Access to Care:
 
Improving access to quality health care is critical towards eliminating health disparities and increasing the quality and quantity of life for all Arizonans. In particular, improved access to clinical preventive services such as screening tests and immunizations can reduce the number of preventable diseases and conditions. To facilitate the provision of such preventive services, it is important that individuals and families have an identified source of ongoing primary health care, i.e., a medical home.

Unfortunately, Arizonans face severe barriers in accessing health care. For instance, data from the 1999 Current Population Survey (U.S. Census Bureau) indicates that 21.2% of all Arizonans lack health insurance coverage. Only Louisiana, Texas and New Mexico have higher rates of uninsurance. This high rate of uninsurance is troubling since uninsured individuals are more likely to report poor health status, delay seeking medical care and forego necessary care for potentially serious symptoms. Indeed, many uninsured Arizonans rely on hospital emergency rooms for primary and preventive care; it is estimated that 150,000 visits to Arizona hospital emergency rooms could be prevented through improved access to primary health care.

Culture and language represent another barrier to health care access. Arizona is 20% Hispanic and has the 2nd largest number of American Indians in the nation; this suggests the need for the broad availability of culturally competent health care. In addition, as baby boomers continue into middle age and beyond, the need for adequate long term care availability and geriatric care providers will increase. By 2010, it is estimated that over 900,000 Arizonans will be 65 years of age or older.

Physical distance and lack of transportation exacerbate problems in accessing health care, particularly in a state with the 6th largest land mass in the nation. Rural and frontier areas have difficulty in recruiting and retaining health care providers. Currently, 96 areas of Arizona are designated by the federal government as Health Professional Shortage Areas (HPSAs). These areas include shortages in primary care, dental and mental health providers.

Some progress has recently been made in improving access to health care in Arizona (e.g., KidsCare and Proposition 204). Additional efforts in the areas of provider cultural competency, long term care availability, clinical preventive services and provider distribution are needed in the next decade to confront disparities and ensure maximal quality and quantity of life for all Arizonans.

Objective #1 
Increase the proportion of persons with health insurance.
 
Strategy 1.1 
Increase public awareness of the availability of health insurance and how to access it.
Strategy 1.2 
Simplify the eligibility and enrollment process for acquiring and maintaining health insurance.
Strategy 1.3 
Expand coverage under existing health insurance programs.
Strategy 1.4 
Create alternatives to existing health insurance programs.

Objective #2 
Increase the proportion of persons who have a specific source of ongoing care (medical home).
 
Strategy 2.1 
Increase public awareness of the importance of having a specific source of ongoing care and how to access services.
Strategy 2.2 
Reduce barriers to utilization of a specific source of ongoing care.
Strategy 2.3 
Expand availability of sources of ongoing care.
Strategy 2.4 
Reduce fragmentation among health care programs and services.

Objective #3 
Increase the proportion of persons with access to clinical preventive services.
 
Strategy 3.1 
Increase public awareness of the importance of healthy lifestyles, clinical preventive service guidelines, and how to access preventive services.
Strategy 3.2 
Increase provider knowledge of basic clinical preventive services guidelines, follow-up counseling, and funding.
Strategy 3.3  
Increase promotion of and access to clinical preventive services through increases in funding and changes in policies and practices.
Strategy 3.4 
Increase the availability of programs that provide clinical preventive services.

Objective #4 
Increase the cultural competency and cultural sensitivity of health care providers.
 
Strategy 4.1 
Identify best practices related to increasing the cultural competency and cultural sensitivity of health care providers.
Strategy 4.2  
Increase availability of and participation in continuing education that promotes cultural competency and cultural sensitivity for health care providers.
Strategy 4.3 
Increase availability of and participation in training that promotes cultural competency and cultural sensitivity among students in health care professional education programs.
Strategy 4.4 
Increase the number of minority students in the health care professions in order to promote greater attention to and understanding of issues related to cultural competency and cultural sensitivity in health care education and practice.

Objective #5  
Increase the proportion of persons with long term care needs who have access to the continuum of long term care services.
 
Strategy 5.1  
Increase public awareness of the availability of services and how to access them.
Strategy 5.2 
Increase health care provider knowledge of long term care service options and available funding resources.
Strategy 5.3 
Develop and implement mechanisms for linking individuals and families who need long term care services with appropriate resources.
Strategy 5.4 
Increase the range of affordable long term care service options.
Strategy 5.5 
Encourage the development of long term care services that promote and prolong independence and that strengthen family support systems.
Strategy 5.6 
Reduce fragmentation and promote continuity among providers of long term care health services.
Strategy 5.7 
Promote access to long term care services for all persons, including rural and minority populations. Explore utilization of telemedicine and other alternative delivery systems.