The objective of this study is to examine the level of awareness of and interest in the Health Insurance Marketplace in West Virginia. Primary survey data were collected in July/August 2013 from a stratified sampling of West Virginians. A mailed survey was completed by respondents in a cross-sectional study. Key variables included general awareness of the Health Insurance Marketplace and the availability of subsidies, the individual mandate, interest in using the Marketplace, and perceptions of respondents' ability to qualify for financial assistance. A total of 6000 surveys were mailed containing a 9-page questionnaire; 1198 completed surveys were returned. Two months prior to launch, awareness of the Health Insurance Marketplace was low in West Virginia, yet interest in the Marketplace was higher among those most likely to benefit--the uninsured and residents likely to qualify for financial subsidies. West Virginians reported being familiar with the individual mandate. Efforts should be increased among government and nongovernment organizations at the federal, state, and local levels to heighten awareness of the Health Insurance Marketplace in West Virginia and, particularly, the availability of subsidies. Many, once made aware, expressed interest in learning more.
Keywords expanded core curriculum, independent living skills, individualized plan of employment, individualized education program, teacher of students with visual impairments, vision rehabilitation therapist, transition, collaboration, pre-ETS, vocational rehabilitation
Objective: To determine the impact of community participation on nonprofit hospital priorities as outlined in a Community Health Needs Assessment. Design: Using 3 completed Community Health Needs Assessments, we compare key stakeholder survey responses with community survey responses and determine their contribution to the finalized priorities. Setting: Three communities in West Virginia served by nonprofit hospitals (1 metropolitan statistical area, 1 micropolitan statistical area, and 1 rural community). Participants: Key stakeholders and the general population of communities served by the hospital. Main Outcome Measure: Finalized priorities as outlined in the Community Health Needs Assessment. Results: Community participation had an impact on finalized priorities. Conclusion: Community participation is key in identifying unique health needs and should be incorporated into the assessment process by nonprofit hospitals, local health departments, and other public health practitioners. As reforms are considered to the Patient Protection and Affordable Care Act, it will be important to emphasize the importance of community input in identifying ways nonprofit hospitals contribute community benefit. CHNAs without adequate public input may not translate into implementation plans that accurately address pressing health concerns.
There is growing recognition that home visitation programs serving at-risk families may be an appropriate mechanism for detecting and reducing intimate partner violence (IPV). More research is needed about how home visitors assess and respond to IPV, especially in rural and underserved areas with unique social and geographic challenges. This study describes the qualitative, needs assessment phase of a larger mixed-methods evaluation of IPV assessment, referral processes, and safety planning with clients within a statewide home visitation program. Three focus groups were conducted with home visitors ( n = 16) in West Virginia’s Home Visitation Program in May 2015. Home visitors represented four separate home visitation models and provided services across 12 of West Virginia’s 55 counties. Guiding questions focused on home visitors’ current protocol, experiences, barriers, and facilitators to (a) screening and assessment for IPV, (b) making referrals after disclosures of IPV, and (c) developing safety plans with IPV-exposed clients. Barriers identified by home visitors included the nature of assessment tools, issues with service availability and access in rural areas, and lack of education and training surrounding safety planning. Facilitators included building relationships and trust with clients, providing anticipatory guidance when making referrals, and tailoring safety plans to clients’ unique situations. Participants also expressed a critical need to develop procedures for assuring home visitor safety when supporting IPV-exposed clients. These qualitative data highlight issues surrounding the management of IPV in home visitation and have the potential to inform future enhancements to programs that are specifically tailored to the needs of rural, disadvantaged communities.
Older adults with visual impairments may benefit from Blindness and Low Vision (BLV) rehabilitation services, such as Vision Rehabilitation Therapy, Orientation and Mobility, Low Vision Therapy, and Assistive Technology. BLV services can be provided in the consumer's home or at rehabilitation facilities. Vision rehabilitation therapists provide adaptive independent living skills instruction and resources to individuals, who are blind and visually impaired, and their families for the performance of activities of daily living. Low vision eye care specialists assess clinical visual acuities and fields using standardized testing protocols. Wearable filters are prescribed after completion of an individualized evaluation with a low vision rehabilitation specialist to address the specific glare challenges in the actual or best simulated environment in which the challenges are experienced. To support computer use, there are available built-in accessibility features as well as specialized software that provide both visual and nonvisual access.
Emergency department (ED) use, by both insured and uninsured, leads to significant health care costs in the United States. While frequent ED use is often attributed to the uninsured, there is some evidence that insured populations also report utilizing the ED when otherwise preventable or nonurgent. We conducted in-person surveys of patients visiting the ED at a large research hospital and examined the differences in their characteristics based on the health insurance status. While less than the uninsured, insured individuals still report barriers to access to care outside the ED that include lack of access to another health care facility and unavailability of a doctor's office or clinic.
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