Health Literacy Implications for Health Care Reform Workshop Summary (2011) / Chapter Skim
Currently Skimming:
3 Opportunities and Challenges for Individuals Under the ACA
3 Opportunities and Challenges for Individuals Under the ACA
Pages 19-32
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From page 19... ...
Health Center #10, Philadelphia Department of Public Health Vulnerable populations, as defined by Final Report of the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry are groups of people "made vulnerable by their financial circumstances or place of residence; health, age, or functional or developmental status; or ability to communicate effectively .
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TV and radio can be used to reach low literacy populations and those without computer access. It is also important to engage groups already in the community that are trusted by vulnerable populations, to help bridge the divide.
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But recruitment and retention of staff are major ongoing challenges for community health centers. In addition, there has been little attention to training in communication with low health literate patients, and in culturally and linguistically appropriate methods.
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Financial incentives can also be used to increase the use of community health workers and liaisons who can take the time to sit with patients who are unable to understand written materials and explain what needs to be done. Other opportunities include using standardized tools to assess a patient's health literacy; teaching simple techniques such as "teach back" to healthcare workers to improve communication; and creating a clearing house for low health literacy materials screened to a very low (e.g., second or third grade)
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From page 23... ...
Summary In conclusion, Bettigole said that systems for enrollment need to include multiple options for populations with low health literacy; there is no "one size fits all" solution. Funded community assistance and ombudsman programs should include the use of trusted community brokers who can help vulnerable populations understand insurance options and serve as advocates for those experiencing problems.
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Many parents, not just low literacy parents, cannot complete insurance forms for child health insurance. Although Children's Health Insurance Program (CHIP)
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and the CHIP Reauthorization Act (CHIPRA) of 2009 that offer financial incentives to states for "eligibility simplification efforts." Sand ers recommended that efforts include enforcing grade-level standards for enrollment forms; outreach campaigns tailored to low literacy and limited English proficiency parents; bundling of eligibility assessments at the time of enrollment in other maternal and child health care programs; and eligibility assessment of all children at school entry and at school health clinics.
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. Opportunities to improve family-centered care as outlined by Sanders include building literacy centers through the medical home; developing low literacy decision aids for children with special health care needs (including easy to use personal health records)
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To Improve Child Patient Safety: Promote national standards for safe-use labeling of liquid pediatric medication • tandardize dosing instructions on prescription and nonprescription liquid S medication • evelop easy-to-understand dosing aids for all pediatric liquid medication D To Improve the Skills of the Pediatric Workforce: Require health literacy training • ake health literacy training a required component of post-graduate training M in child health (e.g., pediatrics, family medicine, pediatric nurse practitio ners) (Section 5301)
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From page 28... ...
A host of medical restrictions are more common in seniors than in younger adults, including dementias of all kinds; chronic pain, which can lead to a disinterest in life and a disinterest in seeking medical care; vision and hearing defects; and physical barriers to obtaining care. There are the same cultural, racial, and ethnic subsets of seniors as there are for other generations.
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From page 29... ...
As an example of local, community-level involvement, Sanders mentioned the Human Services Coalition in Miami, which is involved in expanding child enrollment and would be an ideal recipient agency for funds to improve outreach efforts. There is also a CHIPRA demonstration project in Florida to improve the child medical home, involving 14 primary care sites.
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From page 30... ...
Health literacy should not be viewed as an add-on or extra expense, but a way to change how care is organized and delivered. Sanders agreed, and noted that from the pediatric health perspective there are some good business cases from Rochester and Wisconsin that show that implementing the medical home process as part of discharge for children with special health care needs produced significant savings.
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From page 31... ...
Roundtable Activities A roundtable member asked Fallon for his advice on how to foster health literacy. Fallon responded that, in his opinion, what is needed is to integrate health literacy and improved communication into everything that a physician in the health care system does.
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