Community Options to Fund Aging Services: A National Study to Track Local Initiatives

The majority of federal support for older people needing in-home services and supports comes from the Medicaid program. However, less than 10% of older people are eligible for Medicaid and to receive long-term services, a person must have a severe disability. Many older people with moderate levels of disability or those who are not impoverished are not eligible. In response to these system limitations, some counties across the nation have developed alternative funding strategies, such as property tax levies, to better serve older members of their communities. After identifying 15 states with such initiatives, a survey was distributed to 414 contacts within these states, with a response rate of 55%. Respondents included organizations such as area agencies on aging, councils on aging, and county departments on aging. Local funding varied within and across states, with annual funding ranging from $8,000-$47 million. Most commonly provided services with local funds include home-delivered (81%) and congregate (73%) meals, transportation (61%), and homemaker services (49%). A majority of programs (63%) indicated that local funds are used to provide at least one family or friend caregiver service. This study is the first compilation and description of locally-funded elder service initiatives in the U.S. Locally-funded initiatives can help older people with long-term services needs continue to live in their own homes and communities. On the other hand, some have raised questions about whether this is a good approach to funding aging services, raising concerns that this will lead to further inequities across states and communities.

P004 Non-Invasive Ventilation - Partnering with Paediatric NDIS participants and their families

To discuss a new funding pathway for Non-Invasive ventilation (NIV) in Paediatrics. Since October 2019, the National Disability Insurance Scheme (NDIS) introduced funding for NDIS participants in the category ‘Disability-related Health Supports - Respiratory Support’. From August 2020, a nursing project was funded by the Hospital Executive to facilitate the transfer of NIV consumable costs to the NDIS. A retrospective review of 256 NIV patients (Bi-Level Positive Airway Pressure (BiPAP) and Continuous Positive Airway Pressure (CPAP)) and the patients NDIS eligibility status. 110 patients were identified as potential NDIS eligible patients by Primary diagnosis and their families contacted and supported to access NDIS funding for NIV device and consumables. By May 2021, 163 patients were NDIS participants on NIV therapy. Formal Assistive Technology (Respiratory ventilation) requests were developed with Key stakeholder input and supplier quotes obtained for machines and consumables. Nursing support, whilst labour intensive has shown to benefit Paediatric patients and their families accessing NDIS funding for NIV therapy in the future. Furthermore, the purchasing of disability-related health supports through NDIS funding is an alternative funding model for NIV in Paediatrics.

Financing Strategies to Facilitate Access to High-Cost Anticancer Drugs: A Systematic Review of the Literature

Background: Each country manages access to anticancer drugs differently due to variations in the structure and financing of the health system, but a summary of the various strategies used is absent. This study aimed to review and summarize financing strategies implemented across countries to facilitate access to high-cost anticancer drugs. Methods: We conducted a systematic review of articles referenced in PubMed, Embase, and Web of Science through May 12, 2021. Articles published in the English language from 2000 that describe strategies implemented in different countries to facilitate access to high-cost anticancer drugs were included. Letters, news articles, and proposed strategies were excluded. Quality assessment was not performed as we aimed to summarize the strategies. Data were analyzed by thematic analysis. A review protocol was registered at PROSPERO (CRD42018068616). Results: The review included 204 studies from 176 countries. Three themes of financing strategies were identified: 1) Basic pharmaceutical reimbursement and pricing policies, 2) Alternative funding strategies specific to high-cost drugs, and 3) Financial assistance for individual patients. Access in most countries depends mainly on basic pharmaceutical reimbursement policies (165 of 176 countries). Apart from that, high-income countries tended to use funding strategies targeting high-cost drugs (72% of high-income countries vs 0-24% of the rest), such as Managed Entry Agreements or dedicated funds for high-cost drugs. In contrast, lower-income countries tended to implement financial assistance programs for cancer patients as a tool to increase access (32% of high-income countries vs 62-79% of the rest). Conclusion: Many countries have implemented a combination of strategies to increase access to high-cost anticancer drugs. Most low- and middle-income countries utilized placement of anticancer drugs on a national list of essential medicines and patient assistance programs to facilitate access, while many high-income countries implemented a broader range of strategies.

Prospects and Challenges of Crowdfunding as an Alternative Funding Option in Nigeria

This study aims to review the concept, prospects, and challenges of crowdfunding in Nigeria. Furthermore, it adopts a library-based concept in which secondary sources are relied on data collection using descriptive and deductive approaches of analysis. The results showed that Nigeria has the potential of becoming the hub center of crowdfunding in Africa. However, various challenges are facing the growth of this platform as a means of financing. These include the issues of regulation, lack of adequate awareness, as well as fraud and corruption. Furthermore, this study recommends the need for adequate awareness about crowdfunding and the regulation to ensure its functionality. It also offers additional literature as a means of financing, especially from the Nigerian context.

EVALUASI KEBIJAKAN SABILULUNGAN 1000 KAMPUNG KABUPATEN BANDUNG

Bandung Regency Government adapted the concept of developing an integrated planning area that utilizes a local base with the spirit of sabilulungan (Sundanese: gotong royong) which tries to integrate various development sectors in one activity called "Sabilulungan 1000 Kampung". After two years of implementing this concept where the villages have begun to be developed, it is necessary to see the level of success through an appropriate evaluation mechanism. This study tries to see how the evaluation of the implementation of this policy is through interviews with purposive sampling to the stakeholders of this program. The analytical method used is to utilize 5 evaluation criteria, namely effectiveness, adequacy, equity, responsiveness and accuracy which is used to see how the program has been running for these 2 years. Based on the analysis, it is seen that although programs and activities have shown a tourist attraction that is built and implemented according to the agreed time, the lack of monitoring and evaluation needs to be improved to get more equitable, precise, and sustainable results. More detailed action plans are needed. and operational and alternative funding schemes can help overcome existing barriers.

How Transboundary Learning Occurs: Case Study of the ASEAN Smart Cities Network (ASCN)

While policy study of smart city developments is gaining traction, it falls short of understanding and explaining knowledge transfers across national borders and cities. This article investigates how transboundary learning occurs through the initiation and development of a regional smart cities network: the ASEAN Smart Cities Network (ASCN). The article conducts an in-depth case study from data collected through key informant interviews and document analysis. Spearheaded by Singapore in 2017, ASCN is seen as a soft power extension for Singapore, a branding tool for ASEAN, and a symbiotic platform between the private sector and governments in the region. Most transboundary knowledge transfers within the ASCN are voluntary transfers of policy ideas. Effective branding, demand for knowledge, availability of alternative funding options, enthusiasm from the private actors, and heightened interest from other major economies are highlighted as facilitators of knowledge transfer. However, the complexity of governance structures, lack of political will and resources, limited policy capacity, and lack of explicit operational and regulatory mechanisms hinder transboundary learning. The article concludes that transboundary learning should go beyond exchanges of ideas and recommends promoting facilitators of knowledge transfer, building local policy capacity, encouraging collaborative policy transfer, and transiting from an information-sharing platform to tool/instrument-based transfer.

The political economy of mass transit infrastructure investments in the greater Toronto area

Politicians in the Greater Toronto region have announced major regional and local transit infrastructure investments in recent years. While benefits of enhanced facilities are recognized, experts interviewed assert that projects were identified and justified more predominantly by political preferences, and rarely on objective, expert evidence; while the public also become frustrated with the inability to provide feedback, as well as to witness the delivery of results. Given limitations in funding and attractiveness of alternative funding tools and structures of governance, experts advocate honest, open examination of all feasible ways to plan, implement and deliver transit. In the end, the resulting structure must be effective, progressive and responsive to changing needs. For Toronto, these include improving customer service, facilities, funding and labour management.

The political economy of mass transit infrastructure investments in the greater Toronto area

Politicians in the Greater Toronto region have announced major regional and local transit infrastructure investments in recent years. While benefits of enhanced facilities are recognized, experts interviewed assert that projects were identified and justified more predominantly by political preferences, and rarely on objective, expert evidence; while the public also become frustrated with the inability to provide feedback, as well as to witness the delivery of results. Given limitations in funding and attractiveness of alternative funding tools and structures of governance, experts advocate honest, open examination of all feasible ways to plan, implement and deliver transit. In the end, the resulting structure must be effective, progressive and responsive to changing needs. For Toronto, these include improving customer service, facilities, funding and labour management.

Zakat Funding Solution In Community-Led Total Sanitation (CLTS) Approach For Clean Water And Proper Sanitation In Banten, Indonesia

Providing clean water and sanitation for developing countries presents its problems mainly related to people‘s unhealthy behavior and funding that needed to build clean water facilities and infrastructure. Various attempts were made by both the government and the private sector to provide proper sanitation, particularly for the poor. It also aims to give one of the most significant service delivery challenges related to poverty alleviation and sustainable living. This article presents new sanitation developments focused on community-led total sanitation (CLTS) approach and zakat as a funding solution. The researchers used the Miles and Huberman (1992) research model consisting of data reduction, data display, and verification. The result is LAZ Harfa with the CLTS approach could increase the number of houses with latrines by 40.19 percent in Banten from 2006 to 2019, also coaching schools in building 25 latrines, the number of beneficiaries increased significantly to 47,174 from 14,461 individuals. The article closes by arguing that zakat as possible alternative funding by seeing the potential that can improve the sustainability of sanitation service interventions.

An Overview Of Sukuk Issuance And Their Contribution In Economic Empowerment

As one of the most popular financial instruments under Islamic finance, Sukuk can easily create and ensure economic empowerment if properly mobilized and structured. That is what the Islamic finance theory has shown; Sukuk has a considerable ability to playing a notable role in curbing poverty and creating a proper environment for vulnerable populations, thus, enabling them to shift from being a social burden to a development booster. Sukuk offers viable alternative funding sources to deliver and provide critical infrastructures. Concretely, governments cannot fully fulfill their socio-economic role and create the appropriate necessary environment for economic activity. This situation implies, theoretically, that Sukuk can be used to fulfill governments‘ needs and supply the needed funds to create a good environment and a better livelihood. However, their use as an effective means of economic empowerment is still shyly expanding and widening. This paper studies to what extent does Sukuk issuance serve the objectives of Islamic finance and insures its empowering and financial equality and support goals, through a theoretical overview regarding the scope of their use as an economic empowerment tool and an overview of the multiple experiences of Southeast Asian countries (Malaysia and Indonesia) and international financial institutions in using Sukuk for this role. We will present an overview of actual international cases in which Sukuk has been successfully mobilized to accomplish economic empowerment. Then we will face the impact of these experiences on the effect in combing poverty and empowering vulnerable populations that are awaited from Sukuk issuances. Our study will be completed by an investigation of the various barriers and key challenges impeding and obstructing a larger issuance, capable of bringing more enhanced empowering effect and of setting Sukuk and Islamic finance in general in its natural position: leading the economy for better achievements and bettering the livelihoods of the population.