Access to Care Committee
Action Plan
New Documents
- Guiding principles and options for programs for the uninsured in Durham County: English | Español
- Extended discussion of model options for programs for the uninsured in Durham County
- Glossary of terms
Committee Activities
This committee's activities include:
- advocating for legislative changes that will affect health care coverage for residents across all ages of the continuum but particularly those less than 65 years old;
- bringing together initiatives/partners already addressing access issues; and
- developing community and agency-based strategies to make measurable improvements in access to care for the uninsured and underinsured residents of Durham.
Review of 2007 Durham Health Summit: Listening to the Voices of Durham's Uninsured
The 2007 Durham Health Summit was a very informative meeting, focusing on local access to healthcare issues. Over 200 people attended the forum to learn about proposed initiatives and provide input on them. The event was co-sponsored by the Office of Community Relations of Duke University Health System, Durham County Government, the Partnership for a Healthy Durham, and Durham CAN.
Speakers included
- Representative David Price on national healthcare initiatives
- Pam Silberman, President & CEO of NC Institute of Medicine, on statewide healthcare initiatives
- Jonathan Oberlander, Professor of Social Medicine and Health Policy at UNC, on other statewide initiatives and what is needed to make local initiatives successful (starting with political will and strong leadership)
- Mat Despard, Clinical Assistant Professor at the UNC School of Social Work, on community health plans
- Howard Eisenson, President of the Durham Orange Medical Society, on the Project Access concept currently rolling out in Durham County.
The Durham Herald-Sun covered the event on the front page - Durham CAN has a link to the story at http://www.durhamcan.org/index.php?option=com_content&task=view&id=95&Itemid=1.
Attendees provided input to local healthcare initiatives for the uninsured through polls, small discussion groups, and anonymous surveys. Some of the findings from this input included:
- 13% of attendees reported being without insurance.
- The vast majority of attendees stated that they would be willing to pay $50 - 100 for a basic health plan if they were uninsured.
- The more reported income, the higher the amount folks were willing to pay for medical coverage.
- 32% felt that insurance companies and 27% felt that local government should help with the cost of a low-cost health plan for the uninsured.
- All small groups felt that there would be a need for a low-cost general health plan even once Project Access is up and going.
- 63% of groups reported that a low-cost health plan would be needed primarily for emergency medical need or to avoid medical debt.
- 18% of folks noted that having a primary care home was the main reason to have a low-cost health plan.
- 89% of small groups noted that they would be willing to pay $100 or more in local taxes or fees to help create a low-cost community health plan for uninsured Durham residents.
- 2/3 of the participants thought Project Access should also be available for non-Lincoln CHC patients.
The collaborating organizations will use this information to guide them as they organize Project Access and other programs for the uninsured in Durham County.
Over 100 Attend Community Forum
The Access to Care Committee of the Partnership for a Healthy Durham sponsored a community forum on "Cover the Uninsured in Durham" on May 2, 2006, in conjunction with national Cover the Uninsured Week (www.covertheuninsured.org). Over 100 people attended the forum, which was held in downtown Durham at the First Presbyterian Church.
Brian Letourneau, Director of the Durham County Health Department, opened the forum with a brief introduction about why the uninsured population is such an important and pressing challenge in our county.
Gayle Harris, Assistant Director of the Health Department, then introduced two uninsured Durham residents, Rosa Ortiz-Cruz and Rev. Angeloe Burch. They spoke about how they negotiate care despite having no health insurance - how difficult and demeaning it can be. Rev. Burch described his experience living with a pre-existing condition, dealing with the confusing and sometimes frustrating bureaucracies of various agencies and insurance companies. David Farrell, a local small business owner in Durham, then spoke about how complicated it is for him to provide health insurance coverage to his employees. He struggles to understand the many policy options, as well as how to make it affordable for his business each year as premiums and costs grow faster than inflation and income.
Dr. Pam Silberman, of the NC Institute of Medicine, then took the podium to give the crowd some statistics and background on the problem of the uninsured. She highlighted some interesting facts:
- North Carolina's rates of the uninsured are rising faster than the national rates
- Most of the uninsured are working, many of those in small businesses
- Families with lower incomes are less likely to be insured
- Latinos have particularly low rates of health insurance coverage
- People with pre-existing conditions have a difficult time securing health insurance
- Being uninsured can gravely impact a family's health in many ways
She then introduced the panel, who each discussed what their agencies are already doing to help the uninsured and what their plans and ideas are for future initiatives.
- MaryAnn Black, Associate Vice President for Community Relations at Duke University Health Systems, highlighted Duke's many clinics located in schools, senior housing, and low-income communities. She stated that Duke Health's leadership thinks about this problem and their role in addressing it often and are prepared to help solve it, as evidenced by their sponsorship of the recent Health Disparities Summit.
- Dr. Doug Knoop, Senior Medical Director of Blue Cross Blue Shield of North Carolina, acknowledged that health care has become expensive for many families. He related that Blue Cross and Blue Shield is considering many options for health savings accounts and other models of making insurance more accessible to more people.
- Dr. Edward LaMay, Chief Medical Officer at Durham Regional Hospital, is both an emergency physician and administrator. He described the challenges to an emergency room that has to be the source of primary care for the uninsured as well as deal with true medical emergencies. Everyone loses in this situation - the uninsured get poorer continuity of care in the emergency room than they would with a primary care provider, those with medical emergencies have to wait longer for treatment because of the crowding. It also stretches the hospital's resources to give expensive emergency room care to more patients.
- Ellen Reckhow, Chair of the Durham Board of County Commissioners, highlighted the substantial investment that Durham County has made in its Public Health Department, and that the County Commissioners have officially recognized May as "Cover the Uninsured Month" in Durham. They are interested in next steps for addressing this issue.
- Dr. Evelyn Schmidt, Executive Director of Lincoln Community Health Center, described the challenges of running a "safety net" clinic where a very large percent of patients are uninsured and poor. There are many health problems plaguing our population that are preventable if people can receive health care and education early on.
The Access to Care Committee will process the information gathered, as well as the questions and comments from the attendees, at their next meeting. They will be considering different policies and models that other cities and counties have instituted to cover their uninsured population.
Standing Meetings
We meet on the Second Thursdays of each month, 8:00-10:00 at the Health Department.Meetings in 2008:
- January 10
- February 14
- March 13
- April 10
- May 8
- June 12
- July 10
- August 14
- September 11
- October 9
- November 13
- December 11