Stand Up and Get Care: A Healthcare Campaign in New Orleans
by Ariel White, (Former City Accelerator New Orleans Project Lead with 5o4 HealthNet)
After Hurricane Katrina hit New Orleans in August of 2005, the city was fundamentally changed. As the community came back to rebuild a devastated city health care organizations and local leaders used this as an opportunity to transform the previous system. For years care delivery for the uninsured was through Big Charity, a public hospital located in down town New Orleans. A visit to Big Charity was familiar to many people because they had been going through the giant concrete building for years with their grandparents, parents and their own children. Patients always knew that they would be taken care of at Charity, even if they had to wait.
Charity was closed following the storm forcing people to receive health care in other locations that were not there previously. Out of this need for primary and preventative care to be delivered across a city still rebuilding sprang a network of clinics. They took on the task of putting the health and wellness of the community at the forefront of their work.
This network is still in place ten years later, and built more robustly than ever. In the Greater New Orleans area there are 11 Federally Qualified Health Centers and 11 more service providers that accept patients regardless of their ability to pay. With more than 60 locations scattered across the region they have created opportunities for the community to manage their health in their own neighborhood. The Greater New Orleans area also has received a Medicaid waiver which grants free primary care and behavioral health visits to people living below 105 percent of the Federal Poverty Level. This means that the most vulnerable citizens have the ability to take care of their physical and mental wellbeing. This program, called the Greater New Orleans Community Health Connection (GNOCHC), provides coverage to more than 60,000 people in the region.
In 2014 the Department of Health and Human Services Medicaid Office realized that close to half of the individuals enrolled in the GNOCHC program had not seen their doctor in the last two years. This number is concerning on its own, but especially for New Orleans where there is a history of some of the worst health care outcomes in the nation. In the city 12% of babies are low birthweight, compared to 8% nationally, 12% of residents are diabetic, compared to 9% nationally and Orleans is consistently in the top five among US cities for HIV, and syphilis case rates. Since many of these cases can be addressed, prevented or mitigated in a primary care setting, getting people into care is more important than ever.
Stand Up and Get Care
As a result of the number of people who have not had a primary care visit in the last two years, the City’s Office of Performance and Accountability, the Office of Neighborhood Engagement, the New Orleans Health Department and 504HealthNet partnered to find out why so many people have not seen their doctor recently. Getting people to talk about their health is hard — it is a personal issue that is typically dealt with in a private setting.
Stand Up and Get Care was established to answer two questions: why are people not going to the doctor, and what can the City and their partners do to help. In order to get to those answers, small group meetings, and a larger Design Day event were held to ask participants to define and design their own solutions to the problems they see in the health care system.
The ideas on how to fix the issue spanned the gamut and included: implementing text message reminder programs, producing health care awareness rap songs, advertising the closest clinic locations, posting the cost scale publicly, and many other options.
The ideas were voted on by Design Day participants, and have a chance to be implemented by the City and their partners.
The result of Design Day is an outreach and education plan that will work to engage patients and get them into care through a variety of mediums from text messages, to community organization partners, and a group of community advocates who will be willing to talk about health to their family and friends. The community is looking for a place to go where they know they will be taken care of — and these places exist, we just need to build a better network of trust throughout the city.
Stand Up and Get Care: Meaning
The name Stand Up and Get Care asks people to take an active role in their health and the health of their communities. It also parodies the song played when the New Orleans Saints make a touchdown (although it has not been used much recently, thanks to our somewhat painful losing record).