- Community Health Improvement Plan Progress 2%
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What does Access to Care mean, anyway?
Facilitating access is concerned with helping people to command appropriate health care resources in order to preserve or improve their health. Access is a complex concept and at least four aspects require evaluation. If services are available and there is an adequate supply of services, then the opportunity to obtain health care exists, and a population may 'have access' to services. The extent to which a population 'gains access' also depends on financial, organisational and social or cultural barriers that limit the utilisation of services. Thus access measured in terms of utilisation is dependent on the affordability, physical accessibility and acceptability of services and not merely adequacy of supply. Services available must be relevant and effective if the population is to 'gain access to satisfactory health outcomes'. The availability of services, and barriers to access, have to be considered in the context of the differing perspectives, health needs and material and cultural settings of diverse groups in society. Equity of access may be measured in terms of the availability, utilisation or outcomes of services. Both horizontal and vertical dimensions of equity require consideration.
Copyright The Royal Society of Medicine Press Ltd 2002.
Access to children's therapy is a barrier that I am familiar with. Therapy is needed for children with ADHD, ADD, anxiety, dyslexia, and someone who can test for things in our area. You can travel to Morgantown or Cumberland, but some families might have trouble with transportation.
Thank you, Heather! We heard this over and over in the focus groups during the assessment. Since then there has been a private practice open in McHenry that does at least accept children as clients. However, it continues to be a major concern for our county. In addition, the help for parents is so limited. From the folks we surveyed (over 800) mental health was one of the categories they were least concerned about (6%) for the community. However, During the focus groups people talked at length about the issues of access and stigma. The GCHD does provide school counseling but because of sheer numbers it is limited. I'd like to hear from more people who have run into barriers with this issue and an expert to see what the process is for an initial assessment of the child and what on-going treatment looks like in our area.
Access to adult behavioral health care on the northern end of the county is a problem. I know several people who still experiences trouble with getting appointments in a timely matter and also the transportation to Oakland. Most I believe go out of the county in northern area to get services.
I have also experienced the difficulty/barriers with mental health services for children. I'm currently traveling all the way to Mt. Morris, PA for my son to see a psychiatrist. I have encountered barriers from the local agencies not accepting my insurance to just the lack of child specialists in the area. It's a burden to have to travel so far for care, but right now I don't have any other options.
Jodi, I am so sorry you have to drive to Mt. Morris PA for your son to see a psychiatrist. In a community with so many programs and services for children it is unimaginable that this huge gap exists! Thank you for sharing your personal experience and expressing the unmet needs your family faces living in Garrett County. Your courage on this tool will help others to share and create something people wont' be able to ignore. We need to work together to get this gap filled for our residents. Did anyone ever think a cancer center would be possible at our small local hospital? Awesome things happen when we work together, we have so many examples! Recruiting a psychiatrist who will see children and covering that cost is not impossible in a community of collaboration.
Working with a compromised group of individuals, I see all to well the need for home counseling. We do have a program (O.A.T.S.) that will send a counselor into the home of an elderly person 60+ years old, but what about the younger group that need mental health counseling. We have several clients who are home bound, bed bound, wheelchair bound and manic depressant that have many barriers to getting into counseling, how magnificent it would be if we had a counselor who would go see those under 60 with needs in their own environment! 😀
Access to care may be getting more difficult for those low income persons who rely on GTS to get to their local medical appointments. As of April 1, 2017 it appears that Medical Assistance will no longer pay the full cost of persons going to medical appointments using GTS. A rider fee will be charged. This may restrict access to care, especially for those who have regular appointments for chronic disease management and behavioral health. The rider fee will be anywhere from $1.50 to $5.00 each way depending on the location.
In 2016 this involved 163 individuals and 2,400 separate trips to local medical and mental health appointments. The DHMH plan is to stop paying for any local (in County) appointments for Medicaid patients starting April 1, 2017. This means those patients will have to find or pay for their transportation to appointments. Preventive care and mental health are the most likely areas where Medicaid patients will choose priorities other than the appointment based on comments we are receiving.