The key to improving access to care: Setting health priorities in your community

Improving access to care

March 10, 2022

Present day disparities in health care access are widespread and can result from barriers to transportation, adequate health coverage, etc. Sometimes, it is not even about getting a foot in the door, but instead about getting a foot in the right door. 

An initial step to improving access to care is identifying the distinct health priorities of various communities to ensure patients can receive the right type of care at the appropriate facility.

To help us define how we can identify the health priorities of our communities and effectively meet health needs, we connected with Julian Levine from Greenbrier County, West Virginia, Laura Hopkins from Cleveland, Ohio, and Brandon Kenney from Forsyth County, Georgia. They shared some insight on the different processes to identify health priorities in both their urban and rural communities and how they are helping residents access care.

Q1: What priority are you focusing on to improve access to care, and how did you identify that priority? 

Laura Hopkins: Our priority area is food insecurity with a secondary focus on access to other health and wellness services. In 2017, the Department of Public Health and Prevention Science at Baldwin Wallace University conducted a community health needs assessment with our partners and identified food insecurity as a major issue.

Brandon Kenney: We have been focusing on the technology and the data analytics side of improving access. Through data and the sharing of data, we hope to identify those most in need and to align services in order to provide them a helping hand. We also want to expand our data in a way that will allow predictive and prescriptive analytics to help us with different approaches to solving problems related to behavioral health.

Julian Levine: Greenbrier County Health Alliance focused on a few different projects in the "improve access to care" realm. We identified some core ways that we wanted to dig into access to care: 

  • Support our partners as they develop a community center, which intends to house a full-service medical clinic, senior housing and after school care for kids.
  • Develop a local referral system between health care organizations and local community health improvement programs.
  • Implement a community-engaged research study to get the community's pulse on health equity issues, including access to care and offer health equity focused mini-grants through our Community Ambassador Project.

We started from a place of humility and said "we can't see the future" so let's spread support and effort across multiple projects likely to make a difference. 

Q2. Briefly describe how you are addressing that priority. What approaches are you using to improve access to care?

Laura Hopkins: The CHANGE INC. program recruits, hires and trains local students and community members to serve as Community Health and Empowerment Navigators within our partnering communities. Our navigators work actively to integrate and become a part of the local communities and identify residents who are suffering from food insecurity. Once identified, our navigators work with them regularly to navigate the resources and programs available to them in their community including food resources, health services, etc.

It was a true collaboration with our community partners in developing this model. We discussed the needs of the communities and the best way to meet these needs based on resident feedback and requests.

Brandon Kenney: We are improving access to care by bringing visibility to those most in need through the sharing of data and creating a platform that provides access to all of the available services to best address the needs of our most vulnerable population. 

Julian Levine: If each of the projects that we're involved with succeeds, we'll end up with a new medical clinic, senior housing, and a childcare facility. And as we develop the community-engaged health determinants study, we'll get an on-the-ground snapshot of how residents across our community think about access to care and other determinants in terms of their community's health. We think this will help us see where the gaps are in access to care, and where other community supports are needed to improve our local systems overall. Finally, our Community Ambassador's mini-grant projects are amazing projects which all have the potential to grow into amazing community infrastructure.

Q3. Laura, how do your navigators help your residents identify and prioritize which health needs must be met first? 

Laura Hopkins: Our navigators use a social determinants of health screening tool to understand the needs of the residents with whom they work. This tool is a guide for the navigators to understand the scope of the residents’ needs. They listen to the residents about what they perceive their needs to be. Perhaps snow removal, which in and of itself is not a health issue, is of most concern to the residents, then our navigators work with the residents to find a solution for snow removal. After all, if a resident can’t get out of their house, they can’t get to the grocery store or to their doctor’s appointment. 

Q4. Brandon, how do you think technology is changing how people are accessing care?

Brandon Kenney: Technology is providing a platform that allows us to get information into the hands of those who can have the greatest impact on the delivery of services to those most in need. Our goal is to create a 360 [degree] view of those needing services so that we are getting them in touch with the right resources. We also hope to improve diversion and reduce recidivism within our legal system by providing information to our first responders. This way we can send the appropriate personnel to hopefully de-escalate a situation and to divert the individual from the legal system and into a treatment plan.

Q5. Julian, this last one is for you. How has working with community power holders and residents to improve access to care benefited your community?

Julian Levine:
The grassroots/grasstops approach is critical because everyone in a community is part of that community, and it's easy to operate from a place where we forget that. You have to find ways to connect with the folks on the ground who know the lived experience of their community, just as you need to connect with the grasstops folks who help steer the system and you need to make sure that there are equitable ways for them to share a table. This approach benefits our community because our local network gets tighter and more communicative, so resources get where they need to go in the short term, and, hopefully, we all see where the challenges need to be addressed in the long term. 

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