The Impacts of Choices Services on Clientele, Essay Example

The health services provided by the Community Health Offering Innovative Care and Educational Services (CHOICES) are offered by an organization called Alachua County Board of County Commissioners (BOCC) that aims in improving the access of the locals of Alachua County to health care. This is made possible by the application of innovation and cost-efficient drivers. CHOICES intend to serve the people who are having a hard time accessing health care resulting to deferral of services (“Choices Health Care Services”, 2008). With this program, the number of people who are suffering from health problems and disabilities would be minimized through their delivery of reasonably priced health care services.

The program asserted that their primary goal is to enhance the quality and quantity of services concerning the prevention and management of diseases for medically deprived locals of the county of Alachua. In addition, their aim is to inform the public and trigger the people’s awareness, acceptance and understanding about the behavior towards a healthy lifestyle.

The health services provided by CHOICES are ground breaking fresh concept that provides finances to the health care of the locals of the society. It involves programs that are related to the prevention of illnesses that is suited to the funds of people. The program’s emphasis is to give the enrollees the standard care they need which covers both oral health and medical services. They also offer suitable services to manage diseases such as diabetes, hypertension, congestive heart failure and asthma. Likewise, enrollees who belong to the Senior Citizen group whose age is sixty five and above, with very low income will be provided with oral health care services.

The program has provided the requirements for the eligibility of enrollees (“Choices Health Care Services”, 2008). The criteria stated that eligible enrollees should be eighteen to sixty four years old and citizens of the United States or permanent residents. The enrollee should also be a local of Alachua County with a household income equivalent or lower than 200% of the Federal Poverty Level. Applicants of the program are also obliged to be in employment for an average of one hundred hours or more every month which includes self-employment. The enrollee should also be employed for not less than thirty days. The program also requires that the enrollees should not be qualified for any coverage of health care or public programs including Veterans Administration or Medicaid. Likewise, the health benefits that are offered by employers should be considered as unaffordable. Senior citizens who are receiving limited income are qualified to avail services concerning oral health.

The Activities of the Program

CHOICES have been providing numerous services to its enrollees for the past years. In summary, CHOICES Health Services provide both Outpatient and Ambulatory services that are under the coverage of Medicare except those that are clearly stated to be omitted from the plan. Both Outpatient and Ambulatory services are referred to as services that are offered within the health care provider’s workplace or any patient facility excluding confinement. Likewise, CHOICES provide services that are not included on Medicare plans such as family planning services, dental services, routine physicals, immunizations and vision services.

Typically, uninsured people will only seek for medical care and attention during emergency cases or when the disease has already aggravated. The CHOICES program is an alternative bargain for people who need preventive care. People who are enrolled in this program will automatically get routine medical screenings and checkups that can minimize the probability of getting severe diseases and injuries (Schell, 2006). Enrollees who have availed the CHOICES Health Services plan are privileged to receive 1) physician and primary care services, 2) disease management services, 3) outpatient hospital services, 4) prescription drugs, 5) dental services, 6) family planning services, 7) immunizations, 8) routine preventive care, 9) vision services, and 10) other medical services and supplies. These services are indeed expensive and very important to the medically poor seniors and non-senior patients.

The physician primary care services involve the standard care procedures that are performed routinely. This also covers consultation and attention to the disease and injuries. Enrollees will be transacting with specialists and primary care provider when availing this service. The disease management services’ objective is to enhance the lifestyle and well-being of patients who were diagnosed with illnesses such as diabetes, hypertension, and other chronic diseases. This service involves the physicians and specialists in order to educate the enrollee about his conditions. Likewise, these professionals are responsible for monitoring the compliance of the enrollee to the treatment plan they have provided.

Dental services are very expensive nowadays, and the offers of CHOICES are indeed very helpful to the medically deprived individuals of Alachua. The services that aim to lessen pain and contamination include incision and drainage of abscesses, performance of required radiographs for more accurate diagnosis, evaluation of oral problems, intermittent oral prophylaxis, non-surgical operation on periodontal such as root planning and scaling, recuperative operations such as tooth colored fillings and amalgam, extractions of tooth, denture therapy and other surgical operations related to dentistry.

In the presence of viral and bacterial diseases, the immunization services from CHOICES such as anti-influenza, Hepatitis B and Pneumococcal are very helpful as well. Also, since the growth of population nowadays is very rapid and should be monitored and controlled, the program also aims to help Alachua families to plan their future suitably with their Family Planning Services. Aside from the concerns on population inflation, CHOICES also care about the possibility of transmitting diseases through sexual intercourse. With these, they offer counseling visits, birth control, supply visits, laboratory tests, pharmaceuticals that are linked to family planning, assessment and management of STDs and treatment to these diseases to their enrollees.

It was stated that prevention of diseases is also the program’s goal. Due to this, CHOICES has included services that are necessary to prevent diseases conditions that are usually prevalent in older patients. These services include colorectal cancer screening, routine physical checkups, mammography, pap test, cardiovascular diseases checkups, prostate cancer evaluation tests, examinations for diabetes, screening for glaucoma, measurement of bone mass, and self-management of diabetes. Similarly, patients who are in need of vision services can avail services that are performed by licensed optometrists, ophthalmologists, and opticians.

The Importance of the Impacts of CHOICES

The objective of this paper is to evaluate the impacts of the program of CHOICES on its clientele. It answers the question “How the services do provided impact the clientele?” It is significant to assess the impacts of a program to its population of interest to determine its success and problems all throughout its operation. The State of Victoria, Department of Human Services (2003) defined Impact as the instantaneous outcome of the health advancement programs on individuals, shareholder, and situations to influence the elements of health. These health programs are diverse when it comes to its effect on people and on the physical and social settings.

Impact evaluations normally estimate mediocre effects of a program on the benefit of the recipients (Gertler et. al, 2011). In the case of CHOICE, the impacts may answer several questions like, “Did the introduction of the program minimized the number of people who can’t afford health care services?” “Did the program significantly provided assistance to the poor and seniors of the country?” “Is the program indeed affordable compared to other services?” Basically, impact evaluations cover an adequately big number of recipients or the results may be evaluated from the subdivisions of the receivers. For instance, these subgroups may be the number of male and female who are enrolled in the program or the male and female seniors who are currently benefitting from CHOICES. Thus, it will be easier to determine whether the program’s affordability and accessibility are both ideal for any enrollee coming from different subcategories.

During the impact evaluation, we can determine if the effects of CHOICES correspond to the standard impacts of health care services to its recipients. The State of Victoria, Department of Human Services (2003) stated that the immediate impacts of health promotion programs to individuals include 1) enhanced knowledge in health, 2) abilities and enthusiasm, and 3) modifications to fitness actions and manners. Likewise, the impacts of these programs to its settings include 1) formation of new groups, 2) programs and amenities to uphold health, 3) diminutions in physical health hazards, 4) fitness endorsing modifications to administrative policies, and 5) development to the physical setting to safeguard health.

Impact Variables and its Operational Definitions

Impact variables are defined as a probable element of an attempt that is intentional that has an influence on the patterns of an activity of an organization (Dgeaston, 2011). It can be determined by its operation such as being always available, simultaneously operating, modifiable, and measurable. According to Dgeaston (2011), the seven impact variables include talent, time, knowledge, policies, resources, communication and measures. The impact variables involved on the impact evaluation of the CHOICES program include the following:

CHOICES Disease Management Program – A service provided by CHOICES that involves the management of chronic diseases of CHOICES enrollees.

CHOICES Health Education and Wellness Program – A service provided by CHOICES that offer health awareness activities and programs to benefit and help the Alachua County residents.

Enrollees – The qualified applicants who can avail the services of CHOICES.

Federal Poverty Level Guidelines – Guidelines from the Department of Health and Human Services that demarcates the calculation of income from the families belonging to poverty level.

Health Care Providers – Professionals who provide care to the enrollees, these include the specialists, physicians and nurses.

The Evaluation Design

The evaluation of this program would depend on the related works that were conducted previously. The evaluation design utilized by Scicchitano and Johns (2010) was random sampling from the provided document containing all the enrollees of CHOICES with functional contact numbers. The authors performed random sampling to assure that all enrollees had an identical likeness of being nominated for the survey trial. The authors also considered the listed sample of former enrollees. The design was also randomized because of a similar reason.

Methods of Collecting Data

The data that are used in this impact evaluation was gathered using secondary data. The related works about the impacts of CHOICES on its enrollees were gathered. Scicchitano and Johns (2010) accomplished their study by performing random sampling among CHOICES enrollees who have available contact numbers. The sampling plan that was followed by the authors involves a pretest followed by implementation. Pretesting was deemed necessary to determine the problems that may be encountered upon implementation of the survey. Factors like the design of the questionnaire, question wordings, transitions found in the survey sections, and the clarity of the language and concepts used were evaluated first.

Strengths and Weaknesses of the Design

The strengths of the design include 1) the respondents came from the actual enrollees of the CHOICES program, 2) the documents are verified by the coordinators of CHOICES programs, and 3) the related works that were used as basis were already published and contain verified findings. The impact evaluation of the CHOICES program has its own weaknesses too, these include 1) actual sampling were not performed by the authors, 2) the data that were used are not updated, 3) the results that were included on the cited works may not be equivalent to the probable results that may be gathered in present actual sampling. These weaknesses can be prevented from occurring by performing actual sampling in further studies to be performed to evaluate the program of CHOICES.

Diagram of Logic Model

The diagram of the Logic Model of CHOICES program indicates that the work forces contributions include the assistances provided by the physicians and the health care providers. Likewise, the success of the program also depends on its capacity to serve the enrollees. For instance, questions like “Is the program capable of catering the needs of its enrollees?” “Are the health care providers and physicians involved in the program can provide quality service regardless of the inexpensive payment provided by the enrollees?” and “How can the program compete with other health programs and insurances with its general features and offers?” should be addressed. The support of the Alachua County and the medically poor patients are very important to make CHOICES program a success. It is important to remember that in spite of its affordability, it still needs proper support from the government and the locals of Alachua. If none among the residents would avail the services, it is possible that this program would fail.

The long term effects of the program complement the goals of CHOICES. The probable long term effects of CHOICES include 1) the increase in health awareness and knowledge among the enrollees and residents of Alachua County and 2) the improvement of the affordability of health care services for the medically poor patients. If these long term effects would be sustained, it is therefore possible that the over-all impacts would be established. These impacts include the 1) Increased number of people availing health services and 2) Decreased number of people who can’t afford necessary health care services that are included on the coverage of CHOICES.

Figure 1. The Logic Model of CHOICES Program

Ways to Improve the Program’s Quality

Upon the assessment of the objectives, activities and the reactions of the respondents towards the program, it is recommended that several ways can be performed to improve the program’s quality. First of all, it would be helpful if the coverage of the program would not be limited to people whose age ranges from 18-64. It would be much helpful if younger people can also avail the services through their employed parents. Likewise, the seniors whose age is 65 should not get limited services (dental services) only. These people are weaker and more in need of health care attention due to their age. Therefore, the program would be more efficient if they can also provide the other services to the senior ones. They can come up with a selection of coverage so that the enrollees can choose the services that they prefer. For instance, a senior can avail a coverage that would include vision, dental and preventive care services. This is an easy way of catering the specific needs of the citizens of Alachua County. Further studies can be performed to identify the needs of people and the types of services that are frequently availed.

References

Community Health Offering Innovative Care & Educational Services. (2008). Choices Health Services. Retrieved http://www.alachuacounty.us/Depts/CSS/Documents/choices/Provider_Manual.pdf

Dgeaston. (2011). Can we impact complexity? Retrieved from http://thecomplexityspace.com/?p=309

Gertler, P.J, Martinez, S., Premand, P., Rawlings, L.B., & Vermeersch C.M.J. (2011). Impact Evaluation in Practice. Retrieved from http://siteresources.worldbank.org/EXTHDOFFICE/Resources/5485726-1295455628620/Impact_Evaluation_in_Practice.pdf

Scicchitano, M.J., & Johns, T.L. (2010). Choices: Program Evaluation. Retrieved from https://mail-attachment.googleusercontent.com/attachment/?ui=2&ik=51c54ef466&view=att&th=137402000ba1f02c&attid=0.1&disp=inline&realattid=f_h23m4npt0&safe=1&zw&sadssc=1&sadnir=2&saduie=AG9B_P9_5X5gbFwcydrucQYXnB4&sadet=1336964299001&sads=LcJT76W4RPVue6BoRf62oAtfQRk

Schell, S. (2006). Can’t afford health insurance? Qualifying may get easier for County program. Retrieved http://www.afn.org/~iguana/archives/2006_02/20060205.html

State of Victoria, Department of Human Services. (2003). Measuring health promotion impacts: A guide to impact evaluation in integrated health promotion. Retrieved http://www.health.vic.gov.au/healthpromotion/downloads/measuring_hp_impacts.pdf