OSHA Unit 4

2 Occupational Safety and Health Administration l Formed in 1970 l Prevent workplace injuries and illness l Death rate cut in half since 1970 l 17 persons die every day on job

3 Organization of OSHA l Staff of 2209 (1113 inspectors) l Budget of million l Addresses 100 million persons at 6 million workplaces l Completes 34,264 inspections/year

4 Cooperative Compliance Programs l Set up in industries with high risks l Voluntary Protection Program l 337 companies serve as models of excellence l : Eliminated 981 Federal Register pages of regulations and put 616 pages in “plain English”

5 Enforcement l Unannounced visits l Priorities established for life-threatening injuries or 3 or more hospitalizations related to workplace l Employee complaints l High hazard industries

6 Rate of Injuries l 7.4/100 in 1996 l 2.2/100 serious injuries l Total of 6.8 million injuries and illnesses per year: 5.8 million injuries, 459,000 illnesses (64% repeated illness/trauma), 6,112 fatalities

7 Medicare l Social Security Act of 1935 l Title XVIII: Medicare in 1965 l Period of Great Society l Funded by taxes l Administered by HCFA l Nation’s largest health insurance company - 38 million Americans

8 Budget and Coverage l Budget: $200 billion l Coverage: People who are at least 65 years old; people who are disabled; and people with permanent kidney failure l Entitled to Part A l Pay for Part B as an option

9 Parts A and B l A. Hospital Insurance: inpatient, skilled nursing, home health, hospice, but not custodial care l B. Doctor services, outpatient, medical equipment and supplies, other health services

10 Changes in 1999 l HMO and PPO options l Medical savings accounts

11 Medigap Coverage l For copayments and deductibles l After deductible, Medicare pays 80% of approved charges for rest of year

12 Areas not covered l Custodial care l Dental care l Routine check-ups l Immunizations l Rx l Foot care, eye glasses, hearing aids, etc.

13 HMO Benefits l Provide optional benefits l Some states using HMOs and PPOs to administer Medicare program l Information available at Social Security offices and on WEB

14 Medicaid l Title XIX l Health insurance program for low-income people l State-federal partnership for funding l States have authority to set standards for eligibility, covered benefits, and payment rates

15 Eligibility l 33 million eligible for Medicaid l Low income families with children l Aged l Blind or disabled on SSI l Low income pregnant women and children l People with high medical bills

16 Basic Services Offered l Inpatient and Outpatient hospital services l Lab and Xray l Skilled nursing and home health l Doctors services l Family planning l Health checkups

17 Services Covered Continued l Diagnosis and Treatment for children l Rural health services l PNP and FNP services l Nurse Midwife services l EPSDT for under age 21 l Optional: optometry, pharmacy, intermediate care, dental

18 Trends l Payment of intermediate acute care and home health for aged, disabled l 1995: 1/4 of contracts with managed care