Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 111 - Area Level Planning › Section I-11105 - Ambulatory Care

Current through Register Vol. 50, No. 6, June 20, 2024
A. New
				  Orleans/Bayou-River Health System Area
1. The
				  New Orleans/Bayou-River area is predominantly urban, with a higher per capita
				  income, more physicians and more hospital beds than elsewhere in the state. Yet
				  the area has the highest mortality rate in the state. Mortality rates in the
				  area which have particular significance for ambulatory care planning are those
				  for heart disease, cancer and infants.
2. There is a shortage of primary care
				  physicians in some of the rural sections of the area and in the poverty pockets
				  of New Orleans. Dental services are also relatively inaccessible to some of the
				  poorer residents of New Orleans.
3.
				  Planning Objectives for Ambulatory Care in HSA I
a. ambulatory or mobile health care settings
				  which provide low cost screening diagnosis and treatment or referral should be
				  available and accessible to all residents of the area within 30 minutes travel
				  time. Programs directed especially toward screening for heart disease,
				  hypertension, cancer, tuberculosis, anemia, gonorrhea and syphilis are
				  needed.
b. Primary care physician
				  services should be available in Assumption Parish and in Northeastern St.
				  Tammany Parish, Dulac, Desire/ Florida (N.O.), Teche and Lafitte by
				  1985.
c. Low-cost pre-natal care
				  programs for the low-income population should be available within 30 minutes
				  travel time for all residents of the area, with appropriate referral services
				  for high risk patients.
d.
				  Ambulatory or mobile dental services which provide low-cost screening and
				  treatment should be available to all residents of the area within 30 minutes
				  travel time, but especially in the poverty areas of New Orleans.
e. By 1987, 30 percent of all surgical
				  procedures performed in the area should be performed on an ambulatory
				  basis.
f. By 1987, there should be
				  conformity to goals and standards established in the 1982-87 State Health Plan
				  for radiation therapy services.
g.
				  By 1987, there should be conformity to goals and standards established in the
				  1982-87 State Health Plan for computed tomography services.
h. By 1987, there should be conformity to
				  goals and standards established in the 1982-87 State Health Plan for end-stage
				  renal disease services.
i. By 1987,
				  there should be conformity to goals and standards established in the 1982-87
				  State Health Plan for ambulatory surgical services.
j. By 1987, there should be conformity to
				  goals and standards established in the 1982-87 State Health Plan for preventive
				  health services.
4.
				  Recommended Actions
a. Primary care
				  physicians, dentists and other ambulatory care providers should consider the
				  cost-effectiveness of mobile or "no-frills" type services which can be offered
				  at a lower consumer cost in underserved poverty areas.
b. The Medicaid Program should consider the
				  feasibility of instituting coverage of adult dental services beyond the current
				  denture program, with the possibility of implementing a "co-pay" coverage
				  whereby the recipient would bear 50 percent of the costs.
c. Medicare, Medicaid and major health
				  insurance companies should develop policies that promote the utilization of
				  ambulatory surgical services when medically appropriate, such as patient rebate
				  for same day discharge or cost incentives for hospitals for same day
				  discharge.
d. Assistance from L. S.
				  U. and Tulane Medical Schools and/or Louisiana State Board of Medical Examiners
				  in locating primary care physicians willing to establish practice in the
				  designated manpower shortage areas of the area.