Agenda - 09-06-1983 - Laserfiche WebLink

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ineependently. In many areas, particularly rural ones, community-based services do not lexist or are in short supply. Lack of available services may aide be a problem in large metropolitan areas. Even where the level of comunity-based services is most adequate, individuals can find it difficult to obtain appropriate care because of fragmentation, lack of coordination among the different providers, or ignorance of available resources. People with long-term-care needs who can live in the community often require multiple services---whether home health care, home-delivered meals, chores, transportation, and so on---that are usually available through, not ones but several, federal, state, and local programs, usually with different eligibility requirements, financing mechanisms, and quality of service. Expanded home health carer by matching service to need, can improve the health, social and psychological well-being of the elderly. SacitimAymilabilitx_imAntb_Cacalion Under the Title XX program some services are mandated (counties must provide thee services) while other services are optional (counties can provide these services if they so choose and have the funds). Therefore, the types of social support services available to older adults vary among counties. To meet licensing requirements and "conditions for Medicare participation" a home health agency is required to provide nursing services and one of the following; occupational therapy, speech therapy, physical therapy, medical social services, or home health aide. Medicaid Will reimburse providers for all of the specified services, AlthoUgh every county is served by a home health agency the scope of services varies substantially among county agencies. In 1981-82 home health agencies in North Carolina offered, on the average, 3.8 services. Thirty-eight home health agencies, or 44 percent, offered two or three services. Of the 86 agencies providing reporting information, half of the total visits (50.37Z) were for nursing services. Home health aide visits accounted for the second largest number of visits, 28 percent, and physical therapy was the third with 15 percent statewide. The above statistics indicate that home health agencies tend to be small operations !which primarily provide nursing services. Service capacity of home health agencies in North Carolina could be expanded both in terms of the scope of services and the number served. Also, considering the role that social support and other similar services play in assisting individuals to maintain their independence, home health agencies should expand their capacity beyond the provision of the basic nursing' care services to include other services for which Medicaid provideslreimbursement. IllaibillIx_GaIsCis In addition to the uneven provision of services within and among counties, access to services is limited for older North Carolinians by