Three months ago I decided to write this three part series about the Jackson County Health Care Authority. Several people within the community have commented and asked me about the layoffs and terminations of health care employees along with ambulance purchases, health care quality and financial stability of our hospital and its various clinical and health care organizations.
We are fortunate in Jackson County Alabama to have a functioning rural community hospital with its clinics and supporting organizations in Jackson County Alabama. In part 1 of this 3 part series I'll discuss history and issues of health care in Jackson County Alabama with links about the rural health care crisis in the U.S. and Alabama.
Many thanks to Mrs. Jessica Butler, Director of Marketing/Media Relations for providing me with the basic information regarding the organizational chart and basic staff information. Interviews were conducted with concerned citizens, health care authority board members, local physicians, current and former employees of the health care authority.
The Health Care Crisis in Jackson County Alabama is not a standalone problem; and yes we do have a crisis as Federal Aid for Medicaid recipients is decreasing and insurance payers reduce payments to health care facilities and care providers. Many times insurance carriers are deciding on patient treatment outside of what physicians may recommend.
RURAL HEALTH CARE ACROSS THE U.S. AT A GLANCE: ( "Excerpt from Health Affairs Blog" ) "Over the past several decades, rural hospitals have closed at alarming rates. A 2016 study identified over 650 rural hospitals vulnerable to closure in 42 states with 38 percent of 1,332 Critical Access Hospitals (CAH) operating at a financial loss. CAHs are rural hospitals that meet specified criteria (size/rurality) and have applied to the federal government for CAH designation and subsidy support. The Centers for Medicare and Medicaid Services (CMS) reimburses CAHs for Medicare patients at 101 percent of costs; however, this support is frequently insufficient to maintain solvency. The reasons for closure can be partially attributed to low admission volumes—some hospitals achieve an average daily census of four inpatients, and many intake fewer than one per day—and decreasing reimbursement from third party payers and CMS, which cannot sustain hospital operating costs."
- -Accessibility: Rural residents often travel long distances to receive services, are less likely to be insured for mental health services, and less likely to recognize the illness.
- -Availability: Chronic shortages of mental health professionals exist, as mental health providers are more likely to live in urban centers.
- -Acceptability: The stigma of needing or receiving mental health care and fewer choices of trained professionals create barriers to care.
- -Rural youth are twice as likely to commit suicide.[13
- Rural residents tend to be poorer. On average, per capita income in rural areas is $9,242 lower than the average per capita income in the United States, and rural Americans are more likely to live below the poverty level. The disparity in incomes is even greater for minorities living in rural areas.
- About 25 percent of rural children live in poverty.
- People who live in rural America rely more heavily on the Supplemental Nutrition Assistance Program (SNAP) benefits program. According to the Center for Rural Affairs, 14.6 percent of rural households receive SNAP benefits, while 10.9 percent of metropolitan households receive assistance. In all, 1.1 million households receive SNAP benefits.
- Rural residents have greater transportation difficulties reaching health care providers, often traveling great distances to reach a doctor or hospital.
- Tobacco use is a significant problem among rural youth. Rural youths over the age of 12 are more likely to smoke cigarettes (26.6 percent versus 19 percent in large metro areas). They are also far more likely to use smokeless tobacco, with usage rates of 6.7 percent in rural areas and 2.1 percent in metropolitan areas.
- Rural communities have more uninsured residents, as well as higher rates of unemployment, leading to less access to care. https://www.ruralhealthweb.org/about-nrha/about-rural-health-care
UPDATE June 20, 2017
Patients with cancer is priority #1 on the above list for a reason, the cancer death rate is high for Jackson County Alabama as reflected on the latest map from the National Cancer Institute.