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At least 19 recordsLinked to original sources
PubMed1979

Decisionmaking in regional health planning agencies.

Health Systems Agencies (HSAs), the new regional health planning agencies established by the National Health Planning and Resources Development Act of 1974, have as their major goals quality, accessibility, continuity and cost containment. One of the tools for cost containment available to HSAs is their active participation in the statewide certificate-of-need (CON) program. To help anticipate how HSAs may play their CON roles, this article reviews the CON decisionmaking processes of two Comprehensive Health Planning (CHP) agencies, the predecessors of HSAs. While most CHPs lacked specific health plans and powers. the two California agencies examined have had both regional plans and roles in CON programs comparable to the present HSAs'. Our focus is on the decisionmaking process rather than the effectiveness of CON programs. A simple descriptive model is developed based on the assumptions that the planners seek satisfactory, rather than optimal solutions and that the data available are extremely limited. The cases analyzed suggest that, while most projects exceed the bed need standards, institutions were almost always able to demonstrate a need through various special circumstances. Once a need has been shown, the agency was able to deny an application only if a better alternative were available. This study suggests two approaches to improving regional health planning decisionmaking. First, identified needs can be better met either by increasing the agency's ability to generate alternatives or by encouraging health facilities to submit competing applications. Second, a regional health care budget would force the agency to make choices among competing needs.

California↗
PubMed1976

The National Health Planning Act: significance for mental health agencies.

In examining the National Health Planning and Resources Development Act, the authors identify nine areas that have special meaning for those responsible for planning, administration, and delivery of mental health services. Believing that mental health planning can be done more effectively by mental health agencies, they recommend a series of steps that can be taken by mental health administrators to maintain responsibility for planning their programs while ensuring close coordination with general health planning activities. It is their conviction that mental health authorities should commit themselves to the planning process and put their commitment to work by recruiting knowledgeable and skilled planning staffs.

Financing, Government↗
PubMed1976

Observations on potential contributions of health planning.

The passage of the National Health Planning and Resources Development Act in the United States in 1974 is used to set the context for a new assessment of health planning as a change agent. In reviewing the record of health planning the most striking conclusion is that even its friends have been unable to establish that it has had any quantifiable impact. The authors suggest, however, that comprehensive health planning may have stimulated the belief that changes in medical care organization are crucial to improving the health care system. The authors next consider the role of health planning inferred from three widely espoused "models" of the health care system: professional, central planning, and market. Although market advocates generally deemphasize health planning as contrasted to those supporting a centrally planned system, none of the models is sufficiently developed to indicate specific roles and functions fro health planning. Basing their argument on goals for health care reform generally espoused by students of medical care organization, the authors assert that health planning agenices will be most effective if they are organizationally linked to general-purpose governments, encourage the formation of Health Maintenance Organizations, consciously involve themselves in health system reorganization, and design their policies so they can be effectively evaluated.

Community Participation↗
PubMed1978

Measures of community health status for health planning.

The National Health Planning and Resources Development Act of 1974 (P.L. 93-641) requires health systems agencies (HSAs) to assess the health status of their area populations but limits their data-collecting activity. Numerous measures of health status have been devised, but many of these require data that are not yet available or are available only on the national level. Proposed measures are reviewed, and the problems of applying them to the measurement of health status in small areas, under current technical and practical constraints, are discussed. Several measures have promise for giving reasonable results, but only with further development of data sources, estimation techniques, and social indicator models; under present constraints, HSAs will have to work with less precise and less useful methods.

Health Status Indicators↗
PubMed1976

Implementing formative health planning under PL 93-641.

The National Health Planning and Resources Development Act of 1974 (PL 93-641) melds the Hill-Burton program, Regional Medical Program and Comprehensive Health Planning into a new network for health planning and resources development. Health-systems agencies will possess broader powers than predecessor agencies, particularly in the areas of regulation, control of federal funds, resources development and implementation. PL 93-641 thus offers the possibility of transforming the basic concept of health planning from reactive to "proactive." Successful legislative implementaion will require each health-systems agency to build local legitimacy, ensure constructive consumer/provider dialogue, and respond to state and national managerial requirements. Many questions about planning implementation, the role of subarea councils, agency co-ordination and local governance remain unresolved. The new health-planning network has the potential to assume the function of active system transformation, but will be critically dependent on adequate program budgeting to fulfill this promise. (N Engl J Med 295:698-703, 1976).

Delivery of Health Care↗
PubMed1978

Participating in health planning.

The implementation of the Health Planning and Resources Development Act of 1974 (P.L. 93-641) brought about the realization that occupational therapists can and should participate in a formalized manner in the health planning process. Successful attempts by District V of the Iowa Occupational Therapy Association, and by the Iowa Occupational Therapy Association, to seat an occupational therapist on the governing board of the Illowa Health Systems Agency and on the Iowa State Health Coordinating Council yielded a greater understanding of the law and of the activities of health systems agencies. This article describes the process of selecting representatives for health systems agencies governing boards as it pertains to allied health professionals.

Governing Board↗
PubMed1976

Federal health planning, part 1: legislative background.

U.S. federal health planning legislation is discussed. The Hill-Burton, Comprehensive Health Planning and Regional Medical programs--early legislative initiatives in health planning--are described, and their effectiveness is discussed.

Financing, Government↗
PubMed1976

Mental health care and treatment: will health planning make a difference?

The National Health Planning and Resources Development Act of 1974 establishes a five-tiered system for health planning that begins with the Secretary of Health, Education, and Welfare and reaches the local level through areawide health systems agencies. The author describes the implications of the law for mental health services, focusing particularly on its impact at the local level. He describes the functions of the health systems agencies, points out limitations in their authority, and emphasizes that cooperation of community organizations and agencies is essential if they are to be effective in improving health and mental health care and treatment.

Health Planning↗
PubMed1977

Interest-group representation and the HSAs: health planning and political theory.

Examination of the provisions of the National Health Planning and Resources Development Act, P.L. 93-641, concerning the composition of Health Systems Agencies, which are to be the primary building-blocks of local health planning, suggests that expectations of substantial change may be unrealistic. Specifically, in its provision for representation on the HSAs, Congress appears to have been accepting an implicit theory of pluralist interest-group representation that has long been prevalent in other sectors of public life in the United States, and long subject to significant criticism. Such forms of representation tend to lead to bargaining, log-rolling, and collusive competition among narrowly-defined special interests, with the interests of the broader general public less well-served. The application of this theory to health planning in P.L. 93-641 is examined, and predictions drawn about the implications of this analysis for health planning and health policy in the United States in general.

Community Participation↗