State Legislators: A Critical Role of Ensuring Resources Efficiency - Research Paper Example

 Executive Summary State legislators play a critical role of ensuring that resources are well spent in their areas of jurisdiction by entities aimed at protecting the health of the public. These agencies must educate the public and intervene in a wide variety of issues. These include ensuring that children and adults at risk are immunised. The victims of chronic conditions such as cancer and asthma get assistance through these agencies. These agencies also research on the prevention of sexually transmitted diseases can be prevented. State legislators need to know that the aging population is growing fast. Americans aged 65 and above is predictable to dupe in the two decades due to amplified life expectancy. The aging population is increasingly becoming diverse. The American Census Bureau claims that the older people will be 72% white, 10% African-American, 11% Hispanic and 5% Asian. Also, healthcare costs will increase for the aging. The growing population composition among the old is expected to rise by 25% by the year 2030. Chronic diseases are the major causes of increasing health-care costs. Protracted illnesses cause 70% of deaths in the U.S. This is 75% of the $2 trillion spent annually on healthcare. Research shows that disability and decline are not inevitable consequences of aging (Prevention, The State of Aging and Health in America 2007, 2007). Context and Importance of the Problem State legislators can help improve the health of the aging by promoting healthy aging. It can also expand the use of preventive services. The legislators can also facilitate healthy lifestyles and support effort's to allow older Americans to remain independent and age properly. Information concerning this area of interest can be acquired from Healthy States Website, Health Policy Highlights and Healthy States e–Weekly, Healthy States Quarterly, Forums and Web Conferences and Healthy States Publications. These sources have much information ranging from health topics, chronic disease control, HIV/AIDS and sexually transmitted diseases, vaccines, public health legislative and policy trends school health and health disparities. Legislators can promote the message that it is still not too late. Elderly citizens can profit from approving healthy lifestyles. They can encourage this by conducting communication's campaigns targeted at the seniors. Legislators can use media for the announcements of public services. They can also support the state’s Senior Olympic Games and improve the Older Americans’ Month in May each year. Legislators can also encourage state and local agencies to volunteer opportunities for older adults. Volunteering is a key component in ensuring good health and quality of life (Chapman S, 2005). Legislators can help expand the use of preventive services. They can encourage collaboration between the public health departments of state units to support the aging. It ensures that such programs are delivered most efficiently and to the broadest coverage. Moreover, legislators can establish incentives for third-party insurance coverage of preventive services. Chronic disease self-management programs can be established throughout the state. The rate of adult immunisations should be broadened. Consequently, harmonisation and communication that occurs between providers and the community can be improved. Legislators should establish the healthcare system for retirees who were state employees. It will act as a model for improved access to health-enhancing behaviour. In addition, legislators can increase training to improve the access to health-enhancing behaviours and preventive services (His W, 2007). Legislators can support the aging in place through a number of ways. First, they can provide funding to support community programs that are collaborations between health-care and social service agencies. Successful aging in place strategies recognise and develop on integrated health and social services. In addition, they can provide incentives and guidance to planning boards at a local level to incorporate community and housing design features to achieve ideal communities for older adults. The above is achieved by increasing alternative transport forms and opportunities for safe and reliable physical activity. They can incorporate universal design features in new home construction. It will ensure the safety for all family members. Pedestrian safety can be improved among older adults in extension to safe driving. Therefore, all the above activities aim at developing walkable communities (Journal.com, 2007). Legislators can work to minimise and if possible eliminate the institutional bias in Medicare by providing funds for home and community-based projects. They should provide leadership to take care of end-of-life and palliative care issues, which include pain management and increased use of advance planning and directives. They should learn more about health promotion programs with evidence based track records of success. The latest information on healthy aging can be obtained by the Centres for Disease Control and Prevention (CDC). Critique of Policy Choices In 2005, Choices for Care, began giving allowance for all Medicare eligible seniors to choose where to live in Vermont. The choices are between nursing homes, residential care facilities and their own homes for care. In instances where individuals elect to stay at home, the caregivers are compensated for their time. Policymakers have found that many of the older residents prefer their own homes to receive care. Choices for Care have been instrumental for making this a viable option. In addition, these approaches save healthcare costs by reducing the number of people enrolled in expensive nursing home facilities (Hoffman C, 1996). In 2002, Michigan received grant through the Michigan division that deals with injury and prevention of violence received a grant. The grant was from CDC to institute fall prevention clinics that target those who are at least 65 years old and are at the risk of fall-related injuries. Evaluation outcomes showed that the fall prevention clinics reduced fall injuries including counselling and education and for patients and families. Training courses were developed for healthcare professional. It enables them to provide professional care to deal with adults in fall-related injuries (Kaiser Commission, 2006). Texas strived to increase choices among its aged populations. The launch of an innovative program called Money Follows the Person was launched in 2001. Since its institution, the program has successfully provided the elderly and disabled with options. These options include home and community-based care. They have helped in the transition from institutionalisation for an excess of 12,000 Texans back to their homes. This platform is intended to remove waiting lists for old people in need of Medicare wishing to receive home and community based care instead of staying in Medicare funded nursing facilities. Those who wish to receive care in their own homes and communities can do so through the above program because Medicare funding follows them wherever they choose to receive care (Partnership to Fight Chronic Diseases, 2007). In Florida, the aim was to better health and wellness. With around 23% of its people at least sixty, makes it crucial for Florida to invest in the health and wellness of the old. The HWPP (Health and Wellness Promotion Program) is realised via the Department of Elder Affairs and its 11 Area Agencies on Aging. The initiative critiques the chief fitness glitches that inflict the elderly. Through this initiative, the elderly become better informed about numerous age-related health topics. These include osteoporosis, stiffness, breast tumours, diabetes, circulatory health, prescription administration, psychological health, nourishment and physical fitness. The initiative has made advances in stopping the institution and deterioration of the quality of health for many older adults in Florida (Foundation, 2006). Recommendations Some legislators a long list of legislation to improve the lives of seniors. They have introduced bills to expand case management services. Other recommendations have been to provide no-interest loans for home modifications and the requirements that those who abuse the elderly be immediately reported. Centres in which seniors dwell require have been required to include emergency operation plans. Many legislators have increased efforts towards building services infrastructure that allows seniors to remain in their own homes. The following are recommendations to legislative officers from the point of view of a legislator. The core help to state legislators is adequate planning. The United States has looming crisis since the number of the aged in the group meets an outdated service system. It is significant that there be an institution of comprehensive plans to address the needs of the aging. Funding is also critical to support the essential services. State legislators also need to do their research and get educated. Such materials can be got from offices that are responsible for the formulation of policies in order to give solutions. Building coalitions means that legislators should combine efforts and bring all parties to the table. Policymakers lead the way, however, they need support from advocates, service providers, academia, as well as consumers in order to address the needs of an aging population in the US. It will involve massive investment of time. However, they need to be patient (Lorig, 2001). Legislators should also use the tools that are available to them. Legislators have a high opportunity of drawing attention to both innovative programs and critical areas to ensure that there is service expansion. For example, legislators can hold hearings, town hall meetings, record public service announcements and carry out mail campaigns. Some public health officials who have worked in the health and human services field for an excess of 27 years help legislators on what needs to be dome. These people have been massively involved in the expansion of home- and community-based programs. The following are the recommendations for legislators regarding policies of the aged, from the point of view of the public health official. They advocate for this approach for offering care to the elderly as opposed to placing them in nursing homes. State legislators should not be short-sighted. Many legislators find it difficult to invest massive amounts of money in preventive services such as falls. The reason is because the full benefits of the investment are not realised instantaneously. However, through such services, expensive institutionalisations are mitigated. It means that the state is able to save much money in the long-run. This is the justification for the investment (Hoffman, 1996). Legislators should be reminded that isolation leads to the detriment of the health of seniors. This is because isolation heightens the feelings of loneliness and depression. The deterioration of health leads to an increase in the cost of healthcare to the state. It is paramount to give a chance so that the aged can stay at home with their communities through good policy formulation. These will help to fight off the negative effects caused by social isolation. Legislators must be at the forefront in promoting safe communities. This must continue for as long as possible. The intention is realised by giving the elderly with centres that have recreational and educational opportunities. Sidewalks should be made accessible to wheel chairs. It will provide safety for pedestrians in driving as well as other activities that promote their safety (Rose, 2005). Legislators should always stay informed. They should take an active and central role in health aging policy by staying informed about the numerous issues that affect the aging population in the population of the community. The legislators should listen to their constituents and recall their needs as they draft the policies. This end can be achieved remembering that the number of people over the age of 65 will have doubled by 2030. Also, the country’s generalisation views are widening leading to the creation of distinct age groups within the state. Reduced mortality rates have made some areas in America older than the entire country. However, high immigrant rates and birth rates have slowed the aging of other states (Hoffman, 1996). Also, older Americans desire to age in place. This means that they want to grow older without having to translocate from one area to another, other than the areas an elderly person considers home. Approximately 27% of seniors dwell in Naturally Occurring Retirement Community (NORC). This is a community or neighbourhood where residents remain for many years and grow old as neighbours. Fewer elderly and disabled people lived in nursing centres today than in 1990. However, many elderly people depend on assisted-living residences in order to receive care in their homes (Freedman, 2006). Presently, at least 80% of older Americans are living with at least a single chronic condition. Moreover, 50% have at least two chronic conditions. An excess of 66.67% of the current health-care costs is for dealing with chronic illnesses among older Americans. The percentage of people aged between 65 and 74 who are considered obese is at a whole time high. Of these, 33% are men while 37% are women. Health problems arising from obesity include cancer, cardiovascular disease, breathing problems, osteoarthritis and depression (Globe, 2006). Fall is the main cause of injury among the elderly. These fall lead to hip fractures, which are the most costly fall-related fracture. Twenty-nine percent of people who fracture their hips die within a year. In 2004, around $160 million was spent on long-term services. Long term services makeup a third to a half of total Medicare expenses in most of the states. In 2005, expenses on home and community-based care accounted for $35.2 million of total Medicare long-term care services spending. This was an increase from 14% of the total expenditure in 1991 (Resource, 2007). However, healthcare costs for the old can be reduced. It is known that healthcare costs increase as people age. However, public health programs that reduce disability and maintain independence create opportunities to reduce these costs. One way of reducing these costs includes education on chronic illnesses that provide the elderly with tools that aid in decision making. One study estimated the savings at around $390 to $520 for each person in the course of a two-year period. Other studies have found that older citizens who have no children to care and support them have fewer of ending up in nursing homes. This is the case if they live in a state that spends more on home-and-community-based services. The research finding did not apply to the elderly with children (The State of Aging and Health in America, 2007). Injuries can be prevented. A study was done recently found that efforts to prevent falls aimed at frail adults can minimise the risk of falling and other injuries by around 25%. Some exercises such as tai chi and strength-building have proved effective in maximising muscular strength and balance in elderly adults. The effect of these actions is a decline in the chances of fall-related injuries. It is true that the health of the aging can be preserved. Physical activity carried out on a regular basis contributes massively to fitness, health, functioning and quality of the lives of the aged. High quality of life can be enhanced among the aged through increasing social interactions. Many people have the ability to enjoy good health even past the age of 85. Life in later periods does not need to be a declining state in health. Most aged people experience a number of healthy years followed by a shorter period of bad health just before death (He, 2007). Enhanced fitness has been found to increase strength, boost the levels of activity and elevate people’s moods. Such programs are generally offered by communities. They focus on stretching, flexibility, balance, low-impact aerobics and strength-training activities (Journal.com, 2007). The magnitude of the US economy is a total of what we are all spending. Overall housing spending hits an all-time high when people are about 46 years of age. The resources of this century have provided the United States with an opportunity to deal with the problems afflicting the older population. If the government through legislators who are the policy makers follow the recommendations stated in this policy brief, then the nation will benefit (Chapman, 2005). This is important since the elderly in society take up around 66% of the nation’s total healthcare money. The elderly in America need flu vaccine, pneumonia vaccine and other modern preventive services. Despite the fact that many states have experienced success in tackling obesity, blood pressure and smoking, the above problems present a serious challenge. The mobility of the elderly should not be forgotten when dealing with the safety of Americans. In general, the American population is aging. In addition, it is becoming increasingly racially and ethnically diverse. The racial and ethnic diversity is set to increase as the years go by. The government should deal with respiratory diseases, Alzheimer’s disease and diabetes among the old people. The elderly should not be isolated since the practice leads to lower quality of life as well as independence. People with more than one chronic condition should be given more special attention (Journal.com, 2007). References Chapman S, e. (2005). Trends in the Supply of Long-Term-Care Facilities and Beds in the United States. Journal of Applied Gerontology, 24(4), 265–282. D, R. (2005). The Role of Exercise in Reducing Falls and Fall-Related Injuries in Older Adults. Washington, DC: The National Council of the Aging. Disease, P. t. (2007). The Growing Crisis of Chronic Disease in the United States. Partnership to Fight Chronic Disease. Retrieved from http://www.fightchronicdisease.org/pdfs/ChronicDiseaseFactSheet.pdf Foundation, M. (2006). The Maturing of America: Getting Communities on Track for an Aging Population. Metlife Foundation. Retrieved from http://www.n4a.org/pdf/MOAFinalReport.pdf Freedman VA, e. a. (2006). Promoting Declines in the Prevalence of Late-Life Disability: Comparisons of Three Potentially High-Impact Interventions. The Milbank Quarterly, 84(3). Globe, T. B. (2006). Hip Fractures a Mortal Test for Elders and for Medicine. The Boston Globe. He W, e. a. (2007). 65+ in the United States: Current Population Reports. U.S. Census Bureau. Retrieved from http://www.census.gov/prod/2006pubs/p23-209.pdf Hoffman C, R. D. (1996). Persons with Chronic Conditions: Their Prevalence and Costs. Journal of the American Medical Association, 276(18), 1473–1479. Journal.com, S. (2007). Elderly Less Likely to Enter Nursing Home in States with More Services. Senior Journal.com. Retrieved from http://www.seniorjournal.com/NEWS/Eldercare/2007/7-05-15-ElderlyLess.htm Lorig KR, R. P. (2001). Chronic Disease Self-Management Program: 2-year Health Status and Health Care Utilization Outcomes. Medical Care, 29(11), 1217–23. Prevention, C. f. (2003). Public Health and Aging: Trends in Aging—United States and Worldwide. Morbidity and Mortality Weekly Report, 52(6), 101–106. Prevention, C. f. (2007). The State of Aging and Health in America 2007. Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/aging/pdf/saha_2007.pdf Resource, S. (2007). Aging in Place. Senior Resource. Retrieved from http://www.seniorresource.com/ageinpl.htm Uninsured, K. C. (2006). Medicaid and Long-Term Care Services. Kaiser Commission on Medicaid and the Uninsured. Retrieved from http://www.kff.org/medicaid/upload/Medicaid-and-Long-Term-Care-Services-PDF.pdf Read More