Health Systems Agencies Research Articles

Pharmacist Involvement in Health Systems Agencies

Pharmacist Involvement in Health Systems Agencies

New Opportunities for the Public to Shape the Nation's Institutional Health Care Services

The author of this Comment describes how recent federal legislation (P.L. 93-641, signed into law in January, 1975)--and improved scientific techniques for integrating (1) community medical needs assessment, (2) institutional budgeting linked to regional/state health plans, and (3) budget ceilings--have given the public new authority and technology to shape the nation's institutional health services. He urges administrators and trustees of health institutions--both proprietary and charitable--to become aware of recent developments in this area, and says that active consumer and provider participation in Health Systems Agencies and Statewide Coordinating Councils is necessary if the new federal expectations concerning health planning and regulation are to be met. Given the rising costs of medical care, stronger federal control might be forthcoming if the purposes of P.L. 93-641 are not achieved.

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.

Pharmacist Involvement in Health Systems Agencies

Pharmacist Involvement in Health Systems Agencies

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).

Difficult issues in health planning, development, and review.

To give an overview of the kinds of issues expected to be encountered by the new Health Systems Agencies being established in conformity with Public Law 93-641, the authors draw from the experiences of the Comprehensive Health Planning agency and Regional Medical Program of an Upstate New York area. Problems faced together in the years 1972 to 1975 in health planning, development, review, and public policy are described. The unusual geographic and working relationship of these agencies makes them, together, a useful prototype of the HSA to examine.

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.

Anticipating the impact of Public Law 93-641 on mental health services.

Implementation of the new federal law setting up Health Systems Agencies (HSAs) on a regional basis offers many opportunities for participation by psychiatry. On the basis of interviews with mental health service providers, planners, and citizen representatives, the author formulated an inventory of the law's potential impacts, grouped around six general themes. He discusses the positive aspects of each, along with possible problems and hazards.

Editorial: Health systems agencies

Editorial: Health systems agencies

Position Statement on Mental Health Representation in Governance and Staffing of Health Systems Agencies

Back to table of contents Previous article Next article ArticleNo AccessPosition Statement on Mental Health Representation in Governance and Staffing of Health Systems AgenciesPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.133.5.601AboutSectionsView articleAbstractPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleAbstractThis statement was approved by the Assembly of District Branches at its November 4-5, 1975, meeting and by the Board of Trustees at its December 5-6, 1975, meeting, upon recommendation of the Council on National Affairs. It was prepared by the Task Force on Comprehensive Health Planning.1 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited By Volume 133Issue 5 May 1976Pages 601-602 Metrics PDF download History Published online 1 April 2006 Published in print 1 May 1976

Health Planning in the United States: An Old Idea with a New Significance

This paper examines major features of the National Health Planning and Resources Development Act of 1974 (P.L. 93-641), a piece of legislation that would radically restructure the health planning system of the United States. The Act combines several, previously uncoordinated, health planning and health resources development agencies into one coordinated program. The program is to consist of statutorily restricted federal agency which will generally oversee the operation of the program, a state program directed by a consumer-dominated board and a series of locally based, generally private, nonprofit, consumer-dominated corporations ("Health Systems Agencies") which will carry the bulk of the planning functions. The resource development portion of the act grants funds for a variety of programs. These include both grants and loans (at very favorable interest rates) for medical facilities. In addition there are funds available for innovative projects which hold the prospect of improving health services and environmental conditions within the community. The act also provides the states and local organizations with substantial power over a large portion of the allocations made under the Public Health Act and specifies the process by which health planning must be carried out. Each local planning agency must design a long range health plan for its community and prepare a one-year plan for carrying out portions of the health system plan. These two documents then are used to create State Health plans, plans for construction, modernization or conversion of health facilities and criteria for judging the appropriateness of health services offered in the local areas and in each state. The act seems to create a mechanism whereby the health industry could be quickly converted into a heavily regulated industry. This regulatory process could be implemented in conjunction with national health insurance or by itself.

Comparative analysis of community health planning: transition from CHPs to HSAs.

With the implementation of the National Health Planning and Resources Development Act, comprehensive health planning is moving into a new phase. In search of lessons to guide future planning efforts on the part of the Health Systems Agencies (HSAs) established by the act, this paper reviews organizational and operational characteristics of ten relatively "successful" local comprehensive health planning agencies. Several problems are delineated that HSAs will likely share with their predecessors and strategies for confronting these problems are suggested.

Combat Zone: Residency Training

Public Law 93-641 signed by President Ford on Jan 4, 1975, authorized the establishment of a network of health systems agencies in the several states. The primary function of these agencies is to promote and develop health resources and services in their regions through an orderly planning process. The law defines resource to include manpower as well as facilities. In all likelihood, many of the individuals currently involved in manpower planning will become identified with the health systems agencies now being organized in their states. It is reasonable to expect that in states that have a low physician-population ratio, such as Alaska, Montana, Wyoming, Nevada, and North Dakota, state governments will be urged to establish graduate medical training programs on the assumption that physicians are more likely to set up practice in the state where they served as residents. At present, the US House of Representatives has under consideration HR

National health planning in the United States: prospects and portents.

The National Health Planning and Resources Development Act of 1974 in the United States demonstrates a growing determination in Congress to motivate the system of health services toward greater efficiency in utilization of resources. The Act was designed to overcome some of the weaknesses in earlier planning legislation. More complete coverage and more functional local jurisdictions for planning should result. The Act provides better financial support, and more effective incentives and inducements to assure adherence to plans. Concern is expressed about aspects of the legislation which the authors feel may deserve consideration. The principle of delegating responsibility to voluntary agencies for disbursement of public funds is questioned, and the authors suggest that local public health authorities apply for designation as planning agencies. Reservation is expressed about the adequacy of regional organization as provided by the Act to accomplish its purposes, and the authors recommend demonstrations of regional administrative agencies to implement plans developed by Health Systems Agencies. Failure to incorporate the provision of the House planning bill to set up a national health policy council in the Act is considered unfortunate. Persistence in pursuing the course outlined in the Act is urged.