Health Resource Capacity Assessment for Danielson, Connecticut, June 2003

Recommendations

Potential recommendations were collected from stakeholder interviews, focus groups, the childcare providers' survey and research. These recommendations were reviewed by a group of key stakeholders.

They are presented in no particular order.

• Restore funding to vital health services - This was by far the most commonly cited recommendation across fields and populations. Concerns included the need for provider rates to at least meet the costs of providing care and building the health care safety net. While there was concern about local and federal cuts, the greatest concern was directed at current and proposed state funding cuts. Advocacy must be widespread across the community and on behalf of all sectors and populations.
• Restore coverage to HUSKY parents and further expand coverage under the program - With a large low-income population, public coverage programs are vital to improving the health of Danielson. Advocacy should be directed to restore previous cuts, stop current proposals and work for expansions of coverage. Given budget constraints, reasonable consumer costs and finding opportunities for efficiencies in the system were offered by some stakeholders as options to consider.
• Expand opportunities for local collaborations - While all noted that finding time to collaborate is more difficult in tight budget times, that is precisely when it becomes the most necessary. It is critical that this mechanism be user-friendly, respectful of time constraints, and designed by participants to be effective.
• Develop networks of improved communication at all levels of the health care system - It is particularly important for staff who directly interact with patients to have accurate, timely sources of information to ensure that existing programs are maximized. Several noted the need to include non-health providers who see residents every day, including childcare providers, teachers and clergy. Again, it is critical that this mechanism be developed by participants and consumers of the information to be sure it is used effectively. Several respondents noted a need for more workers to help people identify and apply for various forms of assistance.
• Expand primary care options in Danielson, especially at the Generations Family Health Center - Virtually all stakeholders predict an increase in the number of Danielson residents without insurance coverage. The clinic is "stretched" now and desperately needs a larger facility with more staff. The Danielson community should be solicited for their support. A wellness van, similar to the successful dental van, was suggested for the region.
• Expand options for affordable health coverage for businesses and individuals - Businesses are actively searching for affordable benefit options to offer their employees. While this is difficult to do locally, options include offering better information on currently available options including the state employee pool, CBIA, Chamber of Commerce offerings, packages with reduced benefit packages and options to give consumers more flexibility with less cost. Any of these options must be accompanied by extensive information on financial and health risks, quality of care, coverage details and likely consumer costs.
• Expand transportation options - Churches have created volunteer-based networks offering rides to appointments which could be expanded. Resources to expand the public bus system are needed. Danielson desperately needs a reliable, affordable taxi service. Inappropriate use of ambulance services burdens the system with unnecessary costs that reduce resources available for other services.
• Expand capacity for mental health treatment - The problem is particularly critical for adults with moderate mental health needs. This will require advocacy for more resources from the state and communities.
• Expand capacity for dental services - This problem is especially acute for adults. Expansions of services at the new dental van would build on what is already working for Danielson.
• Expand substance abuse treatment slots, especially long term rehabilitation to ensure success
• Support and expand current child abuse prevention initiatives including treatment, sensitivity toward victims and their families, prevention efforts and community monitoring - Restore funding for the local prosecutor position.
• Expand awareness among state policymakers of the needs of rural communities through advocacy efforts
• Expand public education campaigns about healthy lifestyles including nutrition and exercise
• Expand safe sites for exercise - Specifically mentioned were more places to walk and an indoor pool.
• For elderly residents
• More congregate housing
• A new assisted living facility for the handicapped and those with early dementia
• More physicians with geriatric training
• New senior center with improved, expanded facilities
• Create a community advisory board to develop a plan
• Smoking cessation programs, especially for pregnant women

One very wise stakeholder summed up his recommendation as, "Listen to people. Just listen."

Next: Key Stakeholder Interviews