Are community health workers more effective in identifying persons in need of home and community-based long-term services than standard-passive approaches.

Consumers prefer home and community-based long-term care (LTC) services (HCBS) but lack information on those services. We examined the use of community health workers (CHWs) to find and help Medicaid beneficiaries with unmet LTC needs access HCBS compared to standard HCBS outreach approaches. We found that CHWs were very effective at finding persons with greater needs and were better able to help them access a greater range of HCBS services. We also found that five times fewer HCBS beneficiaries helped by CHWs had to use nursing home care services than those not helped by the CHWs despite the fact that their health status was poorer than those not helped by the CHWs. Our study provides evidence of the effectiveness of CHWs for HCBS service awareness and navigation.

Health Complaints Associated with Poor Rental Housing Conditions in Arkansas: The Only State without a Landlord's Implied Warranty of Habitability.

Arkansas is the only U.S. state that does not have a landlord's implied warranty of habitability, meaning tenants have a requirement for maintaining their rental properties at certain habitability standards, but landlords are not legally required to contribute to those minimum health and safety standards. This project assessed the possibility that this lack of landlord responsibility affects tenants' perceived health. Using surveys and interviews, we collected self-reported data on the prevalence and description of problems faced by renters who needed household repairs from their landlords. Of almost 1,000 renters, one-third of them had experienced a problem with their landlord making needed repairs; and one-quarter of those had a health issue they attributed to their housing conditions. Common issues included problems with plumbing, heating, or cooling systems, and pest or rodent control. Reported health problems included elevated stress levels, breathing problems, headaches, high blood pressure, and bites or infections. Hispanic respondents and those with less than a high school education were both significantly more likely to report problems with their landlords not making repairs as requested. These data suggest that the lack of landlord requirements may negatively impact the condition of rental properties and, therefore, may negatively impact the health of Arkansas renters.

Women's Perceptions of Provider Empathy in the Context of Healthcare Disparities.

An issue in addressing racial healthcare disparities is the need to reduce, often unconscious, provider bias. Provider empathy can overcome such bias. Patient perceptions of provider empathy were explored to identify which provider behaviors patients perceived as conveying empathy and how perceived provider empathy influenced patient-provider interactions. In this qualitative study utilizing in-depth interviews and medical records, interviewers conducted in-depth interviews with 23 patients from three clinics. Patients reported that the following influenced perceptions of provider empathy: Taking time, patient engagement, valuing the patient, clear communication, and the healthcare system. Subtle racial differences existed. This information contributes to research on empathy and patient-provider interaction and provides preliminary evidence for racial differences.

Arkansas Medicaid Family Planning Waiver services: what physicians should know.

The development of family planning services is considered one of the ten greatest achievements in public health in the United States (US) during the 20th century, enabling women to improve birth spacing and control family size. Arkansas Medicaid has expanded eligibility for family planning services to women of childbearing age with income at or below 200% of the federal poverty level (FPL). This paper describes the impact the family planning waiver has had on birth-related and economic outcomes. It also provides information that every physician should know regarding scope of services, client eligibility and provider enrollment.

Program and policy issues affecting home and community-based long-term care use: findings from a qualitative study.

This paper describes a qualitative study of factors affecting decisions about use of Medicaid-funded long-term care (LTC) services in Arkansas for the elderly (aged 65+), non-elderly adults with physical disabilities (aged 21-64), and adults with developmental disabilities (aged 18+). From focus groups with LTC service providers and key informant interviews with consumers and other decision-makers, three themes for improving LTC services emerged: (1) Leveling the playing field for home and community-based services (HCBS) and institutional services; (2) information dissemination and counseling; and (3) expanding services to meet unmet needs. Policy recommendations are made to improve access to HCBS.

The Arkansas Southern Rural Access Program: strategies for improving health care in rural areas of the state.

Rural residents often have poorer health than their urban counterparts. Many factors, including the availability of rural health care providers, contribute to their poorer health status. The Arkansas Southern Rural Access Program offers innovative strategies for improving health care in rural areas of the state including assisting with recruitment and retention, developing rural health networks, nurturing rural health leaders, and facilitating the availability of development capital to enhance the rural health care infrastructure. This paper describes the program, its components and successes, as well as how these resources can be accessed by health care providers around the state.