How Investing in Young Black Women During Sexual & Reproductive Health Care Can Address Inequities

Dina took to Google after feeling some discomfort in her pubic area. Although she was in graduate school several hundred miles away, she waited to see a healthcare provider until she could return home. During her visit with her gynecologist, she learned that her intrauterine device had become dislodged and was moving around—this was the cause of the pain. After talking with her healthcare provider, she decided to get a new device inserted within two days. This outcome was relieving, because what she had found online had scared her and created additional uncertainty around the symptoms she was experiencing. While Dina was able to find the support she needed from her provider, she also experienced a delay in care because she was unsure that she could expect the same level of support from a different provider closer to her school. Dina’s story is not unique: due to previous mistreatment in healthcare settings, some young Black women fear contraceptive care visits will be harmful—or, if they have had favorable experiences, that a worse healthcare encounter is likely.

Aja approached her visit with worry and some optimism. She had been experiencing pain during sexual activity that was becoming increasingly bothersome. She reluctantly shared this information during her annual visit with her gynecologist. Despite having seen more than five different providers over the years for this issue, this provider was the first to empathize with her and acknowledge that sex should not be painful. Although Aja already understood this, hearing it from her healthcare provider and coming up with a plan to find a solution were healing for her. This provider explained the various tests she would order and the reasons why, and solicited Aja’s opinion. Aja described feeling included and informed throughout the visit, and left feeling more at ease and confident that her provider took her seriously. Other providers had not taken the time to listen to her, and often prescribed new methods of birth control without acknowledging her pain or frustration with having to deal with the condition.

While technical aspects of contraceptive care provision can be improved to save patients’ time and money, social and emotional aspects of care provision should not be overlooked. Interviews with cisgender Black women ages 18-29 about their experiences receiving contraceptive care highlighted how important it was to feel heard, understood, and included during provider visits. Women appreciated when providers took the time to empathize, especially if they presented to visits with uncertainty, unexplained pain, and other health issues. These findings demonstrate a need for health systems to “put the care back into health care” and focus on sexual and reproductive health and well-being as a primary goal of healthcare encounters. Health systems can equip providers to engage patients in ways that are adequate, affirming, and responsive to their health needs, especially for those who have historically experienced neglect and mistreatment by health care providers.

Although health care systems would likely believe that their providers offer care that is person-centered and high-quality, women’s narratives do not align with these perspectives.

How to Invest in Contraceptive Care Services for Young Black Women

Before engaging with patients in the clinic, providers should:

  • Learn about and acknowledge the role structural oppressions have on people’s access to contraception and health care in general, and
  • Engage in training and education related to cultural humility and person-centered contraceptive care.

During visits, providers should:

  • Greet patients warmly and consider sitting, rather than standing next to a seated patient
  • Ask the patient about what they want to discuss during the visit
  • Inform them of care procedures and processes before performing them
  • Engage individuals in a dialogue around their health, providing appropriate and relevant education as needed
  • Engage in active listening, asking questions for clarification and repeating back pertinent information
  • Take the patients’ concerns seriously, demonstrate empathy
  • Gain their permission before placing orders
  • If patients experience physical or emotional discomfort during visits or examination, try to reduce discomfort, stop performing the procedure, and ask what could mitigate discomfort
  • Acknowledge when they do not have the answers
  • Demonstrate an overall commitment to helping them achieve their goals and sexual and reproductive health and well-being

A small investment in person-centered care approaches may significantly change the perceptions and experiences of young Black women who use contraceptive care services. As this group has borne the brunt of poor contraceptive care encounters, changing a person’s care experience early in the reproductive health care trajectory may help to address inequities in reproductive healthcare settings. Collectively, contraceptive care service users, healthcare providers, and healthcare systems can work together to achieve sexual and reproductive health and well-being. Health systems can incentivize providers to engage in person-centered contraceptive care approaches by offering training and monitoring person-centered care outcomes. Third party payers focused on ensuring quality provision of healthcare services, including a focus on health equity, could incentivize health systems to implement such measures through pay-for-performance structures. At the provider level, clinicians should partner with service users during visits to establish relationships and foster the trust needed to learn of people’s needs before helping to find solutions. Although the focus here is young cisgender Black women, person-centered and equity-oriented approaches to sexual and reproductive health care can be applied to any service user population—by investing in people, we can help them attain better sexual and reproductive health and better well-being overall.

What Options Do Furloughed Workers Have?

The rapid spread of COVID-19 across the United States caused a serious disruption in the daily lives of most American workers. Although many people are able to work from home, or are still working under “essential employee” status, others have been laid off or furloughed. 

The Healthcare Sector

In the healthcare industry, doctors and nurses, radiologists and anesthesiologists, receptionists, and other healthcare staff are facing furloughs in the millions. As the rise of COVID-19 leads to the restriction of all unnecessary or elective procedures, private doctors’ offices, and specialty clinics such as endoscopy centers, plastic surgery facilities, and out-patient/day surgery centers are out of work across the country. 

In fact, reports this past April cited that nearly 1.9 million Americans were employed at family medicine offices which closed because of the virus. While doctors may still be able to “see” patients through teledoc-type systems, many of the nurses, medical assistants, receptionists, and janitorial staff have either been laid off, are experiencing severely reduced hours, or have been furloughed.

A furlough means workers are suspended without pay but, typically, they do still receive health benefits and are eligible for re-hire once the company reopens. In fact, government workers still retain employment rights that prevent them from being fired during a furlough without the typical process. As helpful as these benefits are, furloughed employees still need a source of income while waiting for the virus to run its course. There is an abundance of uncertainty surrounding how quickly businesses will re-open and when they will get back to full capacity.

Other Employment

While some businesses are shuttered, others may be hiring. In most cases, if a furloughed worker is interested in doing so, they are free to seek other employment. Similar to seeking employment while working, the employer cannot retaliate against an employee for finding another job while they are on furlough. This can be full-time, part-time, permanent, seasonal, or temporary work. 

If a furloughed employee does not want to find another job permanently, they usually have the option of seeking other employment during the length of the furlough. However, employers are able to create policies against furloughed workers having simultaneous employment during the furlough in situations where it may jeopardize the safety and security of the company. This can include trade secrets, protected company information, customer/client sources, and other company property. Employees should check with their individual employers to discuss their options of seeking short term employment until the company is able to bring them back on board. 

Unfortunately, many of the frontline healthcare workers who were battling the virus every day have been furloughed and quarantined due to exposure to, or worse, contraction of the virus. Hundreds of healthcare workers, especially those in states significantly impacted by the virus, have been infected, and countless more have gotten sick in states which have not kept track of their case count. If a healthcare worker is unable to work, unable to seek other employment, and unable to seek temporary employment, what can they do? 

Unemployment Benefits

Thankfully, most furloughed employees are able to receive unemployment benefits. Employees must be careful about unemployment because if upon returning to work, they get back-pay from their employer, the employee will have to repay any benefits they received. However, with new, federal, temporary rules set in place to combat the financial consequences of the virus, many furloughed workers can find help. In addition to receiving $600 each week on top of the state’s maximum amount until July 31st, applicants will also be able to receive benefits for two or three times longer than normal. Also, contractors and self-employed individuals are now eligible for benefits. The waiting period to apply for benefits, the regular check-ins, and the ongoing job search requirements have been waived. With a record 6.6 million Americans filing for unemployment in April and rates still disproportionately high now, this relief couldn’t come soon enough.  

Answering the Call

With COVID-19 still going strong, these furloughed healthcare workers have answered the call to help. In New York, a cry for help yielded over 80,000 healthcare volunteers to relieve those nurses and medical staff run ragged in New York hospitals. With the number of COVID cases rising nationwide, the more doctors there are, the more people treated and, hopefully, the more who recover. 

Many states are loosening licensing requirements in order to meet demand. A simple Google search will lead you to page after page of hospitals asking for volunteers to help with the crisis. Doctors, nurses, and other frontline workers are coming out of retirement to help. Nurses are relocating to other states to provide assistance. Doctors, unable to practice as they regularly would due to the shutdowns, are going back to the basics to help treat the virus.

For those with experience outside of the healthcare industry, there are still many companies that are hiring during the pandemic. All essential companies, including grocery stores, gas stations, many retail stores, and restaurants may have reduced hours in some locations but are “business as usual” otherwise. Companies like 7-Eleven, ACE Hardware, CVS Pharmacy, Dominos, and UPS, to name a few, are experienced a rise in demand due to the virus and are hiring at various locations.

Companies with remote positions are also hiring. This includes positions in the technology field, social media forums, and tech support positions for internet and cable companies. The virtual meeting platform Zoom is experiencing much higher demand since the shutdowns began and is looking for employees, as are internet/television companies like Spectrum. 

Every American has been affected by the spread of COVID-19, in one aspect or another. Whether struggling with the insanity of working a healthcare or retail job, the nuances of working from home, or the financial consequences of a layoff or furlough, most of us are eagerly awaiting the day society returns to normalcy. For those who have been furloughed, the situation is all the more difficult to navigate. Whether you choose to seek new or temporary employment with one of the companies that are still hiring or you decide to take advantage of the current assistance available through unemployment, there is help available. 

Case Managers: The Other Frontline of COVID-19

Case Managers must make impossible choices to manage the complexities of an unstoppable pandemic—and they are working against the clock.

Unless, like me, you are married to or related to a Case Manager, you’ve probably never thought about what they do, yet they are critical to the healthcare system that we all rely on. They reside in the central command center of a crisis. The unrecognized role of Case Managers changes slightly depending on whether they work for a healthcare organization or hospital, long-term care facility, or social service department, but in general, they are responsible for overseeing a patient’s case to ensure the best outcome.

Case Managers, most of them registered nurses and social workers, coordinate with physicians, nurses, mental health and insurance companies, and family and friends of the patient, their client. They receive constant input from stakeholders with vastly different viewpoints, and it’s their job to bring all of that information together to ensure the best interest of their patients is being served. In addition, as part of interdisciplinary teams, professional Case Managers are responsible for tracking outcomes, not only for case management but also for the interventions of the entire team.

Case Managers have a stressful job on the best of days. COVID-19 has made it untenable.

The coronavirus has had an extraordinary impact on their professional and personal lives because we’re dealing with a pandemic that could not only infect patients but also the very system tasked with mitigating the outbreak. Doctors and hospital nurses are often spoken about as being on the frontlines of the coronavirus. I would argue that Case Managers represent another frontline; one that requires them to take incredible risks and make difficult choices every day. And for them, there is no triage.

As I mentioned, my wife is one such person. Due to the unwelcomed, invisible intrusion that is COVID-19, she is now working from home, but with an increased caseload, greater complexity, and more responsibility. And that is on top of adjusting to the reality of being isolated in our home day in and day out. As the world we’re in now calls for social distancing there’s no way for her to distance herself from the call of duty. Things were very different for her when she was able to walk down the hall to speak with a doctor or nurse about something. Now, she is tasked with coordinating people without the benefit of human connection. As many workers in America are finding out, working from home often results in a loss of work-life balance. This is especially true when your job was already taking over your life.

This week alone my wife has been charged with helping cancer patients who are unable to have critical follow-up appointments because oncology offices are closed. A two-year-old asthma patient who was discharged home because his lung doctor’s office is closed. Patients with terminal diseases who came down with coronavirus and, therefore, are unable to see their families when time with them matters most. And patients who are discharged from the hospital after testing for COVID-19 who are being told to self-quarantine but are then unable to get their results.

A lot of patients have become stranded, and even getting critically ill patient-placement has become a challenge. It’s like a scavenger hunt for empty hospital beds! And the virus hasn’t even peaked yet. All of these situations bring tears, confusion, fear, and loss—all of which my wife, and Case Managers like her, are supposed to alleviate from a remote location with little support and in the middle of a system plagued by glitches and breakdowns.

This is ground zero, folks. Case managers are in a battle behind the scenes, huddling daily to plan for the next six months. But mostly these men and women are alone, hunched over computers in trenches of their bedrooms or living rooms, making frantic phone calls, staying focused on the needs of patients even when their families need them, too.

There is no denying that the doctors and nurses you see online sharing photos of their bruised faces after spending hours in protective masks and goggles are heroes. But when those people need the go-ahead to perform surgery or need to know where to send a patient next, they turn to a Case Manager like my wife. She is a hero, too.

If God forbid, you or a loved one ends up in a hospital during this pandemic, utilize your Case Manager, trust your Case Manager, and, please, be kind to your Case Worker. He or she is making a great sacrifice to ensure the best outcome for you.

NASW Iowa Chapter Releases New Assessment of Iowa Labor Force

The NASW Iowa Chapter (NASW-IA) worked with the NASW Foundation and the University of Iowa School of Social Work, in 2018-2019, to assess the Iowa social work labor force. The initiative was funded by a generous $50,000 grant from the Telligen Community Initiative.

“We wanted to gather information in a concise and organized way that would allow us to make the case that we need more professional social workers in the state of Iowa and how professional social workers can improve the lives of Iowans,” according to Denise Rathman, NASW-IA Executive Director.

Two key outcomes of the initiative, she said, are that NASW-IA now has “an excellent action plan that will serve as a roadmap as we work to collect the data we need to do our advocacy work for the profession.  We have a better understanding of why some organizations don’t always look to hire social workers.”

Additionally, Denise said, “We needed hard data to confirm our suspicions that we need additional culturally and linguistically diverse professional social workers to serve the diverse populations of Iowa, more professional social workers to serve older Iowans, and additional professional social workers in our more rural counties.”

To read the full report and an executive summary, please follow the links below.

The project was funded by the Telligen Community Initiative to initiate and support, through research and programs, innovative and farsighted health-related projects aimed at improving the health, social well being and educational attainment of society, where such needs are expressed.

Please visit the NASW Iowa Chapter website for more information about social policy, professional issues, continuing education, and other priorities.  The NASW Foundation is running a special feature about NASW Iowa Chapter, Denise Rathman, in the “Spotlight On Chapters” section.

Global Social Welfare Digital Summit Call for Proposals: Interdisciplinary Approach to Global Social Change

SWHELPER will host its four day annual virtual Global Social Welfare Digital Summit beginning on February 25th through February 28th, 2020. The Summit’s primary goal is to enhance practice for helping professionals by using technology to eliminate geographical borders for training, networking, and collaboration. 

Our goal is to use an interdisciplinary approach for helping professionals to provide news, information, and resources critical to global knowledge sharing,says Deona Hooper, SWHELPER Founder and Editor-in-Chief, and host of the Global Social Welfare Digital Summit. 

The virtual format transcends geographic locations and expands learning to a global classroom. Most importantly, it allows us to provide the same great content as an in person conference yet at a more affordable rate. Our four-day conference will focus on Activism, Health Care, Trauma Informed Care, Prevention and Solutions,Deona concludes.

Call for Proposals 

We are looking for speakers who are interested in giving presentations from micro to macro perspectives on topics of ethics, technology, research, policy and other related themes. All speakers are exempted from paying the participation fee and will have free access to all four days of the conference.  Additionally, each speaker will get a dedicated page where he/she can promote their work and products as well as free marketing and promotion leading up to the Summit. 

  • There are no fees for speakers. All presenters will be given a four-day pass to the live conference along with 1-year access to view all recorded presentation if they can not attend the other presentations live.
  • We will create graphics and posts for each presenter to promote on SWHELPER social media.
  • SWHELPER will publish articles recognizing all speakers chosen to present at the 2020 Summit.

The call for proposals is open, and it will end on September 15th, 2019. Visit https://on.swhelper.org/2LyU54D for more information. Global Welfare Digital Summit will work with other media outlets to arrange interviews for speakers who want to discuss their work and presentations for the Summit. 

About SWHELPER is a woman-owned, award-winning, mission-driven, and progressive news website dedicated to providing information, resources, and entertainment for the social good. Our audience is comprised of academics, policymakers, social workers, students, mental health practitioners, helping professionals, caregivers, and people looking for information to help themselves or a loved one in crisis. Visit us at www.swhelper.org

Medicare For All – Protection for Your Retirement Plans

An unexpected medical emergency, a life-changing diagnosis, or a car accident are a number of countless situations that can land us in the emergency room, setting off a chain reaction of diagnostic tests, follow-up appointments, prescriptions, treatments, and more. Of course, this all has a significant implication on your pocketbook, and even if you have insurance, the bills can still be staggering.

Health insurance is supposed to be an investment, a sort of safety net to minimize your financial obligations in the event of a significant health illness or injury. But rising premiums, high deductible plans, and coverage exclusions have rendered comprehensive, quality, affordable insurance plans a thing of the past.

This can have significant implications for older adults nearing or at retirement age. A car accident, a cancer diagnosis, or any number of other health issues can quickly drain away savings, including retirement plans.

Health Care Costs Threaten Retirement Plans

Amassing a retirement savings large enough to provide a comfortable living for decades is no small feat. Because seniors tend to see increased health issues and health care costs in their latter years of life, a significant portion of their retirement plan needs to be able to cover those increased costs.

According to a study performed by Fidelity, a 65-year-old couple retiring in 2017 will need to cover approximately $275,000 in health care costs throughout their retirement. That amount reflects a 6% increase over the 2016 figure of $260,000. However, that estimate has increased more than 70% when compared with the initial estimate ever performed by Fidelity back in 2002.

Simply saving up enough money to be able to retire can be a challenge, especially when you encounter unexpected health issues and emergencies earlier on in life. According to a survey by Bankrate, only 41% of adults say that they have enough money in savings to be able to pay off an unexpected cost. However, 45% of survey respondents indicated that they’d had a major unexpected expense in the past 12 months.

And if a family has a high-deductible insurance plan, a single visit to the ER can cost tens of thousands of dollars. Families without adequate savings may feel pressured to reach into retirement savings to fund the emergency, leaving them with even less savings than they’d had initially.

A Compounding Problem

The issue of health care costs depleting retirement savings becomes even more urgent when you consider the seniors who can’t afford to retire at all. The U.S. Jobs Report indicated that the retirement age is increasing, with almost 19% of United States seniors aged 65 or older were working at least part time during the second quarter of 2017. Additionally, 19% of 70- to 74-year-olds were still working.

Working later into life leads to increased retirement savings, but this isn’t a practical option for many seniors. Health issues force many seniors to quit their jobs even if their retirement savings aren’t yet large enough to provide them with long-term security.

Simply finding a job can be a challenge, since employers may be more reluctant to hire seniors (despite age discrimination laws). Seniors may find themselves with fewer job options and may have to settle for lower-paying jobs with poor health insurance policy offerings.

Medicare for All: Protecting Retirement Savings

Medicare for All could be a solution to this growing problem. With single-payer health care, all Americans could enjoy protection against unexpected large medical bills. Americans wouldn’t need to dip into their retirement savings for health-related emergencies. And with reduced health care costs, they could put more earnings into their retirement plans.

If more Americans were able to put aside more retirement savings, they could retire at age 65 without having to worry about extending their employment into their senior years. They could enjoy reduced stress and could focus on healing after a health crisis, rather than worrying about the massive bills that would follow.

With access to the medications and treatments that they need, Americans could enjoy better health, happiness, and an improved quality of life. Isn’t that what we want for our seniors, our retirees, and all American citizens?

Startup Gives Free Birth Control In Response to Controversial Pushback

Earlier this month, the administration rolled back the ACA mandate that required the full cost of birth control to be covered by insurance. Under Trump’s agenda, employers can opt out of providing this coverage for “religious” or even “moral” reasons, impacting hundreds of thousands of women.

Nurx, makers of the birth control app, are offering new users up to two months of free birth control with the promo code ‘CHECKYOURFACTS’ today until the end of the year. The telemedicine start-up and mobile health platform makes birth control and PrEP (pre-exposure prophylaxis) more accessible to everyone through partnerships with physicians and in compliance with the Health Insurance Portability Act of 1996 (HIPPA).

Recently, anti-abortion activists have become increasingly vocal against Nurx’s expansion into conservative states. The attacks have been made specifically to the app’s ability to prescribe emergency contraceptives to minors without a parent’s consent.

NC Coalition for life said in a statement “Nurx is dangerous, because it provides another way for children under the age of 18 to obtain contraceptives without the knowledge or consent of their parents.” However, Nurx defers to state laws surrounding minimum age for birth control prescriptions which in some states is 12 years of age.

This recent expansion falls in line with Nurx’s mission to provide safe, affordable and increased access to contraceptives and emergency contraceptives.  The Centers for Disease Control and Prevention credited increased access to low-cost services as a contributing factor to the overall decline in teen and unintended pregnancy rates nationwide. But according to the National Campaign to Prevent Teen Pregnancy, more than 19.7 million females ages 13 to 44 reside in “contraceptive deserts” and lack reasonable access to public clinics that provide birth control. This is defined areas with at least one clinic or provider for every 1,000 women.

“Research shows that the easier and more affordable birth control is, the more women will use it,” said Dr. Edvard Engesaeth, co-founder of Nurx. “Individuals should not have to jump through unnecessary hoops in order to access care. With Nurx, we are changing the way birth control is issued and accessed and allowing women to get the care they need on their own terms.”

New users will receive a $30 credit or two months of no-cost birth control with the promo code. After choosing their birth control brand and type, users answer a few questions and enter their shipping and insurance information for a licensed physician to review. Once the review is complete, the doctor will issue and fill the prescription, which will be delivered on-time and at no additional cost. The promo code ‘CHECKYOURFACTS’ can be entered during checkout until 11:59 PM (PT) on December 31st, 2017.

To download Nurx on Apple and Android devices, visit nurx.com. For more information, follow @NurxApp on Instagram, Twitter and Facebook.

Telemedicine: Aims Toward Convenience and Accessibility of Modern Treatment

Telemedicine is the use of information technology and telecommunication devices to provide a healthcare remotely. It is intended to solve distance barriers, improve access to quality healthcare, and designed to save lives in emergency and critical situations.

Telemedicine began when astronauts first went into space. The early spacecraft had a telemedicine technology to keep track of the astronaut’s health. Succeeding milestones boost the use of telemedicine in the healthcare.

Brief History of Telemedicine

The birth of telecommunication paves the way to the inception of telemedicine. Few hospitals started experimenting with telemedicine about fifty years ago to reach patients in far-flung areas.  It started in the U.S. as a way to resolve the shortages of the physicians.

Telemedicine has tremendously changed. Due to a substantial advancement in technology, it became an integrated service in hospitals, clinics, and other healthcare facilities. During emergencies, it is used to provide patient health records and medical consultation without delay.

At present, people around the world are using telemedicine to provide quality healthcare or help a patient with mobility problems consult a physician from home. It was also used to reach urban populations with shortages of physicians. Currently, people are using telemedicine for convenience, to save time in the waiting room at the doctor, and to get prompt care.

Many companies are motivated to offer patients a 24/7 access to medical care and a platform for the doctor’s virtual visits with their patients. The advancement in technology provides an edge in a competitive healthcare. The wide variety of advanced health apps enables the physician to monitor the health of their patients.

With the advanced medical devices, patients can determine the vital signs, infections, glucose levels, blood pressure without going to the doctor’s clinic or hospital. As patients become proactive about using technology to detect the status of their health, they also become receptive to get an alternative care through telemedicine. Here are some examples of the advantages of Telemedicine:

Accessibility of Quality Health Care

Remote regions get a quality patient care without delay. Clinics in rural areas use video for the interaction between the patient and a specialist in the city. Doctors are also using telemedicine to monitor the situation and provide treatment to patients in remote areas, at home, and in another hospital or clinic.

Provides Convenience to Patients

Telemedicine eradicates the time spent in a crowded room waiting for the physician, with other coughing patients.  It helps you save your strength and prevents you from being infected by others.

It provides ease of scheduling. Your appointment with your physician can be set online or through your mobile phone and consultation can be done via video technology. It places the power of health through a click of the mouse or press on your phone. It also reduced the burden of traveling.

Telemedicine also provides easy access for immobile patients. Patients with complex medical conditions can be given a quality health care from a specialist in another hospital through the use of telemedicine. It provides easy access to quality health care for patients in a very critical condition.

Saves Time for Both the Physician and Patient

It enables the patient to save travel time. Patients who need to travel millions of miles to reach a physical can benefit from telemedicine. It enables effective communication, examination, and treatment of the patients in different locations.

Telemedicine saves the time of physicians. They can connect with patients on a more flexible schedule. It also reduces no-shows because it gives the patient the most convenient way to have an appointment with the physicians. If ever patients missed the appointments, they can easily replace that time by online scheduling.

It also lessens the overhead cost of the physician. Shorter office hours means saving operating expenses such as salaries, electricity, etc. With telemedicine, physicians can continue their work at home.

Saves Cost for Both the Physician and Patient

It eliminates travel expenses. Many patients do not have the financial capacity to travel for medical treatment. However, with telemedicine, they are given a better opportunity to seek medical care.

Telemedicine is helpful for patients with several chronic ailments which require continuous medication.  It helps them spend less for hospital bills. It would allow them to have the medication at home with quality health care. With video calling, it is easier to enhance patient satisfaction through remote quality health care.

Provides a 24/7 Quality Health Services

The patient sometimes needs immediate care from the physician outside the physician’s office hours. With telemedicine, the physician can have a quick overview and appropriate advice that could save the patient’s hassle, time, and money. Telemedicine extends the physician’s working hours and increases the physician’s the availability of urgent service.

Takeaway

Telemedicine is a crucial part of healthcare.  It is one of the rapidly growing sectors in health care. It is designed to enhance the delivery of quality healthcare while reducing costs. It places the patient at the focal point of health care. It is experiencing rapid growth. More and more physicians and patients are using this method. Experts are continuously looking for ways to improve telemedicine and make it more viable for many medical scenarios.

Community Health Workers Lead to Better Health, Lower Costs for Medicaid Patients

As politicians struggle to solve the nation’s healthcare problems, a new study finds a way to improve health and lower costs among Medicaid and uninsured patients.

Researchers at the Perelman School of Medicine at the University of Pennsylvania showed that patients who received support from community health workers (CHWs) – trained local residents who provide tailored support to high-risk patients– had 30 percent fewer hospital admissions in one year compared to those who did not receive CHW support. The results, published today in the

The results, published today in the American Journal of Public Health, also showed reductions in cigarette smoking, obesity, diabetes severity, and mental illness. This is the second clinical trial to demonstrate improved health and hospital reductions with the IMPaCT (Individualized Management for Patient-Centered Targets) CHW program. The annual return on investment for the program was $2 for every dollar invested.

The IMPaCT program pairs CHWs with chronically-ill patients from low-income neighborhoods. CHWs meet with patients regularly to encourage healthier behaviors, and otherwise provide support for the patients’ own health goals.

Emblematic of the kind of patients who benefit from CHW interventions, one young woman was unemployed, struggling with low self-esteem, and had tried for years to lose weight before she met CHW, Saphia Allen. Saphia helped the patient find affordable interview clothes and went with her to job fairs. Saphia also connected the patient to other neighborhood women and twice a week attended get-togethers with the group where the women would go for walks and share their real-life challenges. With her newfound community, the patient lost 10 pounds and successfully gained employment.

In the new study, the Penn team focused on 302 mostly Medicaid-insured individuals who had multiple chronic diseases. Half received regular support from IMPaCT-trained community health workers. After six months, the patients who had received support from CHWs showed better outcomes on several measures, including lower blood sugar levels, lower body mass index and reduced cigarette smoking. Patients in the intervention group also showed greater improvements in mental health, and were 20 percent more likely to rate their primary care as comprehensive and supportive of their self-management of disease.

“This is the second clinical trial that shows improved health and lower hospital admissions for the IMPaCT community health worker program,” says senior author Shreya Kangovi, MD, an assistant professor of Medicine at the Perelman School of Medicine and executive director of the Penn Center for Community Health Workers.

In 2014, Kangovi and colleagues found evidence that the IMPaCT model improved mental health and lowered hospital readmission among patients recently discharged from the hospital. “We now have evidence for state Medicaid programs or health systems looking for proven strategies to improve health and lower hospital use.”

Based on the reduction in hospitalizations seen in the studies, the University of Pennsylvania Health System estimates a return on investment of $2 for every $1 spent on IMPaCT.

“As a nation, we have spent years arguing about healthcare. We need to focus on getting people healthy while reducing spending,” says Ralph Muller, CEO of the University of Pennsylvania Health System. “This program accomplishes both of these goals and shows us a way forward.”

How Republican Plans to Cut Obamacare and Medicaid Hurt Older Americans

Trump on Obamacare

Over the last twelve months, my colleagues and I have spoken at length with close to one hundred Native American seniors across the state of New Mexico about their health care and health insurance. Since November 2016, these seniors have expressed profound apprehension about the future of health care and insurance coverage under President Donald Trump’s administration, both for themselves and for their friends and relatives. As one elderly woman put it, “I have care, but is [Trump] going to take that away from us?”

Most Americans assume that regardless of any changes to the Affordable Care Act (Obamacare), the healthcare needs of seniors will be covered by Medicare, which serves individuals who are 65 years of age or older and who have paid into the Medicare system via payroll taxes. In fact, even if the current Medicare system remains in place, Obamacare repeal will have profoundly harmful effects on older people, especially those under 65 who have low-incomes, live in rural areas, or are in need of long term care or help to stay in their homes. In fact, seniors are among the most likely people to be hurt by plans to replace Obamacare.

How Obamacare Has Benefited Seniors

Seniors age 55 and over make up an increasing part of the U.S. population and their healthcare needs are extensive and complex. The National Council on Aging estimates that 92% of older adults suffer from a chronic illness, such as diabetes or heart disease. Seniors also have high rates of cognitive health problems, including Alzheimer’s and dementia. A growing number of older adults experience mental health and substance use problems. Even as they face such health problems, many seniors have limited incomes and struggle with the costs of housing, food, and health care.

Although Obamacare is often seen as an effort to increase insurance coverage among younger and healthier people, it has also provided numerous benefits to seniors. These benefits are not only endangered by current replacement plans, they appear to be specific targets of Republican proposals. For instance, Obamacare’s prohibition of annual and lifetime limits on insurance coverage – as well as its limits on the ways insurance companies can raise prices for people with preexisting conditions – have made it possible for older adults with a variety of health problems to get affordable insurance and care.

Seniors have also benefitted from Obamacare’s expansion of Medicaid, which extended eligibility to adults at or below 138% of the federal poverty level. According to the Kaiser Family Foundation, more than six million seniors have received new coverage from Medicaid, including older adults under 65, Medicare beneficiaries with low incomes, and seniors who do not qualify for Medicare because they did not pay enough into that program during their working years. This last group includes elderly adults who are homeless or disabled, as well as those who were previously farmers, ranchers, and homemakers.

What is more, Medicaid covers long-term and in-home care services not covered by Medicare. These services allow seniors with serious medical concerns to receive high-quality care, either in a nursing facility or their own homes. In fact, the Kaiser Family Foundation estimates that 6 in 10 nursing home residents are covered by Medicaid.

In addition to extending these critical benefits to seniors, the Medicaid expansion has generated new revenues for providers of healthcare services that many elders need – including mental health and substance addiction services, transportation services, and help to purchase medical equipment needed by adults who wish to remain at home throughout their elder years. These improvements are especially important for seniors in rural areas, where service providers are sparse and patients must travel long distances to find care. As our research in the rural state of New Mexico reveals, healthcare providers report that Obamacare has helped them address the complex health issues faced by aging patients.

Obamacare has also significantly improved Medicare – by ensuring access to no-cost preventive care and screenings and expanding prescription drug coverage. Crucially, Obamacare addresses the previous Medicare gap in prescription drug coverage, where insurance did not pay for drug costs after an individual reached a certain level of costs. Obamacare discounts drug prices for seniors who fall into that coverage gap and aims to close the gap by 2020. Repeal of the law would significantly increase the cost of prescription drugs, disproportionately affecting seniors.

How Republican Plans Will Hurt Seniors Overall

Not only will repealing or reducing core benefits of Obamacare disproportionately hurt seniors, Republican proposals include provisions that will specifically penalize seniors, such as those that would let insurance companies charge older people up to five times more for insurance than younger adults. Families USA estimates that this could put marketplace insurance financially out of reach for 3.3 million people over the age of 55. Proposed caps on lifetime benefits and the elimination of regulations regarding the essential benefits that insurance plans must cover will put seniors at risk of “running out” of coverage as they age or being unable to afford insurance that will actually cover their medical needs.

Whether or not Obamacare is ultimately repealed, cuts to Medicaid – a core part of U.S. health insurance since 1965 — remain likely and will have especially harmful effects on the numerous seniors who rely on the program for long-term care, including the estimated one-third of American seniors who fall below 200% of the federal poverty line. In addition, reductions or caps to federal funding for state Medicaid programs will serve to deepen existing inequities in care for poor, older, and disabled people in the poorest and sickest states.

Better Care for Seniors Helps Everyone

Ultimately, while seniors have specific and complex needs, ensuring their health is important for everyone in all parts of the United States. When older people cannot get health insurance or adequate care, the burdens are often shifted to their adult children and grandchildren. Many seniors also care for their children and grandchildren, many of whom get help from Obamacare’s benefits for all low-income adults and children. Although Obamacare has very real limitations, the prospect of repeal is already plunging seniors into a state of fear and uncertainty. All Americans should join senior citizens in worrying about the drastic downsides for families and communities, especially in rural areas, if current Republican plans become law.

How is Technology Transforming the Healthcare Industry

Since the turn of the millennium, the technology industry has sky-rocketed and there are many types of technology which have become a huge part of our lives. We can now get almost anything with the click of a button, be it a meal, taxi or even renting out an apartment. With the healthcare industry, many people believe it is lagging behind in regard to how some of the other industries have developed their technologies. However, there are many companies which have been working on developing the latest pieces of technology which are slowly transforming the industry.

The Issues with the Health Care Industry

The healthcare industry has certainly not had its shortage of issues over the past few years, and this has driven a number of external companies to try and solve them through designing more pieces of technology. Taking the UK as an example, it is a country where the government provides free healthcare through the National Health Service (NHS). Even though this is great because it saves a lot of money, the government are lacking sufficient funds to develop the NHS, and the rate of healthcare is actually beginning to decline.

Firstly, there is a shortage of staff, and this means that the current staff are extremely stretched and not able to provide a quality service to any of their patients. Secondly, the other big issue is that they are unable to develop the technology used in the hospitals, surgeries and care homes.

This means the healthcare industry has worsened, and people are unable to get the adequate care required. However, many people are not just relying on the government anymore and they are instead starting to utilise the companies which are trying to develop alternatives to traditional healthcare.

How is Technology Transforming it?

Because of the aforementioned issues, the healthcare technology market is now flooded with different pieces of technology which are starting to shape the industries future. A lot of these are only available to private healthcare companies, and can be accessed by paying a fee to these companies – but there are also lots which be accessed on the mass market.

For instance, the popular Fit Bit wristbands are a small item which can let you know information about your body which was previously only accessible by a doctor. They can track your blood pressure, temperature, heart rate, recommend a diet and track how well you are sleeping. This is stopping people going for the same number of check-ups they would usually need and is helping to reduce the strain on staff.

There are also items such as GrandCare which can eradicate the need for elderly or disabled people to receive around-the-clock care. This is an item which is installed into the person’s home and tracks when the person takes their medicine, eats their meal or hasn’t moved for a long time. They can also use the device to communicate with their family and friends through video calls and if they haven’t moved for a long time it will send an alert to their family’s or carers phone.

To Sum Up

The healthcare industry was slightly late to the party, but there is no doubt that it is fully starting to get a grasp of how technology can help elevate to the next level. The two examples mentioned are popular now, but within the next few years there will be many more that will help further develop healthcare for people all around the world.

Erick Eiting, MD (GrandCare Systems) Interview @ 2017 Digital Health & Fitness LIVE

Most New to Medicaid Have No Other Option if Affordable Care Act Repealed

“Lots of Ohioans support the ACA — but where do @ohiogop #OHGOV candidates stand on Medicaid expansion? #SaveACA” via Twitter @kirstinalv

Almost everyone covered through Ohio’s Medicaid expansion would have no other viable insurance option should the Affordable Care Act be repealed, a new study has found.

Law and public health researchers from The Ohio State University determined that 95 percent of newly enrolled beneficiaries would be without a plausible pathway to coverage. The research appears online in the American Journal of Public Health.

“Many of these people have nothing else to turn to,” said Eric Seiber, lead author and associate professor of health services management and policy in Ohio State’s College of Public Health.

“Their choice is Medicaid or medical bankruptcy.”

Ohio is one of 31 states (and Washington D.C.) to expand Medicaid eligibility as part of the Affordable Care Act. The move, which came in January 2014, made eligible those adults with incomes below 138 percent of the federal poverty level. (In 2015, that was about $16,243 earned annually for an individual.)

Prior to the ACA, Ohio generally did not grant Medicaid eligibility to childless adults unless they were pregnant or disabled. Parents qualified for Medicaid only if their family income was below 90 percent of the federal poverty level. By October of last year, enrollment under expansion in Ohio had reached about 712,000 people.

Efforts to repeal or substantially restructure the ACA reforms are under way.

Seiber and Micah Berman, assistant professor of public health and law at Ohio State’s College of Public Health and Moritz College of Law, evaluated data from 42,876 households that participated in Ohio’s 2015 Medicaid Assessment Survey. The telephone survey includes a set of questions to identify coverage immediately before Medicaid enrollment.

The new Ohio State research was driven by this question: “If the ACA is fully or partially repealed, who would lose their coverage and what would happen to them?”

The researchers found that the vast majority would find themselves without insurance in the case of a full ACA repeal.

Though 17.7 percent of survey participants had private health insurance prior to Medicaid enrollment, most had lost their jobs (and their coverage) or were ineligible for employer-sponsored group health plans at the time of enrollment. The researchers found that 4.8 percent of the new Medicaid recipients were eligible for insurance through their jobs, leaving 95.2 percent of new enrollees with no feasible alternative.

Seiber and Berman also found that a rollback would predominantly affect older, low-income whites with less than a college education.

“The impact of insurance is about a lot more than health care,” Berman said. “For people newly enrolled in Medicaid, it means that should they have a major health-related event, they can still pay for food, have stable housing, get out of debt. These are all things that make a huge difference in quality of life.”

A recent Ohio Medicaid analysis, which was conducted with help from Seiber and Berman and mentioned in the new study, found that that the expansion increased access to medical care, reduced unmet medical needs, improved self-reported health status and alleviated financial distress – all results found in other states that have expanded access to government coverage.

The new study shows that the majority of adults newly enrolled in Medicaid did not drop private insurance in favor of the government coverage, Seiber said.

“These are very low-income adults, many of whom lost their jobs and have nothing to go back to,” he said.

Said Berman, “It counters this perception that people have health insurance but then go on Medicaid to save money. That’s just not what the data show.”

That did happen, to an extent, with expansion of Medicaid coverage for children. But that was a different scenario because children’s eligibility begins at much higher family income levels than those in place for new adult enrollees, Seiber said.

Seiber and Berman said they hope the study offers some scientific data that will be useful during discussions of ACA repeal or revision and what it could mean for Americans now covered by Medicaid.

“I don’t think everyone realizes that if you repeal the ACA, that at the same time eliminates the Medicaid expansion,” Seiber said.

One potential weakness of the study is that the researchers were not able to evaluate how many people on Medicaid had the option to move to private insurance – because they were newly employed, for instance – but did not go that route. That type of analysis was not possible with the state-gathered data, Seiber said.

“While it is possible that some portion of these enrollees have since been hired by an employer that offers (insurance), it is unlikely that this would meaningfully improve the insurance outlook for this population,” he and Berman wrote.

The researchers said it’s important to consider the demographics of those covered under Medicaid expansion, including the fact that many are older and already have chronic health conditions that will become more costly and problematic without regular care.

“It’s a really broad cross section, and tends to be older and whiter and more rural than many would expect,” Seiber said.

Comparing Public Healthcare in the US and Europe

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Source: OECD

Since the United States is a very rich nation, many would like to believe Americans are healthier and better off with their public healthcare system compared to their European counterparts. On the contrary, when it comes to public or universal healthcare access, the US lags behind even medium-developed European countries; what more the truly advanced like the UK, France, Belgium, and Germany?

European countries have national healthcare insurance systems that cover for fundamental health conditions and basic services. While some countries provide some of these services absolutely free of charge, there are certain instances when such services will be charged with a small fee for the patient’s participation.

In France, for example, French nationals and legal residents are able to obtain public health care services at only 25 percent of the total cost. For instance, a healthcare service costs 100 Euros, French nationals will only be paying 25 Euros and the remaining 75 Euros is already shouldered by the French national health insurance system. The 25 Euros the French will pay for can also be covered by their private health insurance policy which is, surprisingly, a lot less expensive than the health insurance policies Americans have to pay for.

Is there any other benefit to living in Europe and enjoying its public health care system rather than in the US? Yes, excellent healthcare is also related to life expectancy. The better the health care received by the nationals and residents of a particular country, the longer is the life expectancy of the people of that nation. The United States has an estimated life expectancy of 79 years old as of 2016.

In Europe, the Principality of Monaco has the highest life expectancy at 89.47 years old. There are also 19 other European countries that have a life expectancy rating of more than 80 years old. These include San Marino, Andorra, Italy, Liechtenstein, France, Spain, Sweden, Switzerland, Iceland, the Netherlands, Ireland, Norway, Germany, the UK, Greece, Austria, Malta, Luxembourg, and Belgium. The US ranks No. 53 exceeded by Taiwan and slightly above Bahrain.

Interestingly, Europeans particularly those who live in the European Union or the European Free Trade Association, are among those wiht the highest life expectancy. This is due in part to the unified effort of the European Economic Area to provide public healthcare access to anyone who has a valid European Health Insurance Card (EHIC). With this card, people in European nations are able to obtain the same quality of healthcare that nationals of a particular member nation are entitled to.

This is something that is clearly missing in the US healthcare system. However, hope is not lost because the US now has the Affordable Care Act which is supposed make health insurance compulsory for everyone. Unfortunately, the fate of the limited universal public healthcare program of the US now rests on President Donald Trump and the Republican controlled Congress.

True, the US may be wealthier, and they may have the most advanced healthcare technologies but if only a few people can access these services, what’s the point? A much better model is the European system of public health care in which the US now officially recognizes as essential to the health of its citizens.

Wilhemina’s War: Women of Color with HIV/AIDS in Rural South Carolina

Wilhemina’s War first aired on February 29th, 2016, and the film chronicles the trials and tribulations of family matriarch Wilhemina Dixon, her daughter Toni who is HIV positive, and granddaughter Dayshal who contracted HIV at birth. Filmed over a period of five years from 2009 to 2014, the feature highlights the stages of caring for loved ones with HIV/AIDS using limited resources. Despite working odd jobs to keep the family afloat, Wilhemina pours her spirit into encouraging her daughter and granddaughter to survive.

This intimate look into the daily life of women of color with HIV in rural South Carolina along with the social and political barriers they faced adds to the appeal of this 55 minute docudrama. Every person in the film whether it be the survivor, activist, social worker, politician, pastor, or resident-is impacted by HIV/AIDS.

Cassandra Lizaire, author of “S. Carolina’s Haley Slams Door on HIV Prevention”, stated that, “Wilhemina Dixon knows this devastation well. A 64 year-old great-grandmother living in the dusty backroads of Barnwell, S.C., she spends her mornings in the field picking peas before the onslaught of the midday sun. Her odd jobs provide for her family of six and she takes pride in making an earnest living. Afterwards, as she sits in the shade of her porch, far removed from the political machinations, I imagine Dixon thinks of her daughter Toni who died of AIDS last year [2011] and ponders the future of her granddaughter Dayshal, who was born with the virus.”

“In South Carolina, we are ranked eighth in the nation in the rate of AIDS. Eighty percent of all women in South Carolina living with HIV/AIDS is black. Eighty percent of all children living with HIV are black. Seventy-three percent of all men living with HIV are black. This is a black epidemic for all practical purposes,” clarified Vivian Clark-Armstead, South Carolina HIV/AIDS Council member in the film, “Wilhemina’s War.

June Cross, in the article “June Cross Tells the Story of a Family Fighting HIV in South Carolina”, chose to develop this documentary to raise consciousness and dispel myths about HIV/AIDS among African Americans in the rural South.

According to the Centers for Disease Control and Prevention:

  • In 2009, the highest number of adults and adolescents living with an AIDS diagnosis resided in the Southern part of the United States.
  • In 2010, in the South, the Northeast, and the Midwest, blacks accounted for the largest number of AIDS diagnoses.
  • At the end of 2010, the South accounted for 45% of the approximately 33,015 new AIDS diagnoses in the 50 states and the District of Columbia, followed by the Northeast (24%), the West (19%), and the Midwest (13%).
  • In 2013, an estimated 776 adults and adolescents were diagnosed with HIV in South Carolina. South Carolina ranked 17th among the 50 states in the number of HIV diagnoses in 2013.
  • In 2014, 44% (19,540) of estimated new HIV diagnoses in the United States were among African Americans, who comprise 12% of the US population.
  • In 2014, an estimated 48% (10,045) of those diagnosed with AIDS in the United States were African Americans. By the end of 2014, 42% (504,354) of those ever diagnosed with AIDS were African Americans.

The CDC implies that knowledge of the regions where HIV and AIDS have the greatest impact, informs the equitable distribution of resources for prevention and education in those areas. The CDC also suggests that its approach to the HIV crisis is driven by the 2010 National HIV/AIDS Strategy introduced by President Obama. The four main tenets of the strategy are to: lower the infection rate, expand healthcare availability and improve the quality of life for those who are HIV positive, lower HIV-related health inequalities, and attain a more organized federal approach to the HIV crisis.

However, Lisa Ko asserts in her article titled, “African Americans Hit Hardest by HIV in the South” that, “As seen in Wilhemina’s War…Governor Nikki Haley’s rejection of billions of federal dollars through the 2010 Affordable Care Act (ACA) and cutting of $3 million in AIDS prevention and drug assistance programs has resulted in substandard or nonexistent health services, medication, and medical care.” Wilhelmina’s War brings these statistics to life as it exposes the social and political obstacles Wilhelmina and her family encounter while inspiring the audience to advocate for collective change. Wilhelmina’s War can be accessed through the PBS.org website.

To assist the Dixon family and others with HIV in the rural South, June Cross shares the following ways to get involved:

  • Cross has established a GoFundMe page for Dayshal Dicks.
  • Cross suggests that organizations involved with the #BlackLivesMatter movement and other social justice efforts connect with local HIV advocates.
  • Finally, making financial contributions to HIV foundations to help them continue their community outreach.

In my previous experience working with HIV positive clients in a residential setting, my goal was to promote a safe, drug and alcohol-free community living environment. As residents, clients could access intensive case management, group and individual counseling, and intensive outpatient addiction treatment for up to two years.  During this period, most clients were empowered to acquire and sustain permanent housing. I learned that the best thing I could do for these clients was to show empathy and treat them how I would want to be treated. The only difference between me and them was time and circumstance.

I encourage social work students, practitioners, other helping professionals, and community activists to watch Wilhemina’s War to increase awareness about the status of the HIV/AIDS crisis in the rural South.

What Will a Trump Presidency Mean for Americans

Photo Credit: www.donaldtrump.com
Photo Credit: www.donaldtrump.com

The Indiana, Nebraska, and West Virginia primaries have all ended, and Republican voters have made it clear who they want their presidential nominee to be – Donald Trump. In light of Trump’s crushing victory in the Indiana polls, Ted Cruz, a Republican senator from Texas and presidential hopeful, has reportedly dropped his presidential bid leaving Trump a clear path to earning the official Republican nomination at the party convention this June.

Seeing Trump this close to winning the Republican nomination is astounding in the least. Just under a year ago, when Trump announced his candidacy for president, various reporters, political insiders, and politicians from the right declared it impossible for this businessman from New York with no political experience to be successful on the campaign trail. Only recently have political analysts began to realize a Trump presidency could be looming in the future of the United States.

The reality of Trump being a viable presidential candidate has many social workers, counselors, physicians, and other helping professionals asking what a Trump presidency would mean for healthcare and mental health in our country. The answer to this question can be found by reviewing Trump’s views on these topics.

Trump on Healthcare

Healthcare remains one of the fastest-growing occupations in the United States with a projected total of 163,537.1 million people working in the healthcare sector by 2020. The Affordable Care Act (ACA), signed into law in 2010 by President Obama, has allowed citizens to access health services they may not have been able to afford before the legislation was made law. More people are receiving healthcare, more physicians, nurses, and other medical professionals are providing services, and employment in the healthcare sector still remains desirable as professionals continue to navigate and settle in to the new healthcare environment created by the ACA.

If elected president, Trump reportedly has plans to eliminate the Affordable Care Act (ACA) and create a new system.

“I would end Obamacare and replace it with something terrific, for far less money for the country and for the people,” said Trump

On the surface, a better system for less cost sounds great. However, in a healthcare environment still stabilizing from the most recent changes brought with the ACA, an upheaval of these new policies without a strategic replacement plan would be detrimental for professionals, their clients, and the healthcare workforce as a whole.

A quick look at Trump’s platform on healthcare policy reveals a plan to overturn the ACA, open up a free market insurance system, and allow people access to Health Savings Accounts (HSAs), but completely neglects to inform the public about how this plan will be enacted or what effects it might have on individuals and families who would lose their insurance coverage completely with the repeal of the ACA. The obscurity and lack of any evidential basis in his overall plans leaves healthcare professionals in the dark about how exactly this ‘new’ system would impact them and their clients.

Trump on Mental Health

Each year approximately 1 in 5 adults in the United States will experience mental illness. The current mental health workforce of social workers, psychologists, psychiatrists, and behavioral health specialists is unable to keep up with public need, subsequently causing 4,071 geographic areas in the country to be designated as having a severe mental health professional shortage. While many public leaders agree the deficit in the mental health workforce should be addressed, few seem to be actively doing anything to create such change.

Trump is no exception. In previous interviews and news reports Trump only brings up the lack of mental health service provision as being a significant issue in this country when addressing the wave of gun violence the country has experienced recently. If fact, the only reference Trump makes to mental health in his platform is cited in his views of Second Amendment Rights on how mental health issues should be addressed but should not impede citizens on their gun ownership rights. While Trump claims our country needs to fix the “broken mental health system”, he clearly lacks any willingness or concrete plans to do so.

So what exactly would a Trump presidency mean for healthcare and mental health professionals? From the look of it, we could expect to see (1) a significant increase in people who are uninsured or severely underinsured; (2) a decrease in access to needed health and mental health services; (3) a continued deficit in the mental health workforce; and (4) a system which overall is not adequately able to serve the people living here in the U.S.

Trump’s plan for the healthcare and mental health systems (or lack thereof) in this country doesn’t create any positive solutions to our current issues; making him unfit for the job of President of the United State of America. Our country needs a leader with a strategic plan to enact clear and concise legislation, to increase the effectiveness of our current systems, and to recognize the deficits and fill the gaps in service where needed.

As Americans who are concerned for the future of this country, we must set aside our assumptions, biases, and prior convictions to unite and vote for the candidate who is going to continue the progress we have worked so hard for. We must vote for the democratic candidate, and ensure we never have to experience a Trump presidency.

Observations of a Danish Social Worker on Social Work Practice in the United States

cancer-patient

I was working as a social worker in Denmark for some at a highly specialised university hospital until I moved to the United States, and I have been wondering about the differences and similarities in working with cancer patient in both places. With 10 years of experience working with cancer patients, their families and palliative care in Denmark, I can see how different Denmark is from the U.S. health and social system. I don’t think it will be fair or even possible to do a one to one comparison of the two countries.

In Denmark, the government plays a major role in providing citizens with fundamental social security and access to healthcare, which dates back to the 1800s. With a comprehensive social security system, most of the welfare state tasks is financed by taxes. In the United States, I have learned most of the social support is provided through non-profit organisations and healthcare is mostly secured by insurance. So with such big differences, I thought it would be interesting to see if there are any common denominators.

In my search for work in the United States a question I often get is do you have experience in working with Afro/American women? In the beginning I wondered a lot about that question, but then it made me really think about how do I define myself as a social worker. Working as a social worker here in the United States at a clinic for low income women with cancer I met many different ethnicities.

Mohammad, a 50-year old man, who was working as a bus driver when I first met him. Originally he was from Iraq, but came to Denmark as a political refugee. He was married and had four children. Mohammad’s wife didn’t speak Danish and she didn’t work. I met Muhammad because he was diagnosed with Colon Cancer and wasn’t able to work much longer.

Being diagnosed with cancer is mostly associated with uncertainty, hopelessness and anxiety of not having any control. Many cancer patients also experience stigma, shame and blame depending on the diagnose. Besides that most people are filled with fear of the disease, many also have concerns of what the diagnose means in relation to work, social life, economy and everyday life. A life threatening disease is an extreme and potentially stressful triggering life event which requires psychological coping.

The best results in our line of work I believe is created by being humble in the approach to the patient and by having a natural curiosity towards the patient’s life story. We must first and foremost see the patient as a person who comes to us for help because they are in a place in their life where they cannot stand alone, and we need most of all take a look at the patient’s individual experience of his or her situation. Whether the individual can adapt to the new life situation depends partly on their degree of resilience.

The first couple of times I met with Muhammad he didn’t say much, I would just talk with him about life in general, so he wouldn’t feel I pressured him into speaking about his situation. In my experience, working as a social worker, a patient in a situation like Muhammad’s is going through a lot of emotions. They may have the feeling of loneliness, lack of understanding from their surroundings, social isolation and financial difficulties.

Moreover they go between accepting the situation, to denial or to have some degree of acceptance. Every time I met with Muhammad I told him you can always come back. I would ask him how his treatment was going and asked about his life in general, this was to not only define him by his diagnose and the disease. Then after a couple of meetings he brought his wife and from there the contact to the family became more frequent. I was Mohammed and his family’s social worker until he died 4 years ago.

Sabrina a young mother of three, was diagnosed with melanoma cancer metastasis to the brain and because of some insurance issue, she had not gotten her treatment and scans. Sabrina’s husband was providing for the whole family and wasn’t home a lot which made Sabrina feel very alone in her situation. Also, Sabrina was going to die and she knew and recognized it.

Speaking with a patient in Sabrina’s situation you need to find out what is most important for her to talk about. Is it emotional support or is it more practical support she needs. First of all, I believe that we should all have an open heart, open mind and listen to the stories the patient has to tell, without race or color in mind.

It is important as a social worker to start a conversation with a patient and imperative to distinguish between the problem and the condition for knowing when to take have a solution-oriented approach, and when we do not need to act, but do something else for the patient. Problems such as financial aid, help to clean, help to care for the children and figuring out what the insurance and pension rules are, can be solved. Conditions are more definable as distressing life events, something the patient has to live with. A burden or a grief to be worn like that I am not able to work longer, I have to die from my children and the disease itself. These circumstances affect the patient on a more emotional and spiritual level.

However, it can be difficult to distinguish between problems and conditions as the patient will often ask questions or talk about the difficult life conditions in a way that invites to problem solving. The patient’s narrative and questions must be recognized and unfolded before we can assess whether it is something we must act on or not. It can be difficult to distinguish in practice, since a situation may contain aspects of both conditions and problems. Here, we must be careful not to solve problems before we acknowledge the losses that the patient has in their changed conditions of life.

I think it’s very important to remember to be truly present with people. We bring knowledge, skills, and compassion to listen in a unique and dedicated way. We need to bear witness to people’s physical and emotional pain without abandoning them or being judgmental in any way. Our role is to create a safe space for the patient to share their joys, regrets, fears, strengths, and sorrows.

I do believe parallels can be drawn between the experiences with patients that I’ve had in the United States and in Denmark. When everyday life is shaken by serious life-threatening disease and families are affected, concerns that arise in both countries are similar in nature regardless of social status and ethnicity.

However, it has surprised me that there is so much focus on ethnicity, especially when I see basically the same problems regardless of race and social status.

It is my experience from what I’ve seen here so far, that here it is more about what ethnicity do you have and what social class do you belong to, that determines how the approach to the patient will be.

A different culture, ethnicity or religion it self does not necessarily accompanied by challenges or the need to have a specific kind of approach.

A cancer – regardless of diagnosis – contains significant psychosocial impacts. In addition to the diagnosis of specific problems, patients often live with fear of relapse, depressed mood, attention and memory impairment, reduced work ability, problems in relationships which, individually or together, may adversely affect rehabilitation and retention of social and cultural status.

It’s essential for a good dialog and contact that we listen with an open-mind and acknowledge the problems coming up during the conversation. Also, it is equally important to see the patient as an individual and avoid judging or being distracted by the patient’s cultural or religious appearance. Otherwise there is a risk that factors such as racism and prejudice will get in the way of the patient receiving the best help.

How Crowdfunding Can Be an Effective Alternative for Medical Hardships

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Crowdfunding has turned into a reputable resource for people who succumb to tough times and are looking for an alternative method of support. However, it inadvertently has also turned into one of the few places where people from all walks of life can come together for a common goal.

Most crowdfunding sites enable users to connect with supporters by providing updates and uploading photos. This feature offers a platform for family and friends to leave thoughtful messages and words of encouragement, creating an entire community of support.

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Michael Genest

A campaign can typically be created by the individual needing assistance, or by a family member, friend, or member of the community. While restoring hope to those it benefits, crowdfunding shows people that no amount is too small and making a difference in someone’s life is sometimes just a click away.

For example, Michael Genest has an incredibly positive personality with a “failure is not an option” attitude, even under unfortunate circumstances. Late last year, Michael was diagnosed with a very rare neurological condition known as Bickerstaff’s Brainstem Encephalitis.

The medical center in which he checked into to was completely unaware of the disorder. Michael was on total life support measures for lung, kidney, food and all bodily functions and could not speak and or easily move.

With his inability to work, the immense amount of out-of-pocket medical bills and two daughters in college, Michael’s family turned to Plumfund to crowdfund his medical hardshipAfter only two months, the campaign has already raised more than half of its $15,000 goal and the updates provided by Michael’s wife, Jordan, state that he is in good spirits and was moved to the top rehabilitation hospital in Texas. The support and kind words Michael’s from friends and family are incredible and inspiring.

However, Michael and his family are not alone. Unfortunately, there has been a dramatic increase in people turning to crowdfunding as an alternative method of raising funds for hardships, especially medical.

Thanks to social media, it’s easier than ever to connect with friends, family, coworkers or anyone in your network. Therefore, it also becomes easy to share your crowdfunding campaign and reach more people than traditional fundraising.

Users can collect any amount of donations from anyone anywhere in the world. Location is a limit with traditional fundraising, but with crowdfunding being web-based, it allows people the accessibility of sending and receiving funds at the click of a button. By incorporating technology, crowdfunding makes fundraising simple and more efficient to help ease the stress that comes along with any hardship. 

Failure to Expand Medicaid: Are We Failing Our Most Vulnerable Citizens

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We often hear politicians make promises about what they will do their first day in office if elected, but how often do we actually hear about them keeping those day one promises after being elected? Newly elected Democratic Louisiana Governor, John Bel Edwards, on his first full day in office reversed the decision of his Republican predecessor, Bobby Jindal, to not expand Medicaid for the state’s poorest citizens.

As illustrated by the map above, there are currently 16 States primarily located in the South, and they all have in common Republican-led state legislatures that are still refusing to expand Medicaid and adopt the provisions of the Affordable Care Act (ACA). Despite winning two Supreme Court challenges and being signed into law six years ago, Congressional Republicans have voted to repeal the Affordable Care Act approximately 60 times as recently as August 2015.

According to the United States Health and Human Services (DHHS), the Affordable Care Act is working despite not being implemented in all 50 States as it was originally designed. DHHS states the ACA is “working to improve access, affordability and quality in health care.” Additionally, DHHS states the ACA has helped 16. 4 million Americans who were uninsured gain access to insurance and affordable health care.

According to Kaiser,

In states that have not expanded Medicaid, 3.1 million poor uninsured adults fall into a “coverage gap” and will likely remain uninsured. These individuals would have been eligible under the Medicaid expansion. However, in the absence of the expansion, they remain ineligible for Medicaid and do not earn enough to qualify for premium tax credits to purchase Marketplace coverage, which begin at 100% FPL (Figure 2). Most of these individuals are likely to remain uninsured as they have limited access to employer coverage and are likely to find the cost of unsubsidized Marketplace coverage prohibitively expensive.

Over 1.7 million adults of color fall into the coverage gap, and uninsured Black adults are disproportionately likely to fall into the gap. Overall, about one in ten (11%) or 3.1 million of the total 27.5 million uninsured adults fall into the coverage gap in the 20 states that have not adopted the ACA Medicaid expansion. This group includes over 1.7 million adults of color. Uninsured Black adults are more than twice as likely as White and Hispanic uninsured adults to fall into the coverage gap. Read the Full Report

Researchers have found five medical conditions that are higher in non-Medicaid expanded states which include high blood pressure, heart problems and cancer.

Also, if you fall into the Medicaid expansion gap and ACA plans are too expensive for you, you may be able to access an income based community health clinic in your area. You can look up local resources using this link.

What Can We Do

First, we must advocate to ensure our most vulnerable citizens are protected. The National Health Care for the Homeless Council has put together an extensive resource list and tool kit to help you better advocate on behalf of citizens in your state. Secondly, we must encourage social innovation within our current health care models.

The links between poverty and poor health are well known: Food insecure children, now numbering 17 million in the United States, are 91 percent more likely to be in fair or poor health than their peers with adequate food, and 31 percent more likely to require hospitalization.5 Children under age 3 who lack adequate heat (another 12 million) are almost one-third more likely to require hospitalization.6 And families with difficulty paying rent and housing-related bills face increased acute care use and emergency room visits.7 – Read Full Article

Most of the time, our first responders who tend to the social needs of patients such as social workers and case managers are overloaded due to a shortage of manpower, funding and resources. According to the National Association for Social Workers (NASW), social workers provide 60 percent of the mental health services in the United States. Currently, the NASW is proactively seeking to “promote the inclusion of social workers as essential members of health care teams in coordinated care models” through advocacy and policy initiatives.

Most importantly, we must work collaboratively for collective impact in an effort to add protective factors and increase outcomes for our most vulnerable citizens.

Social Work Students Defend Planned Parenthood Against Deceitful Smear Campaign

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As Social Work students, we are concerned about the deceitful attempt to defund Planned Parenthood, an organization that provides vital health care services to 2.7 million Americans each year. In Louisiana alone, Planned Parenthood annually provides 16,000 visits in both Baton Rouge and New Orleans for services that include birth control, cancer screenings, STD tests and treatment, and other preventative healthcare such as much-needed sexual health education.

This smear campaign is part of a 10-plus year pattern of harassment and violence by extremists whose focus is banning abortion and preventing women from accessing preventive health care at Planned Parenthood health centers. The group behind this video smear campaign is a part of the most militant wing of the anti-abortion movement. They have been behind the bombing of clinics, and the murder of doctors in their homes and in their churches. This group has zero credibility. They set up a fake company. It appears that they used fake government IDs. They’ve even filed fraudulent tax documents and have completely lied about who they are and what they do all in an effort to end safe and legal abortion and bring down Planned Parenthood.

Additionally, we would like to clarify a few things for readers. Donating fetal tissue is a common medical procedure that goes to research seeking to cure Alzheimer’s and Parkinson’s diseases. The only monetary transaction in the video discussed was standard reimbursement costs. There is nothing in these videos that suggest any violation of law, and these tapes are heavily doctored. The clips take the conversations out of context, while the full tapes show the doctors in question state repeatedly that Planned Parenthood does not profit from the consensual donation of fetal tissue.

Furthermore, we want to clarify that Planned Parenthood does not receive federal funding for abortion services. Federal funds are restricted from funding these services by the Hyde Amendment. What the money does fund is healthcare for people who need it. In Louisiana, we have a dearth of healthcare services for low-income people, made worse in recent years.

Social workers see the tragic consequences of lack of health care every day. Per the CDC New Orleans is number two in the nation for HIV infections, and Baton Rouge is number three per capita. People here are struggling with higher-than-average rates of chronic illnesses, and they cannot afford to find treatment. Social Work Students United for Reproductive Freedom (SWURF) does not see this as a pro-choice versus pro-life issue. We see it as a human rights issue. It is about the right to have freedom over one’s body without government intervention. It is about the health of Louisiana women, men, and children. For those reasons, we support Planned Parenthood.

Social Work Students United for Reproductive Freedom – Tulane University Student Members

Kara Cohen, Dana Carbo, Emily Costello, Miriam Eisenstat, Livia Harkow, Becca Hutchinson, Catherine Kelleher, Alex Loizias, Val Lippman, Cat Patteson, Charles Schully, Miranda Stone

For Information, contact us on Facebook at Social Work Students United for Reproductive Freedom or on Twitter at @tulaneSWURF

Press Release: Social Work Helper was not involved in the creation of this content.

Opportunities for Social Workers Expand Under Obamacare

Millions of Americans breathed sighs of relief upon hearing the Supreme Court’s decision to leave in place subsidies in the Affordable Care Act (ACA) for the insured in states where the federal government created the marketplace exchanges. Six of the nine justices believed it was Congress’s intention to provide a healthcare system that would cover as many Americans as possible. Among those waiting to exhale were social workers who are a critical component in the reformation of the healthcare system under the ACA.

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President Obama reacts to hearing news of the Supreme Court’s decision (Official White House Photo by Pete Souza)

President Barack Obama celebrated the validation of his signature legislative accomplishment with his closest staff. Conservatives were appalled by the decision that—for all intents and purposes—institutionalizes a system they derisively named and now is commonly known as Obamacare.

Most Americans know the law for providing healthcare insurance for millions more Americans through affordable premiums and expanded Medicaid. On a larger scale, the ACA is transforming the entire way we look at health and healthcare.

While discussing social workers involvement in the transformation of the nation’s healthcare system with Dr. Darla Spence Coffey, President and CEO of the Council on Social Work Education (CSWE), she pointed out that since the enactment of the ACA the focus of health and healthcare has moved from individualized medical care to an integrated model that includes behavioral health as well as primary care while factoring in social determinants of health.

This is social work’s approach to healthy living that takes into account the biopsychosocial and spiritual dimensions of human existence. As a result of the new direction for healthcare, there is a greater appreciation of the value social workers bring to the process.

CSWE and the National Association of Social Work (NASW) are partnering on a number of initiatives that will expand social work in healthcare settings. One that includes the Society for Leadership Social Work Leadership in Health Care (SSWLHC) is an agreement with the Centers for Medicare & Medicaid Services (CMS) to train Certified Application Counselors (CACs) to enroll the millions of Americans eligible for healthcare insurance who have not yet signed up. Another initiative funded by the New York Community Trust called Social Work HEALS: Social Work Healthcare Education and Leadership Scholars Program, provides scholarships for social work students at 10 universities.

Social workers are receiving training through the Health Resources Services Administration’s (HRSA) $26.7 million Behavioral Health Workforce Education and Training for Professionals program. Sixty-two schools of social work received $19 million of the funding that will allow about one-fourth of accredited MSW programs to provide scholarships to 4000 students at $10,000 each over the next three years. Additionally, CSWE’s Gero-Ed Center presented a series of five webinars on opportunities for social workers under the Affordable Care Act.

Dr. Coffey says the shift to more integrated healthcare service delivery has spurred greater interest in inter-professional education. CSWE’s annual survey which will be released soon, found that 40 of the 223 masters programs that offer joint degrees reported having a MSW/MPH dual degree option. She reports the number of students specializing or pursuing a concentration in healthcare is on a steady incline. The health and integrated health field setting is the second most common setting after mental health. The health/integrative health and mental health setting for baccalaureate students is now the fifth most populated setting—moving up from sixth last year with 400 more students reported for that setting.

Social workers are regaining influence in discharge planning in hospitals as the determinants of health are understood to be more than a menu list of medications and activities. “There is a greater appreciation for social workers in hospital settings,” Dr. Coffey explained, “because hospitals will be penalized for excessive readmissions under the Affordable Care Act.” The ACA contains a provision that reduces Medicare payments to hospitals with higher readmission rates. Having social workers involved in case management and discharge planning should help reduce the number of readmissions.

The demand for medical or healthcare social workers has increased dramatically. According to the Bureau of Labor Statistics (BLS), employment of social workers is expected to rise by 19 percent between 2012 and 2022, greater than the average of all other occupations combined. While BLS puts the average salary for social workers at $44,200 (2012) annually, they report the average annual salary for healthcare social workers as $53,590 (2013) with some states paying significantly higher wages.

Driving this demand is the aging of baby boomers and the expansion of healthcare by the ACA. Now that Obamacare will remain the law of the land, social workers will play a major role in the transformation of the nation’s healthcare.

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