Health Resource Capacity Assessment for Danielson, Connecticut, June 2003

Health Needs and Barriers to Care: Coordination of Efforts, Information¹¹²

While difficult to quantify, a lack of community coordination and information sharing about health issues was apparent in many interviews. This was most apparent in providers who were not aware of what is available in the community. Several health care leaders were frank in noting that they do not know how their colleagues at other institutions in the area are faring either in terms of capacity to handle increasing caseloads or fiscally in tight budget times. In some cases, this leads to misunderstandings about competing/conflicting roles, especially among safety net health, education and social service providers who refer patients to each other.

When asked if the Danielson community was united with a common vision for health, very few stakeholders said yes. One provider noted that in tight budget times, when everyone is asked to do more with less, the first thing to go is the hard work of developing and maintaining collaborations. Others noted that the Danielson community is dealing with so many needs, that it is hard to give each the attention it deserves. Others made stronger comments, including terms such as "fractious" and "everyone is out for themselves."

A few safety net providers described subtle community resistance to their populations. However the ACCESS homeless shelter in Danielson described a process over two years to listen to community concerns about the shelter and its residents and address them with policy changes and improved safety. This sensitivity and responsiveness led to a marked improvement in community relations and a greater appreciation for the shelter and the services provided to Danielson.

There was also a clear need for better information to the community about health care resources. In the course of interviews and survey calls for this study, this researcher encountered a significant number of responders who were unaware of significant policy changes and resources available. These included more than one responder who was unaware that HUSKY parents and children who had received cut off notices were in fact still enrolled in the program due to court action. A care manager was unaware that Connecticut's Medicaid program covers uninsured women at any income level diagnosed with breast or cervical cancer for the duration of their treatment.

There is a clear need for communication and developing a framework for understanding in finding common solutions to common problems. As one social service provider wisely put it, "You can't assume you are OK if you don't get a cut, or only a small cut. If any of us gets cut, it affects us all. There are such limited options in the Northeast corner. We are interdependent."

Information sources for clients were also a source of concern for many respondents. Most had trouble answering the question - Where do people in Danielson go for information about their health? Answers included Day Kimball Hospital, physicians and other health care providers, social service agencies, town hall, INFOLINE, the Internet, local newspapers, the local health dept., and schools. However, several noted that more centralized and publicized sources of health information for residents are needed in all areas. A childcare provider noted the critical role they play in identifying problems and informing parents about health issues - they are trusted advisors who see families every day.

Next: Recommendations

112. Stakeholder interviews, focus groups and childcare provider survey