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APHA Scientific Session and Event Listing

Recorded presentation

Siobhan C. Maty, PhD, MPH¹, Paul J. Bollinger, MPH², Oliver Droppers, MPH(c)³, and Karen Bishop, MPH (candidate)¹. (1) School of Community Health, Portland State University, P.O. Box 751, Portland, OR 97207-0751, 503-725-5108, maty@pdx.edu, (2) Northwest Medical Teams International, PO Box 10, Portland, OR 97207-0010, (3) Mark O. Hatfield School of Government, Portland State University, PO Box 751, Portland, OR 97207-0751

The health care “safety net” serves individuals without health insurance; those covered by government programs who cannot find clinicians to accept government-level reimbursements; and those unable to navigate the mainstream health system. The purpose of this study was to determine the capacity of over 40 public and private health-related agencies and organizations to effectively serve the rising number of people with little or no access to health care in the Portland, Oregon/Vancouver, Washington metropolitan region (six counties, three each in Oregon and Washington). Currently, more than 15% of residents in this region are medically uninsured.

Mailed, self-administered questionnaires and in-depth interviews were used to gather data from executive or medical directors of core safety-net agencies and organizations on the type and recipients of services provided; resources necessary to deliver services; their ability to obtain resources; any unmet needs; and the proportion of care provided to persons outside their service area (other county or state). Results indicate demand for health services for the safety net population is growing and that resources required to satisfy these needs are increasingly unavailable. Capacity to cope with escalating demand varies by agency/organization and geography.

Our presentation will review study results and describe dissemination efforts (community presentations, creation of policy statements, etc.) used to raise awareness of the successes and challenges of the local core safety net system. These results provide previously unavailable data for the current debate on health care delivery and financing in our region. Collaboratively determined regional action steps also will be discussed.

Learning Objectives: