Funding Health Care Services

Funding Health Care Services

Scenario

The writer of this work is a senior advisor of XYZ Health Care Organization and has been tasked with making a recommendation regarding how health care expenses associated with the following services should be funded within your state. The recommendations made will then be a part of a proposal that will be shared with state legislators.

State of Alabama

The State of Alabama has several programs funding healthcare. For example in 1997, legislation was passed to make provision of health care to children of families who were not able to purchase private health insurance. This program is known as the Child Health Insurance Program (CHIP) at the federal level and is called ALL Kids in Alabama. It is reported that the original U.S. legislation "provided $24 billion in aid to be used over a ten-year period. The Department of Public Health is reported to be under a mandate to make provision of services for the improvement and protection of the public's health. Funding for the Department is passed each year by the Legislature and comes from the General Fund. When the fund runs short, services have to be cut." (League of Women Voters, 2010) It is reported that funds are provisioned for these services but the funds generally run out before the year is up.

Programs with Private Funding

Health care programs reported to be administered with private funding includes the following stated pogroms:

(1) ALABAMA CHILD CARING FOUNDATION - This nonprofit private Foundation was founded in 1988 to provide health insurance for children under 18 years of age who do not qualify for other insurance options. It is a partnership program between Blue Cross/Blue Shield of Alabama and the Foundation. Every $240 from the Foundation pays for insurance for one child for one year with matching funds from BC/BS, which covers another child,'s insurance. No public funds are used. This is a program unique to Alabama. The Foundation coordinates with both Medicaid and ALL Kids using a common application. If a child does not qualify for a federal or state program, the application is sent to the Foundation for assistance. Eligibility requires that parent's annual income is equal to or less than 235% of the poverty level. All donated funds cover children in the local county. As of 2009." (League of Women Voters, 2010)

(2) COMMUNITY CHARITY CLINICS: Most urban communities have one or more charity clinics, which have been established by private efforts. Each program has its own guidelines. Most are run by volunteer health care professionals who give a few hours of their time each week. (League of Women Voters, 2010)

It is reported that several offices in Alabama make decisions "regarding policy and funding for the various programs in the state. Those programs include

(1) The Statewide Health Coordinating Council (SHCC) -- Appointed by the governor, the Council makes recommendations for development of state health policy. All members are medical doctors. (League of Women Voters, 2010)

(2) Certificate of Need Review Board (CON) -- Requires hospitals, nursing homes, ambulatory surgery centers and diagnostic imaging facilities to have explicit approval before they can operate. (League of Women Voters, 2010 )

(3) Alabama Department of Public Health. (League of Women Voters, 2010)

(4) Governor's Office -- Influences health decisions through budget and policy recommendations to the Legislature as well as nomination of department heads and other positions such as SHCC. (League of Women Voters, 2010)

(5) Legislature -- Provides funding and oversight for state programs. (League of Women Voters, 2010)

(6) U.S. Government -- Sets mandates for many state programs and impacts state budgets and programs through matching fund requirements. (League of Women Voters, 2010)

It is reported that Alabama has received a total of $9,772,451 in grants for research, planning, information technology development, and implementation of Affordable Insurance Exchanges. In addition, Alabama has received the following stated grants:

(1) $1,180,312 in Planning Grants: This grant provides Alabama the resources needed to conduct the research and planning necessary to build a better health insurance marketplace and determine how its exchange will be operated and governed.

(2) $8,592,139 in Exchange Establishment Grants: These grants are helping States continue their work to implement key provisions of the Affordable Care Act.

Reported as well is that Alabama has received $9,200,000 in grants from the Prevention and Public Health Fund created by the Affordable Care Act. This new fund was created to support effective policies in Alabama, its communities, and nationwide so that all Americans can lead longer, more productive lives." (Healthcare.gov, 2012) Reported as examples of Affordable Care Act grants to Alabama are the following:

(1) $863,000 for school-based health centers, to help clinics expand and provide more health care services such as screenings to students.

(2) $530,000 to support outreach to eligible Medicare beneficiaries about their benefits.