A Guide to Federal Funding for Access to Health Care and Health Services

I recently wrote two blogs on the American Rescue Plan Act of 2021, explaining the funding opportunities for Health and Human Services. Those blogs are listed below for your reference. The second blog was especially long (but useful, I hope), so I’m sharing each of the 5 topic areas individually to make it a bit more digestible. This one covers the funding associated with access to health care and health-promoting services and, of course, the ways that GIS can help.

Blog 1: Your Quick Guide to Security ARP Funding for your Health GIS Strategies?

Blog 2: Health GIS Initiatives that Align with Federal Funding Programs

As a reference, I tend to group the various funding opportunities into three distinct buckets:

1. Direct funding? These monies are, as titled, directly allocated to all state and local governments for a variety of health and non-health-related functions.?
2. Funding from the U.S. Department of Health and Human Services (HHS)? These health-focused funds are awarded through the various agencies and offices of U.S. HHS.
3. Funding from Non-Health Related Agencies? Several national U.S. agencies not formally related to health are supporting health initiatives through their ARP funds.

I’ll refer to these buckets as I review the funding areas worthy of GIS investment.

At the end of this blog, you’ll find a link to a document featuring many pre-configured solutions and other resources that should help you get specific in your health GIS strategy and funding objectives and deploy solutions quickly - often in a matter of days.

The articulation of 5 A’s for access to care, developed by Penchansky and Thomas, has stood the test of time for forty years. The five A’s include: affordability, availability, accessibility, accommodation, and acceptability. Despite the years of knowledge and reference to these components of access, it has become clear that we’ve not yet operationalized access to health care and health promoting services very well. It’s no wonder?all of the A’s are steeped in complexity. The A for geographic accessibility, however, is the most straight-forward, thanks to GIS technology. GIS makes it easier to match care from providers, health centers, and preventive services to individual and community needs. The technology facilitates the determination of those needs through location-based considerations of impediments to access such as social, racial, economic, and physical factors. Further, GIS allows for transportation mode to be considered (driving, walking, biking, public transportation) along with average or specific time of day traffic conditions. Geographic accessibility calculations are solvable. That means that lack of access is also clarified, exposing gaps and providing opportunities to intervene.

The idea of access to care is important across the spectrum of health, from access to primary, specialty, and emergency care to government programs and services, to community resources that promote health and well-being, to health insurance organization requirements to deliver an adequate network of accessible providers. Because of the breadth of access perspectives, you’ll find funding opportunities in all 3 buckets of ARPA. The direct funding bucket can support increasing accessibility to COVID-19 resources (e.g. testing, vaccines). In the U.S. HHS supported bucket you’ll see technology investments through HHS to expand health care, especially remote patient monitoring and telehealth services – potential solutions to fill gaps in access exposed by your GIS analysis. And in bucket #3, look to agencies like the Committee on Veterans’ Affairs and the Federal Communications Commission for expansion of broadband and support of enhanced access to care for veterans and for all through tele-health and other programs.

Ways you should leverage GIS to improve access to care/services:

• Map people and providers/programs.?There are always at least two parts to every accessibility calculation – the first part involves identifying the people seeking access to a health care or health promoting resource and the second part is the resource to which they need the access. You need both inputs to make access calculations worthwhile. The data can be at the individual address level or aggregated to any shape or jurisdictional boundary.
• Calculate travel time and distance.?This is where the magic happens. ArcGIS calculations give the most accurate information available in the world today, from rooftop to rooftop or from centroid to centroid. You can determine travel time and travel distance across modes of travel, days of the week and times of day or night. The calculation relies on highly accurate road network data. Straight line (Euclidean) distance is no longer good enough in today’s world.
• Identify gaps.?Once you’ve calculated travel time and distance between your people and programs, it becomes obvious where the limits of geographic accessibility lie. Enrich the population information for gap areas with data on demographics, behaviors, and social vulnerability to further prioritize interventions to improve access.
• Test scenarios and optimize access.?Map-based apps help you test scenarios that may impact your organization.?What if a provider leaves or retires? How does that impact the network? What is a patient’s experience of access – accounting for inconvenience, disabilities, lack of vehicle ownership or other factors that increase the burden of access to care or services? How can you use the same data to make provider recruitment decisions or determine the best site for a new program location??You may also need this information in emergencies when you need to manage capacity in regional nursing homes impacted by natural disaster or you’re diverting emergency room access during peak times.

The ARPA funding is broad and has many opportunities to support health initiatives. Importantly, including GIS in your funding requests will not only give you a ‘leg up’ in reaching your goals, but GIS represents a configurable system that supports location intelligence needs across your organization’s departments and over time. Our team is happy to help you leap into a brighter future.

For links to deployable solutions and other resources for the topics addressed herein,?please see this document.

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