Heather Baker the Community of Park Slope Essay

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Total Length: 1200 words ( 4 double-spaced pages)

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Heather Baker

The community of Park Slope is an affluent, cohesive neighborhood in Brooklyn, NY. Although relatively healthy, a significant number of individuals who have access to health insurance do not utilize it. Additionally, Park Slope residents have a higher than average rate of tobacco product usage. This report describes two initiatives to address both problems, using community nurses to lead and implement community projects and one-on-one counseling and education programs.

Alleviating Health Insurance Under-usage

Assessment of Problem: The assessment process will proceed in the following phases:

Identification of Population: Approximately 8% of Park Slope residents (~7,900 individuals) have health insurance, but do not use it. These individuals can be identified in the following ways:

a. Emergency Department Reports: According to a recent study, patients with insurance who do not regularly use their plans form a significant subset of emergency department visits (Ginde, 2012). Identifying these individuals while they are being treated in the ED will be important to the success of this initiative.

b. Community Surveys: Door-to-door surveys of Park Slope may yield the most complete and effective results in identifying those individuals who under-utilize their health insurance. This may be coordinated through the Park Slope Civic Council as a potential volunteer effort.

c. Self-Reporting: One of Park Slope's strengths, it's cohesive and connected community, will help community nurses publicize the need to report health insurance under-usage. Community events, public advertising, and social media can all be utilized to encourage individuals who under-utilize their health insurance, to seek out the organizers of this initiative.

2. Defining the Reasons: Once the population is identified, each individual be surveyed to determined why they do not utilize their health insurance. These reasons can be categorized in the following ways:

a. Administrative: The individual does not understand how to enroll, select a primary care physician, set an appointment, or otherwise use his/her insurance.

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b. Logistical: The individual cannot physically reach his/her primary care provider or cannot work out a schedule that enables them to use his/her primary care provider.

c. Individual: The individual has all the resources available to him/her, but does not use his/her health insurance.

Solution Planning: Once a clear understanding of the reasons for health insurance under-usage have been identified and categorized using the definitions above, solutions will be developed in ranked order, from the lowest-cost and most implementable to highest-cost and least feasible.

At this stage, we believe that addressing administrative reasons for health insurance under-usage will be the most effective and cost-conscious. Administrative reasons such as not properly enrolling in available health insurance and problems setting appointments can be addressed through one-on-one counseling and follow-ups.

Logistical problems such as an inability to reach a primary care physician will be targeted after administrative reasons are addressed. Logistical solutions will likely require liaison with the Park Slope Community Council to identify volunteer-based solutions such as rideshares and escorts. If such options are not feasible, grants and other monetary donations may be needed to fund transportation solutions.

Lastly, individual reasons for health insurance under-usage will be targeted. Since there are a myriad of reasons for this type of under-usage, this will require the most varied and intensive investigation and solution development. At this time, we will wait for the results of the health survey prior to attempting to design solutions for individual reasons.

Community involvement will be essential to this initiative. Liaison should be established with the Park Slope Community Council in order….....

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