Description of the Health Promotion Problem
Healthy People 2020 (2017) program encourages healthcare systems to pay increased attention to the health of the elderly population. The US citizens start living longer, which leads to the increased number of older adults who require additional assistance and care. While three years ago there were only about 14% of individuals who were 65 and more years old, professionals believe that there will be almost 24% of them by 2060 (Healthy People, 2017). More than a half of this population have 2 and more chronic conditions, such as heart disease or Alzheimer’s disease that is why it is not surprising that specialized care should be available for these people. The issue is particularly significant for the groups that have insufficient income: they may experience difficulty in accessing care with the help of their funds and might need the support of the government (Department of Elder Affairs, n.d.a). In Florida, 10% of the elderly population can be viewed as economically disadvantaged (Department of Elder Affairs, 2016), which implies that governmental interventions may be needed.
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In order to improve the health condition of the elderly, the care they receive is to be enhanced, regulated, and, if necessary, subsidized. One of the forms of elderly care that require appropriate regulation is home care (Barnay & Juin, 2016). The present paper considers the way the government of Florida approaches the challenge of promoting positive health outcomes in the economically disadvantaged elderly population by making home care accessible.
Description of Specific Population
Improvement of elderly care is especially required in Florida because almost 26% of its population are more than 60 years old. The numbers of males and females do not differ much, but there are many representatives of racial and ethnic minorities, which means that they require specific services, based on the concept of cultural awareness and understanding. More about 10% of these individuals live below poverty guideline and have limited English proficiency (Department of Elder Affairs, 2016). In summary, the elderly population of Florida includes multiple disadvantaged groups, which are in need of high-quality care.
The Department of Elder Affairs (n.d.a) recognizes this fact and offers multiple programs that address the issues experienced by the elderly in Florida. In particular, the Department of Elder Affairs (n.d.c) has developed its Home Care for the Elderly (HCE) program, which is regulated by the rules presented in the chapter 58H-1 of the Florida Administrative Code. The rules cover the eligibility for the program, associated benefits, and various procedures that are required to make home care in Florida accessible. If summarized, the program serves the Floridians aged 60 or older who have a sub-standard income and elect to receive home care. It involves a subsidy meant for supplies, nutritional supplements, medications, nursing services, and other necessities as the key benefit of being enrolled. According to the Department of Elder Affairs (n.d.a), over 150,000 checks are issued every year. In other words, the program directly targets the economically disadvantaged elderly population of Florida and improves access to home care for about 150,000 people every year.
Policy Development and Legislators Involved
The legislative aspects of the policy of HCE are managed by the Legislative Affairs Director of the Department of Elder Affairs (n.d.b) Jon Conley, as well as the entire Office of Legislative Affairs. The Department of Elder Affairs (n.d.d) reports that the Office is responsible for drafting the initiatives pertinent to elder affairs, as well as promoting, disseminating, and supporting them. The Department of Elder Affairs (n.d.a) also specifies the fact that it is engaged in the dissemination of the information relevant to HCE and related policies, and the website of the Department is one of the dissemination mechanisms. In summary, the Department of Elder Affairs and its subdivisions are the main players in the promotion of the policy.
The Role of the APRN
Home care is a relatively wide-spread approach that helps in maintaining the health of the elderly and can have positive effects on their mental state and well-being (Barnay & Juin, 2016). Therefore, the elderly population of Florida should have access to this option. Apart from that, the fact that 10% of the elderly in the state live below the poverty line implies that this group requires financial support (Department of Elder Affairs, 2016). From these perspectives, HCE is a significant asset in caring for the elderly in Florida, which is why the advanced practice registered nurses (APRNs) of the state should offer their support to the policy.
Some of the key ways in which APRNs can support HCE include educating themselves on the topic, participating in the program, engaging in the investigation of the program and its outcomes, and making evidence-based suggestions regarding the potential improvements of the policy. It is noteworthy that the Department of Elder Affairs (n.d.a) disseminates all the relevant information about the program and assumes the responsibility of monitoring and training the human resources involved in it, which facilitates participation for APRNs. Regarding the research opportunities, a preliminary search for relevant articles has determined that no investigation of the impact of the policy has been carried out. Therefore, healthcare professionals can make a major contribution to HCE by providing the evidence that can demonstrate its effectiveness or potential improvements.
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The possibilities for research are multiple. For example, it may be helpful to investigate the well-being of patients; a pre- and post-enrollment study can provide particularly useful information. Also, the satisfaction of patients and their families and their perceptions regarding the effectiveness of the coverage of their needs may be of interest. Such investigations would be helpful in determining the positive and negative features of the program. Consequently, APRNs would be able to make meaningful comments about the effectiveness of HCE and its potential for improvement. For the time being, however, APRNs can support the initiative, as well as similar ones, by participating in related efforts and advocating for the acknowledgment of the need to enhance the access of vulnerable populations to care in modern-day Florida.
Policy Influence on Clinical Practice
There is no direct, scientific information about the exact outcomes of the policy and its impact on the well-being of Floridians. However, the possible outcomes can be inferred based on the specifics of the program. The implementation of the policy is focused on the provision of high-quality home care for the populations that find it difficult to afford. Since the subsidy covers crucial aspects of care, including healthcare services, nutrition, and medication (Department of Elder Affairs, n.d.a), it can be assumed that the resulting care is relatively comprehensive.
In turn, comprehensive care is associated with improved outcomes due to the fact that it takes into account multiple aspects of health and factors influencing it (Bodenheimer & Grumbach, 2016). Apart from that, it can be emphasized that the Department of Elder Affairs (n.d.a) enables healthcare professionals to offer appropriate care to a particularly vulnerable population. Without the subsidies, the population’s access to care would be restricted to a greater extent, which would be likely to result in negative outcomes. Therefore, it can be suggested that the program and related policy have a positive impact on clinical practice by highlighting the significance of comprehensive care and ensuring the presence of the necessary resources.
Inter-Professional Team Involvement and Comprehensive Care
The Department of Elder Affairs (n.d.a) explicitly states that the subsidies under HCE cover a variety of healthcare services, including, for example, nursing services and those of a home health aide. As a result, HCE helps the targeted population to receive care from an interprofessional team. Moreover, it can also be suggested that the program promotes the coordination of care: The Department of Elder Affairs (n.d.a) covers case management services, which typically involve coordinated and comprehensive care (Summers, 2015). The fact that the Department of Elder Affairs (n.d.a) is also responsible for the management of the human resources involved in the program similarly suggests that coordination of care is enabled by the policy.
Apart from that, the policy provides the targeted population with the special resources that can assist an inter-professional team in delivering high-quality and comprehensive care. Indeed, the subsidies cover medications, equipment (for example, wheelchairs), nutrition, and many other aspects of care that are required for a holistic approach to the well-being of an elderly patient (Bodenheimer & Grumbach, 2016). Therefore, the interprofessional teams involved in the program can make sure that the elderly population of Florida receives comprehensive care despite the restrictions related to their income. In summary, healthcare professionals can indeed employ the policy to ensure the provision of coordinated and comprehensive care, and it can be suggested that the policy has been developed to guarantee this outcome.
The increase in the numbers of the elderly population in the modern world implies that there is a greater demand for elderly care. This fact is true for Florida. However, the elderly population of Florida is diverse, and, among other groups, it includes economically disadvantaged people. The issue can be addressed with the help of appropriate policies, and the Department of Elder Affairs (n.d.a) has responded by launching multiple programs, including HCE. Developed by the Office of Legislative Affairs of the Department of Elder Affairs (n.d.a), HCE provides the economically disadvantaged groups of the elderly population of Florida with an opportunity to receive subsidies for home care, which cover the necessities like care services, nutrition, and medications. The program is likely to improve the outcomes for the elderly Floridians by guiding interprofessional teams to provide comprehensive and coordinated care. APRNs should support the initiatives that promote the access of vulnerable populations to care, and in the case of HCE, they can do it by participating in the program, researching it, and making meaningful suggestions on its improvement.
Barnay, T., & Juin, S. (2016). Does home care for dependent elderly people improve their mental health? Journal of Health Economics, 45, 149-160. Web.
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy (7th ed.). New York, NY: McGraw Hill Professional.
Department of Elder Affairs. (2016). 2016 profile of older Floridians. Web.
Department of Elder Affairs. (n.d.a). Home Care for the Elderly (HCE) program. Web.
Department of Elder Affairs. (n.d.b). DOEA management team. Web.
Department of Elder Affairs. (n.d.c). DOEA rules and statutes. Web.
Department of Elder Affairs. (n.d.d). Office of legislative affairs. Web.
Healthy People. (2017). Older adults. Web.
Summers, N. (2015). Fundamentals of case management practice. New York, NY: Cengage Learning.
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