Research Paper on "Integrate Services for People Needing Long-Term Care"

Research Paper 12 pages (3709 words) Sources: 20

[EXCERPT] . . . .

Integrate Services for People Needing Long-Term Care

Over the last several years, health care costs have been rising dramatically. Part of the reason why this is occurring, is due to the fact demand has increased. This has caused the underlying costs for different services to rise. Over the course of time, this is having a ripple effect on the industry and the amount that everyone is paying. Evidence of this can be seen within the insurance premiums that many businesses and individuals are paying. In a study that was conducted by the Common Wealth Fund, they found that businesses are seeing disbursements for health insurance premiums increase by 44% (between 2003 and 2009). While, individuals have seen a 77% increase in the costs that they are paying. (Schoen, 2010, pp. 1- 32) This is significant, because it is showing how skyrocketing health care prices are having an adverse impact on employers, workers and families.

As a result, the federal government has been working with the states to create a program that can deal with the various challenges in these areas. At the heart of this basic plan, is creating a test plan that will allow ten states to integrate various health care solutions under one program. The idea is to be able to address these issues by creating a state plan that can address all of the different needs of the public. Once this occurs, it is hoped that everyone will be able to receive better treatment options at lower costs. (Kasten, 2009)

Virginia is one of the ten states that are setting up a program to address all of these issues. To fully understand how the various aspects of how health care can be implemented into the state's plan requires: examining the current structure, how change can take place, the services offered / financing programs and how it can be implemented on the local levels. Together, these different elements will provide the greatest insights as to how an effective health care strategy can be employed by the State of Virginia. (Kasten, 2009)

The Current Structure for the State of Virginia

In 2006, Governor Kaine created the Health Reform Commission. Their objectives were: to gain a greater understanding of the health care system and make recommendation as to how it can be approved. One area that was of particular interest to the commission was integrating long-term care services as part of a total health care solution. This is because, the population was becoming older and many people wanted to see these kind programs implemented to address gaps in coverage for many Virginians. (Kasten, 2009) What they came up with was a series of the different recommendations for improving the kinds of services that were available to include:

To support and expand the options for long-term care services.

To ensure that consumer, caregivers and families have ample amounts of information about the kinds of services that were available. This would help them to more effectively plan for a wide variety of contingencies.

To improve state and local coordination for health care services.

To create more options for seniors and people with disabilities about the kinds of living facilities that they have available to them. (Kasten, 2009)

These recommendations are important, because they created a foundation of different strategies that could be used (to provide better health care solutions to all Virginians).

This lead to a change in focus on how various health care services were provided. To fully understand how this occurred requires examining the departments and programs that are run by the state. Once this takes place, it will provide specific insights about current structure and the changes.

Departments

There are a number of different departments within the state government that have a responsibility for regulating the health care industry. In general, they have similar powers that will often overlap with each other. This is designed to provide added amounts of regulation on the state level. Some of the most notable include: the oversight of senior citizens, adults with severe mental illness, individuals with physical / mental disabilities and children's disabilities. Each of the departments has a responsibility of regulating these areas in one way or another. The below list identifies each agency and roles that they play inside the industry. (Kasten, 2009)

Department of Medical Assistance Services -- this agency has many different responsibilities. To include: the regulation of financial services, approving / disapproving waivers, reviewing the activities of health care providers and coordinating out of state Medicare / Medicaid programs.

Department of Mental Health, Mental Retardation and Substance Abuse Services -- they have the authority to: regulate local Community Service Boards, licensing for mental health / substance abuse facilities and monitoring these areas for any kind of violations of state law.

Virginia Department for the Aging -- this department has the responsibility for: regulating area agencies on aging and helping patients who are transferring from a state psychiatric facility.

Department for Rehabilitative Services -- they have authority to: oversee employment / rehabilitative services and investigate Social Security Disability claims.

Department of Social Services -- they determine financial eligibility for Medicaid, auxiliary grants and other programs. At the same time they have other responsibilities including: monitoring assisted living facilities / foster homes and they provide adult / child protective services.

Virginia Department of Health -- they have the authority to monitor / license all Medicare certified nursing homes, hospices and home health agencies.

Virginia Office for Protection and Advocacy -- they protect the rights of people with disabilities through: training, investigation and legal representation.

Office of the Comprehensive Services Act -- they provide funding for: programs that are working with high risk youth with emotional and behavioral problems.

Governor's Office -- they are coordinating the integration of health care services through effective leadership.

Virginia Board for People with Disabilities -- they have the responsibility for regulating the Developmental Disabilities Planning Council. (Kasten, 2009)

These different elements are important because, they are showing how there are a wide variety of agencies that will monitor the health care industry. In some cases, these areas of responsibility could be overlapping (effectively providing dual regulation to select segments). (Kasten, 2009)

Long-Term Care Committees

At the same time, the state assembly has enacted the Community Advisory Commission in the Code of Virginia. This law requires that the state establishes committees that will monitor the progress of different government agencies on: how they are integrating people with disabilities in the community. The way this is accomplished is by having each of the local governments establish long-term care committees. They will consist of public officials and local citizens in the community. The basic idea with this approach is to increase the overall levels of accountability for the state government. This is significant, because it shows how Virginia is taking a proactive approach in trying to address their health care challenges. (Kasten, 2009)

How can Change take Place?

The main factor that has been driving integration is the rising demand that many consumers are placing on the health care system. This is because, the total number of people age 65 and older has been steadily increasing and this expected to continue over the next 70 years. Evidence of this can be seen with information that was compiled by the U.S. Census bureau. They found that within the state the total number of people age 65 and older accounted for just 12.9% of the population. In the year 2030, this number is projected to increase to 20.8% of the population. (Kasten, 2009)

Moreover, Lehning (2010) found that integration among health care service providers has become increasingly common over the last several decades. With her writing, "Three promising practices that have emerged in the past few decades include: the culture change movement; service integration that combines medical and social care; and various forms of community residential care that bring together housing and services in a more home-like environment." (Lehning, 2010, pp. 43 -- 63) This is significant, because it is illustrating why the state has been taking such a focus on addressing these issues. As, integration has become a tool that they can use to: keep up with rising demand and changing population demographics.

The Process for Coordinating Change

In order for any kind of integration plan to be effective means that everyone must agree: that change is necessary and there must be some kind of mutual benefit that can be realized for all of the stakeholders. As a result, this helped to fuel the push for these kinds of changes to take place. The reason why is because integration can provide a number of advantages including: you are using economies of scale to reduce costs, companies are gaining increased bargaining power, consumers have greater choices and costs are lower. (Pratt, 2010, pp. 223- 228) These different elements are important, because they are highlighting the underlying reasons for integration to occur.

To coordinate changes to the health care system requires, having people from all walks of life providing insights… READ MORE

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