Florida Public Health And Statutes Health And Social Care Essay

1) Discuss the section of the public health statutes that is of greatest interest to you. Explain why it is important and describe what you learned as new information .

The public health statute dealing with Substance Abuse Services (Chapter 397) is of great interest to me .The chapter basically deals with substance abuse prevention, intervention and treatment services. Substance abuse is a major health problem and leads to profoundly disturbing consequences as serious impairment, chronic addiction, criminal behavior, vehicular casualties, spiraling health care costs, AIDS . It is the intent of the Legislature to ensure within available resources a full continuum of substance abuse services based on projected identified needs, delivered without discrimination and with adequate provision for specialized needs . It is recognized that a substance abuse impairment crisis is destroying the youth and is the underlying cause of many juveniles entering the juvenile justice system, and that substance abuse impairment contributes to the crime the school dropout rate, youth suicide, teenage pregnancy, and substance-exposed newborns and that substance abuse impairment is a community problem, a family problem, a societal problem, and a judicial problem and that there is a critical need to address this emergency immediately. Therefore, it is the intent of the Legislature that scarce funds be invested in prevention and early intervention programs. The economic cost of substance abuse impairment to the state drains existing resources, and the cost to victims, both economic and psychological, is traumatic and tragic. The goal of the legislature to discourage substance abuse by promoting healthy lifestyles and drug free schools, workplaces and communities. The Legislature also intends to provide authority for the department to expand existing services to juveniles, to contract with community-based substance abuse service providers for the provision of specialized services, and to have prototype models developed prior to statewide implementation.

The new topics I came across in this chapter are :

(a)Duties of the Department

(b)Treatment-based drug court programs.

Duties of the department:

A comprehensive state plan has been designed for the provision of substance abuse services which includes: Identification of incidence and prevalence of problems related to substance abuse, description of current services, need for services, cost of services ,priorities for funding .It also provides on a direct or contractual basis public education programs and an information clearinghouse to disseminate information about the nature and effects of substance abuse., training for personnel who provide substance abuse services, a data collection and dissemination system, in accordance with applicable federal confidentiality regulations., basic epidemiological and statistical research and the dissemination of results, research in cooperation with qualified researchers on services delivered. The Department plans to establish a funding program for the dissemination of available federal, state, and private funds through contractual agreements with community-based organizations or units of state or local government which deliver local substance abuse services.

Treatment based drug court programs

The treatment-based drug court programs include therapeutic jurisprudence principles and adhere to the 10 key components, recognized by the Drug Courts Program Office of the Office of Justice Programs of the United States Department of Justice and adopted by the Florida Supreme Court Treatment-Based Drug Court Steering Committee.: (a) Drug court programs integrate alcohol and other drug treatment services with justice system case processing.(b) Using a non adversarial approach, prosecution and defense counsel promote public safety while protecting participants’ due process rights.(c) Eligible participants are identified early and promptly placed in the drug court program.(d) Drug court programs provide access to a continuum of alcohol, drug, and other related treatment and rehabilitation services.(e) Abstinence is monitored by frequent testing for alcohol and other drugs.(f) A coordinated strategy governs drug court program responses to participants’ compliance.(g) Ongoing judicial interaction with each drug court program participant is essential.(h) Monitoring and evaluation measure the achievement of program goals and gauge program effectiveness.(i) Continuing interdisciplinary education promotes effective drug court program planning, implementation, and operations.(j) Forging partnerships among drug court programs, public agencies, and community-based organizations generates local support and enhances drug court program effectiveness

The funding of a treatment-based drug court program under which persons in the justice system assessed with a substance abuse problem will be processed in such a manner as to appropriately address the severity of the identified substance abuse problem through treatment services tailored to the individual needs of the participant.

(2) Identify two different types of approaches or methods used to advance the health of Floridians (e.g., service delivery, regulation). For each, describe an example from the Florida public health statutes and identify a potential limitation that could deter achieving the intended outcome .

The two different types of approaches or methods used to advance the health of Floridians are:

(a ) Health Insurance Access.(ss.408.90-408.910)

(b) Delivery of disease control services-Tuberculosis Control (Delivery of Tuberculosis control services)( chapter 392)

(A) Health Insurance Access: The Legislature finds that a significant number of the residents of this state do not have adequate access to affordable, quality health care because the premiums are unaffordable The Legislature intends to provide a state health insurance program for those people who are without health insurance so that they may have access to preventive and primary care services. The state health insurance program plans to offer basic, affordable health care services to those Floridians who have not had access to the private health insurance market. The Legislature intends that the state program shall target the uninsured and not those who currently have private health insurance coverage. . The Legislature further finds that increasing access to affordable, quality health care can be best accomplished by establishing a competitive market for purchasing health insurance and health services. It is therefore the intent of the Legislature to create the Florida Health Choices Program to:

Expand opportunities for Floridians to purchase affordable health insurance and health services, preserve the benefits of employment-sponsored insurance while easing the administrative burden for employers who offer these benefits , enable individual choice in both the manner and amount of health care purchased, provide for the purchase of individual, portable health care coverage, disseminate information to consumers on the price and quality of health services, Sponsor a competitive market that stimulates product innovation, quality improvement, and efficiency in the production and delivery of health services

Every resident of this state who has a gross family income that is equal to or below 250 percent of the federal poverty level and who meets the requirements of this section is eligible to enroll in the Med Access program. Every eligible person who enrolls in the Med Access program is entitled to receive benefits for any covered service furnished within this state by a participating provider which include physician services, hospital inpatient services, hospital outpatient services, laboratory services, family planning services, outpatient mental health services

Enrollment in the Med Access program is subject to eligibility and fiscal limitations and shall be renewed annually.

Limitations of Med Access Program:

(1) The Med Access program shall not cover benefits that are provided as part of workers’ compensation insurance.

(2) The Med Access program shall exclude coverage for preexisting conditions, except pregnancy, during a period of 12 months following the effective date of coverage as long as:

(a) The condition manifested itself within a period of 6 months before the effective date of coverage; or

(b) Medical advice or treatment was recommended or received within 6 months before the effective date of coverage.

(3) The Med Access program shall not include coverage for outpatient prescription drugs, eyeglasses, dental services, custodial care, or emergency services for non emergent conditions.

(4) Any member of the Med Access program who is determined to be at “high risk” by a participating primary care provider shall, upon renewal, agree to be placed in a case management system when it is determined by the program to be in the best interest of the member and the Med Access program.

(5) No person on whose behalf the program has paid out $500,000 in covered benefits is eligible for continued coverage in the Med Access program.

(B) Delivery of Disease Control Services :TUBERCULOSIS CONTROL(Delivery of tuberculosis control services)

Active tuberculosis is a highly contagious infection that is sometimes fatal and constitutes a serious threat to the public health. There is a significant reservoir of tuberculosis infection in this state and that there is a need to develop community programs to identify tuberculosis and to respond quickly with appropriate measures. Some patients who have active tuberculosis have complex medical, social, and economic problems that make outpatient control of the disease difficult, if not impossible, without posing a threat to the public health. The Legislature finds that in order to protect the citizenry from those few persons who pose a threat to the public, it is necessary to establish a system of mandatory contact identification, treatment to cure, hospitalization, and isolation for contagious cases and to provide a system of voluntary, community-oriented care and surveillance in all other cases. The Legislature finds that the delivery of tuberculosis control services is best accomplished by the coordinated efforts of the respective county health departments, the A.G. Holley State Hospital, and the private health care delivery system.

Community tuberculosis control programs.–The department operates, directly or by contract, community tuberculosis control programs in each county in the state. Community tuberculosis control programs deals with the :

Promotion of community and professional education about the causes and dangers of tuberculosis and methods of its control and treatment to cure; Community and individual screening for the presence of tuberculosis; Surveillance of all suspected and reported cases of active tuberculosis, including contact investigation as necessary and as directed by the department; Reporting of all known cases of tuberculosis to the department; Development of an individualized treatment plan for each person who has active tuberculosis and who is under the care of the department, including provision of treatment to cure and follow up, and the distribution of medication by means of directly observed therapy, if appropriate, to eligible persons under rules and guidelines developed by the department; and Provision of counseling, periodic retesting, and referral to appropriate social service, employment, medical, and housing agencies, as necessary for persons released from hospitalization or residential placement.

The department plans to develop, by rule, a methodology for distributing funds appropriated for tuberculosis control programs. Criteria to be considered in this methodology include, but are not limited to, the basic infrastructure available for tuberculosis control, caseload requirements, laboratory support services needed, and epidemiologic factors. The goal of the treatment plan is to achieve treatment to cure by the least restrictive means. The department shall develop, a standard treatment plan form that must include, but is not limited to, a statement of available services for treatment, which includes the use of directly observed therapy; all findings in the evaluation and diagnostic process; measurable objectives for treatment progress; and time periods for achieving each objective. Each treatment plan must be implemented through a case management approach designed to advance the individual needs of the person who has active tuberculosis. The person’s progress in achieving the objectives of the treatment plan must be periodically reviewed and revised as necessary, in consultation with the person.

Limitations of Tuberculosis control services :

Noncompliance to anti tubercular therapy is a major limitation to the tuberculosis control programs. The failure to take prescribed medication is a universal perplexing phenomenon. This fact must be taken into consideration when one endeavors to treat a patient or control diseases in a community. TB is a communicable disease requiring prolonged treatment, and poor adherence to a prescribed treatment increases the risk of morbidity, mortality and spread of disease in the community The therapeutic regimens given under direct observation as recommended by WHO have been shown to be highly effective for both preventing and treating TB but poor adherence to anti tuberculosis medication is a major barrier to it’s global control. Factors associated with patients for poor compliance in the pre-DOTS (Directly Observed Treatment Short-course) era are relief from symptoms, adverse reactions to drugs, domestic and work-related problems. In an urban tuberculosis control program, noncompliance with DOTS was common and was closely associated with alcoholism and homelessness. Noncompliance is associated with an increase in the occurrence of poor outcomes from treatment and accounted for most treatment failures. Innovative programs are needed to deal with alcoholism and homelessness in patients with tuberculosis.[1]

3) Select a health profession of interest to you. Discuss the main elements of how the profession is regulated, how the regulations benefit the profession and the community, as well as any limitations

A health profession that interests me the most is medical practice(chapter 458).The profession is regulated by a set of rules and the primary legislative purpose is to ensure that every physician practicing in this state meets minimum requirements for safe practice. It is the legislative intent that physicians who fall below minimum competency or who otherwise present a danger to the public shall be prohibited from practicing in this state. Any person desiring to be licensed as a physician, who does not hold a valid license in any state, is supposed to apply to the department on forms furnished by the department. The department provides a license to each applicant who the board certifies: has completed the application form and remitted a nonrefundable application fee not to exceed $500, Is at least 21 years of age, is of good moral character, has not committed any act or offense in this or any other jurisdiction which would constitute the basis for disciplining a physician pursuant and meets one of the following medical education and postgraduate training requirements:

(A)Is a graduate of an allopathic medical school or allopathic college recognized and approved by an accrediting agency recognized by the United States Office of Education or is a graduate of an allopathic medical school or allopathic college within a territorial jurisdiction of the United States recognized by the accrediting agency of the governmental body of that jurisdiction or Is a graduate of an allopathic foreign medical school registered with the World Health Organization and certified pursuant to s. 458.314 as having met the standards required to accredit medical schools in the United States or reasonably comparable standards

(B)Has had his or her medical credentials evaluated by the Educational Commission for Foreign Medical Graduates, holds an active, valid certificate issued by that commission, and has passed the examination utilized by that commission; and

(C)Has obtained a passing score, as established by rule of the board, on the licensure examination of the United States Medical Licensing Examination (USMLE); or a combination of the United States Medical Licensing Examination (USMLE ).

The department and the board assures that applicants for licensure meet all the criteria through an investigative process. When the investigative process is not completed within the time set and if the department or board has reason to believe that the applicant does not meet the criteria, the State Surgeon General or the State Surgeon General’s designee may issue a 90-day licensure delay which shall be in writing and sufficient to notify the applicant of the reason for the delay. Furthermore, the department may not issue an unrestricted license to any individual who has committed any act or offense in any jurisdiction which would constitute the basis for disciplining a physician pursuant to s. 458.331. When the board finds that an individual has committed an act or offense in any jurisdiction which would constitute the basis for disciplining a physician pursuant to s. 458.331, then the board may enter an order imposing one or more of the terms set forth in subsection.

The department also issues penalties for violating rules and regulations such as :The practice of medicine or an attempt to practice medicine without a license to practice in Florida, the use or attempted use of a license which is suspended or revoked to practice medicine, .attempting to obtain or obtaining a license to practice medicine by knowing misrepresentation, attempting to obtain or obtaining a position as a medical practitioner or medical resident in a clinic or hospital through knowing misrepresentation of education, training, or experience.

Limitations of medical practice are:

The Legislature recognizes that the practice of medicine is potentially dangerous to the public if conducted by unsafe and incompetent practitioners. The Legislature finds further that it is difficult for the public to make an informed choice when selecting a physician and that the consequences of a wrong decision could seriously harm the public health and safety.(example: adverse incidents in office practice settings. the term “adverse incident” means an event over which the physician or licensee could exercise control and which is associated in whole or in part with a medical intervention, rather than the condition for which such intervention occurred, and which results in the following patient injuries: The death of a patient, brain or spinal damage to a patient, permanent disfigurement, the performance of a surgical procedure on the wrong patient, The performance of a wrong-site surgical procedure; the performance of a wrong surgical procedure or the surgical repair of damage to a patient resulting from a planned surgical procedure where the damage is not a recognized specific risk as disclosed to the patient and documented through the informed-consent process ).

The department reviews each incident and determine whether it potentially involved conduct by a health care professional who is subject to disciplinary action and disciplinary action, if any, will be taken by the board under which the health care professional is licensed.

When the board determines that any applicant for licensure has failed to meet, to the board’s satisfaction, each of the appropriate requirements set forth in this section, it may enter an order requiring one or more of the following terms:

(a) Refusal to certify to the department an application for licensure, certification, or registration(b) Certification to the department of an application for licensure, certification, or registration with restrictions on the scope of practice of the licensee; or(c) Certification to the department of an application for licensure, certification, or registration with placement of the physician on probation for a period of time and subject to such conditions as the board may specify, including, but not limited to, requiring the physician to submit to treatment, attend continuing education courses, submit to reexamination, or work under the supervision of another physician.