Cutler Institute for Health and Social Policy

Access to Medical Care in Rural America

Abstract: 

Rural residents face many barriers to accessing appropriate medical care, and often have to coordinate care across long distances with few supportive resources. Erika Ziller, Deputy Director of the Maine Rural Health Research Center, brings her expertise on rural access to care in the chapter she authored, in which she highlights the barriers to optimal care for rural residents. Lower income, lower rates of health insurance coverage, and a lack of primary and specialty care in rural areas contribute to the barriers faced by rural residents, and as a result, may compromise their health and well-being. 

 

Suggested Citation: Ziller EC. Access to Medical Care in Rural America. In: Warren JC, Smiley KB, eds. Rural Public Health: Best Practices and Preventive Models. New York: Springer Publishing Company; 2014:11-28.

Publication Type: 
Book Chapter
Publish Date: 
February 24, 2014
URL: 
http://www.springerpub.com/product/9780826108944#.Uwux6BCuSRs

Cutler Institute awarded $600,000 to help youth raised in foster system

Marty Zanghi

USM's Cutler Institute for Health and Social Policy has been awarded a $600,000 grant to help young people raised in Maine's foster system to prepare for college and the workforce.

The money comes from the Annie E. Casey Foundation as part of a $5.4 million national effort aimed at youth who are homeless or in either the foster care or juvenile justice systems.

"Many of these young people have suffered abuse or trauma and were raised in poverty and neglect," said Marty Zanghi, the Cutler Center's youth development director.

The money -- including an expected $400,000 more in matching funds -- will pay for contracted work with agencies in the target areas, starting with the greater Portland area and Penobscot, Kennebec and Somerset counties.

Nationally and in Maine, only about 3 percent of people who grow up in the foster care system achieve a college degree, he said.

"It's dramatically lower than the rate for the general population," Zanghi said. "It's a horrible outcome."

It doesn't have to be that way, though.

"There are young people that overcome these circumstances," he said. "I know people who have master's degrees and Ph.Ds."

The Casey Foundation's national effort is being called the "Learn and Earn to Achieve Potential" (LEAP) initiative.

The initiative is working on partnerships in Maine and nine other areas: Alaska, Arizona, California, Massachusetts, Michigan, Minnesota, Nebraska and New York. In each case, people will adapt two evidence-based models to meet the needs of these youth, including support to address the trauma they may have experienced in their lives.

In Maine, the work will include a pair of successful programs, Jobs for Maine Graduates (JMG) and Jobs for the Future. Results will be carefully tracked, Zanghi said.

After the first year, the program is expected to grow.

"Eventually, the additional help will be available to all children, 14 and over, in the foster care system in the state of Maine," Zanghi said.

New Chartbook on the Use of Maine's Long Term Services and Supports (LTSS)

Long Term Services and Supports Cover page image

Long term services and supports (LTSS) are a vital lifeline for the thousands of Maine adults who need them, and they account for a significant portion of the state's Medicaid (MaineCare) budget.This Chartbook prepared by the research staff at the USM Muskie School, provides information on all Maine adults who use LTSS: older adults; adults with physical disabilities; adults with intellectual disabilities/autism spectrum disorder or other related conditions; and adults with acquired brain injury.

The information provided in this Chartbook about the demographic trends that impact Maine's service system as well as data on the typical MaineCare service utilization and expenditures of different LTSS populations will inform the discussion among policymakers, providers, consumers, and advocates as they work together to ensure that Maine’s system of LTSS meets the needs of all its citizens.

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