Aging Agenda for
Houston-Harris County
"Moving Toward an Elder Friendly Future"

Access to Quality Care

Domain Lead: Jane Bavineau

For More information contact:

Jane Bavineau
Care for Elders/Sheltering Arms Senior Services



© 2009 HCAAA


Improve the competency, availability and scope of senior social services provided by compensated, uncompensated and family caregivers. Ensuring quality care for older adults and family caregivers requires attention to a variety of critical and complex issues, particularly (1) improving access to needed services, (2) recruiting and retaining a well trained and stable direct care workforce, and (3) providing services and support for family caregivers. The three reports that follow describe each of these critical issues in detail.

Older adults confront a variety of barriers when they attempt to access health and social services and supports. Some are caused by systemic issues, others by provider inadequacies, and others are a result of individual limitations and concerns. The system is fragmented and there are few formal linkages among service providers or between systems of care. Some providers and/or their staff s lack cultural sensitivity– essential in our increasingly diverse community. Consumers are largely unaware of many of the services and resources available to them or are prevented from accessing them by poor health, frailty, limited mobility, or lack of funds. Some other older adults lack the care they need because they are unwilling to acknowledge that they need help.

 In recent years, considerable effort has been made to address these issues. For example, in 2006, Care for Elders, a local partnership of more than 80 organizations, established an Access Network to improve service access, optimize system efficiency, and provide older adults and caregivers with an easy-to-remember phone number for community resource information (the United Way’s 2-1-1 HELPLINE). The Access Network, which formally links ten elder service organizations, provides enhanced information and referral services, benefits counseling, and case management to those navigating the long term care system.

In addition to the Access Network, the Harris County Community Access Collaborative has implemented an extensive network of system navigators, known as promodoras, who are trained to assist elders and others in access in needed health care services.

Of course, even the best service delivery system is valueless if services are unavailable or unaffordable. In Houston–Harris County, there are significant service gaps in in-home respite, companion, and accompaniment services, case management, home-delivered meals, financial assistance with utilities, medications, and basic needs, dental care, home repair and modifications, and transportation. In addition, there are serious gaps in residential and facility-based care, for those with challenging illnesses such as Parkinson’s disease. Equally concerning are the low reimbursement rates facilities receive through Medicaid and other public sources, which are insufficient to ensure quality care.