Magazine article Policy & Practice

A Look at the Social Issues Demanding Your Attention

Magazine article Policy & Practice

A Look at the Social Issues Demanding Your Attention

Article excerpt

The shifting HHS landscape is being driven by several social issues: The U.S. population is aging, the opioid epidemic is spreading at an alarming rate and mental health issues are becoming more complex. All of these issues are causing HHS agencies to take notice and take action. As a result, governments across the country are refocusing their efforts on coordinating care and finding innovative solutions.


What once may have been a silent epidemic is now impossible to ignore. Killing more people than automobile accidents, opioids are the leading cause of accidental death in the U.S. According to the Centers for Disease Control and Prevention (CDC), fatalities from opioids more than quadrupled between 1999 and 2014, crossing all socioeconomic groups in urban, suburban and rural areas. It is estimated now that 78 Americans fatally overdose on opioids each day.


1999    4,030
2009   15,597
2014   18,893

Note: Table made from bar graph.

What You're Doing:


Earlier this year, Virginia unveiled its "Sink or Swim" campaign with a website ( and app. The website creates a one-stop shop for addiction resources--users can enter their ZIP code to find nearby treatment centers and support groups.


The graying of the baby-boomer generation--combined with longer lifespans--means that individuals aged 65 and older will comprise about 22 PERCENT OF THE U.S. POPULATION BY 2030. According to the U.S. Census Bureau, the 65-and-over population is projected to double over the next three decades to about 88 million by 2050. Since the majority of older Americans express a desire to age at home, these changes will drive spending on long-term care and technologies to allow them to live independently.

What You're Doing:


To lower Medicaid expenses, many states are trying to delay or prevent unnecessary nursing home placements, which account for some of the highest Medicaid costs for long-term care. For example, in Nebraska, the average cost of nursing home care is $75,000 per person. Conversely, home and community-based services (HCBS) cost significantly less--home care is roughly half the cost of a nursing facility and community-based care is roughly one-quarter of the cost. By taking advantage of federal funding and partnering with organizations such as Area Agencies on Aging, governments can offer HCBS to their communities and lower the Medicaid burden. (2)


To prepare for its aging baby-boomer population (by 2030, the over-65 population Is projected to double), Arlington County, Va., is making senior-friendly improvements. The county offers a door-to-door transportation service for individuals with disabilities and passed a zoning ordinance that allows some homeowners to build "granny flats." (3)


States can educate their communities about available technologies to help seniors maintain their independence. For example, pill dispensers can send voice or text messages to seniors when it's time to take their medication and include alerts when pills are missed. Shoes with GPS trackers can provide real-time location mapping. If a senior leaves the pre-determined zone, the caregiver receives an alert.


Washington is one of the few states that gives public agencies--Including law enforcement, corrections, social services, labor and industries, and more--access to its prescription monitoring system. This allows the Department of Labor and Industries, for example, to closely monitor workers who were already chronic opioid users before filing an Injury claim, and to flag doctors who may be prescribing too many drugs or potentially dangerous combinations of drugs. (4)


Every state except Missouri now has a prescription monitoring database. …

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