Health Care Access

A primary focus at United Way of Greater Atlanta is to ensure that people have access to primary health care. We also strive to reduce unnecessary emergency room visits. Accomplishing these goals decreases medical costs assumed by community hospitals and taxpayers.

Studies show that waiting to seek care only when a condition becomes an emergency often leads to an extended hospital stay, which is the most expensive way for an uninsured person to receive care.

SOBERING STATISTICS

• More than 794,000 people in the Atlanta region do not have health insurance, of which 144,000 are children.
• Georgia ranks 36th in the nation in health care access.
• The use of emergency rooms as a safety net increases the total medical bill to metro Atlantans by $830 million each year.
• Most uninsured Atlantans live at or below the poverty level.

FINDING SOLUTIONS

Along with its partners, United Way is addressing the issue of health care access with a variety of strategies, including free clinics, mobile health units and reducing emergency room visits.

RESULTS

Statistics show that when a person is connected to a medical home, the person’s health improves. In a study of diabetics who tended to use the emergency room to manage their disease, there was an 80 percent reduction in use of the ER when patients were connected to a medical home. United Way’s Hospital to Home program for homeless people has reduced the use of the ER by those seeking repeated health access by 72 percent.

For just $2.4 million in primary health care funds and during just one year:

• 24,901 people accessed primary care services.
• 15,039 people were able to continue living in their own homes.
• 6,512 participants successfully completed substance abuse or mental health treatment.
• 4,145 people improved their daily activities.

HOW DO WE GET THERE?

How do we get there?
A United Way investment of $4.5 million over the next three years will give more than 600,000 people access to quality health care and cut uncompensated health costs by reducing unnecessary emergency department visits.

FREE CLINICS

Georgia has a network of 100 free and reduced-fee clinics that serve patients at one-thirtieth the average cost of a trip to the emergency room. According the Georgia Charitable Care network the clinics in Georgia served 183,625 patients in 2012, with 463,927 patient encounters. Clinics have seen demand increase about 21% over the last year. In addition, it is estimated that for every $1 that is invested in a charitable clinic, $7 worth of services are provided.

The free and reduced-fee clinics are run by volunteer physicians, dentists and nurses. United Way believes that the best and most efficient way to increase health care for poor families in the Atlanta region is to invest in additional capacity in the existing free and reduced-fee clinics we already have. The clinics need additional support personnel, modern equipment and nursing supplies.

United Way has found that funds directed to the Atlanta area free and fee-reduced clinics will generate new patients at a cost of less than $35 per patient. A visit to the emergency room costs an average of $1,500. For free and fee-reduced clinics, the benefit-to-cost ratio is 30-to-1.

United Way secured an AmeriCorps grant and deployed AmeriCorps members to free health clinics throughout the 13 counties to assist doctors, nurses and dentists. The volunteers also help secure SSDI and veterans’ benefits for eligible patients.

HEALTH ON THE MOVE

In 2009, Butts County did not have any safety net resources for its uninsured residents. The entire county has only seven physicians, including one pediatrician and no obstetrics services. Compounding the lack of resources was an absence of public transportation. The Butts County Health Council, led by the Butts County Life Enrichment Team, decided to take action. The community utilized funds a partnership between United Way and Kaiser Permanente to assist the uninsured in receiving healthcare, lab work and medications. The Council quickly learned in the manner of weeks that the need would surpass the funds they had to spend on this initiative.

In 2011, the Butts County Health Council decided to partner with Southside Medical Center to bring their state of the art mobile unit to Jackson to provide primary care, women’s services and dental care to the residents. The project began with a small investment of $20,000 and has been able to leverage over $400,000 since 2011 to keep the unit in place and begin planning for a stand-alone site center for the residents in the county. Building on this success, United Way has expanded its support of mobile health with a partnership in the College Park community and West End Medical Center.

COMMUNITY HEALTH WORKERS

There are more than 300,000 preventable emergency department (ED) visits in Greater Atlanta each year. The vast majority come from DeKalb and Fulton counties. At an average cost of $1,500 per visit, this adds up to about $450 million in excess health care costs.

United Way seeks to improve the health status of low-income and uninsured Atlanta residents through reduction in unnecessary ED visits, increased usage of medical homes and improvements in service delivery.

Frequent users of emergency departments represent a small group of both insured and uninsured people — vulnerable patients accounting for a disproportionately high number of ED visits and medical care costs. Patients who use the ED in place of a medical home often have health insurance but tend to be in poorer health overall. Criteria include:

• Using the ED five or more times within the past 12 months
• Being between 18 and 64 years of age
• Having a chronic disease, such as congestive heart failure, hypertension, diabetes, asthma and respiratory illness

United Way is deploying trained community health workers (CHWs) to do home visits and provide case management services for ED frequent users identified by Grady Health System. Building on the patient navigator work in place at Grady’s walk-in clinic, CHWs will perform home visitation, provide case management and work in partnership with Grady navigators to change the culture of ED use among the target population. In addition, the CHWs will provide valuable insight and data into behaviors to inform future interventions. This model will be valuable in reducing unnecessary ED visits, managing patients’ chronic conditions and establishing medical homes for people who do not have them.

The Red Ribbon

Where did the idea come from?

In 1991 – a decade after the emergence of HIV – a group of 12 artists gathered to discuss a new project for Visual Aids; a New York arts organisation that raises awareness of HIV. They were photographers, painters, film makers and costume designers, and they sat around in the shared gallery space in New York's East Village.

After a short brainstorm they had come up with a simple idea that later became one of the most recognised symbols of the decade - the red ribbon, worn to signify awareness and support for people living with HIV.

Why did we need a symbol?

When the artists sat down to work on this project, their aim was to get people talking about HIV. This was during a time where HIV was highly stigmatised and people living with HIV were suffering behind closed doors, some too scared to even tell their loved ones they were living with the virus. The artists wanted to create a visual expression of compassion for people living with, and affected by, HIV.

The artists were inspired by the yellow ribbons tied on trees to denote support for the US military fighting in the Gulf War. Pink and the rainbow colours were rejected because they were too closely associated with the gay community, and they wanted to convey that HIV went beyond the gay community and was relevant to everyone.

Red was chosen as it is bold and visible – symbolising passion, a heart and love. The shape was chosen simply because it was easy to make and replicate – anyone can make one by just cutting out a piece of ribbon, looping it around your finger and pinning it on.

How did the red ribbon become so well known?

In the early days, the artists made the ribbons themselves and distributing them around the New York art scene and dropped them off at theatres. Initially there was a text that went with it, to explain why they were being worn, but eventually this was dropped as its symbolism no longer needed an explanation.

Within weeks of the red ribbon idea being born, world-famous actors starting wearing the red ribbon to high-profile award ceremonies such as the Oscars and talking about why it was important. The media also cottoned on, and within a short space of time the red ribbon symbol became universally recognised.

At the Freddie Mercury Tribute Concert held at London's Wembley Stadium on Easter Sunday 1992, more than 100,000 red ribbons were distributed among the audience, with performers such as George Michael wearing one. The Red Ribbon continues to be a powerful force in the efforts to increase public awareness of HIV.

Street To Home

United Way of Atlanta offers many exceptional programs to help residents with challenges they are facing. Street-to-Home is an early morning outreach program helps homeless individuals off the streets and into housing.

STREET TO HOME: THE FIRST STEP BACK

The Regional Commission on Homelessness and its community partners created an early morning outreach program to help homeless individuals off the streets and into housing. Once a month, typically before the day light, volunteers and experienced case managers engage homeless individuals and offer a chance to end their homelessness. If a person is interested, they board the Gateway bus and begin the journey toward transitional housing coupled with intense case management.

PEERS REACHING OUT TEAM (PRO)

Street to Home program has created a model to engage the homeless community using previously homeless individuals to build relationships. The Peers Reaching Out Team (PRO) is a group of individuals, whom have transitioned out of homelessness themselves and now have a desire to help serve others facing the same struggle.

RESULTS 2012-2013

• 151 in transitional housing
• 133 were reunited with family
• 75 percent of individuals stayed in housing
• 190 in permanent housing

For more information, please contact Kinte Rollins at 404.614.1042 or krollins@unitedwayatlanta.org

HIV facts

HIV stands for the Human Immunodeficiency Virus. It is a virus which attacks the body's immune system — the body's defence against diseases.

HIV can be passed on through infected bodily fluids, most commonly via sex without a condom or by sharing infected needles, syringes or other injecting drug equipment.

There are now more people than ever living with HIV in the UK — around 100,000 — with a quarter of those people are unaware they have the virus.

Here are a few more facts about HIV in the UK:

• Over 90% of people with HIV were infected through sexual contact
• You can now get tested for HIV using a saliva sample
• HIV is not passed on through spitting, biting or sharing utensils
• Only 1% of babies born to HIV positive mothers have HIV
• You can get the results of an HIV test in just 15-20 minutes
• There is no vaccine and no cure for HIV

Have any of these facts come as a surprise? There is still loads more you can learn about HIV in the UK by visiting HIVaware — our fun, interactive new website which provides all the information everyone should know about HIV. HIVaware gives you facts and stats on HIV, busts common myths and answers your frequently asked questions.

Take your first step to Acting Aware by visiting HIVaware today.