week 5 HSM Law Profile

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1 HSM/230 HSM Law Profile HSM Law Profile University of Phoenix HSM/230 4/12/2015 Erin O’Brien

2 HSM/230 HSM Law Profile When providing services to people in need, there are many laws and regulations that impact the delivery of such services. When working with youth and children the rules can be even more stringent than others. Let’s look at one, in particular, that affects impacts homeless youth, children, and their families. Children in foster care are also affected by the health care law. The Affordable Care Act went into law in March of 2010. There is a plethora of reliable resources to learn about the implications of the Affordable Care Act. The United States National Library of Medicine is an excellent resource. The Society of Human Resource Management is another resource that has a lot of useful information. The United States Interagency Council on Homelessness is arguably one of the best resources available. The National Center on Family Homelessness helps with access to programs for families experiencing homelessness. Lastly, The United States Department of Health and Human Services has all the information a person would need. There are many more resources available about the Affordable Care Act and homelessness. Is the Affordable Care Act going to make things easier or more difficult for those that work in and receive services from the human service field? There are many purposes of the Affordable Care Act. One of the primary goals is to provide affordable health care and other services for impoverished and low-income individuals. Homeless youth and youth in foster care used to become ineligible for benefits when they become emancipated. Due to the Affordable Care Act, they are now eligible until the age of twenty-six. As they transition into adulthood, youth in foster care face significant challenges, including lack of family support, mental health problems, and lack of health care services (English, Scott, Park, 2014, pp. 1-2). Undocumented youth is not eligible for any insurance under any Affordable Care Act provisions. Homeless and foster care youth suffer with mental and physical health issues at a higher rate than the general population of the same age and gender. The health care law provides insurance to help those that are afflicted with ailments.

3 HSM/230 HSM Law Profile Homeless youth is the most vulnerable of all young people. The lack of adult support and health care causes a societal disconnect amongst homeless youth and young adults. Homeless youth’s disconnect from society leads to alcohol and drug abuse. There is up to seventy percent of the homeless youth population that has substance abuse problems. The Affordable Care Act also covers the treatment plans for those that are abusing drugs and alcohol. Another vulnerable group of children is the trafficked ones. There are an alarming number of sexually exploited young children that end up with mental health issues. Counseling is covered under the Affordable care act for sexually exploited youth and young children. There are also preventive programs that are provided under the umbrella of the Affordable Care Act for youth and children. The Affordable Care Act created two programs aimed at young women who could be affected by domestic or dating violence and unintended pregnancy. The first is called the Personal Responsibility Education Program (PREP). A second program called Services for Pregnant and Parenting Teens is also from the Affordable Care Act. Education services for homeless teens are also a benefit of the ACA. There is a program in California that is funded from the ACA. The program is called The California Homeless Youth Project. There are provisions in the ACA that covers lesbian, gay, bisexual, and transgender youth. As Health and Human Services implements the Affordable Care Act, it will pay close attention to the unique health needs of LGBT populations. One of the main goals is to ensure that equality and non-discriminatory services are provided to youth regardless of sexual preference. Training programs are in place to train providers in regards to LGBT youth that have special needs like HIV. As we have seen, there are some practical qualities that the ACA displays.

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4 HSM/230 HSM Law Profile The ACA will affect day-to-day operations within human service organizations in the following ways. Being able to take advantage of the benefits of the law will depend on what state the agency resides. The Medicaid expansion eligibility is left up to the discretion of each state. If the state does not have the Medicaid expansion in place, the human service agency cannot receive the 100% federal funding match to provide services to anyone 19 and over. Why would any state not want to choose the Medicaid expansion? It seems they have a lot to gain by doing so. Not just for financial reasons there are ethical choices to consider for the youth. The individual has to qualify for Medicaid under the state’s guidelines. The implications will be severe for vulnerable groups of young people in states that choose not to implement the ACA Medicaid expansion (English, Scott, Park, 2014 p.7). States that do not implement the Medicaid expansion will have increased numbers of ineligible clients. The agencies in those states will have to turn people away if they do not meet the requirements. Being turned away will force the individual to go to an emergency room or a free clinic. The community as a whole can face being directly impacted by overburdened clinics and emergency room visits. Unfortunately, states that do not move forward with the Medicaid expansion will affect millions of people, including children and youth by limiting their eligibility. Coverage gaps are where the ineligible end up. Additional daily operations can become difficult for organizations that are in the states that do not choose Medicaid expansion. Caseloads will increase on a grand scale. Agency workers will have to make ethical decisions and follow the law or receive the consequences for breaking it. Workers can lose their positions and even face financial consequences. Even for the youth who are eligible, the complexities associated with enrolling in Medicaid may prevent some

5 HSM/230 HSM Law Profile of them from gaining coverage (English, Scott, Park, 2014 p. 8). Unfortunately, people of color are the highest ethnic groups that are reaping the consequences of states not moving forward. Enrollment issues are common as well. Most homeless youth and kids being emancipated from foster care do not know they have to have health care. There are obstacles with addresses for the homeless, especially transient youth. Human service agencies must be advocates to inform the youth of the policies that will help them gain coverage when they are eligible. Some of the arguments for the ACA are that tens of millions of uninsured Americans will obtain access to health coverage from the law. No one can be denied coverage due to having a pre-existing condition. Medicaid has expanded too many men, women, and children that fall below one hundred and thirty-eight percent of the poverty level. Children can stay on their parent’s coverage until the age of twenty-six. There are also arguments against the law as well. There have been tax increases against the healthcare industry and higher earning individuals to help fund the law. The ACA has caused tax filing complications for those who miss the federal poverty line of four-hundred percent. The insurance companies have to cover sick people that increase the cost of insurance for everyone. A person can accidently forget to make a payment and be charged a fee and lose coverage until the open enrollment time. Some employers cut employees hours in anticipation of the employer mandate portion of the law. There are good points to the law as well as bad points. While some people benefit, it seems that other individuals have to pay for them. Until all the states decide to choose the Medicaid expansion, there is going to be problems for agencies, as well as youth and children. The law does help some people and causes other people to have unwarranted consequences.

6 HSM/230 HSM Law Profile With the implementation of the ACA still underway, there are a lot of unknowns at this time. Potential ramifications for organizations and clients that do not follow the ACA are as follows. Some clients that do not have coverage face substantial fines. There are exceptions to this requirement for financial hardship, religious objections, American Indians, those without coverage for less than three months, incarcerated individuals, and certain low–income individuals (Mac, 2010). It is mandatory for human service organizations to follow the Affordable Care Act. Those that do not comply with the law face significant tax increases. Nonprofit human service organizations face losing their tax exemption status. Human service organizations do have a unique set of challenges with the implementation of the law. Eligibility systems are mostly outdated when compared to the most current system for the ACA. Establishing eligibility could be difficult for agencies with older IT equipment. Human service organizations are allowed to get information from the marketplace as long as they have consent and maintain confidentiality requirements. The Affordable Care Act has several years left before it is fully implemented. Human service organizations will know how they are effected in due time.

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7 HSM/230 HSM Law Profile References The Affordable Care Act’s role in preventing and ending homelessness ; (2015) United States Interagency Council on Homelessness; Retrieved from; http://usich.gov/usich_resources/fact_sheets/ACA/ Dorn, Stan (2015) Integrating Health and Human Services programs and reaching eligible individuals under the Affordable Care Act ; Final report; pp.1-25; retrieved from; http://www.urban.org/UploadedPDF/2000153-Integrating-Health-and-Human-Services- Programs-and-Reaching-Eligible-Individuals-under-the-Affordable-Care-Act.pdf English, Abigail, JD, Scott, Jazmyn, MPH, Park, Jane, MPH, NAHIC (2014); Implementing the Affordable Care Act : How Much Will It Help Vulnerable Adolescents & Young Adults? Retrieved from; http://nahic.ucsf.edu/wp-content/uploads/2014/01/VulnerablePopulations_IB_Final.pdf Manning, Shissler Susan (2003); Ethical Leadership in Human Services : A Multi-Dimensional Approach; Ch.7 pp. 152-173 Rafferty, Yvonne, (2013) Child Trafficking and Commercial Sexual Exploitation : A review of promising prevention policies and programs; American Journal of Orthopsychiatry; Vol. 83, No. 4, 559–575; retrieved from; UOP Library: http://search.proquest.com.contentproxy.phoenix.edu/docview/1492504798/fulltextPDF/ 660DA969516F4605PQ/1?accountid=35812 Taylor, Mac, (2010); The Patient Protection and Affordable Care Act : An Overview of Its Potential Impact on State Health Programs; 1-28; Retrieved from; http://www.lao.ca.gov/reports/2010/hlth/fed_healthcare/fed_healthcare_051310.pdf

week 5 HSM Law Profile

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