Transcript Lamp Light Family Health Care Clinic

Lamp Light Family Health Care
Clinic
Our Beginning
Lamplight Family Health Care Clinic was begun in 2011 to
provide primary, non-urgent care to uninsured residents of
Berks County and surrounding areas.
We are a faith based, primary health care center offering care
at no charge for the uninsured of Berks County and
surrounding areas.
We are operated by volunteer physicians, nurse practitioners,
nurses and clerical staff.
Our Services
Chronic health problems
Pediatric care 13 years and older
Preventative Health care
Physical exams
Health education and counseling
Medications
Some small/simple procedures
Smoking cessation education
Spiritual guidance and prayer
Our Objective
To provide accessible health care to the uninsured of Berks
County and the surrounding areas in an atmosphere which
Fosters dignity and respect in a manner reflecting God’s
Unconditional love.
Health Care Unaffordable
Health care is unaffordable for many Berks County resident. 40% of the
respondents identified the cost of health care including insurance coverage. co-pays
and deductibles as the most common health care concern. 4
One in seven adults aged 18-64 or 13.3% is uninsured representing 33,000
uninsured adults. 4
Among the uninsured in Berks County 24.8% visited emergency room for care in the
past year due to lack of health insurance.4
Many adults in Berks County are unable to get needed care due to the cost of the
care. 37,000 individuals reported that there was a time in the past year when they
needed health care but did not receive it due to the cost. 4
Access to Health Care
28% of community leaders and 36% od county at
large felt health care access was a significant
problem.
1
Nearly ½ of the city residents felt that access to
Care was a serious or somewhat serious issue.
1
Poverty in Berks County
The per capita income in Berks County is slightly below ($25,941)
the national average of $26,409. 1
13.5 % of individuals with children live in poverty and
8% without children live in poverty. 1
Reading has the highest percentage living in poverty with 37.2 %
with children and 27.6% without children.1
The percentage of Reading families without children living in
poverty has tripled from 2000 to 2010. All areas of Berks County
are projected to see continued increases in percentage of families
living in poverty according to a recent health assessment.1
Poverty in Reading
95 % of the County identified addressing poverty in the city of
Reading as an important concern. 1
15% of the County live in poverty.1
Even before the recession in 2008 the number of adults living in
Poverty had been increasing steadily over the last decade.1
According to Census Bureau, in 2008 there was a spike in adult
poverty apparently caused by the number of young men without
a high school diploma in the County. 1
A Goal of St. Joseph’s Regional Health
Network
One of the recommendations to the Berks County, Pennsylvania Needs Assessment 4
and a goal of St. Joseph Regional Health Network 2 is to increase the capacity of
existing providers and add new providers to improve access to essential healthcare
Services for at-risk populations.
Berks County Health
15.9% of residents of Berks County are in fair to poor health representing
50,400 adults 4
Adults in the City of Reading (32.6%) are more than twice as likely to be in fair
Or poor health than adults in other areas of Berks County. 4
Common Health Conditions
In Berks County more than one-third of adults (33.4%) have been diagnosed with
High blood pressure this represents 105,400 adults, This does not meet Healthy
People 2020 goal of 26.9%. 4
The percentage of Berks County adults with high blood pressure increased from 26.8 %
To 33.4% between 2008 and 2012.4
The city of Reading (40.0%) has the highest percentage of adults with high blood pressure
This percentage has increased dramatically since 2008 from 29.3% to 40.0% in 2012. 4
Common Health Conditions
One in seven adults (13.9%) in Berks County has been diagnosed with diabetes or
approximately 44,00 adults. The percentage of adults with diabetes is highest among
adults in the City of Reading. 4
49,200 adults in Berks County have asthma (15.5%) with the highest percentage
In the City of Reading. 4
Nearly one-third of adults in Berks County (30.9%) are obese and more than onethird are overweight. The City of Reading has the highest percentage of obese adults
among all Berks areas. 4
Health Care costs a concern
Forty-four percent of survey respondents
identified the cost of health care, including
insurance coverage, co-pays and deductibles as
their top health concern.
4
Chronic Disease
Chronic disease is the second most common
health concern for Berks County Residents at
12.9%. The City of Reading residents being
twice as likely to be concerned about chronic
disease as other residents county-wide.
4
Barriers to Care
Barriers to care for Berks county residents that
were identified by key informants included
insurance and other health care costs,
transportation, communication, beliefs about
the need for health care and cultural
differences.
4
Health Insurance Status
13.3% of adults aged 18-64 in Berks County are
uninsured, representing 33,000 uninsured
adults.
4
This number has increased since 2008 from
8.7% to 13.3 % in 2012.
4
Adults in the city of Reading (23.7%) are more
likely to be uninsured.
4
Undocumented Latinos
Undocumented Latinos are more likely to be
uninsured because, under federal law, they are
not eligible for publicly-funded insurance
programs. Many Latino focus group participants
went without needed care because they were
uninsured and could not afford out of pocket
costs.
4
Uninsured and underinsured
“Information from focus group participants
revealed that many Berks County residents who
are uninsured or underinsured lack sufficient
funds to self-pay for preventive or specialty care
and to pay for needed prescriptions, dental, or
vision care.”
4
Medicare Expansion affects on
Uninsured
According to A Snapshot at Pennsylvania’s
uninusred, Selected findings from 2008
Pennsylvania Insurance Department Health
Insurance Survey; there are approximately
1,021,790 uninsured individuals in Pennsylvania.
According to this same article 600,000 would be
eligible for insurance through medicare expansion.
This represents 59% of the uninsured in
Pennsylvania would be eligible for insurance under
the expansion.
3
Medicare Expansion in Berks County
If 59% of Berks county uninsured are eligible for
insurance under the medicare expansion then
approximately 19,470 individuals would be
eligible for insurance of the 33,000 that are
uninsured.
Emergency Room Utilization
Among the uninsured in Berks County, onequarter (24.8%) visited an emergency room for
care due to lack of insurance this represents
8,100 adults. Uninsured adults in the City of
Reading (44.1%) are more likely to visit an
emergency room due to lack of health coverage.
4
Emergency Room Utilization
Many of the uninsured or underinsured described
going to the emergency departments for nonurgent care because they could not afford to pay for
private care and knew they would not have to pay
the emergency department charges and/or
preferred to be seen as soon as possible.
4
Many mentioned that the emergency departments
become a default source of primary care, which is
costly and lacks the continuity of care that a chronic
condition requires.
4
Emergency Room Utilization
Both St. Joseph and The Reading Health System
provide care for non-emergency self-pay
patients without asking for payment at the
initial point of service. When the bill is received
they can apply for charity care which will waive
part of the costs.
4
Prescription Drug Coverage
One in ten (10.8%) adults in Berks County does not
have prescription drug coverage.
4
According to key informants, many older residents
use their savings to buy prescriptions.
4
This is a problem for many who need medications
for chronic conditions. Many either don’t take their
medications or cut the medication dosage which
causes serious health problems.
4
Economic Barriers
12.0% of adults in Berks County report that there
was a time in the past year when they needed
health care bud did not receive it due to the cost.
4
Unemployment and underemployment are often
major factors in economic barriers which cause
many to lose their health insurance coverage when
they lose their jobs or are working part time.
In the city of Reading 18.5% of adults did not
receive care due to cost.
4
Unfilled prescription
About 43,400 adults in Berks County were
prescribed medication but did not fill the
prescription due to cost in the past year.
4
Population is Transient
“According to key informants, a primary reason
why low income adults may lack Medicaid or
other insurance coverage is that this population
is very transient.”
4
Transportation
Many Berks County residents have difficulty
accessing services because they live in areas
where public bus service is limited.
4
The quality and safety of transportation in Berks
County is a concern.
There has been a slow but steady increase in
ridership of Berks and Reading Transit Authority
over the past four year and those that use the
transit rate it as excellent or good.
1
1
Language
Lack of Spanish speaking staff and poor or nonexistent translation services is a barrier to health
care.
3
Interpreters are available in the hospitals but not in
private practitioners’ offices. Interpreters are
expensive so the Latino patients often rely on
children to interpret, which is a violation of
doctor/patient confidentiality and can also result in
miscommunication.
3
Cultural Differences
Differences between cultures can sometimes
prevent optimal care and service provision.
3
Lack of education is also a barrier to care for the
Latino Population.
3
Many county residents do not understand the
importance of preventive care.
3
Utilization of Services
In Berks County 11.8% of adults do not have a
regular source of care; this represents 36,600
adults.
4
In the City of Reading 18.9% of adults do not
have regular source of care; this percentage has
remained constant since 2008.
4
Utilization of Care
Many residents also lack sufficient access to
mental health and specialty services.
Many families rely on family practitioners to
provide mental health treatment when they
really need specialty mental health care.
4
4
Health Screenings
In Berks County 17.5% of adults did not visit a
health care provider in the past year, this represents
55,200 adults.
4
13.2% of adults in Berks County did not have a
blood pressure test in the past year.
4
Four in ten Berks County women (41.0%) did not
receive a Pap Smear test in the past year. This
represents 66,300 women and is an increase from
31.7% in 2008.
4
Dental Visit
Nearly one-third (30.0%) of all Berks County
adults did not visit a dentist in the past year.
4
Health Needs of Special Populations
Latino population of Berks County has grown
rapidly in the past 20 years, and many are in
poorer health and experience more barriers to
accessing health care than other in the County.
However other populations across Berks County
including Blacks and the poor also lack access to
affordable health care.
4
Latino Health Status
Slightly more than one-third of Latino adults age 18
or older are in fair to poor health representing
15,600 adults.
4
Three in ten (30.9%) Black adults in Berks County
are in fair or poor health.
4
Poor adults across Berks County are more than
three times as likely to be in fair to poor health
compared to non poor adults (40.8 versus 12.6%).
4
Health Conditions of Latinos
High blood pressure, diabetes, asthma, cancer
and mental health are frequently cited health
conditions that require ongoing care.
• More than one-quarter of Latino adults have high blood
pressure
• 15.5% Latino adults have diabetes and
• 18.2 % of Latinos have asthma
• 17.6% Latino adults have been diagnosed with mental health
problems
• 71.9% Latino adults are overweight or obese4
Zip Codes with the Highest needs
Berks County as a whole is a community with
middle range needs. Within Berks County, four
Zip codes in Reading and West Reading have the
highest needs. They are 19604, 19611,19601
and 19602.
4
Unmet needs
• Access to primary and specialty care for the
uninsured and underinsured including access
to dental and mental health care
• Access to affordable prescription medications
• Access to specialty care for those insured
through Medical Assistance
• Transportation to medical care for the low
income and Latino migrant work population
4
Unmet Needs Continued
• More affordable mental health and substance
abuse services, particularly for children and
adolescents.
• Culturally competent care for the Latino
population, including more affordable services
for the uninsured, including more qualified
affordable interpretation services and more
bilingual, bicultural staff.
4
4
RESOURCES
1. Berks County Community Foundation, 2014. Vital
Signs
2. St. Joseph Regional Health Network, 2013.
Community Health Needs Assessment
Implementation Plan
3. Selected findings from 2008 Pennsylvania
Insurance Department Health Insurance
Survey, A Snapshot at Pennsylvania’s Uninsured
according to 2008.
4. The Research and Evaluation Group, 2013. Berks
County, Pennsylvania Community Health Needs
Assessment