When federal health care falls short, tribes improvise

*Medical research has done wonders to rid populations of diseases; however, the U.S. health care system has failed to appropriate the right resources to Medicare patients with one or more chronic conditions. Health Quality Partners in Doylstown, PA enrolls Medicare patients with at least one chronic illness and hospitalization and sends a trained nurse to see them on a routine basis, whether they are healthy or sick. As a result, the HQP program has reduced hospitalizations and cut Medicare costs.

Raton, a town once surrounded by eight coal mines, now has a main street of boarded-up buildings. There is reason for optimism as the town diversifies its local economy, betting on "a mix of small manufacturing businesses, health care and specialty services, and hospitality for travelers" to endure the sudden decline in mining revenue. Its calculated revitalization may hold lessons for other towns.

San Francisco considers the scaling of safe injection sites, which were successfully piloted in Vancouver, to become the first city in the United States to offer this service. However, the main challenge of starting such a service in San Francisco is helping the public get over the concern that safe injection sites encourage drug use for non-abusers. Community groups actively educated the public on the benefits of safe injection sites and politicians made trips to Vancouver to observe the success in action.

Pomegranate Kitchen in Wellington, New Zealand employees refugee women from around the world. The kitchen, which operates collaboratively rather than in a hierarchy, encourages these chefs to grow their cooking and managerial strengths as well as overcome cultural boundaries in order to become financially independent.

Vermont has opened its first donor milk center which acts as a breast milk bank for mothers that are in need of milk for their newborn babies. The Vermont Donor Milk Center aims to be a "one-stop shop," and also offers lactation consultation, maternal education, and supports for non-lactating partners.

Rather than send local residents to city-run testing sites in the East Bay of California, clinics in East Oakland are now running their own testing sites to better serve their community. Although one of the sites has already tested nearly 100 people and residents who are underinsured or uninsured can be tested for free, some believe the effort should have started much sooner.

Frustrated by a tight labor market, two locally owned Grand Rapids employers discovered the virtues – economic, not just moral – of hiring formerly incarcerated people, whose gratitude for an opportunity translated into excellent performance and less risk of adding to rapid turnover. The employers helped guarantee success by paying for support services that made post-prison transitions easier. The employers then talked hundreds of other local employers into doing the same. Besides providing a business advantage, the program changes lives and is evidently contributing to much lower rates of recidivism.

With an influx of COVID relief money, the Russellville school district began hiring and certifying more local, Spanish-speaking staff to help teach English language learners. Districtwide, the percentage of students who met their language proficiency goals increased from 46% in 2019 to 61% in 2022.

Mexico's Pilot Program for Licensed Physicians brings Mexican doctors to the states to address the lack of culturally relevant healthcare and Spanish-speaking healthcare providers, particularly in rural areas with large immigrant populations. Currently, the program has 30 Mexican doctors working in various counties throughout the state.

To enhance rural access to healthcare in Nigeria, the Parkers Mobile Clinic partners with local volunteers, healthcare professionals, educators, and community development advocates to identify and remedy unique healthcare gaps. Outreach programs are then designed to provide localized mental health support, nutritional counseling, and other reproductive health services.