Douglas County Community Health Plan ( .PDF )
Local governments and health care providers in Douglas County unveiled a plan Tuesday for improving the health of the community through strategies that range from improving sidewalks and bike paths to expanding access to primary care physicians and implementing federal health reform.
The Douglas County Community Health Plan is the result of 16 months of work, but organizers say the biggest challenge still lies ahead in turning the plan into action.
"The plan isn't complete," said Dan Partridge, executive director of the Lawrence-Douglas County Health Department, at the end of a wrapup meeting Tuesday morning where the document was released. "We hope that there are going to be pages at the end that articulate and describe how each of your organizations are going to move this plan forward."
The plan focuses on five components of community health: access to health foods; access to health services; mental health; physical activity; and poverty.
Within each component, the plan outlines specific goals, along with strategies to achieve those goals.
In nutrition, for example, the plan sets goals of increasing by 5 percent the number of children and adults who eat five or more servings of fruits and vegetables each day. To achieve that, it sets out strategies for improving meals offered through school and day care programs; promoting healthy options in workplaces and vending machines; and improving food and beverage options at public venues.
But organizers conceded one of the most difficult challenges will be increasing access to health care services, an area that is largely influenced by federal and state policy.
"I think Medicaid and the uninsured are both a real challenge," said Heartland Community Health Center CEO Jon Stewart. "The way our system works in the United States, insurance is just a real facilitator of opportunity for care, and if you don't have insurance you are oftentimes on the outside looking in."
Stewart said he's hopeful that more area residents will gain insurance through a health insurance exchange that the federal government will establish in Kansas and other states later this year.
The exchange, an online marketplace where people meeting certain income guidelines can buy subsidized health insurance, is one of the key elements of the federal health reform law known as the Affordable Care Act.
But Stewart said he's pessimistic that another element of health reform, expansion of Medicaid to cover all people below 133 percent of the poverty line, will be implemented in Kansas.
"Right now, for an adult, Kansas has one of the most restrictive thresholds in the nation," Stewart said.
Under current guidelines, the only adults eligible for Medicaid in Kansas besides pregnant women are those with dependent children and incomes below roughly 24 percent of the poverty line. Childless adults are not eligible in Kansas.
The U.S. Supreme Court ruled last year that states do not have to take part in the expansion if they choose not to, and Kansas Gov. Sam Brownback has not yet said whether he will agree to participate.
"I think at this point, no decision is a decision, at least for this year," Stewart said, meaning that until Kansas takes affirmative action to participate, the expansion will not occur in this state.
In other areas of the plan, however, organizers said the city and county are already making progress.
For example, the goal of reducing poverty in the county calls for expanding career and technical education in public schools, something the Lawrence school district has committed to doing with a portion of the recently approved $92.5 million bond issue.
And in the area of improving physical activity, officials pointed to the city of Lawrence's plan to build a new recreation center and its program of designating bicycle routes on public streets as positive developments.