Current through Register Vol. 50, No. 9, September 20, 2024
A. In
Section 1523 of the National Health Planning and Resources Development Act of
1979 ( Public Law 96-79), the United States Congress charged the State Health
Planning and Development Agency with responsibility for determining the health
needs of the state. In Section 1502 of the same Act, Congress outlined 17
national health priorities which were found to deserve special consideration in
the development and operation of federal, state and area health planning and
resources development programs. These national priorities are:
1. the provision of primary care services for
medically underserved populations, especially those in rural or economically
depressed areas;
2. the development
of multi-institutional systems for coordination or consolidation of
institutional health services (including obstetric, pediatric, emergency
medical, intensive and coronary care, and radiation therapy
services);
3. the development of
medical group practices (especially those whose services are appropriately
coordinated or integrated with institutional health services), health
maintenance organizations, and other organized systems for the provision of
health care;
4. the training and
increased utilization of physician assistants, especially nurse
clinicians;
5. the development of
multi-institutional arrangements for the sharing of support services necessary
to all health service institutions;
6. the promotion of activities to achieve
needed improvements in the quality of health services, including needs
identified by the review activities of Professional Standards Review
Organizations under part B of Title XI of the Social Security Act;
7. the development of health service
institutions of the capacity to provide various levels of care (including
intensive care, acute general care, and extended care) on a geographically
integrated basis;
8. the promotion
of activities for the prevention of disease, including studies of nutritional
and environmental factors affecting health and the provision of preventive
health care services;
9. the
adoption of uniform cost accounting, simplified reimbursement, utilization
reporting systems, improved management procedures for health service
institutions, and the development and use of cost saving technology;
10. the development of effective methods of
educating the general public concerning proper personal (including preventive)
health care and methods for effective use of available health
service;
11. the promotion of an
effective energy conservation and fuel efficiency program for health service
institutions to reduce the rate of growth of demand for energy;
12. the identification and discontinuance of
duplicative or unneeded services and facilities;
13. the adoption of policies which will (a)
contain the rapidly rising costs of health care delivery, (b) insure more
appropriate use of health care services, and (c) promote greater efficiency in
the health care delivery system;
14. the elimination of inappropriate
placement in institutions of persons with mental health problems and the
improvement of the quality of care provided those with mental health problems
for whom institutional care is appropriate;
15. assurance of access to community mental
health centers and other mental health care providers for needed mental health
services to emphasize the provision of outpatient as a preferable alternative
to inpatient mental health services;
16. the promotion of those health services
which are provided in a manner cognizant of the emotional and psychological
components of the prevention and treatment of illness and the maintenance of
health; and
17. the strengthening
of competitive forces in the health services industry wherever competition and
consumer choice can constructively serve to advance the purposes of quality
assurance, cost effectiveness, and access.
B. All planning involves the setting of
priorities because, for many obvious reasons, rarely is it possible to address
all of the problems and issues one might identify. Even more rarely is it
possible to find feasible, timely solutions to all of the problems or to
develop necessary resources to carry out planning strategies. It is, therefore,
essential to any plan that some goals be selected or ranked as more
appropriate, more relevant, or more beneficial so that a hierarchy of goals and
implementation strategies may be developed.
C. In consideration of this need to narrow
the focus of this State Health Plan and in accordance with the Congressional
mandate to establish health needs priorities for the State of Louisiana, three
comprehensive areas within the broad spectrum of health-related issues have
been selected as health priorities for the 1982-87 planning horizon. These
priority areas have been adopted by the Louisiana Statewide Health Coordinating
Council and by the Secretary of the Department of Health and Human Resources as
the primary issues to which attention and initiative should be given.
1. Priority: High Costs of Health Care
a. Goal. The adoption of policies which will
contain the rapidly rising costs of health care and promote greater efficiency
in the health care delivery system.
i.
Sub-goal: The development of policies and effective methods of public education
directed at insuring more appropriate (discriminating) use of available health
care services.
ii. Sub-goal: The
identification and discontinuance of duplicative or unneeded services and
facilities.
iii. Sub-goal: The
development of effective methods through which both public sector and private
sector health care providers can coordinate and consolidate spedicalized
institutional and clinic health services and share support services.
iv. Sub-goal: The training and increased
utilization of physician's assistants, nurse practitioners and other non-M.D.
health professionals for delivery of appropriate health care services not
requiring the presence of an M.D.
v. Sub-goal: The development and use of
cost-saving technology, including uniform cost accounting, simplified
reimbursement, utilization reporting systems and improved management
procedures.
vi. Sub-goal: The
promotion of an effective energy conservation and fuel efficiency program for
health service institutions.
vii.
Sub-goal: The development of lower cost alternatives to inpatient services in
acute care facilities available and accessible through the state, primarily
ambulatory surgical centers and beds.
viii. Sub-goal: The curtailment of
unnecessary medical procedures and excessively lengthy hospital
stays.
ix. Sub-goal: The
encouragement of the development by private industry of more appropriate health
benefits packages for employees.
x.
Sub-goal: The training of medical students regarding the cost implication of
actions by treating physicians.
xi.
Sub-goal: The encouragement of the development of prepaid medical group
practices, health maintenance organizations and other organized systems for the
provision of less costly health care.
2. Priority: Alternatives to Long Term
Institutionalization
a. Goal: The development
and promotion of a comprehensive array of services available at the community
level directed toward preventing, postponing or terminating inappropriate and
costly long term institutionalization of the functionally impaired.
(Functionally impaired is defined as individuals with handicaps due to
advancing age, chronic mental illness, physical or developmental disabilities
and those recovering from mental illness, alcohol and drug abuse disorders.)
i. Sub-goal: A full range of accessible
residential alternatives for the functionally impaired, including special
living arrangements, foster care, supervised apartment living, community living
developments and half-way housing, independent living and subsidized
adoption.
ii. Sub-goal: A full
range of personal and family support services for the non-institutionalized
functionally impaired, including personal care, nutrition, home
health/homemaker transportation, respite care, parent training, family
counseling, and parent-to-parent support programs.
iii. Sub-goal: Day programs for the
non-institutionalized functionally impaired, including day care, medical day
care, education, training, sheltered employment and recreation.
iv. Sub-goal: Diagnostic and treatment
services available and accessible to the non-institutionalized functionally
impaired for needed medical, dental and physical therapy services.
v. Sub-goal: Availability of needed medical
equipment, supplies and prescription drugs for the non-institutionalized
functionally impaired.
vi.
Sub-goal: Case Management services for the functionally impaired which assure
the continuity and availability of appropriate, humane and efficient
non-institutional care and placement, including services for identification,
diagnosis and evaluation, information and referral, individual service plan
development, and implementation, service authorization and placement, and
monitoring of the plan.
3. Priority: Health Promotion
a. Goal: The availability of services at the
community level directed toward informing, educating and motivating the public
to accept responsibility for their own health, adopting lifestyles and
nutritional practices which promote optimal health, avoiding health risks and
making more appropriate use of available health care services.
i. Sub-goal: A populace more knowledgeable
about the signs and symptoms, prevention and treatment of diseases which
significantly affect the citizens of Louisiana, especially heart disease,
stroke, cancer, respiratory disease, diabetes, veneral disease and mental and
emotional disorders.
ii. Sub-goal:
A more knowledgeable citizenry, motivated to avoid the abuse of alcohol and
other drugs and the use of tobacco.
iii. Sub-goal: A population with increased
knowledge and ability to select a diet most conducive to good health.
iv. Sub-goal: A more knowledgeable citizenry,
motivated to participate in a program of appropriate, regular physical
exercise.
v. Sub-goal: A population
increasingly aware of practical methods to avoid safety hazards and accidents
in the home, workplace and on the highway.
vi. Sub-goal: A population increasingly aware
of the need to preserve, protect and improve the quality of the
environment.
AUTHORITY NOTE:
Promulgated in accordance with PI. 93-641 as amended by P.L. 96-79, and
R.S.
36:256(b).