Ndlulela

Sekela i-CHAD
Okubalulekile Kwenqubomgomo

Imenyu

I-CHAD ilandelela eduze inqubomgomo kanye nezibuyekezo zomthetho, izinguquko kanye nezindaba kuwo womabili amazinga wombuso kanye nesifundazwe futhi isebenzisane nezikhulu zekhongolose nezifundazwe ukuze kuqinisekiswe ukuthi izikhungo zezempilo neziguli zazo ziyamelelwa kuyo yonke inqubo yomthetho nenqubomgomo.

Okubalulekile kwenqubomgomo ye-FQHC ukuvikela ukufinyelela ekunakekelweni kwezempilo okuseqophelweni eliphezulu kwabo bonke abantu baseDakota, ikakhulukazi abasemakhaya, abantu abanganamshwalense nabanganakiwe. Okunye okubalulekile okubalulekile wukuqinisekisa ukuhlinzekwa kwezempilo kubo bonke ukuze kugqugquzelwe imiphakathi enempilo kanye nokusimamisa ukusebenza kanye nokukhula kwezikhungo zezempilo kulo lonke elaseDakotas.

I-Federal Advocacy

Umthetho nokwenziwa kwenqubomgomo ezingeni likahulumeni kubathinta kakhulu izikhungo zezempilo eziqeqeshiwe (FQHCs), ikakhulukazi emikhakheni yokuxhaswa ngezimali nokuthuthukiswa kohlelo. Yingakho ithimba lenqubomgomo ye-CHAD lisebenzisana eduze nezikhungo zezempilo ezingamalungu kanye nabalingani bokunakekelwa kwezempilo kuwo wonke ama-Dakotas ukuze kuthuthukiswe izinto ezibalulekile zenqubomgomo futhi badlulisele lezo zinto ezibalulekile kubaholi bekhongolose kanye nabasebenzi babo. I-CHAD ixhuma njalo namalungu ekhongolose namahhovisi awo ukuze ihlale inolwazi ngezindaba ezithinta ama-FQHC neziguli zawo kanye nokubakhuthaza ukuthi bathathe isinyathelo ngemithetho nezinqubomgomo zokunakekelwa kwezempilo ezibalulekile.

Okubalulekile Kwenqubomgomo Yenhlangano

Izikhungo zezempilo zomphakathi zaseDakotas kanye neSouth Dakota Urban Indian Health zinikeze ukunakekelwa okuyisisekelo, izinsizakalo zezempilo zokuziphatha, kanye nokunakekelwa kwamazinyo kubantu baseDakota abangaphezu kuka-136,000 ngo-2021. Zibonise ukuthi imiphakathi ingayithuthukisa impilo, yehlise ukungalingani kwezempilo, idale ukonga kwabakhokhi bentela, futhi ibhekane ngempumelelo inqwaba yezinkinga zezempilo zomphakathi ezibizayo nezibalulekile, okuhlanganisa izifo eziwubhubhane zomkhuhlane kanye ne-coronavirus, i-HIV/AIDS, ukuphazamiseka kokusetshenziswa kwezidakamizwa, ukufa komama, ukufinyelela komakadebona ekunakekelweni, kanye nezinhlekelele zemvelo. 

Ukuze ziqhubeke nomsebenzi wazo obalulekile nomsebenzi wazo, izikhungo zezempilo zidinga ukufinyelela ekhemisi okwandisiwe ezigulini ezinganakiwe, ukusekelwa kwezinsizakalo zezempilo ngocingo zezikhungo zezempilo, ukutshalwa kwezimali kubasebenzi, kanye noxhaso oluqinile noluzinzile. Izikhungo zezempilo zifuna ukuqhubeka nokusebenza ngokubambisana neCongress ukubhekana nalezi zinkinga ezilandelayo. 

Ukwandisa Ukufinyelela Ekhemisi Ezigulini Ezingalutholi usizo

Ukunikeza ukufinyelela ezinhlobonhlobo zezinsiza ezithengekayo, ezibanzi, okuhlanganisa nezinsiza zekhemisi, kuyisici esibalulekile semodeli yesikhungo sezempilo somphakathi. Ukongiwa okuvela ohlelweni lwe-340B kumele kutshalwe kabusha emisebenzini yesikhungo sezempilo futhi kuyingxenye yekhono lezikhungo zezempilo lokusekela imisebenzi eqhubekayo. Eqinisweni, izikhungo zezempilo eziningi zibika ukuthi ngenxa yemikhawulo yazo yokusebenza emincane, ngaphandle kokulondoloza imali evela ohlelweni lwe-340B, zizolinganiselwa kakhulu ekhonweni lazo lokusekela izinsizakalo zazo eziningi eziyinhloko nemisebenzi yeziguli zazo. 

  • Kwenze kucace ngokusobala lokho Izinkampani ezikhavwe ze-340B zinelungelo lokuthenga zonke izidakamizwa ezikhavwe zabakhiqizi bezidakamizwa ngamanani angu-340B ezigulini ezifanele ngamakhemisi enkontileka yebhizinisi ngalinye. 
  • Xhasa i-PROTECT 340B Act (HR 4390), evela ku-Reps. David McKinley (R-WV) kanye no-Abigail Spanberger (D-VA) ukuze bavimbele abaphathi bezinzuzo zemithi (PBMs) kanye nemishwalense ekuhlanganyeleni imikhuba yenkontileka ebandlululayo noma "i-pick-pocketing" 340B yokonga ezikhungweni zezempilo. 

Nweba I-CHC Telehealth Amathuba

Zonke izikhungo zezempilo zomphakathi e-Dakotas zisebenzisa i-telehealth ukuhlangabezana nezidingo zeziguli zazo. Izinsizakalo zeTelehealth zisiza ukubhekana nobhubhane, indawo, ezomnotho, ezokuthutha, nezithiyo zolimi ekufinyeleleni ekunakekelweni kwezempilo. Ngenxa yokuthi ama-CHC adingeka ukuthi anikeze izinsiza ezibanzi ezindaweni ezinesidingo esikhulu, okuhlanganisa nezindawo zasemaphandleni ezingenabantu abambalwa, izikhungo zezempilo ziyivulandlela yokusebenzisa ucingo ukuze zandise ukufinyelela ezinsizeni zokunakekelwa kwezempilo ezisezingeni eliphezulu.  

  • Sekela imizamo yomthetho neyokulawula ukuze kuqinisekiswe ukwelulwa kwezimo eziphuthumayo zezempilo yomphakathi (PHE) ngokushintshashintsha kwenqubomgomo unomphela noma okungenani iminyaka emibili ukunikeza izikhungo zezempilo isiqiniseko. 

  • Ukusekela uMthetho we-CONNECT for Health Act (HR 2903/S. 1512) kanye Nokuvikela Ukufinyelela ku-Post-COVID-19 Telehealth Act (HR 366). Lezi zikweletu zenza inqubomgomo ye-Medicare ibe yesimanje ngokuqaphela izikhungo zezempilo “njengezindawo ezikude” futhi zisuse imikhawulo “yezindawo eziyimvelaphi”, okuvumela ukutholakala kwezempilo ngocingo nomaphi lapho isiguli noma umhlinzeki ekhona. Lezi zikweletu zivumela futhi izinsiza zezempilo ukuthi zibuyiselwe ngokulinganayo ekuvakasheleni mathupha. 

Abasebenzi

Izikhungo zezempilo zomphakathi zincike kwinethiwekhi yabahlengikazi, abahlinzeki, kanye nabasebenzi abangaphezu kuka-255,000 ukuze bafeze isithembiso sokunakekelwa kwezempilo okuthengekayo nokufinyelelekayo. Ukutshalwa kwezimali kwesikhathi eside kubasebenzi bokunakekela okuyisisekelo besizwe kuyadingeka ukuze kuzuzwe ukonga izindleko izwe elikudingayo kanye nokuqinisekisa ukuthi izikhungo zezempilo ziyakwazi ukuhambisana nezidingo zezempilo ezikhulayo nezishintshayo emiphakathini yazo. Ukushoda okukhulu kwabasebenzi kanye negebe elikhulayo lamaholo kwenza kube nzima ngezikhungo zezempilo ukuqasha nokugcina abasebenzi abadidiyelwe, abahlukahlukene ukuze banikeze ukunakekelwa kwekhwalithi ephezulu. I-National Health Service Corps (NHSC) nezinye izinhlelo zenhlangano yabasebenzi zibalulekile ekhonweni lethu lokuqasha abahlinzeki emiphakathini ebadingayo. Siyalwazisa uxhaso oluhlinzekwe ku-American Rescue Plan Act ukubhekana nokushoda kwabasebenzi okubangelwe yilolu bhubhane. Ukutshalwa kwezimali okuqhubekayo kubalulekile ekwandiseni amapayipi abasebenzi izikhungo zezempilo ezincike ekuhlinzekeni ukunakekelwa ezigulini.  

  • Amaprosesa asekelwe U-$2 billion we-NHSC kanye namaRandi ayizigidi ezingu-500 woHlelo Lokubuyiswa Kwemalimboleko Yabahlengikazi. 
  • Amaprosesa asekelwe Uxhaso oluqinile lwe-FY22 kanye ne-FY23 yazo zonke izinhlelo zabasebenzi bokunakekela okuyisisekelo, okuhlanganisa nesihloko VII Health Professions kanye nesihloko VIII Nursing Workforce Workforce izinhlelo. 

Sekela Izikhungo Zezempilo Zomphakathi

Siyalwazisa uxhaso lwe-American Rescue Plan Act olunikezwe izikhungo zezempilo ukuze ziphendule ku-COVID-19 kanye noxhaso olungeziwe lwezisebenzi zokunakekela okuyinhloko kanye nokusatshalaliswa komgomo. Umqedazwe we-COVID-19 ugqamise ukungalingani kohlelo lokunakekelwa kwezempilo emiphakathini yethu yasemakhaya, idlanzana, omakadebona, abadala nabangenamakhaya. Manje kunanini ngaphambili, izikhungo zezempilo bezingabambiqhaza ababalulekile ohlelweni lwezempilo lomphakathi - ukuhlinzeka ngezinsizakalo zezempilo ezidingeka kakhulu kanye nezokuziphatha ngesikhathi sodlame lwamazwe ngamazwe. Ngo-2022, sibheke kuCongress ukuthi igcine uxhaso oluyisisekelo lwama-CHC futhi itshale ekukhuleni okuzayo kohlelo. 

  • Sekela okungenani amaRandi ayizigidi eziyizinkulungwane ezimbili ku-Health Center Capital Funding ukushintshanisa, ukulungisa, ukulungisa kabusha, ukunwetshwa, ukwakhiwa, nezinye izindleko zokuthuthukisa imali ukuze izikhungo zezempilo zikwazi ukuqhubeka nokuhlangabezana nezidingo zezempilo zeziguli ezikhulayo kanye nemiphakathi eziyisebenzelayo.

Ukuvikela Amakhono Ochwepheshe Bezempilo Bokuzithandela Okusebenzela Ezikhungweni Zezempilo Zomphakathi

Ochwepheshe bezempilo abangamavolontiya (VHPs) bahlinzeka ngokusekela kwabasebenzi okubalulekile ezikhungweni zezempilo zomphakathi kanye neziguli zazo. Umthetho we-Federal Tort Claims Act (FTCA) okwamanje uhlinzeka ngekhava yokungasebenzi kahle kwezokwelashwa kulawa mavolontiya. Kodwa-ke, lesi sivikelo siphelelwa yisikhathi ngo-Okthoba 1, 2022. Ukushoda okukhulu kwabasebenzi bokunakekelwa okuyisisekelo ngaphambi nangesikhathi sobhadane lwe-COVID-19 kugqamisa ukuphuthuma okubalulekile kokuthi amavolontiya angochwepheshe bezokwelapha angakhokhelwa ukuthi athole ukuvikelwa okuqhubekayo kwe-FTCA kokuziphatha kabi kwezokwelapha.  

  • Nweba unomphela ukufakwa kwe-Federal Torts Claim Act (FTCA) kuma-VHP esikhungo sezempilo somphakathi. I isandiso okwamanje sifakiwe engxoxweni yoSIZO yeSenethi ye-bipartisan Uhlaka Lomthetho Wokulungisela Futhi Uphendule Kumagciwane Akhona, Izinsongo Ezintsha Ezisafufusa (UKUVIMBELA) Izifo Eziwubhubhane.  

Resources

I-North Dakota Advocacy

Ukusekela umsebenzi nomsebenzi wezikhungo zezempilo zomphakathi kanye nokuvikela ukufinyelela ekunakekelweni kwezempilo kwabo bonke abantu baseNyakatho Dakota kuyizimiso ezisenkabeni yemizamo yokumela ye-CHAD. Ithimba lethu lisebenzisana eduze nezikhungo zezempilo ezingamalungu kanye nozakwethu bokunakekelwa kwezempilo kulo lonke elaseNyakatho Dakota ukuze liqaphe umthetho, lithuthukise izinto eziza kuqala zenqubomgomo, futhi libandakanye abenzi bomthetho nezinye izikhulu zombuso nezendawo. I-CHAD izibophezele ekuqinisekiseni ukuthi ama-CHC kanye neziguli zabo bayameleleka kulo lonke uhlelo lokwenziwa kwenqubomgomo.

Okubalulekile Kwenqubomgomo yaseNyakatho Dakota

Isishayamthetho saseNyakatho Dakota sihlangana njalo eminyakeni emibili e-Bismarck. Phakathi neseshini yomthetho ka-2023, i-CHAD isebenzela ukukhuthaza izinto eziza kuqala zenqubomgomo ezikhungweni zezempilo zomphakathi kanye neziguli zazo. Lezo zinto ezibalulekile zazihlanganisa ukusekelwa kwezinguquko zokukhokha kwe-Medicaid, ukutshalwa kwezimali kombuso kwama-CHC, nokwandisa izinzuzo zamazinyo, abasebenzi bezempilo bomphakathi, kanye nokutshalwa kwezimali kokunakekelwa kwezingane.

I-Medicaid Payment Reform

I-North Dakota Medicaid kanye nezikhungo zezempilo zomphakathi (CHCs) zinomgomo ofanayo wokuthuthukisa imiphumela yezempilo yabazuzi beMedicaid. Sidinga imodeli yokukhokha esekela indlela yokunakekela efakazelwe ukuthuthukisa ikhwalithi kanye nenani eliphelele lezindleko. Ama-CHC akhuthaza abenzi bomthetho ukuthi bakhe imodeli yokukhokha ye-Medicaid ethi:

  • Isekela izinhlobo zezinsizakalo zenani eliphezulu eziye zaboniswa ukuthuthukisa imiphumela, okuhlanganisa ukuhlotshaniswa kokunakekelwa, ukukhuthazwa kwezempilo, usizo ngoshintsho lokunakekelwa, kanye nokuhlolwa kwezinto eziyingozi emphakathini ukuze kwenziwe ukudluliselwa okunomthelela omkhulu ezinsizeni ezidingekayo zomphakathi;
  • Ihlanganisa izilinganiso zekhwalithi ezisekelwe ebufakazini futhi inikeza izikhuthazo zezezimali kubahlinzeki lapho imigomo yekhwalithi nokusetshenziswa ifinyelelwa;
  • Iqondana namamodeli akhona okushintsha izinkokhelo njengekhaya lezokwelapha eligxile esigulini (PCMH) kanye neBlue Cross Blue Shield yohlelo lweBlueAlliance lweNorth Dakota; futhi,
  • Iqeda isici esiphikisayo sohlelo lokuphathwa kwecala lokunakekelwa okuyinhloko oluholela e-Medicaid enqabela izinsizakalo zokunakekelwa okuyisisekelo ezidingekayo (kanye nenani eliphezulu). Ukwenqaba kwamanje kwe-Medicaid ukukhokhela izinsizakalo zokunakekelwa okuyisisekelo lapho isiguli sibona umhlinzeki iMedicaid engazange imqoke njengomhlinzeki wabo wokunakekela oyinhloko (PCP) kuholela ekuvakasheni okungadingekile kwegumbi lezimo eziphuthumayo kanye nokulahlekelwa okukhulu kwezimali kwama-CHC nabanye abazama ukusiza iziguli emphakathini.

Amazinyo

Izikhungo zezempilo zomphakathi zihlinzeka ngokunakekelwa okuphelele kweziguli kuyo yonke iNyakatho Dakota, okuhlanganisa nokunakekelwa kwamazinyo. Ubufakazi buxhumanisa imilomo enempilo nomzimba onempilo. Isibonelo, ucwaningo lwango-2017 lwabantu abanesifo sikashukela lubonisa ukuthi izindleko zezokwelapha ziphansi kwe-$ 1,799 ezigulini ezithole ukunakekelwa kwezempilo komlomo okufanele kunalezo ezingakenzi. Ukungavikeleki kwamazinyo okunganele kungaholela ekuvakasheni okwengeziwe kwegumbi lezimo eziphuthumayo, okungaba nomthelela omubi umfutho wegazi, ukulawulwa kwesifo sikashukela, nempilo yokuphefumula.

  • Nweba izinzuzo zamazinyo kubo BONKE abamukeli beMedicaid baseNyakatho Dakota, kuhlanganisa nabantu abakhavwe ukunwetshwa kwe-Medicaid.

Ukutshalwa Kwezimali Zombuso Ezikhungweni Zezempilo Zomphakathi

Izikhungo zezempilo zomphakathi (ama-CHC) eNyakatho Dakota zidlala indima ebalulekile ohlelweni lokunakekelwa kwezempilo lombuso wethu oluhlinzeka ngeziguli ezingaphezu kuka-36,000 ngonyaka. Izifundazwe ezingamashumi amabili nesishiyagalolunye njengamanje izinsiza zikahulumeni ezifanele kuma-CHC ukuze zisekele umgomo wazo wokuhlinzeka ngokunakekelwa kwabantu abanganakekelwa kahle nabasengozini. Ama-CHC aseNyakatho Dakota angathanda ukungezwa kulolu hlu.

Sikucela ukuthi ucabange ukwaba amaRandi ayizigidi ezi-2 ezinsizeni zombuso kuma-CHC ukuze asimamise futhi akhulise ikhono lawo lokusebenzela abantu abasengozini futhi abanganakekelwa kahle esifundazweni. Bazosebenzisa izinsiza ukuhlangabezana nalezi zinhloso ezilandelayo:

  • Yehlisa ukuvakasha kwegumbi lezimo eziphuthumayo kanye nokulaliswa esibhedlela kwabahlomulayo beMedicaid kanye nabangaqinisekisiwe;
  • Ukusekela insiza yomphakathi edingekayo kwabasengozini kakhulu;
  • Ukusabela ezinseleleni zabasebenzi kanye nokushoda;
  • Yenza izimali ze-IT zezempilo ezisekela ukuthuthukiswa kwekhwalithi; futhi,
  • Nqoba izithiyo ezithinta impilo emiphakathini enganakiwe ukuze kusekelwe ukufinyelela kokudla okunempilo nezindlu ezithengekayo, ukulondoloza ukufinyelela, ukuhumusha, ezokuthutha, nezinye izinsizakalo ezingakhokhisi.

Abasebenzi Bezempilo Bomphakathi

Abasebenzi bezempilo bomphakathi (ama-CHWs) bangabasebenzi bezempilo abaqeqeshiwe abaphambili abanobudlelwano bezenhlalakahle nobudlelwano emiphakathini abayisebenzelayo, abasebenza njengezandiso ezisekelwe emphakathini zezinsizakalo zokunakekelwa kwezempilo. Ama-CHW anganweba ukufinyelela ekunakekelweni kwezempilo eNyakatho Dakota, ehlise izindleko zokunakekelwa kwezempilo, futhi enze ngcono imiphumela yezempilo eNyakatho Dakotas. Uma kuhlanganiswe nokunakekelwa kwezempilo okuyisisekelo, ama-CHW angathuthukisa ukunakekelwa okusekelwe eqenjini, okugxile esigulini ngokuhambisana nomsebenzi wochwepheshe bokunakekelwa kwezempilo. Ama-CHW asiza abahlinzeki bokunakekelwa okuyisisekelo baqonde izinkinga zangempela amaklayenti abhekana nazo nsuku zonke. Bangasiza ukwakha ukwethembana phakathi kweziguli namathimba azo okunakekelwa kwezempilo ukuze baxazulule izinkinga futhi bathole ukuthi bangazisebenzisa kanjani izinhlelo zabo zokunakekelwa kwezempilo.

Njengoba izinhlelo zezempilo zisebenza ngamasu okuthuthukisa imiphumela yezempilo, ukunciphisa izindleko zokunakekelwa kwezempilo, kanye nokunciphisa ukungalingani kwezempilo, iNyakatho Dakota ingacabangela ukusebenzisa imithetho yokusungula izinhlelo ezisimeme ze-CHW.

  • Dala ingqalasizinda esekelayo yezinhlelo ze-CHW, ukubhekana nobunikazi bomsebenzi, imfundo nokuqeqeshwa, izimiso, kanye nembuyiselo yosizo lwezokwelapha.

Tshala Ekunakekelweni Kwezingane ukuze Unikeze Ukunakekela Okufinyelelekayo, Kwekhwalithi Ephezulu, Nokuthengekayo

Ukunakekelwa kwezingane, yiqiniso, kuyingxenye ebalulekile yomnotho othuthukayo. Ukufinyelela ekunakekelweni kwezingane okuthengekayo kubalulekile ukuze abazali bahlale besemsebenzini futhi kuyisici esibalulekile sokuqasha abasebenzi emiphakathini yethu. Ngokwesilinganiso, imindeni esebenzayo eNyakatho Dakota isebenzisa u-13% wesabelomali somndeni wayo ekunakekeleni izingane. Ngasikhathi sinye, amabhizinisi okunakekela izingane alwela ukuhlala evulekile, kanti abasebenzi abanakekela izingane bathola ama- $ 24,150 uma besebenza isikhathi esigcwele, behambela phezulu nje kwezinga lobumpofu lomndeni wabathathu.

  • Sekela amaholo anyusiwe ezisebenzi zokunakekela izingane, lungisa iziqondiso zeholo ukuze unikeze imindeni eyengeziwe ngosizo lokunakekela izingane, wandise izibonelelo zokuzinzisa ukunakekelwa kwezingane, futhi wandise izinhlelo Zokuqala Kwamakhanda kanye Nezokuqala Kwama-Early Head.

Resources

I-South Dakota Advocacy

Ukusekela umsebenzi nomsebenzi wezikhungo zezempilo kanye nokuvikela ukufinyelela ekunakekelweni kwezempilo kwabo bonke abantu baseNingizimu Dakota kuyizimiso ezisenkabeni yemizamo yokumela ye-CHAD. Ithimba lethu lisebenzisana eduze nezikhungo zezempilo ezingamalungu kanye nozakwethu bokunakekelwa kwezempilo kuyo yonke i-South Dakota ukuze liqaphe umthetho, lithuthukise izinto eziza kuqala zenqubomgomo, futhi libandakanye abenzi bomthetho nezinye izikhulu zombuso nezendawo. I-CHAD izibophezele ekuqinisekiseni ukuthi izikhungo zezempilo neziguli zazo ziyamelelwa kulo lonke uhlelo lokwenziwa kwenqubomgomo.

Okubalulekile Kwenqubomgomo YaseNingizimu Dakota

Isishayamthetho saseNingizimu Dakota sihlangana minyaka yonke ePierre. Abangama-2023 iseshini yomthetho Waqala ngoJanuwari 10, 2023. Phakathi neseshini, i-CHAD izoqapha  ukunakekela impilo-umthetho ohlobene ngenkathi ukwesekaIng futhi ukhuthazeIng ezine okubalulekile kwenqubomgomo:

Abasebenzi - Ukuthuthukiswa Nokuqashwa Kwabasebenzi Bezempilo

Izixazululo zabasebenzi bokunakekelwa kwezempilo emiphakathini yasemaphandleni ziyaqhubeka nokudinga ukutshalwa kwezimali okwengeziwe. Olunye uhlelo oluthembisayo wuHlelo Lokubuyiswa Kwemalimboleko Yombuso. Lolu hlelo luvumela izifundazwe ukuthi zibeke izinto ezibalulekile endaweni ukuze kukhokhwe imali ebolekiwe kochwepheshe bezempilo abasebenza ezindaweni ezishodayo zezempilo. Siyabonga ukuthi uMnyango Wezempilo eNingizimu Dakota usanda kusebenzisa lezi zimali ukuze weseke ukuqashwa kochwepheshe bezempilo.

Siyazi ukuthi isidingo salolu hlobo lohlelo siphezulu, futhi singakhuthaza ukwesekwa okwengeziwe kwalezi zinhlelo ukuze kuhlangatshezwane naleso sidingo. Ezinye izixazululo zihlanganisa ukuqinisa izinhlelo ezikhona zepayipi labasebenzi bokunakekelwa kwezempilo, ukutshala imali ekuthuthukiseni izinhlelo ezintsha zamapayipi, nokwandisa ukutshalwa kwezimali ezinhlelweni zokuqeqesha.

Abasebenzi - Umthetho Wokuzilolonga Wethimba Elilungile

Izikhungo zezempilo zomphakathi kanye ne-South Dakota Urban Urban Indian Health zithembele ekwazini nasekuqeqesheni abasizi bodokotela (ama-PAs) kanye nabanye abahlinzeki bokuzivocavoca abathuthukile ukuze bahlangabezane nezidingo zemiphakathi yasemaphandleni neyasemadolobheni abayisebenzelayo. Isimo semvelo sokusebenza kwezokwelapha esithuthukayo sidinga ukuguquguquka ekwakhiweni kwamaqembu ukuze kuhlangatshezwane nezidingo ezahlukahlukene zeziguli. Indlela ama-PA nodokotela abasebenza ngayo ndawonye akufanele inqunywe ezingeni lomthetho noma lokulawula. Kunalokho, lokho kuzimisela kufanele kwenziwe ngomkhuba ukuze kuzuze iziguli kanye nemiphakathi abayisebenzelayo. Izidingo zamanje zinciphisa ukuguquguquka kweqembu futhi zikhawulele ukufinyelela kwesiguli ekunakekelweni ngaphandle kokuthuthukisa ukuphepha kwesiguli.

340b Vikela Ukufinyelela Emithini Ethengekayo ngoHlelo lwe-340b

Izikhungo zezempilo zomphakathi kanye neSouth Dakota Urban Indian Health zisebenzela ukuhlinzeka ngohlu olugcwele lwezinsizakalo zokunakekelwa kwezempilo ezithengekayo, okuhlanganisa nekhemisi. Ithuluzi elilodwa esilisebenzisayo ukusebenzela lowo mgomo wuhlelo lwentengo yezidakamizwa lwe-340B. Lolu hlelo lwasungulwa ngo-1992 ukuze lunikeze amanani entengo athengekayo ezigulini ezihlinzekwa ngabahlinzeki bamaphandle kanye nenetha yezokuphepha.

Izikhungo zezempilo ziyisibonelo sohlobo lohlelo lwenethi yokuphepha uhlelo lwe-340B obekuhloswe ngalo ukusekela. Ngokomthetho, zonke izikhungo zezempilo:

  • Khonza kuphela izindawo zokushoda kochwepheshe bezempilo;
  • Ukuqinisekisa ukuthi zonke iziguli zingakwazi ukufinyelela uhla oluphelele lwezinsizakalo ezizihlinzekayo, kungakhathaliseki isimo somshuwalense, imali engenayo, noma ikhono lokukhokha; futhi,
  • Kudingeka ukuthi kutshalwe kabusha konke ukonga kwe-340B emisebenzini egunyazwe uhulumeni ukuze kuthuthukiswe umgomo wabo wokupha wokuqinisekisa ukufinyelela ekunakekelweni kwabakade benganikezwanga.

Sicela umbuso uvikele lolu hlelo olubalulekile olunikeza zonke iziguli ezikhungweni zezempilo ithuba lokuthola imithi ethengekayo kadokotela. Abakhiqizi abahlukahlukene basabise ngokulahlekelwa izaphulelo zezidakamizwa zezidakamizwa ezithunyelwa kumakhemisi enkontileka aphethe izidakamizwa ezingama-340B egameni labanye babahlinzeki abanomthelela omkhulu wezwe lethu. Lokhu kuhlosiwe kwamakhemisi enkontileka kuyakhathaza ikakhulukazi emiphakathini yasemaphandleni, lapho amakhemisi endawo asevele edonsa kanzima ukuze aqhubeke nokusebenza.

Ukuqaliswa Kokwandiswa Kwe-Medicaid

ENingizimu Dakota, i-Medicaid izokwandisa lolu hlelo ngoJulayi 2023. Ezinye izifundazwe ezinwebise uhlelo lwazo lwe-Medicaid zibone ukufinyelela okuthuthukisiwe kokunakekelwa, imiphumela yezempilo ethuthukisiwe, nokunciphisa ukunakekelwa okungakhokhelwa, okwenza ukunakekelwa kwezempilo kufinyeleleke kuwo wonke umuntu.

Ukuqinisekisa ukuqaliswa kokunwetshwa kwe-South Dakota Medicaid kusebenza kahle, sicela ukuthi ubeke phambili eMnyangweni Wezinsizakalo Zezenhlalakahle lezi zincomo:

  • Ukuthuthukisa i-Medicaid Expansion Advisory Committee, noma ikomidi elincane le-Medicaid Advisory Committee, ukuze kube lula futhi kuthuthukiswe ukuxhumana nabahlinzeki, izinhlelo zezempilo, kanye neziguli ukuthi lokhu kuzoba nomthelela;
  • Sekela isicelo sesabelomali sikaMbusi uNoem sokwandisa abasebenzi kanye nobuchwepheshe ohlelweni lwe-Medicaid; futhi,
  • Nikeza ngoxhaso ezinhlanganweni eziyizwi elethembekile ekunakekelweni kwezempilo komphakathi kanye nokuhlinzekwa komshwalense wezempilo ukuze zenze ukufinyelela okuthile ezigulini ezintsha ze-Medicaid.

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