HLTH 3110 WALDEN UNIVERISTY CURRENT ISSIES IN HEALTHCARE POLICY AND PRACTICE

To prepare for this Assignment:

• Review the Learning Resources related to the acute healthcare facilities and services presented this week (Week 2) and the long-term healthcare facilities and services that will be presented next week (Week 3).
• Identify the healthcare (both acute and long-term) facilities and services in your community.
• Gather specific information about the different healthcare options that you selected, such as services, coverage, and accessibility
• Review U.S. News & World Report’s. “2018–Healthiest Communities Rankings,” located in the Learning Resources
• MY COMMUNITY IS: VIRGINIA

The Assignment

Imagine that you are a member of a community health advocacy group whose mission is to advocate for access to comprehensive, quality healthcare in the community. You have been asked by the group to prepare a presentation for the city council that will describe the community’s current healthcare facilities and services, any gaps in services, and the impact the services or lack of services have on the community.

The presentation should be 6 to 8 slides, not including the title and the reference slides. To complete the presentation, each PowerPoint (PPT) slide (except the title, objectives, and references slides) should contain talking points in the “Speaker Notes” section of the PPT that act as a narration script for the slides. The talking points should be written as if they were going to be read word for word during the presentation while displaying the slides. You should also include information about your community’s health rankings using the U.S. News & World Report’s “2018 Healthiest Communities Rankings” interactive website.

It is not necessary to provide a recorded audio narration as part of the Assignment.Tutorials on how to create a PowerPoint presentation and add to the “Speaker Notes” section can be found in the Walden Writing Center and in the Learning Resources.

1/28/24, 2:05 PM
Healthiest Counties in the US | US News Healthiest Communities
NEWS
Sign In
See COVID-19 Data for Your Community »
Home / News / Healthiest Communities / Overall Rankings
Healthiest Communities Rankings 2022
Measuring health and wellness across the U.S. using 89 metrics
County Name or ZIP Code
( G E T T Y I M AG E S )
Explore the 2022 rankings of the top 500 Healthiest Communities nationwide. See how each county scored across 10
categories that drive community health on a scale of zero to 100.
READ MORE
RANK
C O U NT Y
1
Los Alamos County, New Mexico
2
Falls Church city, Virginia
3
Douglas County, Colorado
https://www.usnews.com/news/healthiest-communities/rankings
1/6
1/28/24, 2:05 PM
Healthiest Counties in the US | US News Healthiest Communities
4
Morgan County, Utah
5
Carver County, Minnesota
6
Sioux County, Iowa
7
Ozaukee County, Wisconsin
8
Hamilton County, Indiana
9
Broomfield County, Colorado
10
Delaware County, Ohio
11
Dallas County, Iowa
12
Loudoun County, Virginia
13
Arlington County, Virginia
14
Union County, South Dakota
15
Teton County, Wyoming
16
Morris County, New Jersey
17
Fairfax County, Virginia
18
Howard County, Maryland
19
Williamson County, Tennessee
20
Johnson County, Kansas
https://www.usnews.com/news/healthiest-communities/rankings
2/6
1/28/24, 2:05 PM
Healthiest Counties in the US | US News Healthiest Communities
21
Lincoln County, South Dakota
22
Waukesha County, Wisconsin
23
Dodge County, Minnesota
24
Hamilton County, Nebraska
25
Washington County, Minnesota
Expand List
Peer Groups
In addition to the overall national rankings, counties were divided into peer groups based on their urban-rural status
and economic performance to allow for comparisons among similar communities.
Urban, High-Performing
Urban, Up-and-Coming
Rural, High-Performing
Rural, Up-and-Coming
Learn More About Healthiest Communities
The 2022 Healthiest Communities rankings were created with the assistance of the University of Missouri Extension
Center for Applied Research and Engagement Systems – a research institution skilled in understanding natural
resource systems, public health risks and community health assessment.
The overall rankings identify the top 500 Healthiest Communities in America, ranging from No. 1 Los Alamos County,
New Mexico, to No. 500 Madison County, Nebraska.
https://www.usnews.com/news/healthiest-communities/rankings
3/6
1/28/24, 2:05 PM
Healthiest Counties in the US | US News Healthiest Communities
Beyond the rankings, the Healthiest Communities platform offers data on each of the thousands of communities
evaluated, fostering insights and analysis that will educate and inform consumers and policymakers on what’s
occurring in their communities. Users also can dive into the data with our interactive explorer tools.
Healthiest Communities Data Explorer
Dive into the Healthiest Communities data with our interactive explorer tools. You can view existing charts, create your own with the 89 metrics used
to discover the nation’s Healthiest Communities and draw county-to-county comparisons across categories.
Explore the Data
Healthiest Communities Methodology
U.S. News uses data from well-recognized sources such as the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid
Services to assess U.S. counties for the Healthiest Communities rankings. See the full list of data sources and learn how counties are scored.
Learn More
YOU MAY ALSO LIKE
How to Stay Warm in Layered Clothing and Avoid Frostbite This Winter
As a bout of bitter and deadly cold sweeps the U.S., millions of Americans are being told to dress in layers
if they must go outside
Associated Press Jan. 19, 2024
How to Stay Healthy During Cold, Flu and COVID-19 Season
Getting through winter healthy means trying to protect yourself from respiratory viruses
Associated Press Jan. 19, 2024
https://www.usnews.com/news/healthiest-communities/rankings
4/6
1/28/24, 2:05 PM
Healthiest Counties in the US | US News Healthiest Communities
Defense Department to Again Target ‘Forever Chemicals’ Contamination Near Michigan
Military Base
The U.S. Department of Defense plans to install more groundwater treatment systems at a former
Michigan military base to control contamination from so-called forever chemicals
Associated Press Jan. 19, 2024
Powering more businesses than anyone.
See why businesses choose Comcast Business.
AD
Comcast Business
LEARN MORE
A First-Ever Experiment Shows How Pigs Might One Day Help People Who Have Liver
Failure
Researchers at the University of Pennsylvania have externally attached a pig liver to a brain-dead human
body and watched it successfully filter blood
Associated Press Jan. 18, 2024
Wastewater Tests Can Find Mpox, Study Finds. Expect More Bugs to Be Tracked That Way
New research bolsters a push to use sewage to track more diseases in the U.S. Wastewater testing does
a good job at detecting mpox infections
Associated Press Jan. 18, 2024
Load More
HEALTHIEST COMMUNITIES
Healthiest Communities is an interactive destination developed by U.S. News & World Report for consumers and policymakers.
Backed by in-depth research and accompanied by news and analysis, the site features comprehensive rankings drawn from an
examination of nearly 3,000 counties and county-equivalents on 89 metrics across 10 categories, informing residents, health care
leaders and officials about local policies and practices that drive better health outcomes for all. Data was gathered and analyzed by
the University of Missouri Extension Center for Applied Research and Engagement Systems (CARES).
https://www.usnews.com/news/healthiest-communities/rankings
5/6
1/28/24, 2:05 PM
Healthiest Counties in the US | US News Healthiest Communities
BEST COUNTRIES
BEST STATES
THE REPORT
PHOTOS
HEALTHIEST COMMUNITIES
ELECTIONS
NEWS
EVENTS
About Editorial Guidelines Contact Press Advertise Newsletters Jobs Site Map Store
Copyright 2024 © U.S. News & World Report L.P.
https://www.usnews.com/news/healthiest-communities/rankings
Terms & Conditions/Privacy Policy/U.S. State Privacy Notice/Your Privacy Choices
6/6
1/28/24, 2:12 PM
Long-Term Care in the United States: A Timeline | KFF
Kaiser Commission on Medicaid and the Uninsured
Long-Term Care in the United States: A Timeline
The independent source for health policy research, polling, and news.
Published: Aug 31, 2015





Long-term care (LTC) in the United States has evolved over the course of the last century to better serve the needs of
seniors and persons with disabilities. This timeline outlines the major milestones in LTC from the nursing home era, which
created an institutional bias in LTC, to the era of home and community based services (HCBS) and integration, and into
the era of health reform and beyond. These milestones include key legislation and court decisions that were instrumental
in providing LTC funding; improving the quality of care and safety in nursing homes; and allowing people with LTC needs
to stay in their communities. Despite these successes, proposals by commissions and legislators for broader and more
comprehensive national LTC policies have not been fully realized; though efforts in this area continue. Download the PDF
(https://www.kff.org/wp-content/uploads/2015/08/8773-long-term-care-in-the-united-states-a-timeline1.pdf).
Timeline by year:
1935 | 1950 | 1965 | 1967 | 1968 | 1974 | 1975 | 1978 | 1980 | 1981 | 1982 | 1984 | 1987 | 1988 | 1989 | 1990 | 1993 | 1994 | 1995 |
1999 | 2000| 2001 | 2005 | 2006 | 2010 | 2011 | 2013 | 2014 | 2015
THE ERA OF NURSING HOMES
1935:
Social Security Act (SSA) enacted.
Under the SSA, the Old Age Assistance program makes federal money available to the states to provide financial
assistance to poor seniors. The law specifically prohibits making these payments to anyone living in public institutions
(poor houses, which had become known for their terrible living conditions), thus spawning the creation of the private
nursing home industry.
1950:
An amendment to the SSA requires payments for medical care to be made directly to nursing homes rather than
beneficiaries of care. Under the amendments, states are also required to license nursing homes in order to participate in
the Old Age Assistance program.
1965:
Medicare and Medicaid are passed as amendments to the SSA. Medicare’s focus is on acute care only and does notSign up for the latest
on health policy
provide for long-term care (LTC). Medicaid requires coverage of LTC in institutions but not in the home, creating a bias in
favor of institutional LTC. Under this legislation, the federal and state governments become the largest payers for LTC:research, polling,
nursing home utilization increases dramatically, along with government expenditures.
and news,
twice a week.
Older Americans Act (OAA) enacted, establishing Administration on Aging within the department of Health, Education and
Email *
Wellness (HEW).
1967:
As a response to public outcry over fraud and abuse in nursing homes, 1967 Amendments to the SSA include a provision
for states to govern the licensing of nursing home administrators.

Long-Term Care in the United States: A Timeline

Subscribe
1/5
1/28/24, 2:12 PM
Long-Term Care in the United States: A Timeline | KFF
1968:
“Moss Amendments” are passed to authorize HEW to standardize the regulations for the Medicare and Medicaid programs
and to withhold funding from nursing homes that do not meet those standards, paving the way for comprehensive
regulations to improve nursing home care.
THE ERA OF COMMUNITY-BASED SERVICES
1974:
1974 SSA amendments authorize federal grants to states for social services programs including homemaker services,
protective services, transportation, adult day care, training for employment, nutrition assistance and health support.
Final regulations for skilled nursing facilities are put into effect and enforcement of compliance with standards such as
staffing levels, staff qualifications, fire safety, and delivery of services become a requirement for participation in Medicare
and Medicaid.
1975:
1975 SSA amendments create Title XX, which consolidate the federal assistance to states for social services into a single
grant. Under Title XX states are required to prevent or reduce inappropriate institutional care by providing for home and
community-based services (HCBS).
1978:
The Comprehensive OAA Amendments of 1978 require all states to develop and implement a nursing home ombudsman
program and to prioritize community alternatives to LTC.
1980:
Mental Health Systems Act of 1980 provides federal funding for ongoing support and development of community mental
health programs with an emphasis on deinstitutionalization.
The U.S. Department of Health and Human Services’ (HHS) National Long-Term Care Channeling Demonstration to test
quality and cost-effectiveness of HCBS for frail seniors is implemented. It runs through 1986.
1981:
HCBS waiver program is enacted under Section 1915(c) of the SSA, allowing states to offer home and community-based
services that are not strictly medical in nature through Medicaid as an alternative to institutional care.
1982:
Established under the Tax Equity and Fiscal Responsibility Act, the Katie Beckett Medicaid state plan option permits states
to cover children with disabilities living in the community; previously, these children were eligible for Medicaid only if
institutionalized.
1984:
Reauthorization of OAA reaffirms role of State Area Agencies on Aging in coordinating HCBS.
1987:
Under OBRA-87, The Nursing Home Reform Act imposes quality standards for Medicare and Medicaid-certified nursing
homes in response to well-documented quality issues facing seniors in nursing homes. Reauthorization of the OAA adds
six additional distinct authorizations of appropriations for services including in-home services for frail seniors; LTC
ombudsman; and prevention of elder abuse, neglect and exploitation.

Long-Term Care in the United States: A Timeline

2/5
1/28/24, 2:12 PM
Long-Term Care in the United States: A Timeline | KFF
The Robert Wood Johnson Foundation (RWJF) begins support for long-term care public/private partnership programs in
four states to encourage people to purchase LTC insurance in order to potentially offset their need for care financed by
Medicaid.
1988:
Medicare Catastrophic Act of 1988 – Among other things, expands skilled nursing facility (SNF) benefits by removing time
limits on most hospital service coverage and establishes protections against spousal impoverishment from nursing home
expenses, but still does not pay for long-term custodial nursing home care. It also requires Medicaid to cover Medicare
premiums and cost-sharing for Medicare beneficiaries with incomes below 100% FPL and limited assets (Qualified
Medicare Beneficiaries, QMBs).
Congress creates the U.S. Bipartisan Commission on Comprehensive Health Care to recommend legislative action on
health and long-term care. The Commission is renamed the Pepper Commission in honor of its creator and first chair,
Representative Claude Pepper (D-FL).
1989:
Repeal of Medicare Catastrophic Act; provisions on spousal impoverishment and QMBs are kept in place.
1990:
OBRA-90 – Requires state Medicaid programs to cover premiums for Medicare beneficiaries with incomes between 100120% FPL. Medicare is expanded to cover partial hospitalization services in community mental health centers.
The Pepper Commission issues report on LTSS financing options, with a set of recommendations on LTC that include an
initiative that would establish government or social insurance to keep resources intact for people with severe disabilities
at home or with the potential to return home after a short nursing home stay, and would establish a floor of protection
against impoverishment for all nursing home users, no matter how long their stay. It also proposes to cover the first 3
months of nursing home care with 20% copayment and coverage of home care services for Medicare elders with 3+
Activity of Daily Living (ADL) impairments. The recommendations are never enacted.
Americans with Disabilities Act (ADA) enacted. The Act emphasizes the importance of integrating people with disabilities
into the community and ending exclusion and segregation.
1993:
Clinton Health Care Plan includes plans to expand HCBS; improve Medicaid coverage for institutional care; and establish
minimum standards to improve the quality of private insurance for LTC and tax incentives to encourage its purchase. The
plan is never enacted.
1994:
The final rule for OBRA-87 is published, eight years after the law is passed.
1995:
As part of a larger attempt to reform Medicaid, the Nursing Home Reform Act is nearly repealed, but through interventions
by consumer advocates demonstrating the positive effects of the reform provisions, repeal is averted.
HHS and RWJF initiate the Medicaid cash and counseling demonstration, allowing beneficiaries to self-direct their HCBS
in lieu of traditional agency-provided services.
1999:
Supreme Court’s Olmstead decision promotes broader HCBS coverage for people with disabilities, per ADA’s community
integration mandate.
2000:

Long-Term Care in the United States: A Timeline

3/5
1/28/24, 2:12 PM
Long-Term Care in the United States: A Timeline | KFF
Americans Act Caregiver Program established, authorizing grants to states to fund a range of supports that assist family
and informal caregivers to care for their loved ones at home.
2001:
New Freedom Initiative established to remove barriers to community living for people with disabilities.
Centers for Medicare & Medicaid Services and Administration on Aging Real Choice Systems change grants available to
states and non-profit agencies to develop integrated LTSS systems.
2005:
Deficit Reduction Act provides federal funding to states to expand community-based care; authorizes the Medicaid Money
Follows the Person (MFP) Rebalancing demonstration program; allows states to add an optional Medicaid state plan
benefit for HCBS ; and allows states to offer self-direction of personal care services. It also lengthens the look-back period
for transfers of assets for nursing home Medicaid applications from 36 to 60 months. In addition, it allows for Qualified
State Long-Term Care Partnerships, which encourage individuals to purchase LTC insurance while still allowing them to
qualify for Medicaid if their LTC needs extend beyond the period covered by their insurance policy.
2006:
OAA Amendments of 2006 signed into law, including the principles of consumer information for long-term care planning,
evidence-based prevention programs, and self-directed community based services to older individuals at risk of
institutionalization.
THE ERA OF HEALTH REFORM
2010:
The Affordable Care Act (ACA) provides new options to states under the Medicaid program to incentivize the improvement
of their LTC infrastructures and expand HCBS. Provisions include the Balancing Incentive Program, the Community First
Choice state plan option and an MFP extension, among others. In addition, for the 5-year period beginning January 1,
2014, states are required to apply spousal impoverishment standards in determining eligibility for married Medicaid
applicants receiving HCBS. Prior to this, these standards were applied to the spouses of nursing home residents only.
Under the ACA, The Community Living Assistance Services and Supports (CLASS) Act is enacted, with the intention of
offering a national, voluntary long term services and supports (LTSS) insurance program financed by individual premium
contributions.
2011:
First of the nation’s baby boomers turn 65.
2013:
The American Taxpayer Relief Act of 2012 repeals the CLASS Act and establishes the time-limited, bipartisan Commission
on Long-Term Care.
The Commission on Long-Term Care issues a report to the Congress, reviewing LTSS policy and program issues. The
report makes recommendations regarding service delivery and workforce. No agreement on financing recommendations
are reached; instead the report puts forward financing approaches suggested by members.
2014:
CMS finalizes new rules outlining the qualities that settings must meet to be considered “home and community-based”
for the provision of Medicaid services.
2015:

Long-Term Care in the United States: A Timeline

4/5
1/28/24, 2:12 PM
Long-Term Care in the United States: A Timeline | KFF
CMS revises the Five-Star Quality rating system for nursing homes, reflecting an improvement of performance standards.
GET THE LATEST ON HEALTH POLICY
Sign Up For Email Alerts
Enter email address…
SIGN UP 
© 2024 KFF
Powered by WordPress VIP
CITATIONS AND REPRINTS PRIVACY POLICY
KFF Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270
www.kff.org | Email Alerts: kff.org/email | facebook.com/KFF | twitter.com/kff
The independent source for health policy research, polling, and news, KFF is a nonprofit organization based in San Francisco, California.

Long-Term Care in the United States: A Timeline

5/5