National aid, transmitted and modified by the state and supplemented by the community, is only beginning to be specifically applied to the housing needs of the indigent aged. It is to the question of government's role in the housing of this element of the population that this study is addressed.

The purpose of the study is to determine what effect medicare has had on the distribution of public health care expenditures in the state of Oklahoma. The study tests that there is a significant correlation between medical vendor payments and indigency in Oklahoma or in other words that pre-medicare public health care dollars in Oklahoma were distributed to indigents.

Thesis advisor: Alan Rogers / It was not until relatively recently in United States history that the right to counsel for the accused, embodied in the Sixth Amendment to the U.S. Constitution, was interpreted as a government responsibility. When the Supreme Court of the United States announced in 1963 that the states had to provide attorneys to indigent defendants in most serious criminal cases, state and local governments struggled to fund and coordinate the effort. Simultaneously, a legal services movement had reemerged for the civil legal needs of poor populations. This thesis provides a history of the progress of legal representation in both the criminal and civil contexts in Boston, Massachusetts from 1963 to 1983. It documents and examines the role of the state legislature, the Supreme Judicial Court, the Boston Bar Association, and gives special emphasis to the indispensable contributions by national entities and federally-funded legal service providers. / Thesis (BA) — Boston College, 2011. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: History Honors Program. / Discipline: History.

No description available.

Patients who are unable to comply with their health care regimen are almost 3 times more likely to have an adverse health outcome and are more likely to suffer irreversible progression of a chronic disease process. Increasing patient return clinic visits is essential, not only to curtail rapidly rising costs of health care but also to improve patient outcomes. This project focused on an uninsured patient population of a clinic in a rural community in the southeastern United States. The purpose of the project was to conduct a systematic review of the literature and identify the barriers and motivating factors for chronic care return primary care visits among uninsured patients. The theoretical models supporting the project were the health belief model and the chronic care model. A search of scholarly databases resulted in 366 articles meeting the inclusion criteria of peer-reviewed English-language literature published since 2014 that focused on outpatient care among uninsured populations. All identified articles were reviewed, and several interventions emerged as options to increase patient return rates: care transition and coordination services, patient education, patient follow up, pharmacy assistance programs, food assistance programs, and integration of computer-based literacy interventions. The clinic administrators determined that the best option for the site would be implementation of an on-site food program. The findings of this project have potential to create social change in clinics for uninsured in the community by addressing food insecurity and providing patients an incentive to return for care every 6 months.

The Indigent Care Collaboration (ICC), a partnership of Austin, Texas, safety net providers, gathers encounter data and manages initiatives for the community's medically indigent patients. One such initiative is the establishment of a care management program designed to reduce avoidable hospitalizations. This study developed predictive models designed to take year-one encounter data and predict inpatient utilization in the following two years. The models were calibrated using 2003 through 2005 data for the 41,260 patients with encounters with ICC partner providers in all three years. Predictor variables included prior inpatient admissions, age, sex, and a summary measure of overall health status: the relative risk score produced by the Diagnostic Cost Groups prospective Medicaid risk-adjustment model. Using the 44,738 patients with encounter data in each of years 2004 through 2006 data, the performance of the predictive models was cross-validated and compared against the performance of the "common sense" method of choosing candidate patients based on prior year chronic disease diagnoses and high utilization, referred to herein as the Utilization Method (UM). The 620 patients with three or more 2005 through 2006 inpatient admissions were considered the actual high use patient subset. Each model's highest-risk 620 patients comprised its high-risk subset. Only 344 high-risk patients met the UM’s criteria. Prediction accuracy was described in terms of positive predictive value (PPV), i.e., the proportion of identified high-risk patients who were high-use patients. Three of the predictive models had a PPV of near 25% or greater, with the highest, the linear model using the DCG relative risk score, at 26.8%. The PPV of the UM was 17.1%, lower than that of all predictive models. When all high-risk subsets were limited to 344 patients (the number identified by the UM), the performance of the UM and the predictive models was similar. This study demonstrated that “common sense” targets for case management can be identified via simple filter as effectively as through empirically-based predictive models. However, once the supply of easily identifiable targets is exhausted, predictive models using a measure of health status identify high-risk patients who could not be easily identified by other means. / text

No description available.

The extent of a community experiencing social vulnerability depends on the community’s ability to access resources that may contribute to coping mechanisms (either within the household or provided externally by a responsible authority) that decrease the impacts and effects of a disaster. Therefore, the purpose of this research was to identify the existence of social and institutional mechanisms that aim to reduce experiences of water inaccessibility and the causes of social vulnerability, and increase coping mechanisms within Kayamandi. Kayamandi is a low income residential community on the north-westerly periphery of the greater Stellenbosch town in the Western Cape. The research attained responses through questionnaires and surveys from residents, community organisations and responsible personnel. These surveys allowed the researcher to produce raw attribute data for each household that assisted in spatially representing vulnerable households and informing the five priority areas of the Hyogo Framework for Action. Contributing to this method of attaining information, secondary geographic data collection was obtained through the Stellenbosch Local Municipality, the National Geospatial Information Directorate and the National Demarcation Board. The findings of this thesis established that household and public water infrastructure contribute to the risk of experiencing social vulnerability that affects economic standings and quality of health within the community. Contributing to this and due to Kayamandi’s politically sensitive and historically fractioned community, social cohesion has also been noted as an area of vulnerability. Although these vulnerabilities are experienced, residents are able to implement technical, social and municipal reliant coping mechanisms. However, although efforts from Stellenbosch Local Municipality do respond to most of the key indicators within the Hyogo Framework for Action, the study found no concrete efforts within the Stellenbosch Local Municipality that illustrate integrated mechanisms to reduce the impacts of disasters and compound effects. / Magister Artium - MA

This chapter describes the implementation of two service-learning courses within the setting of a primary-care clinic for homeless and indigent individuals. The two courses are a campus-wide Introduction to Community Service and a Community Health Nursing Practicum. Although these two courses have different learning outcomes, they both address the primarygoals of service-learning, including (1) developing students' understanding about the responsibility of citizenship and preparing students for effective roles in society; (2) improving students' communication skills, problem-solving skills, and project-specific skills; (3) enhancing students' self-esteem and sense of social reality; and (4) providing an interdisciplinary perspective (Kendall and Associates 1990). The sections that follow describe the setting that the two service-learning courses share, the university-wide course, and the community health nursing practicum. Common issues faced in both courses that are discussed include reflective learning practices, community/client impact, communicating expectations to the student and the site personnel, collaboration to accomplish both service and learning outcomes, and practical issues associated with service-learning in a clinic for the homeless and indigent.

<p>The extent of a community experiencing social vulnerability depends on the community&rsquo / s ability to access resources that may contribute to coping mechanisms (either within the household or provided externally by a responsible authority) that decrease the impacts and effects of a disaster. Therefore, the purpose of this research was to identify the existence of social and institutional mechanisms that aim to reduce experiences of water inaccessibility and the causes of social vulnerability, and increase coping mechanisms within Kayamandi. Kayamandi is a low income residential community on the north-westerly periphery of the greater Stellenbosch town in the Western Cape. The research attained&nbsp / responses through questionnaires and surveys from residents, community organisations and responsible personnel. These surveys allowed the researcher to produce raw attribute data for each household that assisted in spatially representing vulnerable households and informing the five priority areas of the Hyogo Framework for Action. Contributing to this method of attaining information, secondary geographic data collection was obtained through the Stellenbosch Local Municipality, the National Geospatial Information Directorate and the National Demarcation Board. The findings of this thesis established that household and public water infrastructure contribute to the risk of experiencing social vulnerability that affects economic standings and quality of health within the community. Contributing to this and due to Kayamandi&rsquo / s politically sensitive and historically fractioned community, social cohesion has also been noted as an area of vulnerability. Although these vulnerabilities are experienced, residents are able to implement technical, social and municipal reliant coping mechanisms. However, although efforts from Stellenbosch Local Municipality do respond to most of the key indicators within the Hyogo Framework for Action, the study found no concrete efforts within the Stellenbosch Local Municipality that illustrate integrated mechanisms to reduce the impacts of disasters and compound effects.</p>