Georgia’s Uninsured and the Healthcare Safety-Net

This is the second entry in a series of posts highlighting GCO’s new report, Increasing Access to Quality Healthcare for Low-Income Uninsured Georgians. The first entry provided an overview of the report .

Unfortunately, 19 percent of Georgians lack health insurance, the sixth highest percentage in the country in 2012.[i] Of the nonelderly uninsured, 56 percent live in households that make less than 139 percent of the federal poverty level (FPL), which is $16,221 for an individual and $33,151 for a family of four.[ii]

While it can be difficult for uninsured individuals to find care – particularly those with low-incomes – some uninsured individuals access care through Georgia’s healthcare safety-net. These providers include community health centers, charity clinics, public hospitals, local health departments, and private office-based physicians who provide limited free care.[iii]

Community Health Centers

The state’s community health centers provide primary and preventive care to many uninsured individuals on a sliding fee scale based on patient or family income. In 2011, Georgia’s Federal Qualified Health Centers (FQHCs) – local, non-profit, community-owned healthcare providers – served more than 317,000 patients at 152 delivery sites across the state. Of the FQHC patients, 51 percent were uninsured. The National Association of Community Health Centers estimates that 13 percent of Georgia’s low-income uninsured population was served by an FQHC in 2011.[iv]

Charity Clinics

Uninsured individuals in 90 of Georgia’s 159 counties have access to a charity clinic as another option to help meet their primary care needs. In 2012, the state’s 96 nonprofit, independent charity clinics served 183,625 unique patients, and 62 percent of these patients were below the poverty level.[v] Due to their volunteer nature, clinics are able to provide an average of $7 worth of services for every $1 invested, and the average cost per patient visit is $29.[vi]The total value of the services provided by Georgia’s charity clinics in 2012 was over $200 million.[vii]

Public Hospitals

In addition to community health centers and charity clinics, many uninsured patients seek care in hospital emergency rooms. Since many low-income uninsured individuals can only afford a small portion of the care they receive and hospitals are required to provide emergency healthcare to anyone needing it, providers are often uncompensated for the services they provide. In 2012, Georgia hospitals provided $1.6 billion in uncompensated care, including $936 million in free, indigent, and charity care and $671 million in care for which the patient did not pay his or her bill and was not qualified for the hospital’s indigent or charity care programs.[1],[viii]


[1] Uncompensated care is an overall measure of hospital care provided for which no payment was received from the patient or insurer. It is the sum of care for which the hospital never expected to be reimbursed and care for which it is unable to obtain reimbursement for the care provided, called “bad debt.” Uncompensated care excludes other unfunded costs of care, such as underpayment from Medicaid and Medicare.

[i] The Henry J. Kaiser Family Foundation, “Health Insurance Coverage of the Total Population,” accessed March 12, 2014, http://kff.org/other/state-indicator/total-population/.

 [ii] The Henry J. Kaiser Family Foundation, “Distribution of the Nonelderly Uninsured by Federal Poverty Level,” accessed March 12, 2014, http://kff.org/uninsured/state-indicator/distribution-by-fpl-2/?state=GA.

 [iii] Mark A. Hall, “Health Care Safety Net Resources by State,” Robert Wood Johnson Foundation, February 2012, http://www.rwjf.org/en/research-publications/find-rwjf-research/2012/02/health-care-safety-net-resources-by-state.html.

 [iv] National Association of Community Health Centers, “Georgia Health Center Fact Sheet,” http://www.nachc.com/client/documents/research/GA12.pdf.

 [vi] Georgia Charitable Care Network, “Georgia Charitable Care Network – Partners in Georgia’s Safety Net,” Handout provided by the Georgia Charitable Care Network.

 [vii] Ibid.

 [viii] Georgia Hospital Association, Hospitals 101: A Resource Guide for Elected Officials, Fourth Edition, February 2014, 3, https://publications.gha.org/Portals/4/Hospital101UpdatedApril2014.pdf; American Hospital Association, “American Hospital Association: Uncompensated Hospital Care Cost Fact Sheet,” January 2013, http://www.aha.org/content/13/1-2013-uncompensated-care-fs.pdf.


Breakthrough Norcross Partners with Local Elementary School

Breakthrough Norcross, after nearly two years of working toward establishing a collective impact project to improve educational outcomes for Norcross students, partnered with Beaver Ridge Elementary to offer a Robotics camp for their rising fourth and fifth graders. Students who are interested in the subject of Robotics were able to sign up for a weeklong day camp over the summer, and, as a  part of my summer internship with Georgia Center for Opportunity, I had the opportunity to check out what was going on at the Robotics Camp ­– dubbed Beaver Bots – last Thursday.

Environmentally, the robotics room is a collection of the parts, programs, and challenges for the robots that would be the primary tool of the weeklong camp. Two teachers facilitate the camp for approximately 30 students, who all spend most of their time in the robotics room. The Mindstorms, as the machines are officially named, are designed by Lego with the capacity to carry out a series of complex tasks. Various challenge courses are then set up in order to test the robots and their human operator through a diverse array of task completion.beaver bots1

The teachers lead each of the kids through the tasks at a very basic level that eventually handed over full reign of the robots and their programming to the kids. In fact, the teachers made it their mission to equip and not baby their students, and the kids loved it. The kids would cheer each other on through their successes and encourage each other through their missteps. Both boys and girls were learning to wrestle with the complex tasks assigned to them, and this development of perseverance – or grit as some call it – served as the crux for success in future tasks for the club.beaver bots

One of the students was so excited about her experience there that she couldn’t help but exclaim how much she loved working with her friends and other students. She remarked that it wasn’t about winning or losing, although that was a component of the camp; but it was about trying your hardest and having fun with friends.

Of course, there were winners and losers, but the winners encouraged the losers, and the losers cheered on the winners; and everyone was having fun. Furthermore, and most significantly, the kids were not criticizing each other for their initial shortcomings on the challenge field. In fact, they outright refused to submit to failure, consistently returning to  the drawing board until they found success.beaver bots2

Kids are playing with robots, encouraging each other, and carving a pathway into higher learning. It sounds utopic and in some regards it really is. It’s the start of something great, albeit unfinished. It’s just one small part of a larger story that’s unfolding through Breakthrough Norcross, and I have a feeling that the best is yet to come.

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This blog was written by Patrick DeMartino.  Patrick is pursuing a B.S. in Psychology from the University of Georgia.  This is his second summer interning with GCO working to support our Solution Delivery work.

Family Promise – Providing a Hand-Up

Photo found at http://www.stmaustin.org/catholic-single-parents.

Photo courtesy of St. Thomas More Catholic Church,  http://www.stmaustin.org/catholic-single-parents.

When someone mentions the word homeless, what picture first comes into your mind? A person huddled under a bridge in a sleeping bag or lying on a park bench next to a grocery cart with a few belongings; or perhaps a person standing on the street corner holding cardboard sign that reads, “Hungry. Anything Helps.”  While these are tragic pictures of the reality of homelessness in our country, many people are homeless in less overt ways all around us.

In its simplest form, a person is homeless if they lack stable housing.[i] This situation may include a wide range of circumstances, from living on the street, to staying in a shelter or transitional house, to doubling-up with family members or friends for a short period of time. The stark reality is that those who are homeless face instability, and this takes a toll on people, especially children.

Georgia has a number of organizations that work to address the issue of homelessness. One notable organization, Family Promise of Gwinnett County, Inc. (Family Promise), focuses specifically on addressing the needs of families that have become homeless due to a temporary change in circumstances like losing a job. This interfaith non-profit is part of a national organization founded in 1986 which has 182 local organizations nation-wide. Family Promise’s mission is “to mobilize communities of congregations that partner with social service agencies to end homelessness – one family at a time.”[ii]

Family Promise stands as one of the few shelter programs in Gwinnett that specifically target homeless families. Their emphasis on families as opposed to individuals is rooted in the reality that families with children are among the fastest growing segments of the homeless population.[iii] Estimates in Gwinnett County show that 60 percent of the homeless family population consists of children, and 50 percent of these children are under the age of six. This reality is reflected in the Gwinnett County School System which accommodated over 3,000 homeless students during the 2011-2012.[iv]

Georgia as a whole ranked 41st in the nation in matters related to child homelessness in 2010, having an estimated 45,566 homeless children.[v]

Most of the families served by Family Promise are single-parent households, and 60 percent of their guests have experienced situational homelessness before.[vi] Families must go through a thorough interview process to qualify for the 30 to 90 days shelter program, which involves a review of their work history, evictions, criminal background, and drug history. In addition, families must have a child under 18 years of age to qualify for the program, and at least one person in the household is required to have at least a part-time job during their stay.

Families stay in the program 51-55 days on average. They must move to a new host church every week as a way preventing them from becoming too comfortable and as a way of balancing the demand placed upon the host churches. Participants are required to actively search for a job and to work regularly once they obtain one. Typical jobs that participants obtain include fast food service, retail, housekeeping, landscaping, and customer service.

In 2013, Family Promise served a total of 38 families of whom 74 percent graduated from the program. Of these graduates, 55 percent had a job and 64 percent had a place to live upon leaving the program.[vii]

Chuck Ferraro, executive director of Family Promise, estimates that there are more than 400 churches of various sizes in Gwinnett. His job is to recruit these churches to be partners by agreeing to house up to four homeless families in their church building for one week out of the year. Currently, families rotate weekly among 30 Host Congregations in the network. Each host congregation is responsible for providing lodging, three meals a day, and general hospitality three to four times a year. Lodging consists of church classrooms and other open rooms in the building that can be converted into living spaces for these families during the week. Churches are able to do this in areas of their buildings that require limited use during the week.

Ferraro said that if he can get thirteen churches committed to housing a homeless family once a quarter, the needs of families that they serve could be covered for an entire year. However, getting churches to make this sort of commitment is a major challenge, he expressed. They are often pulled in a variety of directions when it comes to ministry focuses, and housing homeless families is not always a popular draw (despite the fact that caring for the poor is a central mission of the Church, he argues).

Nonetheless, Ferraro explained that there are ample opportunities for congregations to be involved in the work besides hosting families, and these include providing regular volunteers and funding. Volunteers are essential to the success of Family Promise as they provide a wide range of services that keep the program in operation, from cooking and serving meals, to playing with children and helping them with homework, to interacting with guests and providing overnight security.

As a way of addressing the needs of families beyond the immediate shelter program, Family Promise has created an aftercare program that supports families for up to a year after their time in the shelter program. Families who enter the aftercare program will receive case management, parenting and nutrition classes, and financial support that will help them on their pathway toward self-sustainability. The organization is looking to target twelve families per year for this program.

Addressing the needs of homeless families can be an overwhelming task. However, when members of a community join together to serve in the unique capacity that each is able, a tangible and significant difference can be made in the life and trajectory of a family.

 


[i] National Health Care for the Homeless Council, “What is the official definition of homelessness?” accessed June 23, 2014, http://www.nhchc.org/faq/official-definition-homelessness/.

[ii] Family Promise of Gwinnett County, Inc., “A Recovery & Sustainability Program for Homeless Families,” Brochure, received June 6, 2014.

[iii] National Coalition for the Homeless, “Who is Homeless?” Fact Sheet, July 2009, accessed June 23, 2014, http://www.nationalhomeless.org/factsheets/who.html.

[iv] Family Promise of Gwinnett County, Inc., “A Recovery & Sustainability Program.”

[v] Ellen L. Bassuk et al., America’s Youngest Outcasts 2010: State Report Card on Child Homelessness, The National Center on Family Homelessness, December 2011, 35, http://www.homelesschildrenamerica.org/media/NCFH_AmericaOutcast2010_web.pdf.

[vi] Interview with Chuck Ferraro, Executive Director at Family Promise of Gwinnett County, June 6, 2014.

[vii] Family Promise of Gwinnett County, Inc., “A Recovery & Sustainability Program.”

Changing the Paradigm: Restorative Justice and America’s Criminal Justice System

Below is a guest blog by Jesse Wiese, Policy Analyst at Justice Fellowship, the legislative advocacy arm of Prison Fellowship Ministries. 

Image Credit: Molly Rowan Leach/Feverpitched. All Rights Reserved.

Image Credit: Molly Rowan Leach/Feverpitched. All Rights Reserved. Found at Transformation.

For decades America has taken a “tough-on-crime” approach to criminal justice. This philosophy has generated little in the way of positive results and has resulted in burgeoning state budgets, overcrowded prisons, and low success rates.  States are beginning to understand that we cannot incarcerate ourselves out of the problem of crime and recidivism. Fortunately, lawmakers are beginning to shift from a “tough-on-crime” approach and focus more on the science of criminology, or evidence-based-practices. This shift, however, is motivated predominantly by shrinking state budgets and the need to reduce the rising cost of corrections.

These reforms, while positive, do not go far enough. If we want to realize lasting change within the criminal justice system, we must do more than trim state budgets, institute new programs, or provide staff training — though these actions offer a good starting point. What is needed is a paradigm shift. We as a society need an altering of the lens through which we view crime, the men and women who commit it, and the victims and communities it affects. For a criminal justice system to be truly effective, it must recognize the broken moral foundations which lead to crime and provide a philosophical basis that perpetuates and restores the notions of human dignity and value.

Restorative justice addresses inefficiencies of the status quo and offers solutions that can provide lasting and refreshing change. By placing the victim at the center of the case, restorative justice places government in its rightful role as a facilitator of justice rather than a direct party. More importantly, restorative justice prioritizes victim participation, promotes offender responsibility, and cultivates community engagement. Identifying the needs and responsibilities of these three parties — victims, offenders, and community — is the fuel to realizing restorative outcomes and can be summed up in the following three questions:

First, do the victims and survivors of the criminal act have the right and opportunity to be validated and restored? Under the current system, the proper status of victims and survivors is usurped by the government’s unbalanced role of both victim and prosecutor. Restorative justice promotes the need for victims to be consistently considered throughout the criminal justice process. Although criminal acts often result in damages that can never be fully restored, victims and survivors have legal rights that should be enforced. Victims and survivors of crime may also need help regaining a sense of safety and control over their lives and assistance with damages they suffer, material or otherwise.

Second, are offenders given a fair process, proportionate and definitive punishment, and the expectation and opportunity to make amends? Restorative justice requires that the criminal justice system do more than warehouse people convicted of crimes. By holding men and women accountable for the harm they have caused to their victims and communities, the restorative justice process requires these men and women to take the necessary steps toward making amends and rebuilding trust within their communities. With the goal that those convicted of a crime are treated with dignity and fairness, restorative justice can ensure that punishments delivered will be proportional to the harm caused by the offense.  Through this approach offenders are offered an opportunity for a fresh start, even if incarceration is necessary.

Third, is community safety improved and do communities play a role in restoring victims and those who have completed criminal punishment? Because crime affects communities by eroding public safety and confidence, disrupting order, and undermining common values, communities need to play an integral role in the restoration process. Additionally, communities can actively work to support victims and survivors of crime and help to facilitate the reintegration of those who have completed their criminal punishment. Government should, in turn, promote safety through proven crime reduction practices and the promotion of community education and solutions.

As a society, we have begun to consider the consequences of a “tough-on-crime” approach to criminal justice. Fortunately, there seems to be wide ranging support across both the political and religious spectrums for moving toward a system of restorative justice. However, the much-needed restorative justice reforms will only take place if citizens like you and me speak up, join together, and advocate for change.

You can do so by joining the Justice Fellowship Network. You will be kept up-to-date about reforms that advance restorative justice principles in your state and given opportunities to advocate for those reforms.

 

School May Be Out, But The Grades Are Coming In

courtesy photos-public-domain.com

courtesy photos-public-domain.com

This week, the Center for Education Reform released its Education Tax Credit Rankings and Scorecard, which evaluates the fourteen tax credit funded scholarship programs across the country.

Georgia’s program, which was created in 2008, received a “B”.

The Georgia program scores well in many of the categories like program design and eligibility requirements.  However, we fall out of the top of the rankings because the total program is capped at $58 million annually–which might sound like a lot of money but actually only represents 0.14% of the overall state budget.  The program is so popular, the $58 million cap was reached this year in just three weeks.  Nearly all of the Student Scholarship Organizations who distribute the scholarships to students have waiting lists.

By contrast, the Florida program, which received an “A”, allocates $286 million in tax credits to fund scholarships that allow almost 60,000 students to attend a school that better meets their individual needs.

Arizona, the other state receiving an “A” grade, does not limit the total dollar value of individual donations and caps corporate donations at $36 million annually.  There are more than 42,000 students on tax credit scholarships in Arizona.

Georgia’s program serves about 13,000 students who have moved from a traditional public school to a private school using scholarships funded by individuals and corporations who receive a tax credit for their donations. That represents a mere .007% of Georgia’s 1.7 million public school students.

Because every child is different, we need a variety of options at our disposal when it comes to education.  Tax credit scholarships are just one of many ways we can ensure that all Georgia children have access to a quality school.  And given our grade in the report card, perhaps we still have more to learn from other states that continue to give even more families the flexibility to meet the educational needs of their children.

To learn more about Georgia’s Tax Credit Scholarship Program and other school choice options in the state, see our 2014 School Choice Handbook.