Athens, Georgia: Poverty in the Midst of Prosperity

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Athens, GeorgiaPoverty in the Midst of
Prosperity

• James Shrum
• September 5, 2007

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OneAthens Health Initiative Team

• Partners for a Prosperous Athens
• http//prosperousathens.org/
• OneAthens

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OneAthens Health Initiative Team

• Five PPA Co-Conveners
• All Government
• Chamber of Commerce
• Family Connection
• UGA
• Clarke County School District

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OneAthens Health Initiative Team

• Ten PPA Committees
• Regional Economy
• Education
• Health
• Affordable Housing
• Public Transportation
• Family Enrichment
• Human Economic Development
• Teen Pregnancy
• Early Learning
• Foundation

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OneAthens Health Initiative Team

• The Problem
• Georgia is
• 45th in the Nation in overall health status
• Last in Public Health Spending
• Last in Per Capita Health Spending
• Tied for 6th as the Most Obese State
• 4th worst in Infectious Disease
• Tied for 8th worst in Premature Death
• Tied for 7th highest in Infant Mortality
• Tied for 10th worst in Cardiovascular Deaths
• Georgia Health Policy Center
• Georgia State University

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OneAthens Health Initiative Team

• The Problem
• Employer-sponsored insurance coverage
• is eroding
• 3 decline in firms offering between
• 2002 and 2004
• Most decline in coverage in firms with
• 25 to 99 employees
• Most firms that do not offer coverage
• say it costs too much
• Georgia Health Policy Center
• Georgia State University

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OneAthens Health Initiative Team

• The Problem
• The uninsured are
• more likely to delay seeking care
• less likely to get needed medications for
• chronic diseases
• more likely to seek emergency care
• sicker when they are admitted to the
• hospital
• more likely to be re-admitted for the
• same illness
• Georgia Health Policy Center
• Georgia State University

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OneAthens Health Initiative Team

• The Problem
• A family of three with a household
• income of 50,000 pays about 800 annually toward
  the cost of the
• uninsured
• Georgia Health Policy Center
• Georgia State University

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OneAthens Health Initiative Team

• The Problem
• 26,000 (28.3) people in ACC live
• in poverty (Bishop, 2006)
• 14,250 (19) people in ACC are
• uninsured
• Georgia Health Policy Center/Georgia State
  University
• (GA County Guide 2005 Census Estimate)

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OneAthens Health Initiative Team

• James Shrum - Chair, ARMC
• Virginia Day - St. Marys Healthcare System
• Monica Knight - Clarke County School District
• Terry Tellefson - Advantage Behavioral Health
• Diane Dunston or Jennifer Richardson -
  Neighborhood Health
• Tracy Thompson - Mercy Clinic
• Deb Williams - Nurses Clinic
• Claude Burnett - Athens-Clarke County Health Dept
• Bob Galen - School of Public Health, UGA
• Farris Johnson - Family Practice
• Pamela Robinson - Wellcare
• Kathy Hoard - Athens-Clarke County Commission
• Karen Schlanger - UGA Cooperative Extension
• John Culpepper - Athens-Clarke County Finance
  Dept
• Mark Ebell - Professor, Family Practice
• Sherrie Ford - Power Partners
• Lisa Caine - Daily Bread
• Trina von Waldner - UGA School of Pharmacy
• Allison McCullick - UGA Heath Initiatives

Support Staff Delene Porter Fanning
Institute Adam Gobin Intern, School of
Public Health
Indicates PPA Steering Committee Member
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OneAthens Health Initiative Team

• OneAthens Health Mission
• Create a plan to coordinate and fund basic health
  services for those in poverty and near poverty

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OneAthens Health Initiative Team

• OneAthens Interim Report

• There is the equivalent of only two full-time
  providers (physicians, nurse practitioners, or
  physicians assistants) dedicated to providing
  care for the uninsured among ACCs three clinics
  serving this population.

• Six more primary care providers are needed to
  provide a medical home to uninsured residents
  of ACC.

• 48 of uncompensated care in the local emergency
  departments is for residents outside of ACC.

• Many Athens physicians are reluctant to care for
  uninsured patients and either do not accept
  patients without insurance or require payment at
  the time of service. Some specialty medical care
  is unavailable for patients with Medicaid or
  without insurance.

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OneAthens Health Initiative Team

• OneAthens Interim Report (continued)
• Racial and ethnic disparities in health care
  access and quality largely disappear when
  patients have a medical home.
• A change in rules for distribution of indigent
  care funding has resulted in a financial crisis
  for some clinics and the Health Department.
• There is currently no structure to facilitate
  collaboration among health care providers for the
  underserved population.
• There is no information system to connect
  clinics, hospitals and providers. Lack of an
  information system could compromise patient
  safety, inhibit continuity of care and is an
  obstacle to data collection.

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OneAthens Health Initiative Team

• OneAthens Health Recommendations
• Create a local Health Coverage Plan
• Obtain designation as a Federally Qualified
  Health Clinic
• Implement the Medical Homes Concept
• Create an Outreach Network with Navigators
• Create a Referral Network for voluntary specialty
  care
• Implement a Medication Assistance Program