. ACCESS TO CARE A review of progress toward key recommendations from Healthy Kansans 2010 February 16th, 2007

2. Access to Care Programs for HK2010 • Recommendations for Access to Care in Kansas • Performance on the HK2010 Access to Care Indicators • Progress and impact of program initiatives related to Access to Care in Kansas • Barriers/challenges to adopting Access to Care programs in Kansas • Opportunities for future Access to Care program initiatives in Kansas

3.  I. Address ability of state to create incentives for insurance industries serving the private sector to provide coverage to previously uninsured individuals and improve quality of care and coverage to underinsured individuals. • Identify system barriers for increasing insurance to under-insured and uninsured • Promote strategies that encourage healthy individuals, 20-something age group, to purchase insurance, resulting in greater capacity/resources for low income/disadvantaged. • Investigate strategies to improve participation of small business in providing health coverage to employees • Re-evaluate working poor, promote incentives to offer insurance plans to working poor. • Promote plans affordable for small businesses.

4. Insurance Expansion • Businesses that have been in existence for less than two years and businesses having never before provided health insurance for employees may take advantage of a state tax credit program. • SB 309 proposes a health connector act to establish an exchange where qualified individuals may chose between qualifying health insurance products.

5.  II. Assess potential and engage schools/school districts to serve as a vehicle for change in the health of disadvantaged/advantaged persons within the school district, resulting in improved health of the broader community. • Identify school districts as crossing point/entry point/coordinating entity for social connectedness and community engagement. • Seek ways to reach out to school district residents who do not have children (e.g. seniors, singles) to further connect them with families/children already involved in schools/school districts. • Recognize and promote the school building as a physical center and cultural center of the community. • Promote lifelong learning in the community.

6. III. Encourage broader implementation of successful care coordination and case management models, particularly among disadvantaged populations. • Expand the use of case management and care coordination models used with uninsured population.

7.  IV. Quantify the impact of social determinants of health on health outcomes and promote social marketing of this information, engaging decision makers and the general media and promoting intelligent use of social determinants data. Incorporate HP2010 outcome indicators into data/information efforts. • Provide information on correlation between health status, social determinants, and state expenses.

8. Kansas Performance on Healthy People 2010 Access to Care Indicators

13. Current Program Efforts in Kansas to Address Access to Care • Current Programs (KDHE Office of Local & Rural Health) • Focus: Workforce supply and accessibility of affordable care • Impact: Incentive programs and access projects

14. Workforce Development • Improve data systems for collection and assessment of medical, nursing, dental and behavioral health professional workforce information and practice characteristics • Expand use of mid-level practitioners and extended care permits to improve access to dental care • Continue to develop efficient models of primary care practice • Increase career recruitment, training and distribution of under-represented minorities into the health care professions • Expansion of Charitable Health Care Provider Program

15. Health Care Safety-Net Growth • KDHE program objective in the primary care office: to establish primary care clinics in high need areas throughout Kansas where poverty, lack of insurance, or inability to retain a private medical or dental provider is a barrier to accessing continuous health care services

16. Health Care Safety-Net Growth • 24 Clinics now serve patients in 20 counties with sites in more than 35 locations across the state. These safety-net clinics reported providing 270,000 patient visits to nearly 95,000 patients in 2005.

17. Access to Care • Gaps in Program Efforts Geographic areas without identified providers of care for the uninsured Uneven sharing of data between agencies and organizations working on gap identification and access initiatives Data on practicing health professionals is declining in quality and completeness

18. Access to Care Opportunities for New Programs Two community based clinics have submitted federal applications for designation as Federally Qualified Health Centers (FQHC) Additional community-based clinics are expected to file applications for state funding of primary care clinics by the March 15 deadline.

19. Barriers to Implementing • Effective Access to Care Programs • Stability and expansion of funding • Outreach and enrollment issues for immigrant populations

20. Suggestions for overcoming barriers • Begin or continue a broad-based, participatory process for ongoing community health assessment at the local level. • Document the status of the local system of care, local access to the health care system, and the health status of the residents in your community • Inform your community - - good news and bad, progress and slippage, regarding issues related to health care access