Area 3: Access to Health Care

Four key factors drive how the older population will impact health care. Meeting these future health care challenges will require more resources, new approaches to care delivery, and a much greater focus on wellness and prevention. The key factors include:

• The significant change in the number of older persons,
• The prevalence of chronic diseases is increasing among older persons,
• Older adults have different needs and expectations than past generations,
• More medical services and technologies are available than ever before.

According to comparison data from the Health Resources Administration, Chesapeake has a higher death rate for selected chronic diseases than a group of counties that have similar demographic, economic, and geographic characteristics.

Coordinated systems of health care will improve access and the quality of care, particularly for seniors with multiple chronic conditions. Emphasis on prevention and wellness are integral to helping seniors achieve optimal health.

Action Item 3.1 – Improve Older Adult Wellness and Preventive Health Care: The scientific evidence points to the importance of management of chronic conditions and preventive approaches to health care.

• Foster opportunities for coordination of care and care innovations in the delivery of health care to older adults, including partnerships among individuals, faith based organizations, private insurers, healthcare, employers, government, and other community organizations.


• Implement prevention programs and evidence-based lifestyle change programs for people at high risk for type 2 diabetes, obesity, and heart disease.


• Develop programs for long term management of chronic medical conditions using coordination of care models as well as emerging technology. Reduce barriers such as transportation and financial limitations.


• Collaborate across the community in improving the delivery of services to individuals, as well as advocating for policy changes that take a prevention approach to improving the health of populations (e.g., walkable neighborhoods, access to fresh, nutritious foods).


• Develop programs that create connections with older persons to identify early warnings of problems, particularly for persons who live alone or are home bound.


• Implement fall prevention programs across the community including education, home safety checklists, T'ai Chi or other workshops to help seniors with balance and fall prevention, and medication review programs to identify potential medication issues which may lead to confusion or balance issues.

Action Item 3.2 – Support the Availability of a Highly Trained Healthcare Work Force: With the growing older population, the need for healthcare workers of all types will significantly expand.

• Consider the healthcare workforce development needs in the secondary school educational curriculum.


• Create linkages as appropriate between workforce development, healthcare entrepreneurism, and economic development.


• Encourage the implementation of healthcare workforce education and training programs within the community through public and private educational initiatives.


• Reduce barriers to healthcare workforce employee retention, i.e. transportation, financial, living wages.

Action Item 3.3 – Engage the community in Advance Care Planning. Work with the Advance Care Planning Coalition of Eastern Virginia to roll out the As You Wish Program.

• Establish easily available information about advance care planning and broadly circulate the materials in the community for adults of all ages.


• Develop advance care planning “counselors” who are trained to answer questions about advance care planning and who are easily accessible to assist community members.


• Encourage healthcare and human services providers of all types to learn about advance care planning and how to engage their patients in advance care planning discussions.


• Encourage residents to complete advance directives and register them with the Virginia Registry.

Action Item 3.4 – Increase Access to and Appropriate Use of Medical Care Services.

• Eliminate the primary care Health Professional Shortage Area in South Norfolk to improve access to medical care.


• Develop strategies to increase the number of mid-level providers such as Nurse Practitioners and Physician Assistants as well as Primary Care Physicians, particularly those with geriatric medicine specialization, and that accept Medicare/Medicaid insurance coverage.


• Develop ways to make medical services focused on primary care and chronic disease management more accessible using mobile services, technology, pharmacy deliveries, i.e. bring services to where people live.


• Encourage the development and use of community wide electronic medical records to facilitate the appropriate sharing of patient specific information to increase the consistency and appropriateness of care.


• Develop screening programs for identifying depression in the senior population. Implement treatment programs and support for families and caregivers.


• Develop screening programs for identifying mental health issues including depression and the need for trauma informed care for seniors. Implement treatment programs and support for families and caregivers.