Tsiba kwisiqulatho main

Inkxaso ye-CHAD
Iiprayorithi zoMgaqo-nkqubo

imenyu

I-CHAD ilandelela ngokusondeleyo umgaqo-nkqubo kunye nohlaziyo lwemithetho, utshintsho kunye nemiba kumanqanaba omabini kunye nombuso kwaye isebenza kunye namagosa e-congressional kunye ne-state ukuqinisekisa ukuba amaziko ezempilo kunye nezigulane zabo zimelwe kulo lonke inkqubo yomthetho kunye nomgaqo-nkqubo.

Eyona nto iphambili yomgaqo-nkqubo we-FQHC ikhusela ukufikelela kukhathalelo lwempilo olusemgangathweni kubo bonke abantu baseDakota, ngakumbi abantu basemaphandleni, abangakhuselwanga kunye nabemi abangagcinwanga. Enye into ephambili ephambili kukuqinisekisa ukhuseleko lwezempilo kubo bonke ukukhuthaza uluntu olusempilweni kunye nokugcina yonke imisebenzi kunye nokukhula kwamaziko ezempilo kulo lonke elaseDakotas.

I-Federal Advocacy

Umthetho kunye nokwenziwa komgaqo-nkqubo kwinqanaba le-federal lichaphazela kakhulu amaziko ezempilo afanelekileyo (FQHCs), ngokukodwa kwiinkalo zenkxaso-mali kunye nophuhliso lwenkqubo. Yiyo loo nto iqela lomgaqo-nkqubo le-CHAD lisebenza ngokusondeleyo namaziko ezempilo angamalungu kunye namaqabane okhathalelo lwempilo kulo lonke elaseDakotas ukuphuhlisa izinto eziphambili zomgaqo-nkqubo kunye nokudlulisela ezo zinto ziphambili kwiinkokeli zenkongolo kunye nabasebenzi bazo. I-CHAD idibanisa rhoqo kunye namalungu e-congressional kunye neeofisi zabo ukuze bahlale benolwazi ngemiba echaphazela i-FQHCs kunye nezigulane zabo kunye nokubakhuthaza ukuba bathathe inyathelo kwimithetho ephambili yokhathalelo lwempilo kunye nemigaqo-nkqubo.

Imiba ePhambili yoMgaqo-nkqubo we-Federal

Amaziko ezempilo oluntu aseDakotas kunye neSouth Dakota Urban Indian Health abonelele ngokhathalelo lokuqala, iinkonzo zempilo yokuziphatha, kunye nokhathalelo lwamazinyo kubantu baseDakota abangaphezu kwe-136,000 ngo-2021. Babonise ukuba uluntu lungayiphucula impilo, lunciphise ukungalingani kwezempilo, lukhuphe ukonga lwabarhafi, kwaye lulungise ngokufanelekileyo inkitha yeengxaki zempilo yoluntu ezibiza imali eninzi nezibalulekileyo, kubandakanywa ubhubhane womkhuhlane kunye ne-coronavirus, i-HIV/AIDS, ukuphazamiseka kokusetyenziswa kweziyobisi, ukusweleka koomama, ukufikelela kumagqala kukhathalelo, kunye neentlekele zendalo. 

Ukuqhubeka nomsebenzi wawo obalulekileyo kunye nenjongo yawo, amaziko ezempilo adinga ukufikelela kwikhemesti okwandisiweyo kwizigulana ezingabonelelwanga kakuhle, inkxaso yeenkonzo zempilo yezempilo yamaziko ezempilo, utyalo-mali kubasebenzi, kunye nenkxaso-mali eyomeleleyo nezinzileyo. Amaziko ezempilo afuna ukuqhubeka nokusebenza ngokubambisana neCongress ukujongana nale miba ilandelayo. 

Ukwandiswa koFikelelo kwiKhemesti kwiZigulana ezingancedwanga

Ukubonelela ngofikelelo kuluhlu olupheleleyo lweenkonzo ezifikelelekayo, ezibanzi, kubandakanywa neenkonzo zekhemesti, yinxalenye ephambili yemodeli yeziko lezempilo loluntu. Imali eyongiwe kwinkqubo ye-340B kufuneka iphinde igawulwe kwimisebenzi yeziko lezempilo kwaye ibalulekile kwisakhono samaziko ezempilo ukugcina imisebenzi eqhubekayo. Enyanisweni, amaziko ezempilo amaninzi achaza ukuba ngenxa yemida yabo yokusebenza encinci, ngaphandle kokugcinwa kwenkqubo ye-340B, baya kunqunyulwa kakhulu ekukwazi ukuxhasa ezininzi zeenkonzo zabo eziphambili kunye nemisebenzi yezigulane zabo. 

  • Yicacise ngokucacileyo loo nto Amaqumrhu angama-340B akhuselweyo anelungelo lokuthenga amayeza angaphandle agqunyiweyo abenzi bamachiza kumaxabiso angama-340B kwizigulana ezifanelekileyo ngokusebenzisa ikhemesti zekhontrakthi yequmrhu ngalinye. 
  • Umxhasi we-PROTECT 340B Act (HR 4390), evela kwiReps. David McKinley (R-WV) kunye no-Abigail Spanberger (D-VA) ukuba bathintele abaphathi benzuzo yamayeza (PBMs) kunye nee-inshurensi ukuba babandakanyeke kwiikhontrakthi ezinocalucalulo okanye "pick-pocketing" 340B yokonga kumaziko ezempilo. 

Yandisa i-CHC yamathuba ezempilo

Onke amaziko empilo oluntu aseDakotas asebenzisa umnxeba ukuhlangabezana neemfuno zezigulane zawo. Iinkonzo zempilo yomnxeba zinceda ukujongana nobhubhane, indawo, ezoqoqosho, ezothutho, kunye nemiqobo yolwimi ekufikeleleni kukhathalelo lwempilo. Ngenxa yokuba ii-CHCs zifuneka ukuba zibonelele ngeenkonzo ezibanzi kwiindawo ezinesidingo esikhulu, kubandakanywa iindawo ezisemaphandleni ezinabantu abambalwa, amaziko ezempilo angoovulindlela ekusebenziseni i-telehealth ukwandisa ukufikelela kwiinkonzo zempilo ezisemgangathweni.  

  • Ukuxhasa iinzame zomthetho nezolawulo zokuqinisekisa ukwandiswa koguqulo lwezempilo lukarhulumente olungxamisekileyo (PHE), ngokufanelekileyo ngotshintsho lomgaqo-nkqubo osisigxina okanye ubuncinci iminyaka emibini ukunika ingqiniseko kumaziko ezempilo. 

  • Inkxaso yoMthetho woQhagamshelwano lwezeMpilo (HR 2903/S. 1512) kunye noKhuseleko loFikelelo kwiPost-COVID-19 Telehealth Act (HR 366). La matyala aphucula umgaqo-nkqubo we-Medicare ngokuqaphela amaziko ezempilo "njengeendawo ezikude" kunye nokususa izithintelo "zendawo yokuqala", evumela ukhuseleko lwe-telehealth naphi na apho isigulane okanye umnikezeli akhoyo. Le mithetho isayilwayo ikwavumela iinkonzo zempilo ukuba zibuyiselwe ngokulinganayo kutyelelo lwangaphakathi lomntu. 

Umsebenzi

Amaziko ezempilo oluntu axhomekeke kuthungelwano lwabasebenzi bezonyango abangaphezu kwama-255,000, ababoneleli, kunye nabasebenzi ukuze bafezekise isithembiso sokhathalelo lwempilo olufikelelekayo nolufikelelekayo. Utyalo-mali lwexesha elide kubasebenzi bokhathalelo oluphambili lwesizwe luyafuneka ukuze kuzuzwe ukonga iindleko ezifunwa lilizwe kunye nokuqinisekisa ukuba amaziko ezempilo anokuhambisana nokukhula nokutshintsha kweemfuno zempilo kwiindawo abahlala kuzo. Ukunqongophala okukhulu kwabasebenzi kunye nezikhewu ezikhulayo zemivuzo yenza kube nzima kumaziko ezempilo ukuba afune kwaye agcine abasebenzi abadibeneyo, abahlukahlukeneyo ukuze babonelele ngononophelo oluphezulu. I-National Health Service Corps (NHSC) kunye nezinye iinkqubo zabasebenzi be-federal zibalulekile ekukwazini kwethu ukufumana ababoneleli kuluntu olubadingayo. Siyayibulela inkxaso-mali enikezelweyo kuMthetho weSicwangciso sokuHlangula saseMelika ukulungisa ukunqongophala kwabasebenzi okubangelwa ngubhubhane. Utyalo-mali oluqhubekayo lwembumba luyimfuneko ekwandiseni imibhobho yabasebenzi amaziko ezempilo axhomekeke ekuboneleleni ngokhathalelo kwizigulana.  

  • inkxaso I-2 yeebhiliyoni zeerandi kwi-NHSC kunye ne-500 yezigidi zeedola kwiNkqubo yokuBuyiselwa kweMali-mboleko yeNurse Corps. 
  • inkxaso Inkxaso-mali eyomeleleyo ye-FY22 kunye ne-FY23 yazo zonke iinkqubo zabasebenzi bokhathalelo olusisiseko, kubandakanywa neSihlokwana se-VII soBuchwepheshe bezeMpilo kunye neSiqulatho VIII iinkqubo zoPhuhliso lwaBasebenzi boMsebenzi. 

Ukuxhasa amaZiko ezeMpilo oLuntu

Siyayibulela inkxaso-mali ye-American Rescue Plan Act eyabelwa amaziko ezempilo ukuphendula kwi-COVID-19 kunye nenkxaso-mali eyongezelelweyo yokhathalelo lokuqala kunye nokuhanjiswa kwesitofu sokugonya. Ubhubhani we-COVID-19 uqaqambise ukungalingani kwenkqubo yokhathalelo lwempilo kumaphandle, igcuntswana, amagqala, abantu abadala, kunye noluntu olungenamakhaya. Ngoku kunanini na ngaphambili, amaziko ezempilo ebengabathathi-nxaxheba abayimfuneko kwinkqubo yezempilo yoluntu- ebonelela ngeenkonzo zempilo ezifuneka kakhulu kunye nezokuziphatha ngexesha lendyikityha yesibetho samazwe ngamazwe. Kwi-2022, sijonge kwiCongress ukugcina isiseko senkxaso-mali ye-CHC kunye nokutyalomali ekukhuleni kwexesha elizayo kwinkqubo. 

  • Ukuxhasa ubuncinci i-2 yeebhiliyoni zeedola kwiZiko lezeMpilo leNgxowa-mali eyiNkunzi ukutshintshwa, ukulungiswa, ukulungiswa kwakhona, ukwandiswa, ukwakhiwa, kunye nezinye iindleko zokuphucula inkunzi ukuze amaziko ezempilo akwazi ukuqhubeka nokuhlangabezana neemfuno zempilo zezigulane zabo ezikhulayo kunye noluntu olusebenzayo.

Ukukhusela amaVolontiya okukwazi ukuSebenza kumaZiko eMpilo oLuntu

Amavolontiya ezempilo (VHPs) abonelela ngenkxaso yabasebenzi exabiseke kakhulu kumaziko ezempilo oluntu kunye nezigulane zawo. I-Federal Tort Claims Act (FTCA) ngoku ibonelela ngokhuseleko lonyango kula mavolontiya. Nangona kunjalo, olu khuseleko luphelelwa ngo-Okthobha 1, 2022. Ukunqongophala okumandla kwabasebenzi bokhathalelo lokuqala kunye naphambi kobhubhani we-COVID-19 kuqaqambisa ukungxamiseka okubalulekileyo kwamavolontiya angoochwephesha abangahlawulwayo ukufumana ukhuseleko oluqhubekayo lwe-FTCA kunyango olugwenxa.  

  • Yandisa ngokusisigxina i-Federal Torts Claim Act (FTCA) yokufikelela kwiziko lezempilo loluntu kwii-VHPs. I Ulwandiso lufakwe ngoku kwingxoxo ye-bipartisan Senate HELP Idrafti yoLungiselelo kunye nokuPhendula kwiiNtsholongwane eZikhoyo, iZigrogriso eziNtsha ezisakhulayo (UKUTHINTELWA) kwiPandemics Act.  

Resources

North Dakota Advocacy

Ukuxhasa umsebenzi kunye nomsebenzi wamaziko ezempilo oluntu kunye nokukhusela ukufikelela kukhathalelo lwempilo kubo bonke abantu baseMntla Dakota yimigaqo ephakathi kwemigudu ye-CHAD yokukhuthaza. Iqela lethu lisebenza ngokusondeleyo namaziko ezempilo angamalungu kunye namaqabane okhathalelo lwempilo kulo lonke elaseMantla Dakota ukubeka iliso kumthetho, ukuphuhlisa izinto eziphambili kumgaqo-nkqubo, kunye nokubandakanya abenzi bomthetho kunye namanye amagosa karhulumente nawengingqi. I-CHAD izibophelele ekuqinisekiseni ukuba ii-CHCs kunye nezigulane zabo zimelwe kuyo yonke inkqubo yokwenza umgaqo-nkqubo.

Izinto eziphambili zoMgaqo-nkqubo waseNorth Dakota

Indlu yowiso-mthetho yaseNorth Dakota idibana rhoqo emva kweminyaka emibini eBismarck. Ngethuba leseshoni yowiso-mthetho ye-2023, i-CHAD isebenza ukukhuthaza izinto eziphambili zomgaqo-nkqubo kumaziko ezempilo oluntu kunye nezigulane zabo. Ezo zinto ziphambili zibandakanya inkxaso yohlaziyo lwentlawulo ye-Medicaid, utyalo-mali lwelizwe lwe-CHCs, kunye nokwandisa izibonelelo zamazinyo, abasebenzi bezempilo boluntu, kunye notyalo-mali lokunakekelwa kwabantwana.

Uhlaziyo lweNtlawulo yeMedicaid

INorth Dakota Medicaid kunye namaziko ezempilo oluntu (CHCs) anenjongo ekwabelwana ngayo yokuphucula iziphumo zempilo kubaxhamli beMedicaid. Sidinga imodeli yokuhlawula exhasa indlela yokunyamekela ebonakaliswe ukuphucula umgangatho kunye neendleko eziphantsi. Ii-CHCs zikhuthaza abenzi bomthetho ukuba baphuhlise imodeli yentlawulo ye-Medicaid ethi:

  • Ukuxhasa iintlobo zeenkonzo zexabiso eliphezulu eziye zaboniswa ukuphucula iziphumo, kubandakanywa ukulungelelaniswa kwenkathalo, ukukhuthaza impilo, uncedo ngokuguqulwa kokunyamekela, kunye novavanyo lwemingcipheko yentlalo yoluntu ukwenza ukuthunyelwa kweempembelelo eziphezulu kwiinkonzo ezifunekayo ezisekelwe kuluntu;
  • Ibandakanya imilinganiselo yomgangatho osekelwe kubungqina kwaye ibonelela ngenkuthazo yemali kubaboneleli xa iinjongo zomgangatho kunye nokusetyenziswa zifezekisiwe;
  • Ingqamanisa neemodeli zohlaziyo lwentlawulo ezikhoyo ezifana nekhaya lonyango eligxile kwisigulane (PCMH) kunye neBlue Cross Blue Shield yaseMntla Dakota inkqubo yeBlueAlliance; kwaye,
  • Iphelisa inkalo echaseneyo nenkqubo yolawulo lwenkqubo yokunyamekela ephambili ekhokelela kwi-Medicaid ukukhanyela okufunekayo (kunye nexabiso eliphezulu) iinkonzo zokunakekelwa kweprayimari. Ukwala kwangoku kwe-Medicaid ukuhlawula iinkonzo zokunakekelwa kweprayimari xa isigulane sibona umnikezeli we-Medicaid engazange atyunjwe njengomboneleli wabo oyintloko (i-PCP) ekhokelela ekutyeleleni okungadingekile kwigumbi likaxakeka kunye nokulahlekelwa okukhulu kwemali kwii-CHC kunye nabanye abazama ukukhonza izigulane kuluntu.

Amazinyo

Amaziko ezempilo oluntu abonelela ngokhathalelo olubanzi lwezigulane kuwo wonke uMntla Dakota, kuquka nokhathalelo lwamazinyo. Ubungqina budibanisa imilomo enempilo kunye nomzimba ophilileyo. Ngokomzekelo, uphando lwe-2017 lwabantu abanesifo sikashukela lubonisa ukuba iindleko zonyango ziyi-$ 1,799 ephantsi kwizigulane ezifumene unyango olufanelekileyo lomlomo kunabo bangenayo. Ukungonelanga kwamazinyo kunokubangela utyelelo olongezelelweyo kwigumbi likaxakeka, elinokuthi lichaphazele kakubi uxinzelelo lwegazi, ulawulo lweswekile, kunye nempilo yokuphefumla.

  • Yandisa izibonelelo zamazinyo kubo BONKE abafumana iMedicaid yaseMntla Dakota, kuquka nabantu abakhuselwe kukwandiswa kweMedicaid.

Utyalo-mali lukaRhulumente kumaZiko ezeMpilo oLuntu

Amaziko ezempilo oluntu (CHCs) kuMntla Dakota adlala indima ebalulekileyo kwinkqubo yethu yokhathalelo lwempilo karhulumente ebonelela ngaphezu kwama-36,000 ezigulane ngonyaka. Amazwe angamashumi amabini anesithoba ngoku afanelekileyo kwizibonelelo zikarhulumente kwii-CHC ukuxhasa injongo yabo yokubonelela ngokhathalelo kubantu abangabonelelwanga kakuhle nabasemngciphekweni. INorth Dakota CHCs ingathanda ukongezwa kolu luhlu.

Siyakucela ukuba uthathele ingqalelo ukwaba izigidi ezi-2 zeerandi kwizibonelelo zikarhulumente kwii-CHCs ukuze zigcine kwaye zikhulise amandla azo okusebenzela abantu abasesichengeni kunye nabangakhathalelwanga kurhulumente. Baya kusebenzisa izibonelelo ukuhlangabezana nezi njongo zilandelayo:

  • Ukunciphisa ukutyelelwa kwegumbi likaxakeka kunye nezibhedlele kubaxhamli beMedicaid kunye nabangakhuselwanga;
  • Gcina isibonelelo esifunekayo soluntu kwabo basengozini kakhulu;
  • Ukusabela kwimingeni yabasebenzi kunye nokunqongophala;
  • Yenza utyalo-mali lwe-IT lwezempilo oluxhasa ukuphuculwa komgangatho; kwaye,
  • Ukoyisa imiqobo kwimpilo kwiindawo ezingagcinwanga kakuhle ukuze kuxhaswe ukufikelela kukutya okunempilo kunye nezindlu ezifikelelekayo, ukugcina ukufikelela, uguqulo, uthutho, kunye nezinye iinkonzo ezingahlawulelwayo.

Abasebenzi bezeMpilo basekuhlaleni

Abasebenzi bezempilo boluntu (ii-CHWs) baqeqeshwe ngabasebenzi bokhathalelo lwezempilo abakwinqanaba langaphambili kunye nobudlelwane boluntu kunye nobudlelwane kuluntu abalusebenzelayo, abasebenza njengezongezo ezisekelwe kuluntu kwiinkonzo zokhathalelo lwempilo. Ii-CHWs zinokwandisa ufikelelo kukhathalelo lwempilo eMntla Dakota, zehlise iindleko zokhathalelo lwempilo, kwaye ziphucule iziphumo zempilo kuMntla Dakotas. Xa zidityaniswe nokhathalelo lwempilo olusisiseko, ii-CHWs zinokuphucula ukhathalelo olusekwe kwiqela, olugxile kwisigulane ngokuncedisana nomsebenzi wabasebenzi bokhathalelo lwempilo. Ii-CHWs zinceda ababoneleli bokhathalelo lokuqala baqonde ezona ngxaki abathengi abajongana nazo yonke imihla. Banokunceda ukwakha ukuthembana phakathi kwezigulane kunye namaqela abo okhathalelo lwempilo ukusombulula iingxaki kunye nokufumanisa indlela yokuphumeza izicwangciso zabo zokunakekelwa kwezonyango.

Njengoko iinkqubo zempilo zisebenza kwizicwangciso zokuphucula iziphumo zempilo, ukunciphisa iindleko zokhathalelo lwempilo, kunye nokunciphisa ukungalingani kwezempilo, uMntla Dakota unokuqwalasela ukuphumeza imithetho ukuseka iinkqubo ezizinzileyo ze-CHW.

  • Ukudala isiseko esixhasayo seenkqubo ze-CHW, ukujongana nobungcali, imfundo noqeqesho, ummiselo, kunye nembuyekezo yoncedo lwezonyango.

Tyala kukhathalelo lwaBantwana ukuze uBonelele ngokuFikelelekayo, kuMgangatho oPhezulu, kunye noKhathalelo olufikelelekayo

Ukhathalelo lwabantwana, ngokuqinisekileyo, licandelo elibalulekileyo kuqoqosho olukhulayo. Ukufikelela kukhathalelo lwabantwana olufikelelekayo kubalulekile ukuze abazali bahlale emsebenzini kunye neyona nto ibalulekileyo ekufuneni abasebenzi kuluntu lwethu. Ngokwe-avareji, iintsapho ezisebenzayo kuMntla Dakota zichitha i-13% yohlahlo lwabiwo-mali losapho lwazo ekunakekeleni abantwana. Kwangaxeshanye, amashishini okhathalelo lwabantwana ayasokola ukuhlala evulekile, kwaye abasebenzi abagcina abantwana bafumana iidola ezingama-24,150 ukuba basebenza ixesha elizeleyo, behambela phezulu kwinqanaba lentlupheko kusapho lwabathathu.

  • Ukuxhasa intlawulo eyandisiweyo yabasebenzi bokunakekelwa kwabantwana, ukulungelelanisa izikhokelo zengeniso ukubonelela iintsapho ezininzi ngoncedo lokunyamekela abantwana, ukwandisa izibonelelo zokuzinzisa ukunyamekelwa kwabantwana, kunye nokwandisa iNqalo yeNtloko kunye neenkqubo zokuQala kweNtloko.

Resources

South Dakota Advocacy

Ukuxhasa umsebenzi kunye nomsebenzi wamaziko ezempilo kunye nokukhusela ukufikelela kukhathalelo lwempilo kubo bonke abantu baseMzantsi Dakota yimigaqo ephakathi kwemigudu ye-CHAD yokukhuthaza. Iqela lethu lisebenza ngokusondeleyo namaziko ezempilo angamalungu kunye namaqabane okhathalelo lwempilo kuwo wonke uMzantsi Dakota ukubeka iliso kumthetho, ukuphuhlisa izinto eziphambili kumgaqo-nkqubo, kunye nokubandakanya abenzi bomthetho kunye namanye amagosa karhulumente nawengingqi. I-CHAD izibophelele ekuqinisekiseni ukuba amaziko ezempilo kunye nezigulane zabo zimelwe kuyo yonke inkqubo yokwenza umgaqo-nkqubo.

OkuPhambili koMgaqo-nkqubo waseMzantsi Dakota

Indlu yowiso-mthetho yaseMzantsi Dakota idibana rhoqo ngonyaka ePierre. I-2023 iseshoni yowiso-mthetho qalisa ngoJanuwari 10, 2023. Ngexesha leseshoni, i-CHAD iya kubeka iliso  ukhathalelo lwempilo-umthetho onxulumeneyo ngelixa inkxasoba kwaye unyuseba Ne izinto eziphambili ngomgaqo-nkqubo:

Abasebenzi - Uphuhliso kunye nokuGaywa kweeNgcali zezeMpilo

Izisombululo zabasebenzi bokhathalelo lwempilo kwiindawo zasemaphandleni ziyaqhubeka nokufuna utyalo-mali olongezelelweyo. Enye inkqubo ethembisayo yiNkqubo yokuBuyiselwa kweMali-mboleko kaRhulumente. Le nkqubo ivumela amazwe ukuba abeke izinto eziphambili kwindawo yokubuyisela imali mboleko kubasebenzi bezempilo abasebenza kwiindawo zokunqongophala kweengcali zempilo. Siyayibulela into yokuba iSebe lezeMpilo laseMzantsi Dakota kutshanje lisebenzise le mali ukuxhasa ukufunwa kwabasebenzi bezempilo.

Siyazi ukuba imfuno yolu hlobo lwenkqubo iphezulu, kwaye singakhuthaza inkxaso eyongezelelweyo kwezi nkqubo ukuhlangabezana nelo mfuno. Ezinye izisombululo ziquka ukuqinisa iinkqubo ezikhoyo zokunakekelwa kwezempilo zabasebenzi, utyalo-mali ekuphuhliseni iinkqubo zemibhobho emitsha, kunye nokwandisa utyalo-mali kwiinkqubo zoqeqesho.

Abasebenzi-uMthetho wokuziqhelanisa neQela

Amaziko ezempilo oluntu kunye neSouth Dakota Urban Indian Health axhomekeke kubuchwephesha kunye nobuchule babancedisi boogqirha (PAs) kunye nabanye ababoneleli beprakthiza abaphambili ukuhlangabezana neemfuno zoluntu lwasemaphandleni kunye noluntu lwasezidolophini abalusebenzelayo. Imeko yonyango eqhubekayo ifuna ukuguquguquka ekubunjweni kwamaqela ukuhlangabezana neemfuno ezahlukeneyo zezigulane. Indlela i-PAs kunye noogqirha basebenza ngayo kunye akufanele imiselwe kwinqanaba lomthetho okanye lolawulo. Endaweni yoko, oko kuzimisela kufuneka kwenziwe ngokusebenza ngokufanelekileyo kwizigulane kunye noluntu abalusebenzelayo. Iimfuno zangoku zinciphisa ukuguquguquka kweqela kunye nokunciphisa ukufikelela kwesigulane kukhathalelo ngaphandle kokuphucula ukhuseleko lwesigulane.

340b Khusela ukuFikelela kumayeza afikelelekayo ngeNkqubo ye-340b

Amaziko ezempilo oluntu kunye neSouth Dakota Urban Indian Health asebenzela ukubonelela ngoluhlu olupheleleyo lweenkonzo zempilo ezifikelelekayo, kubandakanya ikhemesti. Esinye isixhobo esisisebenzisayo ukusebenzela loo mishini yinkqubo yamaxabiso amachiza angama-340B. Le nkqubo yasekwa ngo-1992 ukuze ibonelele ngamaxabiso afikelelekayo kwizigulane ezibonelelwa ngababoneleli basemaphandleni kunye nokhuseleko.

Amaziko ezempilo angumzekelo wohlobo lwenkqubo yenethi yokhuseleko inkqubo ye-340B eyayijoliswe ekuxhaseni. Ngokomthetho, onke amaziko ezempilo:

  • Ukukhonza kuphela iindawo zokunqongophala kweengcali zempilo;
  • Ukuqinisekisa ukuba zonke izigulane zinokufikelela kuluhlu olupheleleyo lweenkonzo abazinikezelayo, kungakhathaliseki ukuba bunjani ubume be-inshurensi, umvuzo, okanye ukukwazi ukuhlawula; kwaye,
  • Kufuneka baphinde batyale yonke imali eyongiweyo ye-340B kwimisebenzi evunywe ngurhulumente ukuze baqhubele phambili umsebenzi wabo wesisa wokuqinisekisa ukufikelela ekukhathaleni kwabo bangafumani nkonzo.

Sicela urhulumente akhusele le nkqubo ibalulekileyo enika zonke izigulane zamaziko ezempilo ukufikelela kumayeza kagqirha afikelelekayo. Abavelisi abohlukeneyo batyityimbisel' umnwe ngelahleko yezaphulelo zamachiza athunyelwa kwiikhemesti zekhontrakthi ezilawula amachiza angama-340B egameni labanye bababoneleli belizwe lethu abanempembelelo. Oku kujoliswa kwiikhemesti zekhontrakthi kuyakhathaza ngakumbi kwiindawo zasemaphandleni, apho iikhemesti zengingqi sele zisokola ukuhlala zisebenza.

Ukusetyenziswa koKwandiswa kweMedicaid

EMzantsi Dakota, i-Medicaid iya kwandisa inkqubo ngoJulayi 2023. Amanye amazwe awandise inkqubo yawo ye-Medicaid abone ukufikelela okuphuculweyo kukhathalelo, iziphumo eziphuculweyo zempilo, kunye nokunciphisa ukhathalelo olungahlawulwanga, okwenza ukuba ukhathalelo lwezempilo lufikeleleke ngakumbi kuye wonke umntu.

Ukuqinisekisa ukuphunyezwa kolwandiso lwe-South Dakota Medicaid luyasebenza, siyakucela ukuba ubeke phambili kwiSebe leeNkonzo zoLuntu ezi ngcebiso:

  • Ukuphuhlisa iKomiti yeeNgcebiso zoKwandiswa kweMedicaid, okanye i-sub-committee ye-Medicaid Advisory Committee, ukuququzelela kunye nokuphucula unxibelelwano nababoneleli, iinkqubo zempilo, kunye nezigulane eziya kuba nefuthe;
  • Ukuxhasa isicelo sohlahlo lwabiwo-mali lweRhuluneli uNoem sokwandisa abasebenzi kunye nobuchwepheshe kwinkqubo yeMedicaid; kwaye,
  • Ukubonelela ngenkxaso-mali kwimibutho enelizwi elithembekileyo kukhathalelo lwempilo yoluntu kunye nokhuseleko lwe-inshurensi yezempilo ukwenza ukufikelela ngokuthe ngqo kwizigulane ezitsha zeMedicaid.

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