Author: osheao

Image from Schenectady County home page

In terms of community health, Schenectady created the Schenectady County COVID-19 Emergency Response Coalition to respond to the COVID-19 pandemic. The coalition brought together the Schenectady foundation, the Boys and Girls Club and other local foundations to address the non-medical coronavirus-related needs of the community. The main focus of the coalition was to deliver groceries and other essentials, while also identifying services offered by partner organizations for those with additional needs: child care, legal aid etc. A hotline was created so that residents could reach out with questions whenever they needed: 518-621-3536. Residents in need of groceries or other essential items could call the number and they scheduled a drop off time for the resident. If residents were in need of greater services such as temporary housing or financial aid, the coalition stated, “Representatives from the County Department of Social Services will also be on hand to assist with shelter, temporary assistance programs and Medicaid issues. Staff will also have information about resources available to address other identified needs” (Schenectady County). This seems to have been a huge success and asset to the community. Just two months into the pandemic the coalition took over 22,000 calls, made 13,000 deliveries and helped over 8,000 residents.

Emergency Response Coalition Numbers

Ellis hospital, the local hospital in downtown Schenectady remained open and provided medical services to individuals in need. They posted a resources page on their website in which they provided information on how to have proper hand hygiene, how to access their testing site and important links and phone numbers. Schenectady also provided a couple of additional testing sites around the city in order to help limit the spread of the virus.

Union College members also make up a large part of the Schenectady community and as a whole responded promptly to the pandemic. Students and faculty were sent home immediately and those who contracted the virus were placed in quarantine until safe to return to the community. The college did a great job communicating with students and faculty and transitioned smoothly to online classes. When it was time for students to return to school they made sure to test all students before entering the community in order to prevent an outbreak in the area. Students then got tested once a week from then on. The college updates a COVID-19 dashboard daily so members are able to follow any developments in cases. 

COVID-19 Dashboard Union College 

Overall, community members were provided with many resources and reminded that they were not alone during the difficult time.

Sources:

Emergency Coalition- https://www.schenectadycounty.com/content/schenectady-county-covid-19-emergency-response-coalition-launched

Union College- https://www.union.edu/where-you-are/covid-19-dashboard

Ellis Hopsital- http://www.ellismedicine.org/covid19/public.aspx

Resource: The Joan Nicole Prince Home is a home for the terminally ill in Scotia, NY. It is free of cost to the individual; that includes all food, supplies, medicine, toiletries and anything else needed. The home runs off of donations from the community and fundraising events and has two beds available. Residents are chosen on a basis of who is in the most need when being evaluated. The home has staff members present at all times including a nurse, and volunteers. Families are allowed to visit their loved one whenever, as well as spend time in the home’s living room, kitchen or backyard. The main goal of the home is to provide a comfortable, safe place for residents and their families to spend their last days together. They pride themselves on acting as a resident’s ‘surrogate family’ and providing them with not just physical care but emotional care as well.

Who can access: In order to get a spot, individuals can be recommended by Hospice or they can call the home directly and inquire. JNPH will send a staff member out to evaluate the recommended person; the home does not take anyone with difficult behaviors, or extraordinary care needs because they are not a hospital and therefore are not properly equipped. In order to receive a spot at the home the recommended person needs to be enrolled in their local Hospice program, have a prognosis of three months or less to live, and have a DNR order.

Resource: The Community Hospice provides end of life care services to Upstate New York. The non-profit organization provides services to 8 counties: Albany, Rensselaer, Saratoga, Schenectady, Montgomery, Columbia, Greene and Washington. The organization consists of professionals (nurse, social worker, chaplain, and home health aide) as well as volunteers who “provide companionship, transportation, pick-up and delivery of medications, respite and other services” (The Community Hospice). A plan of care is developed for each individual based on the particular needs of the patient and their family. They deliver care at patient’s homes, hospitals or nursing homes, whichever is the best fit for the individual. The organization also provides free grief and bereavement support to family members as well as the general public.

Who can access: They are able to service 4,500 seriously ill patients per year and all cost is covered by Medicare, Medicaid or private insurance companies; “patients and their families rarely have to pay out-of-pockets costs for hospice care, and no one is ever turned away due to an inability to pay” they state on their website. They serve patients of any age, as long as they have a prognosis of 6 months or less to live by their physician. They are also able to service more advanced patients making it a good option for people facing any disease, including heart disease, emphysema, chronic bronchitis, cancer, kidney disease, Parkinson’s, ALS, MS, liver disease, HIV/AIDS, Alzheimer’s and dementia (The Community Hospice).

Taken from The Community Hospice website: http://www.communityhospice.org/

Resources:

http://www.communityhospice.org/

https://www.joannicoleprincehome.org/

How are different patient populations served in your community? What factors influence the patients’ access to care and how they receive care?

Schenectady is a culturally diverse city with low income neighborhoods and a wide range of ethnicities. It is largely made up of two communities: local residents and members of Union College, a private institution of 2,242 students.  Within Schenectady there are different options to help serve everyone in the community. Often times patients are without health insurance or the ability to pay for health care and this stops them from proactively seeking out treatment they need. Hometown Health, which is located at 1044 State Street, was started by a local physician volunteering in his community to help these residents. The clinic serves patients on a sliding fee discount program: “Hometown Health Centers offers a sliding fee discount program for all eligible uninsured, underinsured, and/or low income patients based on household size and family size”. This ensures that no one in this community will be turned away based on their inability to pay for what they need. They also provide assistance with translation, either through a bilingual staff member, or a free phone service to lessen the language barrier.  The literature they provide is accessible to patients in English or Spanish. The clinic is doing their best to try to get patients in the door so that they can be seen regularly and stay healthy before their symptoms escalate. One of the tools they use is their social media platform, where they are able to advertise their services in a way that might reach more residents.  New Choices Recovery Center is another valued resource in the community. Their mission statement is as follows, “New Choices Recovery Center through its caring responsive staff, provides innovative and comprehensive addiction treatment services that enhance the quality of life for the individuals and the community we serve”. They offer substance use prevention services, gambling recovery, and residential and clinical services. They do their best not to turn residents away without ensuring their safety if they are relocated to a different location or are returning home. The Center is flexible regarding payment options and tries to accommodate all residents whether that be through a sliding fee payment plan or help applying for health insurance. They have a great impact on the community and provide tremendous support to residents in need.

As far as access to health care goes there are obstacles that stand in the way of Schenectady residents. These obstacles can be broken down into physical, linguistic, and financial obstacles. In terms of the Schenectady community, physical access primarily consists of location of health care facilities and transportation challenges.  Ellis hospital is the primary hospital for the community, it’s a “general medical and surgical facility” located downtown, and also provides outpatient services at McClean Street Health Center and inpatient services at Bellevue Women’s Center (Ellis Hospital). There are bus routes that can take patients to stops near the hospital (and are handicap accessible), and Uber is accessible around the city as well. The hospital also provides a free shuttle service with regular stops at six locations around the community.  With current times, most health care providers are using Telehealth to communicate with patients. 77.2% of households in Schenectady have access to internet, so this provides a challenge for ~ 23% of residents. Schenectady is a culturally diverse community, so another obstacle is communication, if the provider is not able to understand the patient’s symptoms due to a language barrier, they will not be able to provide proper care. To accommodate patients’ needs, Ellis Hospital provides interpreter services via video remote systems. There can also be disconnects that can occur between patients and their providers regarding diagnoses and severity of diagnoses, so interpreters that are able to understand the patient’s cultural background are very important. With 17.2% of the community in poverty, some residents may be hesitant to get care because of the sheer expense. Ellis Hospital offers financial assistance to patients, “If qualified and approved, Financial Assistance reduces your Ellis Hospital bill. How much it is reduced is based on established guidelines that include: income level, existing debts, medical situation, and other indicators of inability to pay…” (Ellis Hospital). Even if the patient has insurance it can still be difficult to pay copays, for transportation to appointments or child care while at appointments if applicable. According to the U.S. census, 21.9% of Schenectady residents have a bachelor’s degree or higher; this can make higher paying jobs less accessible and therefore limit income possibilities for many residents. To remedy this, Hometown Health Centers clinic was created. Their mission states Hometown Health Centers “helps people live healthier lives by improving health outcomes and health equity through quality primary care and preventative services. Anyone seeking care, regardless of income, will be helped and treated with respect by people who are mindful of cultural uniqueness and dedicated to continuous improvement” (Hometown Health Centers). They provide a sliding fee discount program to those who are unable to afford services. As summarized above, although residents do face obstacles in accessing health care, there are resources that help to alleviate some of the barriers for the community. 

Resources:

Ellis Hospital: https://health.usnews.com/best-hospitals/area/ny/ellis-hospital-6214560

Bus Routes: https://www.cdta.org/routes-and-schedules/schenectady

Shuttle: http://www.ellismedicine.org/medical-home/community-shuttle.aspx#:~:text=Ellis%20Medicine%20offers%20a%20free,600%20McClellan%20Street%2C%20Schenectady).

Interpreter services: http://www.ellismedicine.org/patients-and-visitors/patient-information.aspx#:~:text=If%20for%20any%20reason%20you,provide%20assistance%2C%20including%20an%20interpreter.

U.S. Census: https://www.census.gov/quickfacts/schenectadycitynewyork

Health clinic: https://www.hometownhealthcenters.org/ 

Schenectady is a heavily populated city with 6,135 people per square mile and a population of roughly 65,000 residents. This is an important factor when considering the health of the community, especially during the current pandemic. The sheer density of people can make it difficult for residents to social distance and avoid contact with other infected residents. The median household income in Schenectady is $44,000 with 18.4% of people in poverty. Not all residents have the ability to buy fresh, healthy food that will allow them to boost their immunity and fight off illness, generally speaking. It often makes more sense financially for them to buy less expensive fast-food, which does not provide the nutrients needed and often further increases health conditions. The majority of Schenectady residents work hourly jobs which do not include health benefits as part of the package, making access to healthcare limited. Even if residents have insurance, many still have to worry about a co-pay for the visit. 61.4% of residents work civilian labor jobs, restricting their ability to work remotely and practice social distancing. Many residents also utilize communal transportation to get to and from work, or for other day to day needs, further increasing their exposure. 11.2% of residents under the age of 65 have a disability. Additionally, there is limited access to green space around the city; green space and grounding in nature play very important roles in lowering stress levels of residents and therefore help in potentially fighting off illness . The city has put resources in place for residents, such as the Schenectady County Public Health Services website: here they provide updates on public health concerns, mental health resources, information on how to prevent overdoses, etc. In regards to the pandemic, the city offers free testing Monday’s and Thursdays and the New York State Department of Health provides a hotline for concerns regarding the Covid-19 virus. The Schenectady Senior Community Center has had to close due to the pandemic, but they provide a telephone number so that they can be reached when needed. Hospice homes for end of life care are still accepting new residents.