A Note From The Editors
by frank news
March 11, 2020
The below list is an ongoing collection of definitions of terms and services relevant to this months theme. These are colloquial definitions created with and by medical professionals. Part one can be found here.
Long Term Care Services
Facility-based long-term care services include: residential facilities, assisted living facilities, nursing homes, and continuing care retirement communities.
*Board and care homes, also called residential care facilities or group homes, are small private facilities, usually with 20 or fewer residents. Rooms may be private or shared. Residents receive personal care and meals and have staff available around the clock. Nursing and medical care usually are not provided on site.
**Assisted living is for people who need help with daily care, but not as much help as a nursing home provides. Assisted living facilities range in size from as few as 25 residents to 120 or more. Typically, a few "levels of care" are offered, with residents paying more for higher levels of care.
Assisted living residents usually live in their own apartments or rooms and share common areas. They have access to many services, including up to three meals a day; assistance with personal care; help with medications, housekeeping, and laundry; 24-hour supervision, security, and on-site staff; and social and recreational activities. Exact arrangements vary from state to state.
***Nursing homes, also called skilled nursing facilities, provide a wide range of health and personal care services. Their services focus on medical care more than most assisted living facilities. These services typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities. Rehabilitation services, such as physical, occupational, and speech therapy, are also available.
Community Based Services
Community-based services are designed to support individuals living in their own community and include a broad array of outpatient services, medication management, case management, crisis services, and intensive evidence-based services as well as a variety of other services provided on a lessthan-24-hour basis.
SAMHSA (Substance Abuse and Mental Health Services Adminstration: lead agency in HHS)
Funds community mental health centers, childrens mental health services, projects for homelessness transition, protection and advocacy for individuals with mental illness.
HRSA (Health Resources and Services Admin)
Health care for rural, HIV, mothers/families and a lot of public health programs like national loan forgiveness.
CMS (Center for Medicaid and Medicare)
*Medicare: older americans, end stage renal disease, anyone getting disability insurance.
*Medicaid: low income individuals.
The below list is an ongoing collection of definitions of terms and services relevant to this months theme. These are colloquial definitions created with and by medical professionals.
Federal program that provides coverage of health care services for individuals aged 65 years and older, certain individuals with disabilities, and individuals with end-stage renal disease.
Centers for Medicare and Medicaid Services (CMS)
The CMS administers Medicaid, Medicare, the Children’s Health Insurance Program, and insurance regulations for federally qualified health insurance policies offered through state and federal insurance marketplaces established under the ACA.
HIPAA & patient privacy
Health Insurance Portability and Accountability Act (HIPAA) allows patient information to be shared in order to provide care coordination. HIPAA allows disclosure without the consent of the patient for purposes of payment, treatment, and health care operations.
Health & Human Services (HHS)
Coordinates three tiers of health departments, the federal health department, state health department and local health department.
*In relation with state and local government, the federal government provides states with funding to ensure that states are able to retain current programs and are able to implement new programs.
**The health department at state level needs to safeguard good relations with legislators as well as governors in order to acquire legal and financial aid to guarantee the development and enhancements of the programs.
***The state sets up the regulations and health policies whereas the local health departments are the ones implementing the health policies and services.
42 CFR and Patient Privacy
Specifically, a federal statute written in the 1970s called the Confidentiality of Alcohol and Drug Abuse Patient Records, 42 Code of Federal Regulations (CFR) 2 (known as 42 CFR Part 2) was intended to protect patient privacy by keeping SUD records separate from other medical records.89 To be sure, disclosure of information related to the diagnosis and treatment of SUD could harm patients and cause them to avoid treatment. The disclosure of treatment records has the potential to lead to adverse outcomes such as loss of employment, loss of housing, loss of child custody, discrimination by medical professionals and insurers, arrest, prosecution, and incarceration.
*While intended to protect individuals from these outcomes related to the stigma surrounding treatment, 42 CFR Part 2 has had the unintended consequence of limiting treatment providers from sharing information that would provide better and more integrated care for a patient who is also seeking care for other health conditions. Primary care practitioners, for example, have no way of knowing about a patient’s SUD and accompanying treatment unless the patient discloses that information during a visit.