SCENARIO: As a mid-career health policy administrator, you have recently been hired as the Health Policy Coordinator for the Bayou Region of Louisiana in the United States of America (BR). The Director of the Louisiana State Health Department has requested that you prepare a policy briefing discussing the delivery of Healthcare Services to the BR residents. FACTS: The Bayou Region of Louisiana contains approximately 12,600 square miles with a population of 265,000 residents. The institutional healthcare system contains one regional medical center, five small community hospitals, a regional health center, and a contracted behavioral health provider group. There are physician medical clinics in 14 towns, but most of the BR is remote, composed of small villages, semi-swamp, or reservation land for several indigenous groups. (You do not manage this health system, but these are the regional facilities in the area). In the BR, 100 percent of the population would be considered rural by Federal standards, and only 23 percent live in towns of 20,000 or more. 73 percent of residents come from families with at least one full-time worker. In the BR, the residents who do not live in towns tend to be more seasonally employed, in part-time work, or self-employed, with a low likelihood of employer provided insurance. Historically, of the uninsured who are poor, half (50 percent) of those are from families with full-time workers. One-fourth of the uninsured are between the ages of 45 and 64 years old, and 26 percent report being in fair or poor health. In addition, recent surveys of the behavioral health system, clinics, and tribal health center report significant rates of depression, post-traumatic stress disorder, schizophrenia and substance abuse / dependence among BR residents. There is concern that these issues are related to high rates of suicide and domestic violence. Finally, other reports from social service agencies show that there is a significant population in the BR that is effectively homeless, living seasonally (or sometimes year-round) in campers, tents, or out of automobiles, moving between campgrounds or camping areas in the state park grounds. This population includes families with children in some cases. The Director of the Louisiana State Health Department has requested that you prepare a policy briefing discussing the delivery of Healthcare Services to the BR residents. INSTRUCTIONS: Develop a policy paper based on the scenario presented below in form of a policy briefing. The product should be a minimum of three and a maximum of five pages (excluding cover page, appendices, charts, and references), conforming to writing guidelines and the American Psychological Association standards (double spaced, font size and style: 12 Arial, unique file name, current references, proper citations etc.). [Please write healthcare instead of health care]. The paper should accomplish the following: 1. Examine the structure of the delivery system and how this helps or hinders health delivery. 2. Discuss the problem of underserved populations and subgroups, including characteristics of those groups and barriers to delivery. 3. Explain the impact of the Patient Protection and Affordable Care Act. 4. Make clear and logic recommendations as appropriate for meeting the health delivery challenges of the BR. Please prepare a well written and organized, professionally structured policy paper leading the reader to a logic conclusion supported by scientific evidence, metrics, statistically significant data. Thank you! NOTE: The facts in this scenario are hypothetical. While the bayou region of Louisiana is a real place with geographic characteristics as described, the population, health system, and other particulars are hypothetical for purposes of this paper.

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