INSTRUCTIONS: For your first examination you are offered two options: develop a policy analysis paper or develop a presentation with a short desk briefing.

You should utilize the facts below as a starting point and conduct your own research from scholarly and credible sources. The paper / presentation should not simply report statistics but utilize and analyze (calculations, percentages etc.) these to support your concepts and point of view.

A policy analysis is based on the scenario presented below. The product should be a minimum of 5 and a maximum of 12 pages (excluding cover page, appendices, charts, and references), double spaced, conforming to APA standards. This paper is going to your executive director and the executive management of the organization it should be professionally written and formal.


The desk briefing is an executive summary of the presentation including the key points to draw to attention of the executives, the summarized analysis, recommendations and next steps (ask of them).


NOTE: Some of the facts in this scenario are hypothetical; others are actual.


As a mid-career health analyst, you have recently been hired as the Health Policy Coordinator for the Alliance for Rural Health.

The Executive Director of the Alliance has requested that you prepare a policy briefing and / or presentation to the executive management discussing the delivery of Health Care Services to the residents of Appalachian Kentucky.


The Appalachian region of Kentucky is comprised of 54 counties with a total population of approximately 1.2 million. In Appalachian Kentucky, 100% of the population would be considered rural by Federal standards, as only 2.6% live in a town of 20,000 or more, the single incident of Richmond city. The average adult in Appalachian Kentucky reports feeling physically unhealthy 47% more often than the average American and 23% more often than the average adult in non-Appalachian Kentucky. The

average adult in Appalachian Kentucky reports feeling mentally unhealthy 25% more often than the average American and 15% more often than the average adult in non-Appalachian Kentucky.

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 Appalachian Kentucky residents. There is concern that these problems are related to high rates of suicide and domestic violence.

Finally, other reports from social service agencies report that there is a significant population in the region 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 following are guiding questions / topics. The paper should accomplish the following:

1. Discuss the problem of underserved populations and subgroups, including characteristics of those groups and barriers to delivery.


2. Demonstrate an understanding of social determinants and population health concepts.


3. Examine the structure of the delivery system and how this helps or hinders health delivery at a local and national level using current delivery methods including technology.


4. Discuss the impact of ACA (2020 version) and other current legislative changes in the delivery of care.


5. Make clear recommendations as appropriate for meeting the health delivery challenges of Appalachian Kentucky with reference based recommendations supported by literature, credible sources and other facts

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