Searching for new ways to provide health care for the most vulnerable

Despite the Pennsylvania Department of Human Services’ massive initiative over the past 20 months to expand Medicaid coverage – a plan that has resulted in adding 670,000 people to the ranks of the insured, as previously covered in City & State PA – there is still much work to be done to provide health care to the most vulnerable citizens of the state.

That was the recurring theme at City & State PA’s On Healthcare Forum, which took place Wednesday at Temple University’s Center City campus.

The event began with a keynote presentation by Evan Anderson, JD, Ph.D., a fellow at Penn’s Center for Public Health Initiatives, that focused on the issues faced by providers not just in helping people to get and stay healthy, but to even define what “healthy” is.

The rest of the forum was taken up by a panel on the challenges that arise when trying to provide health services to vulnerable populations in Philadelphia and the commonwealth. Arthur Evans, Ph.D., the commissioner of Philadelphia’s Department of Behavioral Health and Intellectual DisAbility Services, illustrated how the traditional “black box” approach to treating people with mental health issues is preventing more innovative and comprehensive approaches – ones that would reach more people for less money – from gaining traction. “What we have to do is to think more in terms of populations and addressing issues within those populations; by doing that, we improve our strategies with the most vulnerable,” he explained.

Allen Glicksman, Ph.D., the director of research and evaluation at Philadelphia Corporation for Aging, took a similar tack when describing what is being done and what still needs to be done to care for the ever-increasing number of Pennsylvanians aged 65 and over. Currently 2.1 million strong, or 16 percent of the state’s population, that number is expected to grow to 3.2 million within the next two decades. This unprecedented demographic shift, Glicksman emphasized, must be accompanied by a commensurate expansion of services that can reach not just the elderly, but the elderly living in deep poverty – defined by the government as making $5,700 or less – of whom there are almost 20,000 in Philadelphia alone.

The final panelist was Philadelphia City Councilwoman Cindy Bass, whose 8^th Council District encompasses some of those seniors, as well as citizens facing other health care challenges, including food deserts where it is easier to purchase a six-pack than to find fresh vegetables. “We have over 20 stop-and-go’s” – essentially convenience stores that sell alcohol – “in my district,” Bass said. “Someone can go in there and get their shot of Bacardi at the same time a child is buying a snack.” She added that curtailing these stores is just one of the initiatives she is in the process of pushing as the Chair of Council’s Committee on Public Health and Human Services.