Ukuqonda ukuhlobana okuyinkimbinkimbi phakathi kwezimiso zikahulumeni wendawo kanye nokukhetha kwezempilo kubalulekile emikhayeni ehamba phambili eyinkimbinkimbi yezinkonzo zezempilo. Izinqumo zikahulumeni wendawo zingakuthonya kakhulu ukutholakala, ukutholakala, ukuvuleka, nokufaneleka kwezindlela zokunakekela impilo. Nakuba uhulumeni nombuso ugunyaza ukuba kuthathwe izihloko eziphambili, kusesifundazweni, edolobheni, nasemazingeni kamasipala lapho kuvela khona imiphumela esheshayo ekuphileni kwansuku zonke. Ukusekela izimali emitholampilo yomphakathi kuya ekwakheni imithetho enquma ukuthi ikuphi isibhedlela, izimiso zendawo zithuthukisa indawo ezungezile yempilo ngezindlela ezijulile. Lesi sihloko sihlola izindawo lapho izinhlangano zikahulumeni zendawo zihlangana khona nezinqumo zempilo yomkhaya, kunikeza ukuqonda indlela imikhaya engasekela ngayo kangcono izidingo zayo futhi yenza ngayo izinqumo ezibonisa ulwazi.

Indima Kahulumeni Wendawo Ekunakekeleni Impilo

Uhulumeni wendawo ufeza indima ebalulekile ekulolongeni izimiso zezokunakekela impilo ezithinta imikhaya ngokuqondile. Lezi zimiso zingahlukahluka kusukela eminyangweni yezempilo yendawo exhasa ngezimali kuya ekuqondiseni izakhiwo zempilo nezinkonzo. Ngokungafani nezinhlelo zikahulumeni ezinjengeMedicare noma i-Medicaid, ukuthatha izinyathelo zendawo kuvame ukuhlotshaniswa nezibalo ezithile zomphakathi nezinselele zomphakathi othile. Ngokwesibonelo, isifunda sasemaphandleni singabeka indawo yezezisekelo ze-telehealth, kuyilapho idolobha lasedolobheni ligxila ekuhambeni emitholazweni nasezimpahleni.

Izindawo eziyinhloko zethonya likahulumeni wendawo zihlanganisa:

  • [ Ukuhlela izindlela zomphakathi zempilo [ - izimali zendawo zinikeza imithombo yemali yokugoma, ukuhlola izifo, nemikhankaso yemfundo yezempilo.
  • [[I- Ukumiswa kwabaphathi bempilo [ – amabhodi a-Licens kanye neminyango yezempilo kubeka izindinganiso zemitholampilo, izibhedlela, nodokotela ngabanye.
  • Izimiso zezempilo[ - Izinhlangano zendawo zinikeza izinhlelo zikahulumeni nohulumeni ezinjengethi Women, Infants, nethi Children (WIC) noma izinkonzo zempilo yengqondo yomphakathi.
  • [ Izilinganiso zempilo ezihlangene - ukuhlola okuvamile kuveza izinkinga zempilo ezicindezela kakhulu endaweni, eziqondisa isimiso esiza kuqala.

Ohulumeni bendawo basebenza nezinhlangano ezingazuzisi inzuzo nezinhlangano ezizimele ukuze bagcwalise amagebe. Ngokwesibonelo, idolobha lingase lifake umthola-mpilo okhululekile endaweni engakhokhwa noma linikeze izisusa zentela zokukhanga ochwepheshe bezokwelapha ezindaweni ezidinga inzuzo enkulu. Lezi zinqumo zithinta ngokuqondile ukukhetha okungatholakala emikhayeni.

Ukutholakala Kwendlela Yokunakekela Impilo Nokusebenza

Ukukwazi ukufinyelela empilweni ngokuvamile kunqunywa yizimiso zikahulumeni wendawo ezithinta ukwabiwa kwemithombo yezokwelapha. Imikhaya ingase ithole ukuthi ukukhetha kwayo kwezempilo kulinganiselwe ngokuba khona kwezinkonzo endaweni yayo. Indawo ye-ographic, izinga lemali, ngisho nezindawo zokuhamba konke kuthonywa imithetho yendawo nokusebenzisa izinto eziza kuqala.

Amaphuzu ayinhloko ahlanganisa:

  • I-Project ezibhedlela nasemitholampilo - imithetho yokuzingela nokuhlela indawo kunquma ukuthi zingakhiwaphi izakhiwo zezokwelapha. Imikhaya ezindaweni ezisemaphethelweni asanda kwakhiwa ingase intula izindlela zokukhetha eziseduze uma uhulumeni wendawo engagunyazi isisekelo sempilo kulezozindawo.
  • Izindawo ezikwazi ukukhokha ochwepheshe - emaphandleni ngokuvamile kuyanzima ukudonsa ochwepheshe ngenxa yenkokhelo enciphisiswayo nokusekela okulinganiselwe kochwepheshe. Izinhlelo zokukhokha imali yendawo zingakhuthaza ochwepheshe ukuba basebenzise emiphakathini engagciniwe.
  • Izinketho zokuhlanganisa [ – Nakuba umshuwalense ulawulwa kakhulu ngokwezinga likahulumeni, ohulumeni bendawo bangathonya uhlobo lwamacebo anikezwa ngezinhlelo zezempilo zezisebenzi zomphakathi noma ngokwenza isivumelwano sokuthengela amabhizinisi amancane.
  • Izinkonzo zokuthumela ama-aprport eziya esibhedlela - Izilinganiso eziningi zisebenza izinhlelo zezokwelapha zokuthutha ezingaphucuzeki. Ngaphandle kwezinkonzo ezinjalo, imikhaya engenazimoto ibhekene nezithiyo ezinkulu ekunakekeleni okuvamile.

Izibonelo Zokutholakala Kwamaphoyisa Endaweni

Ohulumeni bendawo bangamisa izimiso ezithinta ngokuqondile ukutholakala kwempilo. Izibonelo zezwe langempela zihlanganisa:

  • Izikhungo zezempilo zomphakathi ezifundisa ezindaweni ezigciniwe – Amadolobha anjenge Chicago aye asebenzisa iminikelo kahulumeni nemali yendawo ukuze avule izikhungo ezintsha zempilo ezindaweni ezizungezwe yizimo ezingezona ezikhona, ezinciphisa indawo yesimo esiphuthumayo.
  • [ ukubambisana nezinkonzo zokuthutha zendawo - Amanye ama-odoli asebenzisa izinhlelo zokuhamba ezithatha ijubane ezisendleleni zokwelapha, uhlobo olwaba lubaluleke kakhulu phakathi nomqedazwe we-COVID-19.
  • Izinkonzo ze-telehealth zokufinyelela amanani abantu abakude – izibalo zasemaphandleni ezifundazweni ezinjengeMontana neWyoming ziye zasebenzisa izakhiwo zesakhiwo ezibanzi zezentengiselwano nezindawo ezisezikhungweni ze-telehealth, zivumela imikhaya ukuba ithintane nochwepheshe bamakhulu amakhilomitha kude.

Imikhaya kufanele icwaninge ngemibiko yomnyango wezempilo wendawo yayo noma iye emihlanganweni yomkhandlu wedolobha ukuze iqonde ukuthi yiziphi izinyathelo zokungena endaweni ethile (noma zingekho.)

Izinga Lezinkonzo Zezempilo

Izinga lenkonzo zokunakekela impilo lingenye indawo ebucayi ethonywa yizimiso zikahulumeni wendawo. Imikhaya ixhomeke ekunakekeleni okuphakeme, okungathonywa ngezimiso ezilawulayo nezinqumo zokuxhasa ngemali. Ubukhazikha abubangelwa nje ikhono lomuntu ngamunye onakekelayo, futhi bubonisa izici zesimiso njengezindinganiso zezindawo zokunakekela imoto, imithetho yokuvikela yesineke, nezakhiwo zezempilo zomphakathi.

Izindawo eziyisihluthulelo zethonya lendawo:

  • Izilinganiso zezindawo zokwelapha - Izimiso zokwakha nendawo kanye nezimiso zokuphepha umlilo ziyasebenza ezibhedlela nasemitholampilo. Okubaluleke kakhulu, iminyango yezempilo ihlola futhi iphoqelele ukuba kugcinwe indle futhi kugcinwe izindinganiso zokulawula izifo.
  • Izimfuneko ezigunyaza izimfuneko zochwepheshe bezempilo – nakuba ukufushanisa ngokuyinhloko kuyisilinganiso sikahulumeni, ohulumeni bendawo ngokuvamile bengamela izingqgibo zezisebenzi zezempilo zomphakathi futhi bangabeka izimfuneko ezengeziwe zokusebenza ezimbonini zendawo.
  • Ukusungulela izinhlelo zokuqeqeshelwa nokufundiswa - Amakholiji omphakathi nezinhlelo zemisebenzi eziqeqesha abahlengikazi, abasizi bezokwelapha, nochwepheshe bancike ekuxhaseni imali yendawo. Izisebenzi eziqeqeshiwe zithuthukisa izinga lokunakekela ngokuqondile.
  • Imikhankaso yezempilo ye-Public ukuthuthukisa ukuchuma – imikhankaso yokulwa nokubhema, izinhlelo zokuvimbela ukukhuluphala, kanye nokuqapha ngengqondo ngokuvamile kuklanywa ezingeni lendawo ukuze kuhlangatshelwe izidingo zomphakathi ezithile.

Izinyathelo Zokuthuthukisa Imfanelo Yasendaweni

Ngokuvamile ohulumeni bendawo basebenzisa izinyathelo ezihloselwe ukuthuthukisa izinga lokunakekela.

  • Izinhlelo zokuthuthukisa izinga lezibhedlela – Amanye amadolobha asungule izinqubo ezivuza izibhedlela ngokunciphisa amazinga okufunda noma ukuthuthukisa ukwaneliseka kweziguli.
  • Izinqubo zokugunyazwa kwezindawo zokwelapha - - iminyango yezempilo yendawo ingadinga ukuqashwa kwemizimba njenge-Joint Commission njengesimo senshuware, ukuqinisekisa isisekelo somgangatho wezinga.
  • Ukubika ngokuhlolwa kwempilo kuphumela [ - ukwaziswa okubonisa ngokucacile ngamazinga okungenwa yizifo, izinkinga zokuhlinza, nemiphumela yeziguli kwenza imikhaya ikwazi ukwenza izinqumo ezinolwazi. Ngokwesibonelo, umnyango wezempilo waseNew York City ukhipha amakhadi esibhedlela.

Imikhaya ingasebenzisa lemibiko yomphakathi ukuze iqhathanise izibhedlela noma imitholampilo yendawo futhi isekele izindinganiso eziphakeme lapho imiphumela ingahambi kahle.

Izindlela Zokunquma Impilo Nezenhlalo

Ukulingana kuyindaba ebalulekile ohulumeni bendawo okumelwe bayicabangele. Izimiso ezikhuthaza ukulingana kwempilo zingaholela empilweni engcono kuyo yonke imikhaya, kungakhathaliseki ukuthi injani izenhlalo. Izigwebo zempilo (njengezindlu, imfundo, neholo) zithonywe kakhulu yizinqumo zikahulumeni wendawo, futhi lezi zici zivame ukudlula ukunakekelwa kwempilo yonke.

Izindawo eziyinhloko zihlanganisa:

  • Izinqanda ezempilo ze-adiskeria zezempilo - izinqubo zendawo ezisendluni engabizi, iholo elincane, nemfundo yomphakathi zinemiphumela eqondile yempilo. Ngokwesibonelo, idolobha elifaka imali emapaki aphephile lindisa amathuba okusebenza okuzivivinya.
  • Izinhlelo zokunciphisa umehluko wempilo - Omasipala abaningi banezinhlelo ezihloselwe imiphakathi enemibala, izakhamuzi ezithola imali ephansi, noma abafuduki. Lokhu kungahlanganisa ukuhlola umdlavuza mahhala, usizo lokudla, noma izinkonzo zokuchaza ulimi.
  • [ ukuthembisana komphakathi ekuhleleni impilo - Ibhodi lezempilo nemikhandlu yezempilo yomphakathi kunikeza izakhamuzi iphimbo ekubekeni kuqala izindaba zempilo zendawo kanye nezimali zokuhlela.

Izinqubo Zokuthuthukisa Impilo Efanele

Amasu aphumelelayo okuthuthukisa ukulingana kwezempilo ngokwezinga lendawo ahlanganisa:

  • [ Ukungenisa izindlu nemfundo ezifinyelelekayo [ - - Izindlu eziqinile zinciphisa ukucindezeleka nokuchayeka ezingozini zendawo ezungezile, kuyilapho imfundo ephambili iholela ekutholeni ulwazi olungcono lwempilo namathuba ezomnotho.
  • Ukuthola ukudla okunomsoco - Ohulumeni bendawo bangasekela izimakethe zabalimi, izingadi zomphakathi, nezinhlelo eziletha imikhiqizo emisha ezindaweni ezitholakalayo eziphansi (ngokuvamile ezibizwa ngokuthi "usizo lwezingwadule lokudla").
  • [ Ukunakekela okufanele ngokwesiko – ukuxhasa izinkonzo zokutolika, izisebenzi zokuqeqesha ukuzwelana kwempucuko, nokuqasha izisebenzi zezokunakekela impilo ezihlukahlukene kusiza ukuqinisekisa ukuthi izinkonzo ziyafinyeleleka kuzo zonke izakhamuzi.

Imikhaya ingasekela ukulingana kwempilo ngokuhlanganyela ekuhloleni impilo nokusekela izinhlangano eziphoqelela izinguquko zenqubo, njenge- i-Robert Wood Johnson Foundation’s Culture of Health art of Health [[FLT: 1].

Umshuwalense Nemithetho Ekhokhelwayo

Ohulumeni bendawo bathonya futhi ukuzikhethela kwezempilo yemikhaya ngezimiso ezihlobene nomshuwalense. Nakuba umshuwalense womuntu siqu ulawulwa ezingeni likahulumeni nohulumeni, izinhlangano zendawo ngokuvamile zisebenzisa ezazo izinhloso zempilo zezisebenzi zomphakathi futhi zingamisa imithetho yokukhokhela izinkonzo ezithile ezinjengempilo yengqondo, amazinyo, noma ukunakekela amehlo. Ngaphezu kwalokho, ama-aupiblic amaningi asebenza izinhlelo zokunakekela ezinikeza izakhamuzi ezinezingakhokhelwanga ngesihle noma ngemali.

Izibonelo zemiphumela yomshuwalense wendawo:

  • Amasu ezisebenzi zempilo ye-Public [ - Isifunda-godna noma idolobha lingase linqume ukunikeza amacebo aphezulu angenzekayo noma ukukhetha okugcwele, okungasebenza njengesibonelo samabhizinisi amancane endawo.
  • Izikhungo zezempilo ezishelelayo zezimali - Izikhungo zezempilo ezifanele (FQHCs) ezivame ukusekelwa amadollar entela endawo, izindleko ezisekelwe emalini eholweni, okwenza ukunakekelwa kuthengeke kakhulu.
  • Imithetho yendawo ezungezile yokuhlanganisa[ – Amanye amadolobha aye adlulisa imithetho efuna abaqashi abakhulu ukuba banikeze izinzuzo zempilo noma ukukhokhela esikhwameni semali sedolobha, njengoba kuboniswa kuhlelo lwe-San Francisco "Ukuphila kwaseSan Francisco".

Imikhaya kufanele ihlole ukuthi indawo yakubo inikeza yini izakhamuzi ezithola imali encane noma ukuthi kunemali yini yendawo yokuthenga.

Ukunakekelwa Kokuzivikela Nempilo Yomphakathi

Ukunakekelwa kokuzivikela kungenye indawo lapho izimiso zikahulumeni wendawo zinethonya eliqondile nelingenakugwenywa empilweni yomkhaya. Iminyango yezempilo yomphakathi iqhuba imitholampilo yokugoma, ukuhlolwa kwezifo, nokuqashwa kwezifo. Zibuye zithathe isinyathelo futhi ekuqubukeni kwezifo, okungathinta ukuya esikoleni nezimiso zomkhaya.

Izimiso zendawo zimisa ukunakekela kokuvimbela ngezindlela eziningana:

  • Izimfuneko zokugoma - Iminyango eminingi yezempilo yendawo imisa izimiso zokugoma izikole zomphakathi, nezimiso zokungagonyeli ezihlukahluka ngokwemithetho.
  • Izinhlelo zokuvimbela isifo seChronic [ - Amadolobha angaxhasa ukubhema amakhosi okufaka ikhefu, amashabhu okuvimbela isifo sikashukela, noma izinhlelo zokuzivivinya emapaki.
  • [[[NT:0] Izimiso zempilo ezingokwezimo - Imithetho yendawo elawula izinga lomoya, ukuphepha kwamanzi, kanye nopende womthofu kuthinta ukuchayeka kwemikhaya ezingozini zempilo ngokuqondile.

Imikhaya ingathola izinkonzo zokuvimbela iminyango yezempilo yendawo, eminingi yayo enikeza ukuhlolwa kwamahhala noma okungabizi kakhulu. Inhlangano yesizwe ye-County and City Health Accounts[[FLT: 1] inikeza imithombo yokuthola izinhlelo zendawo.

Impilo Yengqondo Nokusekela Komphakathi

Izinkonzo zempilo yengqondo zithonywe kakhulu izimiso zikahulumeni wendawo, ikakhulukazi ngemva kokususwa kobuzwe nokushintshela ekunakekeleni umphakathi. Izikhulu zempilo yendawo ziqoqa izimo eziphuthumayo, izikhungo zokweluleka, nezinhlelo zokwelapha ngezidakamizwa. Lezi zinkonzo ngokuvamile ziyizinhlu zokuqala zokusekela imikhaya ebhekene nokucindezeleka, noma ukulutheka.

Amathonya ayinhloko endawo ahlanganisa:

  • Ukuhlela izikhungo zezempilo zengqondo zomphakathi - i-Counties zinikeza intela nezindawo zikahulumeni zokusekela lezikhungo, ezinikeza ukwelashwa, ukuphathwa kwemithi, kanye nokuphathwa kwezezimo.
  • Izimiso zokuphendula ze-CLT - Amanye amadolobha asungule amaqoqo anezimo ezihamba-hamba asebenza ochwepheshe bezempilo yengqondo esikhundleni samaphoyisa, anciphisa ukuboshwa okungadingekile nokuhanjelwa egunjini lengozi.
  • [ Izinhlelo zezempilo yengqondo ezisekelwe ku- - izikole zendawo, ngokubambisana neminyango yezempilo, zinganikeza iseluleko nezinhlelo zokuvimbela ukuzibulala.

Imikhaya kufanele iqaphele izinkonzo zegunya lempilo yengqondo lendawo. Ngokwesibonelo, [FLT: 0] i-Substance Abuse and Mental Service Service Administration[[FLT: 1] inikeza ukhombo lwabaphathi bendawo.

Izinkonzo Zempilo Nezesikole Zezingane

Impilo yabantwana izwela kakhulu ezimisweni zikahulumeni zendawo ngoba izingane zichitha isikhathi sazo esiningi ezikoleni nasemphakathini. Amabhodi esikole (ngokuvamile akhethiwe) enza izinqumo mayelana nemfundo engokomzimba, izindinganiso zokondleka kwasemini zasesikoleni, kanye nokuba khona kwabahlengikazi besikole. Iminyango yezempilo yasesifundani inganikeza futhi izintambo zamazinyo, izimboni zokubona, kanye nezivivinyo zomthofu ezikoleni.

Izibonelo:

  • Izinhlelo zasemini zesikhathi sasemini - Izimiso zendawo zingadlula iziqondiso zikahulumeni ukuze zinikeze izindlela ezinempilo, kodwa izithiyo zokuhlela uhlelo lwemali ngezinye izikhathi ziholela ekugawuleni.
  • [ Imvume yokufakwa [ - Isikole siboshelwe emarekhodini okugoma; iminyango yezempilo yendawo ivame ukuba nemitholampilo yamahhala ukuqinisekisa ukuthobela.
  • [ Asthma kanye nokuphathwa kwe-allergy - Ezinye izindawo zidinga izikole ukuba zibe nezihonjisi ze-epinephrine, ezingasindisa ukuphila.

Abazali bangahileleka ngokuba khona emihlanganweni yesikole noma ukuzihlanganisa nabazali abafundisayo abasekela izimiso zezempilo.

Ukulungiselelwa Okuphuthumayo Nokusabela

Ohulumeni bendawo bangabaphendula kuqala ezimweni eziphuthumayo zempilo yomphakathi − kusukela ezingozini zemvelo kuya ezifweni. Amasu abo anquma indlela imikhaya ethola ngayo ukunakekela okuphuthumayo, ukwamukela ukwaziswa, nokuthola izinto ezinjengemithi yokugoma noma imithi. Phakathi nobhadane lwe-COVID, izinqumo zendawo zokufihla imvume, izindawo zokuhlola, kanye nezivalwa kwesikole zaba nethonya eliqondile empilweni yomkhaya nasekuphileni kwansuku zonke.

Imikhaya kufanele iqaphele amasu ayo aphuthumayo endawo elungiselela. Iminyango eminingi yezempilo yesifunda inaye Ready.gov izinhlelo ezihlangene ezinikeza abaqondisi bokuhlela umkhaya ngezinhlekelele.

Ukuhlanganyela Nobushiqela Emphakathini

Ukuthembisana komphakathi kubalulekile ekuqinisekiseni ukuthi izimiso zikahulumeni wendawo zibonisa izidingo nezithandwa yimikhaya. Imizamo yokuqasha ingasiza ekulolongeni izimiso ezimisa ukutholakala kwempilo nezinga lempilo. Imikhaya ivame ukuwathatha kalula amandla ezwi layo lendawo, (hhono umzali oyedwa okhathazekile okhuluma emhlanganweni womkhandlu wedolobha angabangela ushintsho.

Izindlela zokuhileleka:

  • Ihlanganyela emabhodini empilo endawo - Izindawo eziningi zinebhodi lemihlangano yezempilo evulekele umphakathi. Lamabhodi ahlela isimiso ezindabeni ezinjengokuhlolwa kwezindawo zokudlela, ukubika izifo, nemfundo yezempilo.
  • Ukusekela izinqubo zomkhaya – ngokwesibonelo, ukulwela imithetho ekhokhelwayo yekhefu elikhokhelwayo kuqinisekisa ukuthi imikhaya akudingeki ikhethe phakathi kwesheke lemali nokunakekela ingane egulayo.
  • Ukuhlanganisa nezinhlangano zendawo zezokuthatha isinyathelo sezempilo – Amaqembu asekelwe kukholo, kanye nokuhlangana kwabazali ngokuvamile kuhambisana nezinhlangano zikahulumeni ukuze zinikeze izinkonzo. Ukuzithandela kunganikeza ukuqonda ngendlela izimiso ezisetshenziswa ngayo.

Imikhaya ingasebenzisa futhi amathuluzi e-inthanethi, anjenge- i-Government yemithombo yemali, ukulandelela umthetho wendawo nokuthola ukwaziswa kokuxhumana kwabenzi besinqumo.

Isiphetho

Ukuhlobana phakathi kwezimiso zikahulumeni wendawo nezindlela zokunakekela impilo zomkhaya wakho kukhulu. Ngokuqonda lobu buhlobo, imikhaya ingasebenzisa kangcono izindlela zokunakekela impilo yayo futhi isekele izinqubo ezikhuthaza impilo nenhlalakahle. Izinqumo zendawo mayelana nezimali, imithetho, ukubopha, nezinhlelo zomphakathi zidala uhlelo phakathi kwemikhaya eyenza izinqumo zempilo zansuku zonke. Kungakhathaliseki ukuthi ikhetha isibhedlela, ukufinyelela ukunakekelwa kwengqondo, noma ukuqinisekisa ukuthi izingane zithola izivivinyo ezivimbelayo, lezi zilolongwa yizenzo zezikhulu zesifunda, amalungu embuthweni wedolobha, amabhodi esikole, nezikhulu zezempilo zomphakathi. Ukuhlala zinolwazi nezibophanazo zomphakathi kuyindlela engcono kakhulu yemikhaya ukuqinisekisa ukuthi uhulumeni wendawo azisekeli nje empilweni yazo, kodwa zisekela izinga lazo lokuphila kwazo.