Regulatory Agencies Regarding Long-Term Care

HCS437

Long Term Care

Regulations are imposed by a government unit, either federal, state, or local. That would also include the county and municipal branches of government, because of their duty to look after and keep safe from hard those individuals for whom this instrument of healthcare has been designed. The protection of the welfare of the public is foremost in these efforts, especially the most vulnerable members of the public, such as those the federal government ascertains as having the inability to protect themselves. That protection appears to cover two primary areas: quality of service and payment of services.

One of the three regulatory agencies that will be discussed here is the Agency for Health Care Policy (AHCPR). They are part of the Federal Government as a principle player regarding the care and quality of services for the seniors involved.

It was first brought on board in 1999 in order for its members to make the necessary recommendations regarding the correct method or role of this agency in its aging concern for the health services being researched. This Task Force on Aging scrutinized the AHCPR research portfolio, over several months, as members of this particular Task Force conducted meetings and discussed with other staff members who were working via other Federal agencies, foundations, and additional professional societies that would support the necessary research regarding the aging question.

This agency and the Task Force study program focused on the essential evidence for the cost-effective involvement that would help to enhance the health-related quality of life (otherwise known as HRQOL). In this manner, they give the older adults in the program more assistance as they prevent disabilities, help to extend the lives of the seniors, and by reducing the functional decline. With this in mind, the Task Force specifically centered on gaps in various areas controlling that particular area of ability of services for health care, as they strive to improve the functioning and HRQOL which would also include the financing, cost, barriers, their organization and care, along with clinical practice. These issues work together with each of the patient’s characteristics and preferences, their individual families and their communities. This agency helps to give a rationale for the development, implementation, and dissemination of the agenda for health services study as it relates to aging. They also emphasize the necessity for strengthening the Agency’s organization and resources in its support of aging research, as it sustains the development, coordination, and dissemination of the agenda on research along with the findings pertaining to this type of research.

Our country’s rising senior population, along with ever-increasing health care costs and the rapid health system change, produces a major challenge in the maintenance of health care to these senior citizens. In order to achieve the aims that the patient health research produces, the AHCPR obtains funding mechanisms in a variety of ways. These would include contracts, grants, and agreements with inter-agencies. Recipients would be academic institutions, researchers, various states, organizations based in the different communities, national organizations, and of course Federal agencies. Their overall aim of this investment would be to promote the above-average (or high quality) of care through the vast availability of data that would be helpful to clinicians and patients matching the very best in science with the individual’s needs and also preferences. Additionally, this type of investment has the ability to create a sustainable foundation for the production of future research. This will enable the U.S. healthcare system as it strives to deliver the best, the highest quality of care to Americans.

There is also a federal agency known as the Health Care Financing Administration and is also recognized as the HCFA. They are in charge of the extensive resources made available from the federal agency administering Medicare, Medicaid, and the State Children’s Health Insurance Program. GRACE (Geriatric Resources Assessment and Care of Elders) and the Affordable Care Act come under their jurisdiction.

HCFA has the duty of providing health insurance for many Americans, in all probability there may be over 74 million via Medicare, Medicaid, and Child Health. Most of these same individuals obtain their benefits by way of the Fee-for-Service delivery system; however, due to the numbers of insured increasing, many of them choose the managed care plans.

This agency, HCFA, also controls all of the laboratory testing (except those used in research) in the United States, via the Clinical Laboratory Improvement Amendments Program, otherwise known as the CLIA program. Their special projects are involved in Compliance for the Year 2000, Fraud and Abuse, Your Medicare Center, and State Health Reform.

There are millions of senior citizens who are users of Medicare and Medicaid and have major health issues. Some of these seniors have conditions that would be classified as chronic and have functional limitations along with annual healthcare costs for them are placed in the 95th percentile (Steven Counsell, Spring 2011). As these issues are addressed, researchers as well as clinicians called upon the interdisciplinary team to test a new model called GRACE, which stands for Geriatric Resources for Assessment and Care of Elders. Several initiatives present in the Affordable Care Act as it was aimed at further testing and disseminating innovative models like GRACE.

The majority of seniors dually eligible for Medicare and Medicaid have chronic conditions and functional limitations, and annual healthcare costs for this group are in the 95th percentile. To address these issues, clinicians and researchers at Indiana University Center for Aging Research designed and tested a new model of interdisciplinary team care previously mentioned (GRACE, Geriatric Resources for Assessment and Care of Elders). This information presents several initiatives in the Affordable Care Act aimed at further testing and disseminating innovative models like GRACE.

For the first time in a long time, American families have been struggling to meet the double demands of their work and their families’ caregiving. Certainly, demographic trends will help to exacerbate these trends, particularly with the senior adult aging population as it has created more of the families’ responsibilities in the coming years. Our current recession has compounded these financial cares within the confines of these federal agencies, as many families have been affected because of jobs being cut and less money coming in to their life savings. According to an article in Generations, this information will help to address some of the problem areas that the Affordable Care Act health care reform along with the Federal agency governing it, struggles to overcome (Generations. Spring 2011).

Another example is the Regional Transportation Authority that sponsors our neighborhood PACE Buses. They get a traveler to where they are going locally as they have three transit divisions: the Chicago Transit Authority (CTA) bus and rail system, METRA commuter rail service, and PACE suburban bus service. The Regional Transportation Authority is just about the largest public transportation system in our country as it provides rides for over 2,000,000 people on a daily basis. It covers 7,200 route miles as it traverses the six-county region currently with about 8,000,000 in population. Assets are placed at more than $42 billion which would include 5,640 bus and rail cars in addition to 650 van-pool vehicles. In 1983, an Act (the RTA Act) was amended with major changes given to its organization, funding, and operations. This Act created their three primary responsibilities known as their service boards. They are the Chicago Transit Authority (CTA), Metra rail service for the commuters, and the Pace suburban bus system. It is the RTA’s to oversee the financial and budgetary requirements along with their regional transit planning needs. The Board has 15 members along with a chairman and are appointed from across the six-county area. The American Public Transportation Association released information in their March Transit Savings Report that Chicago commuters who select to ride public transportation, rather than driving a vehicle saved an average of $1,006 in March, or a total of $12,069 on a yearly basis. The average savings on a national level was $844 in March and a total of $10,120 for the year. This system of transportation is regularly and highly utilized by not only seniors in wheelchairs, but younger people who are afflicted with being disabled. They are equipped with lifts for bringing the person and/or their implement (wheelchair, walker, etc.) up into the vehicle. There is also a place on the front of the bus for a bicycle for those who can get around but not able to walk very far or very well.

References

www.hcfa.gov/y2k/default.htm

www.hcfa.gov/medicare/hsqb/clia.htm

www.hcfa.gov/medicare/fraud/default3.htm

Counsell, Steven R.. Generations, Spring 2011, Vol. 35 Issue 1, p56-59

Ness, Debra. Generations, Spring 2011, Families and Affordable Care Act’s

Bright Promise, Vol. 35, Issue 1, p56-59