La. Admin. Code tit. 48 § I-10501

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-10501 - National and State Priorities

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.

La. Admin. Code tit. 48, § I-10501

Promulgated by the Department of Health and Human Resources, Office of Management and Finance, LR 13:246 (April 1987).

AUTHORITY NOTE: Promulgated in accordance with PI. 93-641 as amended by P.L. 96-79, and R.S. 36:256(b).