Community Assessment Project
Lori L. Lindsey-Clarkston
Lakeview College of Nursing
RN 404 Nursing in Community Health
April 24, 2011

Community Assessment Project
Descriptive data/demographics:
                                    Danville							United States
Population estimate    32,760								307,006,550
% Caucasian		70.2								79.6
% Black		24.4								12.9
% American Indian/Alaska native  0.2						1.0
% Asian		1.2								4.6
% Hispanic/Latino	4.6								15.8
% 65 years or older	16.6								12.9
% under 5 years old	7.1								6.9
% under 18 years old	24.9								24.3
% <65>18 years old	51.4								55.9
% persons below poverty level   18.1							13.2
Person per square mile  1,994.4							79.6
% high school graduate  75.2								80.4
% Bachelor degree or higher  15.7							24.4
% unemployed		9.6							5.7

2010 State medical aid report total per aggregate
•	Children		1,630,291
•	Disabled adults	252,795
•	Other adults		608,283
•	Senior adults		161,088
Aggregate:  Low to no income population to healthcare.  There are many programs available to individuals in the state of Illinois and the city of Danville.  They include:
•	WIC  Woman Infants & Children~ provides Federal grants to States for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk.  http://www.fns.usda.gov/wic/   retrieved May 15, 2011.  The WIC food packages provide supplemental foods designed to meet the special nutritional needs of low-income pregnant, breastfeeding, non-breastfeeding postpartum women, infants and children up to five years of age who are at nutritional risk. WIC food packages and nutrition education are the chief means by which WIC affects the dietary quality and habits of participants. http://www.fns.usda.gov/wic/benefitsandservices/foodpkg.HTM  Retrieved May 15, 2011.  
Research has shown that there is no better food than breast milk for a baby’s first year of life. Breastfeeding provides many health, nutritional, economical and emotional benefits to mother and baby. Since a major goal of the WIC Program is to improve the nutritional status of infants, WIC mothers are encouraged to breastfeed their infants. WIC has historically promoted breastfeeding to all pregnant women as the optimal infant feeding choice, unless medically contraindicated. WIC mothers choosing to breastfeed are provided information through counseling and breastfeeding educational materials. Breastfeeding mothers receive follow-up support through peer counselors. Breastfeeding mothers are eligible to participate in WIC longer than non-breastfeeding mothers. Mothers who exclusively breastfeed their infants receive an enhanced food package. Breastfeeding mothers can receive breast pumps, breast shells or nursing supplementers to help support the initiation and continuation of breastfeeding.  http://www.fns.usda.gov/wic/Breastfeeding/mainpage.HTM  Retrieved May 15, 2011
•	Family Care~ covers health care services for parents or caretaker relatives of children with income up to 185% of poverty. Parents who are Illinois residents can get FamilyCare if they are U.S. citizens or meet immigration requirements and have income within the FamilyCare income standard for their family size.    FamilyCare offers healthcare coverage to parents living with their children 18 years old or younger. FamilyCare also covers relatives who are caring for children in place of their parents. FamilyCare covers doctor visits, dental care, specialty medical services, hospital care, emergency services, prescription drugs and more. If you have health insurance and your family income qualifies for FamilyCare Share, Premium or Rebate, you have a choice. FamilyCare Rebate helps to pay for your insurance premiums. FamilyCare Share and FamilyCare Premium provide a medical card to help cover medical services that your plan does not cover. Parents can get FamilyCare if they live in Illinois and meet the FamilyCare income limits. They must be U.S. citizens or meet immigration requirements. All Kids or FamilyCare health benefits will not affect your immigration status unless you receive services in a nursing home or mental health facility. There are small co-pays, from $2 to $3, for doctor visits and prescriptions. Parents in FamilyCare Premium pay a monthly premium, from $15 to $40, depending on the number of family members covered.  http://www.familycareillinois.com/  Retrieved May 15, 2011
•	Moms and Babies~provide health care coverage to pregnant women and their infant up to 200% of poverty. Pregnant women who are residents of Illinois can get Moms and Babies if their income in within the Moms and Babies income standard for their family size. There is no cost to the women and infants in Moms and Babies.  http://www.hfs.illinois.gov/programs/  Retrieved May 15, 2011.
•	Health Benefits for persons with breast or cervical cancer~covers persons who are screened through the Illinois Breast and Cervical Cancer Program operated by the Illinois Department of Public Health (DPH) and found to need treatment. Referrals for enrollment must come from the public health program.  http://www.hfs.illinois.gov/programs/  Retrieved May 15, 2011

Although many people can define the term “uninsured,” not as many know what “underinsured” means. Underinsured people have some form of health insurance, but lack the financial protection needed to cover out-of-pocket medical care expenses. 
A more formal definition of underinsured individuals includes people who are insured all year but have at least one of the following qualifiers: 
•	Medical expenses greater than 10 percent of annual income 
•	An annual income less than 200 percent of the federal poverty level and medical expenses greater than 5 percent of annual income 
•	Health plan deductibles equal to or greater than 5 percent of annual income
Compared to adequately insured adults, the underinsured have limited access to care similar to the uninsured. More than 16 million people (aged 19-64) were underinsured in 2003, in addition to the 45 million people who were estimated to be uninsured. http://www.aaos.org/news/aaosnow/mar08/reimbursement1.asp  Retrieved May 8, 2011.

 
SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC)	
( Data as of April 29, 2011)	
Fiscal	PROGRAM PARTICIPATION	Food	NSA*	Average	
Year	Women	Infants	Children	Total	Costs	Costs	Food Cost	
ANNUAL SUMMARY	
FY 2010	2,138,302	2,174,232	4,862,944	9,175,478	4,564,262,865	1,910,590,385	41.45	
FY 2009	2,182,395	2,224,241	4,715,144	9,121,779	4,640,848,150	1,787,930,690	42.40	
FY 2008	2,153,192	2,222,462	4,328,857	8,704,510	4,534,499,366	1,607,585,987	43.41	
MONTHLY DATA	
FY 2008	
Oct 2007	2,167,886	2,228,555	4,253,173	8,649,614	362,806,160	154,465,290	41.94	
Nov 2007	2,142,497	2,215,226	4,220,520	8,578,243	365,629,804	105,137,386	42.62	
Dec 2007	2,084,007	2,178,117	4,143,013	8,405,137	359,214,204	146,466,708	42.74	
Jan 2008	2,137,797	2,214,963	4,234,232	8,586,992	372,932,054	146,431,054	43.43	
Feb 2008	2,123,584	2,207,872	4,209,698	8,541,154	369,344,633	128,759,884	43.24	
Mar 2008	2,134,879	2,217,335	4,260,286	8,612,500	373,297,611	126,896,882	43.34	
Apr 2008	2,165,157	2,232,547	4,321,185	8,718,889	380,670,214	135,471,668	43.66	
May 2008	2,162,377	2,227,903	4,353,945	8,744,225	376,762,930	127,209,638	43.09	
Jun 2008	2,167,193	2,228,334	4,396,347	8,791,874	384,515,220	136,506,753	43.74	
Jul 2008	2,186,508	2,239,573	4,456,566	8,882,647	396,684,181	143,442,504	44.66	
Aug 2008	2,177,816	2,234,777	4,516,808	8,929,401	392,862,431	146,205,311	44.00	
Sep 2008	2,188,599	2,244,338	4,580,507	9,013,444	399,779,924	110,592,909	44.35	
FY 2009	
Oct 2008	2,207,372	2,259,435	4,637,913	9,104,720	402,815,721	172,506,392	44.24	
Nov 2008	2,152,737	2,213,592	4,577,867	8,944,196	392,249,549	122,586,288	43.86	
Dec 2008	2,146,972	2,216,029	4,596,512	8,959,513	391,525,368	142,914,775	43.70	
Jan 2009	2,161,557	2,213,795	4,631,505	9,006,857	393,314,732	140,391,260	43.67	
Feb 2009	2,149,827	2,196,831	4,622,582	8,969,240	378,397,365	147,973,800	42.19	
Mar 2009	2,182,454	2,222,680	4,690,980	9,096,114	383,695,958	131,960,318	42.18	
Apr 2009	2,193,283	2,224,360	4,728,601	9,146,244	380,414,599	143,132,464	41.59	
May 2009	2,175,527	2,210,672	4,729,362	9,115,561	377,758,893	152,207,544	41.44	
Jun 2009	2,195,662	2,228,084	4,792,489	9,216,235	382,549,508	163,140,193	41.51	
Jul 2009	2,213,910	2,240,840	4,823,988	9,278,738	381,892,874	153,512,383	41.16	
Aug 2009	2,210,756	2,239,494	4,875,355	9,325,605	386,878,505	146,987,618	41.49	
Sep 2009	2,198,681	2,225,074	4,874,571	9,298,326	389,355,078	170,617,655	41.87	
FY 2010	
Oct 2009	2,183,034	2,213,550	4,907,610	9,304,194	382,638,061	59,088,214	41.13	
Nov 2009	2,151,427	2,197,231	4,901,356	9,250,014	377,673,371	78,575,580	40.83	
Dec 2009	2,133,012	2,198,078	4,889,528	9,220,618	378,578,164	124,009,357	41.06	
Jan 2010	2,125,194	2,187,652	4,852,594	9,165,440	380,086,778	129,571,462	41.47	
Feb 2010	2,092,276	2,159,949	4,772,660	9,024,885	368,752,802	147,708,060	40.86	
Mar 2010	2,143,912	2,191,112	4,849,005	9,184,029	380,865,787	150,500,714	41.47	
Apr 2010	2,148,481	2,180,971	4,857,623	9,187,075	379,635,386	145,823,827	41.32	
May 2010	2,128,579	2,162,540	4,834,421	9,125,540	380,451,487	138,323,469	41.69	
Jun 2010	2,143,017	2,164,095	4,849,663	9,156,775	383,768,966	180,718,869	41.91	
Jul 2010	2,132,024	2,148,472	4,845,885	9,126,381	379,224,715	137,178,773	41.55	
Aug 2010	2,144,106	2,148,210	4,906,418	9,198,734	385,572,899	158,587,598	41.92	
Sep 2010	2,134,557	2,138,926	4,888,569	9,162,052	387,014,449	460,504,462	42.24	
FY 2011	
Oct 2010	2,111,482	2,125,372	4,844,566	9,081,420	377,760,506	84,103,090	41.60	
Nov 2010	2,089,041	2,114,133	4,798,610	9,001,784	379,758,073	114,549,159	42.19	
Dec 2010	2,066,950	2,094,883	4,737,163	8,898,996	382,400,614	156,940,215	42.97	
Jan 2011	2,079,390	2,107,981	4,724,084	8,911,455	382,193,302	189,434,373	42.89	
Feb 2011	2,040,523	2,074,333	4,614,058	8,728,914	375,261,681	264,341,892	42.99	
*NSA = Nutrition Service and Administrative costs.  Approximately two-thirds of total costs are used to provide nutrition education, breastfeeding promotion and support, and linkages to health and other client services (e.g.,immunization; drug, alcohol and tobacco education; referrals to family and child health social programs).  The remaining third is used for traditional management functions. 

The annual average food cost is the benefit per month. FY 2011 data are preliminary; all numbers are subject to revision.	

I.	FamilyCare Monthly Income Standards 	

	
Find the size of your family in the first column. Be sure to count yourself. Read across the row to see where your monthly gross income falls. That will tell you which FamilyCare plan you may be able to get.
Parents & Caretaker Relatives
Family
Size	
FamilyCare 
Assist	
FamilyCare 
Share	
FamilyCare 
Premium 
Level 1 	
FamilyCare
 Rebate	

1	
$0 - 1,207 	
$1,208 - 1,361  	
$1,362 - 1,679  	
$1,208 - 1,815	

2	
0 - 1,630	
1,631 - 1,839	
1,840 - 2,268	
1,631 - 2,452	

3	
0 - 2,054	
2,055 - 2,316	
2,317 - 2,857	
2,055 - 3,088	

4	
0 - 2,477	
2,478 - 2,794	
2,795 - 3,446	
2,478 - 3,725	

5	
0 - 2,901	
2,902 - 3,271	
3,272 - 4,035	
2,902 - 4,362	

6	
0 - 3,324 	
3,325 - 3,749 	
3,750 - 4,623 	
3,325 - 4,998 	

For each additional person add 	
$423 	
$478 	
$589 	
$637 	

Interviews:
According to Kara Wangler, FNP-C, a local family nurse practitioner, the poverty level in Danville is very high, she predicts that over 90% of the patients she serves are uninsured or underinsured.  The amount of individuals that take advantage of government programs growing everyday due to the economic state of the world.  There are things Wangler tries to do to help her patients with cost, she provides medication samples provided by pharmaceutical companies when available, she tries to prescribe medications that are available in generic form and she tries to cluster care so that multiple issues can be addressed in one visit so as not to incur higher cost that could occur over multiple visits.  Health care is an important issue that cannot be ignored Wangler states with or without insurance patients need to keep up on preventative healthcare for themselves to avoid more serious issues that could develop that would cause higher levels of care and more cost.  (Interview, Kara Wangler, FNP-C March 3, 2011)
Support Specialist at Provena Medical Center Danville Illinois reports that the hospital offers an income based care program that patients can apply for to help relieve the cost of healthcare services at any Provena facility. The cost for healthcare is based on patient income.  (Interview March 27, 2011)
Jody Milewski employee at Aunt Martha’s clinic in Danville IL, reports that the clinic provides healthcare services from sick, dental, preventative, and mental health services for a sliding scale cost based on income and the type of insurance a person has.  Any age patient is welcome at Aunt Martha’s draw backs that patients face are long waits for service for a sick patient and the number of patients in need is so great that preventative services can sometimes take months for appointment times.  (Interview April 12, 2011).
A person who prefers to remain anonymous that lives in Danville, IL that has insurance but still struggles has concerns that include the fact that the health department in Vermillion county has downsized and does not provide services.  The main concern is that there is no place for persons with sexually transmitted diseases to get treatment, advise, or education, the same is true for young pregnant woman, and for individuals with health disparities to go for guidance, education, or referral for drug or alcohol abuse. (anonymous community source interview, April 12, 2011.
Problem list:
•	Pregnancy~Low/no-income, teen, young adult, single, all races
•	Alcohol/drug dependency~Low/no-income, teens, elders, both genders, all races
•	Chronic disease states~all ages and economic statuses, all races
•	Abused~Low/no-income, children, teens, single, both genders, all races
•	Preventative Medicine/immunizations~Low/no-income, children, teens, single, elders, both genders, all races
Community Strengths:
•	Aunt Martha’s Clinic
•	Indigent programs at clinics and the main hospital 
•	Cross Point facility that provides shelter for abused woman and children and income based programs for counseling and substance abuse programs.
•	Vermillion County Health Dept 
•	There are many individuals in the community who care deeply about Danville and strive to make the community a better place.
My Summary:
I went to college and worked in the city of Danville, I do not live or work there any longer, but through this research and my experience as a practicing nurse who served individuals of all incomes and social economic status I learned that Danville is a community in need. There are many programs available for individuals but not all programs have a voice and some do not have enough resources to afford to advertise.  In the office where I worked we made referrals for people in need when we could.  I also learned that it up to the individual to take advantage of the resources suggested. Many patients are too lazy, don’t care, or simply decide not to take advantage of what is available to them.  I strive to help the patients I serve to my upmost potential providing information to them or finding resources for them as I can.