没有地方像家一样:PPACA在扩大老年人家庭护理服务方面的不足。

Journal of law and health Pub Date : 2015-01-01
Nick Vento
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引用次数: 0

摘要

2010年3月23日,奥巴马总统签署了《患者保护和平价医疗法案》(PPACA)。为了重新平衡各州在长期服务和支持(LTSS)上的支出,使其向家庭护理倾斜,PPACA在医疗补助计划下创造了四个新的选择,各州可以通过这些选择向其公民提供家庭护理服务。虽然PPACA创建的这四个可选的医疗补助HCBS项目允许各州为其公民提供更大的灵活性和能力,但它未能完全解决医疗补助中现有的制度偏见,因为它未能为家庭护理服务创建强制性的医疗补助州服务计划。第二部分描述了家庭护理工作者,提供了家庭护理服务的立法历史,并概述了医疗补助计划如何提供护理设施护理。第三部分分析了PPACA计划在改善家庭护理服务的获取和提供方面的不足。第四部分提出建议,以更好地为老年人提供可靠和负担得起的居家护理服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
There's No Place Like Home: How PPACA Falls Short in Expanding Home Care Services to the Elderly.

On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (PPACA). In an effort to rebalance states' spending on long-term services and supports (LTSS) towards home care, PPACA created four new options under Medicaid with which states could provide home care services to their citizens. While PPACA's creation of these four optional Medicaid HCBS programs allows states more flexibility and the capability to provide enhanced home care services to its citizens, it falls short of completely addressing the existing institutional bias in Medicaid by failing to create a mandatory Medicaid state service plan for home care services. Part II describes home care workers, provides a legislative history of home care services, and outlines how Medicaid provides nursing facility care. Part III analyzes the shortcomings of PPACA's plan to improve access and delivery of home care services. Part IV proposes recommendations to better provide the elderly with reliable and affordable home care service.

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