INSTRUCTIONS: Develop a policy analysis 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. NOTE: Some of the facts in this scenario are hypothetical; others are actual. FACTS: As a mid-career health analysis, 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 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 paper should accomplish the following: 1. Discuss the problem of underserved populations and subgroups, including characteristics of those groups and barriers to delivery. 2. Examine the structure of the delivery system and how this helps or hinders health delivery. 3. Discuss the impact of ACA. 4. Make clear recommendations as appropriate for meeting the health delivery challenges of Appalachian Kentucky. Please prepare a well written, well organized, and professionally structured policy paper as requested

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