Four months ago, we launched The Listening Project to engage in community dialogues about the gaps between health insurance coverage and the receipt of quality health care in communities that experience health inequities. We wanted to know how we could help close those gaps so that everyone in Connecticut understands how, when, and where to get the care they need.
We worked in partnership with the Hispanic Alliance, Christian Community Action, and the African-American Health Council to convene listening events in New Haven and New London, and also joined the African Caribbean American of Parents with Disabilities’ (AFCAMP) forum, the North Central Regional Mental Health Board’s Affordable Care Act community conversation with people in recovery, the Rural Health Forum, the Southeast Asian American Community Health & Wellness Listening Session, and Connecticut’s Healthcare Social Media Chat (#hcsmct). We’re grateful to all our partners, and to all the community members who shared their stories, struggles, and ideas for solutions in these dialogues.
Though we heard from many different communities, each with their own unique experiences, we found common themes in both the challenges faced and ideas for solutions. As The Listening Project comes to a close, we want to share what we’ve learned and tell you a little about what we’re doing with that information. You can also read our interim report.
Insufficient Access to Providers
From rural areas where there just aren’t enough providers and transportation is an issue, to more urban areas where doctors are too busy to accept new patients or are unwilling to accept certain types of insurance, access to health care providers is a significant barrier.
As a possible solution, participants explored the idea of making it easier for clinicians trained outside of the U.S. to get credentialed to practice here. We also talked about incentives that might distribute the responsibility of care across more providers in both the public and private sectors. We also saw an opportunity to dispel the myth of lower quality care from safety net providers.
Disconnects Between Health Care Systems and People
There was a strong sense across communities that the experiences and needs of everyday people are not sufficiently factored into decisions made by health care leaders and policy makers who do not reflect the diversity of our communities.
Complex and confusing systems collide with health literacy challenges for Connecticut residents of all walks of life, but especially in communities of color where there are more language, cultural, and educational barriers.
The potential solutions we heard focused on simplifying navigation and engaging organizations who have an understanding of these systems to serve as a bridge between the health care system and communities.
We had fun with a discussion question that asked participants what health care leader or policy maker they would want to ride in an elevator with. They told us what they would want that official to know and what they would ask that person to do to improve health care if they had them as a captive audience for 30 seconds.
A Desire for Community-Integrated Care
People talked about wanting health care to come to community settings where people naturally can be reached while they work, learn, and worship.
In the solutions discussions, schools came up frequently. Participants were proponents of school based health centers and brainstormed ideas about expanding services to students’ family members. They also talked about an expanded role for schools in providing health information to families. Several participants spoke about mobile vans and health fairs as models they were familiar with.
So what next?
What we heard from our communities over the past four months has informed CT Health’s planning, budgeting, and funding strategies for 2016. For example, we plan to release a grant opportunity to develop solutions for connecting people of color to primary care. And we are particularly invested in making community health workers part of the delivery and payment system with their potential to help people navigate the system, overcome health literacy barriers, and connect health care with communities.
We have already started having conversations with our state’s decision makers, including the leaders of Access Health CT, about how we can partner to address some of the community concerns about provider access.
And we want to be open about what is a good fit for us and what is not. For example, though support for mobile vans and health fairs won’t be a significant part of our funding strategy as a foundation focused on systems change, we do plan on identifying other ways we might support the development of community-integrated care.
Though this formal Listening Project has come to an end, the listening has not. We plan to continue listening to and engaging with diverse communities across the state, both online and offline. It’s the only way we’ll know if we’re indeed improving lives from how we go about changing systems.