A growing population of Fayetteville Arkansas is the elderly, 65 y.o and older. Projected to increase over 20% from 2013-2018. Arkansas consistently ranked one of the poorest states in the country. According to “Washington Regional Medical Center” (n.d.) “Arkansas is 400% below the poverty line. 19% of Arkansas has below 12th-grade education” (Services). It is a culturally diverse population because of the University of Arkansas and the various low-skilled jobs in the area. One of the highest growing populations is Hispanics. It is expected to grow 23% by 2018 compared to the total projected growth of 6.7% (“Washington Regional Medical Center”, n.d.). Average household income is $51,538 compared the US at $69,637 and expected to drop to $49,061 in 2018 compared to the US at $71, 917. There is a large population of uninsured, 23.3% or 41, 210 people. (“Washington Regional Medical Center”, n.d.). The top five most important health problems are obesity, heart disease and stroke, diabetes, cancer, and aging. Public Health VulnerableCultural
Agency Services Goals Prevention Populations Diversity Washington Regional Medical Center. (WRMC)
WRMC is a 366-bed, acute care medical center located in Fayetteville, Arkansas. Services include asthma care, bone density testing, cancer services, center for exercise, clinical research, diabetes education, dialysis, emergency/trauma, faith in action, gynecologic oncology, gynecology, heart services, home health, hospice, imaging, lifeline, neurology, neurosurgery, obstetrics, pain management, pastoral care, pelvic therapy, senior services, sleep disorders, urology, women’s health, and wound care (“Washington Regional Medical Center”, n.d.). WRMC goal is to improve the health of the people in the communities in which they serve through compassionate, high-quality care, prevention and wellness education (“Washington Regional Medical Center”, n.d.). Primary prevention programs include; Strike out-volunteers go to the local baseball games and hand out flyers on stroke prevention. Exercise classes at the hospitals health center, baby care classes, nutrition counseling, and stress relief classes to name a few.
Secondary prevention programs include diabetes education, CHF management, and cardiac maintenance. Tertiary prevention include, cardiac and stroke rehabilitation programs, chronic disease management programs such as diabetes, arthritis and depression, support groups for cancer, stroke, dementia, parent’s grief support and many others (“Washington Regional Medical Center”, n.d.). Elderly expected to increase by 23% by 2018. Hispanic and Marshallese related to income, education, and language barriers. Undereducated. Other vulnerable populations served include low-income, poorly educated, drug and alcohol addictions, and domestic violence victims (“Washington Regional Medical Center”, n.d.). . The Hispanic population projected to grow 23% by 2018. Washington County has the highest number of Marshallese people in the US. The University of Arkansas educates people from all over the world (“Washington Regional Medical Center”, n.d.). Department of Human Services (DHS)
DHS services include AR Kids First health insurance for children, the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps), Transitional Employment Assistance (TEA) and Medicaid. DHS pays for 64% of the babies born in Arkansas each year and for the care of 69 % of the state’s nursing home patients. DHS protects children and the elderly who have been abused or neglected; finds adoptive homes for foster children; funds congregate and home-delivered meals for the elderly; regulates nursing homes and childcare facilities; supports early childhood education; treats and serves youth in the juvenile justice system; oversees services for blind Arkansans; runs residential facilities for people with developmental disabilities; manages the Arkansas State Hospital and Arkansas Health Center for those with acute behavioral health issues. The agency also works with a system of community mental health care centers to provide mental health services to nearly 74,000 people each year (“Arkansas Department Of Human Services”, 2011).
Arkansas citizens are healthy, safe, and enjoy a high quality of life. Primary prevention includes education on alcohol, drug, and tobacco use. Prevention of domestic violence and child abuse. Nutrition education for at-risk people. Immunization education. Prenatal education. No texting and driving programs. Secondary prevention regulatory oversee of nursing homes, foster homes, adoptive parents, childcare facilities, care facilities for disabled individuals and behavioral health services. Tertiary care includes support groups, vocational rehabilitation programs to retrain workers for new jobs when they have recovered as much as possible from injury or illness. (“Arkansas Department Of Human Services”, 2011). Elderly, children, homeless, mentally ill, low-income, domestic violence, child abuse victims and the disabled. Cultural diversity with elderly, children, low-income and disabled affects all cultures, Arkansas has a mixture of Hispanic, Marshallese, Caucasian, Middle Eastern and a small variety of other cultures. Seven Hills Homeless Shelter
Services include shelter, food, financial funding and education. Funding is provided in limited amounts to assist with rent, deposits, and utilities. Education is provided for debt resolution, financial management, developing a healthy family environment and mental health referrals (“7 Hills”, n.d.). Primary goal is to help individuals and families with a stable home with resources to continue to live in the house and maintain the family by being self-sufficient (“7 Hills”, n.d.). . Primary prevention includes targeting individuals and families of lower income and education and assisting them in debt resolution, job placement, and training to prevent homelessness. Secondary prevention involves supporting people to get into a home quickly through assisting with rent, deposits, and utilities and helping them focus on remaining in their homes.
Tertiary prevention targets people who are homeless and helping them to get into homes, mental health care referrals to help those in need who are unable to hold down a job, assist veterans with their disabilities and obtaining permanent housing for them or at least providing shelters (“7 Hills”, n.d.). Vulnerable populations include low income, no income, disabled, veterans, children, drug and alcohol dependent individuals, fire or natural disaster victims, and mentally ill. Homeless does not discriminate. All cultures can be involved. Children and domestic violence make up a large portion of the homeless along with the mentally ill from all cultural backgrounds. Springwoods Behavioral Health
Services include adolescent psychiatric programs for treating youth ages 12-17 with substance abuse, depression, anxiety or other mental health issues. Adult programs for 18 and older to include alcohol and drug abuse by inpatient, day treatment, partial hospitalization and intensive outpatient programs. They also treat a full range of psychiatric illness. Specialty programs also include Center for Women which treats depressive disorders related to women’s issues, anxiety and obsessive disorders, relationship issues, eating disorders not requiring hospitalization. Other services include geriatric psychiatry which includes Alzheimer’s / dementia, acute psychotic disorders, acute and chronic depression, adjustment and grief reactions, anxiety, behavior changes, chemical dependency/dual diagnosis, medication management, mood disorders, panic attacks, social withdrawal, and suicidal impulses (“Springwoods Behavioral Health”, 2015).
Goals include allowing patients to be productive members of society through treatment, education and outpatient services. The goal to have measurable improvement in their patients, treat patients ethically and fair, work as a team with the patient and be compassionate (“Springwoods Behavioral Health”, 2015). . Primary prevention includes targeting individuals with early signs of depression and anxiety and educate them on ways of controlling or preventing the symptoms. Evaluation of pre-teens for signs of mental illness and educating schools about signs and symptoms to watch for. Secondary prevention teaching patients how to manage their symptoms, prevent new symptoms and medication and psychological treatment to maximize their functioning.
Tertiary prevention includes treating the patient, managing their medications and psychiatric treatment to improve function or to maintain a steady disease process (“Springwoods Behavioral Health”, 2015). . Vulnerable populations include patients with known psychiatric disease process, patients of domestic violence, and veterans with PTSD, mentally disabled, drug and alcohol addictions and head injury patients who have a change in their mental status. Springwoods treats the culturally diverse community to include causation, Indian, Marshallese, black, white, Middle Eastern and a variety of other cultures brought to NWA by the University of Arkansas to attend school.
Gaps Effectiveness Interaction Family
The biggest gap with WRMC is the lack of higher level of care for pediatrics, pelvic traumas, and burns. These types of patients have to be transferred to the higher level of care which means a 3-4 hour commute for families to the receiving facility. Other gaps include lack of transportation to people living outside of the city. No mental health offered in the hospital, no drug or alcohol inpatient services and limited in-house translation services. The “Washington Regional Medical Center” (n.d.) website: Washington County outperforms both state and nationally in nearly all causes of death with chronic lower respiratory disease being the only area with a significantly higher mortality rate. WRMC does referrals to outside agencies through their social service department for mental health care, drug and alcohol rehab, support group information, community needs such as homeless services, financial aid services, and other basic needs.
WRMC works with other hospitals to provide transfers for burns, pelvic trauma and pediatric oncology and critical care for pediatrics. The focus family has used and continues to use Washington regional for their health care. S.A. was first seen at WRMC when he developed swelling in his neck. He was treated and referred to his PCP, who later referred him to Arkansas Children’s Hospital (ACH) for further treatment for his Hodgkin’s Lymphoma. After S.A. Junior was diagnosed, he received intermittent treatment for fevers at WRMC. He would be treated and stabilized prior to transferring care to ACH. Department of Health Services.
Federal funding is always a problem in servicing people in need. Need for more free clinics for medical health, dental and mental health. DHS serves more than 1.2 million Arkansans every year (“Arkansas Department Of Human Services”, 2011). The agency works with a system of community mental health care centers to provide mental health services to nearly 74,000 people each year (“Arkansas Department Of Human Services”, 2011). The focus family’s children are part of the AR Kids funded health insurance program. Because of the Hodgkin’s Lymphoma, a school teacher is also sent out to the child’s home for education. 7 Hills
Lack of funding. More services needed to support the thousands of individuals and families in NWA who are in need. Need for increased free medical care, housing, food, and financial assistance (“7 Hills”, n.d.). 7 Hills served 2700 individuals and families a year using six different programs (“7 Hills”, n.d.). This is a continuing problem in not only NWA but across the United States. 7 Hills works with other agencies such as community food banks, free medical and dental clinics, financial donors, business to provide the basic needs of the homeless community (“7 Hills”, n.d.). Presently the focus family is not in need of the services provided by 7 Hills but anyone can lose their family to a fire, natural disaster, or lose their source of income. Family and friend support have greatly benefited the focus family. Community fundraisers have provided extra financial assistance; volunteer babysitters had assisted the family when they had to go to ACH and the other parent had to work. Springwoods Behavioral Health
Gaps include limited number of beds for psychiatric treatment. Limited funding inpatient drug and alcohol treatment. Of Arkansas’s approximately 2.9 million residents, close to 116,000 adults live with severe mental Illness and about 31,000 children live with serious mental health (“Springwoods Behavioral Health”, 2015). Many are repeat patient in mental health care facilities. Many diagnoses require ongoing treatment. Springwoods interacts with local law enforcement, hospitals, social service departments to provide psychiatry care of transferred patients and ongoing outpatient care. Currently, the focus family has not needed psychiatric care.
Arkansas Department of Human Services. (2011). Retrieved from
7 Hills. (n.d.). Retrieved from http://7hillscenter.org/
Springwoods Behavioral Health. (2015). Retrieved from http://www.springwoodsbehavioral.com Washington Regional Medical Center. (n.d.). Retrieved from