Improving the quality and cost-effectiveness of publicly financed health care
Empowering People to Take Control of Their Health: One Community-Based Organization's Experience
Greg had out of control diabetes, unchecked hypertension, severe pneumonia, and was homeless when he was first introduced to the HEALTH Project. Now, 18 months later, he is on the mend and taking an active role in maintaining his health and his life.
"When people have control over their health, it gives them confidence to address other areas in their lives such as education, employment, and housing," says Petra Stanton, Health Services Director at MAAP. Through a $50,000, one-year grant from the Center for Health Care Strategies, the HEALTH Project*, conducted by MAAP, a non-profit community-based organization in Sacramento, California, empowered homeless people and people living in transitional housing with disabilities and chronic illnesses served by Medicaid, to access timely, quality health care services. More specifically, the grant project trained 18 homeless or formerly homeless Medicaid consumers to serve as peer counselors and reached more than 300 others through workgroups focusing on diabetes and Hepatitis C. The peer counselors continue to work with other homeless people to help train them about how to navigate the healthcare system and manage their own care. Based on a pre- and post- survey, participants' involvement in managing their own care rose from two percent to 87 percent in one year.
"The key to the success of this project was finding consumers who were concerned about their health, taking the time to build relationships, giving them respect, and developing an approach where they can see immediate results," says Stanton. For instance, the Hepatitis C group participated in a Liver Walk that raised funds for Hepatitis C research and gave participants an opportunity to meet others dealing with the same illness.
Another reason for the success of the Hepatitis C and diabetes consumer groups is the active role of the participants. For example, the diabetes group holds weekly cooking classes to educate consumers with diabetes on how to prepare healthy meals. The class includes a trip to the local food closet. Participants learn about proper dietary options in addition to learning how to manage their diabetes. Each week, participants prepare a healthy meal that resembles the types of foods they could cook in their own apartments (transitional housing complexes). The group currently is writing a cookbook. Local response to this project has been very positive - in fact, the University of California at Davis has agreed to continue running the nutrition class, and the diabetes group recently held a training session to mobilize other community-based organizations to develop similar initiatives. In addition, the grantee held a Hepatitis C training session for case managers, nurses, social workers, and mental health workers.
The HEALTH Project continues to be an integral component of MAAP's work to empower the homeless to manage their own health care needs. "Project participants are actively working together and joining forces with other community agencies to change the system and assure that medical services are available for the chronically ill and disabled in the community," says Stanton.
* formerly of the Community Services Planning Council