ABOUT AT A GLANCE On seven measures of health care quality, access, and cost, the majority of adults expect to be neither better-off nor worse-off in than inbut of those expecting a change inmore expect to be worse-off than better-off. Adults are more pessimistic about health-related costs in than about health care quality and access.
The Advisory Committee on Immunization Practices ACIP recommends vaccine schedules for children, adolescents and adults based on scientific evidence and the benefits of preventing infectious diseases.
School and daycare immunization requirements serve as a "safety net" for children who do not receive their recommended immunizations as an infant or small child.
All school requirement laws are state-based and usually reflect the recommendations of the ACIP. It is important to note that some states give the state public health officer the authority to change school requirements through administrative rule.
Others revise school requirements through a combination of rules and legislation or strictly by legislative action. School requirements are not without controversy, however.
Some parents and advocates contend that vaccine mandates infringe on a person's individual rights to choose, especially if a parent is concerned that vaccines may harm children. Therefore, many states have expanded their immunization exemption laws to accommodate those who may not believe in immunization mandates.
State Mandates of Immunization and Vaccine Preventable Diseases Exemptions States have implemented a variety of immunization exemption laws and administrative rules.
Although exemption laws vary from state to state, all states allow exemptions for medical reasons, and almost all states except Mississippi and West Virginia grant religious exemptions for people who have sincere religious beliefs that prohibit immunizations.
Some states have passed laws allowing individuals to claim philosophic exemptions. Currently, 20 states have some type of philosophical exemption law. These laws allow parents to claim an exemption based on their personal, moral or other beliefs.
National Conference of State Legislatures webpage.
The two sources of federal funds are: This program provides free vaccines for children who are uninsured, Medicaid-eligible, underinsured if receiving immunizations in a federally qualified health center or rural health clinicNative American or Alaska Native.
Under sectionprior to enactment of the ACA, states could purchase only recommended childhood immunizations; however, the ACA authorizes states to purchase recommended vaccines for adults as well.
Department of Health and Human Services secretary can negotiate and contract with vaccine manufacturers, allowing states to receive adult vaccines at a negotiated price and provide these vaccines to adults in their immunization programs.
State Programs The majority of states depend primarily on federal resources to purchase vaccines. However, federal programs do not cover all children, so many states supplement these funds.
As of7 states Indiana, Maine, New Hampshire, New Mexico, Rhode Island, Vermont, and Washington have universal purchase policies where the states or territory purchase all recommended vaccines for all children, including those who are fully insured.
Two other states Florida and North Dakota and American Samoa have universal purchase polices for public providers. Ohio has a universal select program for public providers.
Once purchased, these vaccines are distributed to all public and private providers, who may charge an administration fee. The ACA requires new health plans and insurance policies to provide coverage without cost sharing, such as copayments or coinsurance, for certain preventive services.
Preventive services in the law specifically include immunizations recommended by the national Advisory Committee on Immunization Practices ACIP —15 health experts appointed by the U.
Secretary of Health and Human Services, who recommend vaccine schedules for children, adolescents and adults.Abuse, Neglect, and Exploitation in Long-Term Care Facilities. Sadly, older persons are not always treated with respect nor do they always get the care they need.
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The United States spends approximately 15 percent of its gross domestic product on health care, making health care the largest single sector of the U.S. economy. Describe the critical policy issues related to quality of care. Quality of care becomes increasingly important in the face of managed care and concerns about the implications of doing less.
Funding to evaluate new treatment methods and diagnostic tools is . Describe the critical policy issues related to access to care, cost of care, and quality of care. Pick your future career within the healthcare field.