Access to Health Care

Access to health care services continues to be a serious problem in many communities in Texas. Many people living in all areas of the state face barriers to getting access to even the most basic health services.

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While some churches have already built remarkable programs to support access to care, the topic remains a top priority for churches across the Diocese. In fact, over half of our churches that responded to the Spring 2015 survey identified access to care as a top community health concern. At the same time, churches recognize the critical supportive role they can play, often with relatively little investment of money, to bring health care services to their community.

Access can be hindered in many ways: being uninsured or having insufficient funds to pay for care, lack of appropriate and sufficient providers for community health care needs, lack of transportation, barriers related to language or providers' lack of understanding of cultural issues, or insufficient knowledge about how to navigate the health care system. Together, these barriers can feel overwhelming. However, congregations can play an important role in breaking down those barriers.

Below are a few ways that churches can contribute.

Enrollment Support

People without health insurance face a commonly recognized barrier, particularly in Texas, which leads the nation in the rate of people who are uninsured. Helping people enroll in the health insurance programs for which they are eligible can be an incredibly effective way for churches to impact community health. Access to care and enrollment support are wonderful ministries for leveraging small efforts into significant benefits and creating life-changing opportunities. When enrollment in health care is combined with enrollment in other social service programs like food stamps, the benefit of the effort multiplies. The gold standard is when those efforts are combined with support and education to help people navigate these systems, which can be a daunting prospect particularly for those new to the health care system. The opportunity to increase enrollment can include programs like Medicaid, the Children’s Health Insurance Plan (CHIP), county health care programs, and the Affordable Care Act (ACA or Obamacare). Because each of these programs has specific eligibility criteria and can be a challenging process for those unfamiliar, having help to get enrolled is often the difference between having access to care or not. So, one way that congregations can support access to care is by supporting enrollment in insurance and benefits programs, along with navigation when possible.

Transportation Support

In many rural areas in particular, poor access to transportation is a critical barrier to getting timely health care services. While many of us take for granted having a car and being able to get around, many low-income families have to make transportation arrangements to be able to do simple things like go to the grocery store or to the doctor. Many churches have helped to break down this barrier by offering the use of their vans or even private cars.

Language and Cultural Support

Communities with large numbers of new immigrants may have a special need for access related to language services and cultural training of providers. Congregants with special language skills can be an invaluable resource in helping raise awareness among providers of the need to develop cultural awareness to better serve local populations. Unfortunately, patients often will simply opt not to go to providers than express a need for more culturally-tailored attention.

Medical-legal Partnerships

Another model for supporting access to care is the medical-legal partnership, where legal expertise is brought to bear in advocating for patients. Such a model can be powerful in churches with legal expertise available and who work in communities where discrimination can pose challenges to health. The EHF video below tells the story of the collaboration between People's Community Clinic and the Austin Medical-Legal Partnership.

Dee's Story: The Dramatic Impact of Addressing Root Causes from Episcopal Health Foundation on Vimeo.

Examples

One example of a program focused on access to care is:

Epiphany Community Health Outreach Services (ECHOS)
ECHOS was originally an outreach ministry of Epiphany Episcopal Church in Houston to provide enrollment services for families. ECHOS was formed in 1999, “as an organized response to health and social services needs in the increasingly ethnically diverse area of southwest Houston.” ECHOS became its own non-profit 501(C) 3 organization in 2001.

From the ECHOS website:

The mission of ECHOS is to assist those in need of medical and social services in accessing the services that are available in a manner that promotes dignity for all. This is done both by providing on-site medical screening, support and intervention services as well as through referrals to various community service providers

In addition to getting help with completing applications for health care benefits programs, clients can receive daily screenings and referral to free or low cost services for those who have high blood pressure, high blood sugar or high cholesterol; twice weekly vision screenings; twice monthly screenings for HIV/Syphilis/Hepatitis C; and monthly screening mammograms provided by The Rose. Other medical services include monthly immunizations for children and adults and dental services provided by the University of Texas Dental Branch mobile van.

  • ECHOS—Epiphany Community Health Outreach Services
    http://www.echos-houston.org

  • Links to Information, Resources

    An access to care initiative does require some minimal investment such as: setting up the program, training for enrollers/navigators, providing computers, and communications to let people know about the program. However, programs do not need to be a large-scale clinic like the ECHOS program to make a difference in the community. An appropriate effort for some churches might be to educate the congregation and community about where enrollment support can be obtained in their community.

    Support from EHF

    EHF can provide basic information to communities about whether access to care is a significant problem in their community, and what kinds of support might be most helpful. We can also identify opportunities to link with existing organizations’ efforts toward enrollment or other supports, or how churches might develop their own initiatives to meet particular community needs. Although Episcopal churches have developed ambitious efforts such as setting up new clinics, such efforts require significant ongoing time and financial investments from churches. Therefore we encourage churches to thoughtfully consider which avenues for increasing access to care are most appropriate for their community needs and the resources they have to offer.

  • Affordable Care Act and Your Community - Health Care Law Toolkit for Faith and Community Based Organizations
    http://www.hhs.gov/partnerships/aca_act_and_community/index.html

  • The Center for Faith-based and Neighborhood Partnerships have webinars for faith and other community organizations on how to support enrollment in the Affordable Care Act.
    http://www.hhs.gov/partnerships/resources/aca_101-invite.html

  • Enroll America is an independent nonprofit, nonpartisan organization with the mission to maximize the number of Americans who enroll in and retain health coverage under the Affordable Care Act. They help consumers learn more about their new health insurance options and enroll in coverage. Enroll America works with more than 4,600 partners across the country, including city governments, hospitals, community colleges, faith institutions, and small businesses.
    https://www.enrollamerica.org/about-us/our-mission

  • The US Department of Health and Human Services holds webinars on how the faith-based community can be involved in enrollment efforts:
    http://www.HealthCare.gov

  • Spanish language website providing information on the ACA’s Health Insurance Marketplace, the website to enroll in health insurance.
    http://www.CuidadoDeSalud.gov

  • Social media on the health care law, including blogs, tweets and stories of people who now have health insurance.
    http://www.hhs.gov/healthcare

  • How to locate a community health center.
    http://www.HRSA.gov

  • Information on the Medicaid program that assists people with low incomes.
    http://www.Medicaid.gov

  • Information on the Medicare program that assists people with low incomes.
    http://www.Medicare.gov