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Advancing the Fiscal Health of Patients with Diabetes: A Wellness “Win-Win”
By Doreen Treacy
Director, CivcHealth Institute
DotWell
What if you could multiply your impact with patients managing diabetes by introducing fiscal health
resources to your work as a provider? We are trained to look at the whole person: the physical,
emotional and spiritual aspects when assessing any chronic disease. But in fact, fiscal health is critical
measure of health which needs to be assessed and addressed in clinical encounters.
Health outcomes and wealth outcomes are connected. Indeed, “wealth” is a determinate of health
(from PBS UnNatural Causes). We know that stress negatively impacts many chronic diseases,
including diabetes. And today, more than ever, the #1 stressor is personal finances.
Consider some key findings from the “American Psychological Association Stress in America Survey of
2008”:
• Money and the economy now top the list as sources of stress for 8 out of 10 people
• Financial stressors top the list of sources of stress regardless of gender or ethnicity
• More than 8 in 10 people (86 %) recognize that stress increases their likelihood of becoming
sick…and has a very strong negative impact on a variety of conditions
• More Americans (48% vs. 43%) reported overeating or eating unhealthy foods to manage stress
this year.
Our diabetic patients and others who are managing chronic diseases are even more vulnerable. The
current economy is offering us a tremendous opening to discuss “fiscal health” concerns with patients
because across the economic spectrum, finances and money are at the forefront of everyone’s mind.
And, there is growing evidence that integrating financial education and asset-building strategies with
clinical services at community health centers improves the outcomes of both. As a “trusted” advisor
and partners in promoting health and well-being, health practitioners have a central role to play in
diagnosing and treating identified financial health issues for their patients.
Treacy proposed that healthcare providers be “Descriptive” and discuss specific financial issues with
our patients/clients, and then be “Prescriptive” and offer concrete actions and opportunities to
address compromised financial health. Simple questions such as the following can help the provider
establish a shared definition of baseline indicators of positive financial health.
By asking direct questions during appointments with patients, you can determine the need for a fiscal
health “prescription” that may include a referral to a fiscal health provider. You can help by
“connecting the dots” for patients --leveraging and strategically coordinating both internal and
external resources --so that the patient has a clear “next step” to take.
It starts with assessing your organizations own resources.
• Find out who in your organization knows “what’s out there” for your patients?
• Who is the maven or connector to internal/external resources?
• What program/resources already exist internally that you can create a more direct connection to?
• Where are programs and services located if your organization doesn’t offer them?
• Are they easily accessible for your patients/clients?
• How is your patient referred? What is the mechanism?
Technology can help. DotWell health centers use electronic medical records software that allows
doctors to manage patient care across specialties via a shared medical record. The same software
allows providers to print “prescriptions” for non clinical programs and flyers about fiscal health
programs like the free tax clinics and credit counseling. Once a patient enrolls in any non-clinical
program, a record is created in a social services software that tracks efforts and the progress of the
client through various programs.
The following are examples of Dotwell initiatives to improve the fiscal health of their patients:
• Created Eat Green Save Green – A 7-week healthy cooking/financial education class for diabetic
patients. Emphasis is on how to manage finances in order to buy healthy food.
• Diabetes Tune Up Days: Inclusion of Fiscal health staff and Credit Counselors with group
visit model.
• Prepared over 12,000 free tax returns over the last 8 years and returned over $4.5 million
in tax refunds to community members in 2009.
• Helped over 4000 households understand and improve their credit score through the Credit
Counseling and Asset Building Program
• Trained youth in personal finance and tax preparation certification through the Skills for Life
Program and engaged them as community volunteers.
• Piloted a Fiscal Health Screening Program and have assessed nearly 100 households to date.
Over 65% of individuals assessed have taken at least one concrete action to improve their
fiscal health.
Other Resources for Promoting Fiscal Health in Massachusetts
The Center for Social Policy. McCormick Graduate School at UMass Boston. “Advancing the Fiscal
Health of Low-Income Families: A Public and Community Health Approach”, Working Paper March 2009,
by Doreen Treacy
Financial Resources
The following are annotated resources for a variety of financial issues (Note: Use caution with live
links)
Help Paying Bills
Link to matched savings (IDA) accounts in Massachusetts
Comprehensive Credit Counseling and Money Management
Massachusetts Credit Unions
Foreclosure Prevention Resources
RAFT program (rent and utility payment assistance)
Fuel Assistance
Money Management Assistance
Free Tax Preparation Assistance
(Note: Many of the sites listed here are AARP sponsored and may limit services to adults 50+…you can
contact the IRS hotline at 1.800.829.1040 for more information.)
Find free tax preparation in Massachusetts
Find free tax preparation in Central Massachusetts
Find free tax preparation in Boston
Food Resources
Massachusetts Farmers Market Coupon Program
Food Pantries in Massachusetts
Dollar-a-Bag/Fair Foods Explanation
Dollar-A-Bag Sites
SERVE New England
Community organizations that offer services
Connect to a community health center (CHC)
Connect to a community action agency (CAP)
Connect to a community development agency (CDC)
back to statewide meeting page
By Doreen Treacy
Director, CivcHealth Institute
DotWell
What if you could multiply your impact with patients managing diabetes by introducing fiscal health
resources to your work as a provider? We are trained to look at the whole person: the physical,
emotional and spiritual aspects when assessing any chronic disease. But in fact, fiscal health is critical
measure of health which needs to be assessed and addressed in clinical encounters.
Health outcomes and wealth outcomes are connected. Indeed, “wealth” is a determinate of health
(from PBS UnNatural Causes). We know that stress negatively impacts many chronic diseases,
including diabetes. And today, more than ever, the #1 stressor is personal finances.
Consider some key findings from the “American Psychological Association Stress in America Survey of
2008”:
• Money and the economy now top the list as sources of stress for 8 out of 10 people
• Financial stressors top the list of sources of stress regardless of gender or ethnicity
• More than 8 in 10 people (86 %) recognize that stress increases their likelihood of becoming
sick…and has a very strong negative impact on a variety of conditions
• More Americans (48% vs. 43%) reported overeating or eating unhealthy foods to manage stress
this year.
Our diabetic patients and others who are managing chronic diseases are even more vulnerable. The
current economy is offering us a tremendous opening to discuss “fiscal health” concerns with patients
because across the economic spectrum, finances and money are at the forefront of everyone’s mind.
And, there is growing evidence that integrating financial education and asset-building strategies with
clinical services at community health centers improves the outcomes of both. As a “trusted” advisor
and partners in promoting health and well-being, health practitioners have a central role to play in
diagnosing and treating identified financial health issues for their patients.
Treacy proposed that healthcare providers be “Descriptive” and discuss specific financial issues with
our patients/clients, and then be “Prescriptive” and offer concrete actions and opportunities to
address compromised financial health. Simple questions such as the following can help the provider
establish a shared definition of baseline indicators of positive financial health.
- “Are you able to pay for your medications and healthy groceries?”
“Are you worrying about money or how you will pay your bills?”
By asking direct questions during appointments with patients, you can determine the need for a fiscal
health “prescription” that may include a referral to a fiscal health provider. You can help by
“connecting the dots” for patients --leveraging and strategically coordinating both internal and
external resources --so that the patient has a clear “next step” to take.
It starts with assessing your organizations own resources.
• Find out who in your organization knows “what’s out there” for your patients?
• Who is the maven or connector to internal/external resources?
• What program/resources already exist internally that you can create a more direct connection to?
• Where are programs and services located if your organization doesn’t offer them?
• Are they easily accessible for your patients/clients?
• How is your patient referred? What is the mechanism?
Technology can help. DotWell health centers use electronic medical records software that allows
doctors to manage patient care across specialties via a shared medical record. The same software
allows providers to print “prescriptions” for non clinical programs and flyers about fiscal health
programs like the free tax clinics and credit counseling. Once a patient enrolls in any non-clinical
program, a record is created in a social services software that tracks efforts and the progress of the
client through various programs.
The following are examples of Dotwell initiatives to improve the fiscal health of their patients:
• Created Eat Green Save Green – A 7-week healthy cooking/financial education class for diabetic
patients. Emphasis is on how to manage finances in order to buy healthy food.
• Diabetes Tune Up Days: Inclusion of Fiscal health staff and Credit Counselors with group
visit model.
• Prepared over 12,000 free tax returns over the last 8 years and returned over $4.5 million
in tax refunds to community members in 2009.
• Helped over 4000 households understand and improve their credit score through the Credit
Counseling and Asset Building Program
• Trained youth in personal finance and tax preparation certification through the Skills for Life
Program and engaged them as community volunteers.
• Piloted a Fiscal Health Screening Program and have assessed nearly 100 households to date.
Over 65% of individuals assessed have taken at least one concrete action to improve their
fiscal health.
Other Resources for Promoting Fiscal Health in Massachusetts
The Center for Social Policy. McCormick Graduate School at UMass Boston. “Advancing the Fiscal
Health of Low-Income Families: A Public and Community Health Approach”, Working Paper March 2009,
by Doreen Treacy
Financial Resources
The following are annotated resources for a variety of financial issues (Note: Use caution with live
links)
Help Paying Bills
Link to matched savings (IDA) accounts in Massachusetts
Comprehensive Credit Counseling and Money Management
Massachusetts Credit Unions
Foreclosure Prevention Resources
RAFT program (rent and utility payment assistance)
Fuel Assistance
Money Management Assistance
Free Tax Preparation Assistance
(Note: Many of the sites listed here are AARP sponsored and may limit services to adults 50+…you can
contact the IRS hotline at 1.800.829.1040 for more information.)
Find free tax preparation in Massachusetts
Find free tax preparation in Central Massachusetts
Find free tax preparation in Boston
Food Resources
Massachusetts Farmers Market Coupon Program
Food Pantries in Massachusetts
Dollar-a-Bag/Fair Foods Explanation
Dollar-A-Bag Sites
SERVE New England
Community organizations that offer services
Connect to a community health center (CHC)
Connect to a community action agency (CAP)
Connect to a community development agency (CDC)
back to statewide meeting page
| Spring Statewide Meeting - May 1, 2009 |
|
