Senior Services ↔ relates to ↔ Healthcare

gton and Oregon to the west; the state shares a small portion of the Canada–United States border to the north with the Canadian province of British Columbia. Idaho's state capital and largest city is Boise. With an area of 83,569 square miles (216,440 km2), Idaho is the 14th-largest state by land area. The state has a population of approximately two million people; it ranks as the 13th-least populous and the seventh-least densely populated of the 50 U.S. states. For thousands of years, and prior to European colonization, Idaho had been inhabited by natives. In the early 19th century, Idaho was considered part of the Oregon Country, an area which was disputed between the U.S. and the British Empire. Idaho officially became a U.S. territory with the signing of the Oregon Treaty of 1846, but a separate Idaho Territory was not organized until 1863, instead being included for periods in Oregon Territory and Washington Territory. The state was eventually admitted to the Union on July 3, 1890, becoming the 43rd state. Forming part of the Pacific Northwest (and the associated Cascadia bioregion), Idaho is divided into several distinct geographic and climatic regions. The state's north, the relatively isolated Idaho Panhandle, is closely linked with Eastern Washington, with which it shares the Pacific Time Zone—the rest of the state uses the Mountain Time Zone. The state's south includes the Snake River Plain (which has most of the population and agricultural land), and the southeast incorporates part of the Great Basin. Idaho is quite mountainous and contains several stretches of the Rocky Mountains. The United States Forest Service holds about 38% of Idaho's land, the highest proportion of any state. Industries significant for the state economy include manufacturing, agriculture, mining, forestry, science and technology, and tourism. Idaho has been a predominantly Republican state since statehood, with the Republican Party dominating in both state and national elections; abortion is severely restricted and the state retains the death penalty, including methods like the firing squad. The state contains the Idaho National Laboratory. Idaho's agricultural sector supplies many products, but the state is best known for its potato crop, which comprises around one-third of the nationwide yield.

The most parsimonious explanation we think is that people came down the Pacific Coast, and as they encountered the mouth of the Columbia River, they essentially found an off-ramp from this coastal migration and also found their first viable interior route to the areas that are south of the ice sheet. An early presence of French-Canadian trappers is visible in names and toponyms: Nez Percé, Cœur d'Alène, Boisé, Payette. Some of these names appeared prior to the Lewis and Clark and Astorian expeditions, which included significant numbers of French and Métis guides recruited for their familiarity with the terrain. Idaho, as part of the Oregon Country, was claimed by both the United States and Great Britain until the United States gained undisputed jurisdiction in 1846. From 1843 to 1859, present-day Idaho was under the de facto jurisdiction of the Provisional Government of Oregon. When Oregon became a state in 1859, what is now Idaho was situated in what remained of the original Oregon Territory, designated as the Washington Territory. Between 1849 and the creation of the Idaho Territory in 1863, parts of present-day Idaho were included in the Oregon, Washington, and Dakota Territories. The new Idaho territory included present-day Idaho, Montana, and most of Wyoming. The Lewis and Clark expedition crossed Idaho in 1805 on the way to the Pacific, and in 1806, on the return trip, largely following the Clearwater River in both directions, making it one the last states settled by European Americans. The first non-indigenous settlement was Kullyspell House, established on the shore of Lake Pend Oreille in 1809 by David Thompson of the North West Company for fur trading. In 1812 Donald Mackenzie, working for the Pacific Fur Company at the time, established a post on the lower Clearwater River near present-day Lewiston. This post, known as "MacKenzie's Post" or "Clearwater", operated until the Pacific Fur Company was bought out by the North West Company in 1813, after which the post was abandoned. The first organized non-indigenous communities within the present borders of Idaho were established by Mormon pioneers in 1860. The first permanent, substantial incorporated community was Lewiston, in 1861. Early in its history, Idaho saw a large influx of Chinese immigrants, who by 1870 made up about 28.5% of the territory's population. Idaho achieved statehood in 1890, following a difficult start as a territory, including the transfer of the territorial capital from Lewiston to Boise, disenfranchisement of Mormon polygamists upheld by the U.S. Supreme Court in 1890, and a federal attempt to split the territory between Washington Territory, which gained statehood in 1889, a year before Idaho, and the state of Nevada which had been a state since 1864. Idaho was one of the hardest hit of the Pacific Northwest states during the Great Depression. Prices plummeted for Idaho's major crops: in 1932 a bushel of potatoes brought only ten cents compared to 1919 for $1.51, while Idaho farmers saw their annual income of $685 in 1929 drop to $250 by 1932. Between 1991 and 2002, Idaho expanded its commercial base to include the science and technology sector which accounted for over 25% of its gross state product in 2001. During the COVID-19 pandemic, Idaho enacted statewide crisis standards of care as COVID-19 patients overwhelmed hospitals.

The landscape is rugged, with some of the largest unspoiled natural areas in the United States. For example, at 2.3 million acres (930,000 ha), the Frank Church-River of No Return Wilderness Area is the largest contiguous area of protected wilderness in the continental United States. Idaho is a Rocky Mountain state with abundant natural resources and scenic areas. The state has snow-capped mountain ranges, rapids, vast lakes and steep canyons. The waters of the Snake River run through Hells Canyon, the deepest gorge in the United States. Shoshone Falls falls down cliffs from a height greater than Niagara Falls. By far, the most important river in Idaho is the Snake River, a major tributary of the Columbia River. The Snake River flows from Yellowstone in northwestern Wyoming through the Snake River Plain in southern Idaho before turning north, leaving the state at Lewiston before joining the Columbia in Kennewick. Other major rivers are the Clark Fork/Pend Oreille River, the Spokane River, and, many major tributaries of the Snake River, including the Clearwater River, the Salmon River, the Boise River, and the Payette River. The Salmon River empties into the Snake in Hells Canyon and forms the southern boundary of Nez Perce County on its north shore, of which Lewiston is the county seat. The Port of Lewiston, at the confluence of the Clearwater and the Snake Rivers is the farthest inland seaport on the West Coast at 465 river miles from the Pacific at Astoria, Oregon. The vast majority of Idaho's population lives in the Snake River Plain, a valley running from across the entirety of southern Idaho from east to west. The valley contains the major cities of Boise, Meridian, Nampa, Caldwell, Twin Falls, Idaho Falls, and Pocatello. The plain served as an easy pass through the Rocky Mountains for westward-bound settlers on the Oregon Trail, and many settlers chose to settle the area rather than risking the treacherous route through the Blue Mountains and the Cascade Range to the west. The western region of the plain is known as the Treasure Valley, bound between the Owyhee Mountains to the southwest and the Boise Mountains to the northeast.

EMTs are often employed by public ambulance services, municipal EMS agencies, governments, hospitals, and fire departments. Some EMTs are paid employees, while others (particularly those in rural areas) are volunteers. EMTs provide medical care under a set of protocols, which are typically written by a physician. EMTs often work alongside other EMS professionals such as paramedics, who receive additional training and are granted a greater scope of practice. Hazard controls EMTs are exposed to a variety of hazards such as lifting patients and equipment, treating those with infectious disease, handling hazardous substances, and transportation via ground or air vehicles. Employers can prevent occupational illness or injury by providing safe patient handling equipment, implementing a training program to educate EMTs on job hazards, and supplying PPE such as respirators, gloves, and isolation gowns when dealing with biological hazards. Infectious disease has become a major concern in light of the COVID-19 pandemic. In response, the U.S. Centers for Disease Control and Prevention and other agencies and organizations have issued guidance regarding workplace hazard controls for COVID-19. Some specific recommendations include modified call queries, symptom screening, universal PPE use, hand hygiene, physical distancing, and stringent disinfection protocols. Research on ambulance ventilation systems found that aerosols often recirculate throughout the compartment, creating a health hazard for EMTs when transporting sick patients capable of airborne transmission.

Primary care paramedic Primary care paramedics (PCP) are the entry-level of paramedic practice in Canadian provinces. The scope of practice includes performing semi-automated external defibrillation, interpretation of 4-lead ECGs, administration of symptom relief medications for a variety of emergency medical conditions (these include oxygen, epinephrine, dextrose, glucagon, salbutamol, ASA and nitroglycerine), performing trauma immobilization (including cervical immobilization), and other fundamental basic medical care. Primary care paramedics may also receive additional training in order to perform certain skills that are normally in the scope of practice of advanced care paramedics. This is regulated both provincially (by statute) and locally (by the medical director), and ordinarily entails an aspect of medical oversight by a specific body or group of physicians. This is often referred to as "medical control", or a role played by a base hospital.

Advanced EMT Advanced EMT is the level of training between EMT and paramedic. They can provide intermediate life support (ILS) care including obtaining intravenous or intraosseous access, basic cardiac monitoring, fluid resuscitation, capnography, and administration of some additional medications. Paramedic Paramedics typically represent the highest degree of pre-hospital medical provider, providing advanced life support (ALS) care.

Community health is a subset of public health that is taught to and practiced by clinicians as part of their normal duties.

Community health is a major field of study within the medical and clinical sciences which focuses on the maintenance, protection, and improvement of the health status of population groups and communities, in particular those who are a part of disadvantaged communities. It is a distinct field of study that may be taught within a separate school of public health or preventive healthcare.

Medical interventions that occur in communities can be classified as three categories: Primary care, Secondary care, and Tertiary care. Each category focuses on a different level and approach towards the community or population group. In the United States, Community health is rooted within Primary healthcare achievements. Primary healthcare programs aim to reduce risk factors and increase health promotion and prevention. Secondary healthcare is related to "hospital care" where acute care is administered in a hospital department setting.

An assisted living residence or assisted living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States. Still, the setting is similar to a retirement home, in the sense that facilities provide a group living environment and typically cater to an older adult population. There is also Caribbean assisted living, which offers a similar service in a resort-like environment (somewhat like assisted vacationing). The expansion of assisted living has been the shift from "care as service" to "care as business" in the broader health care system predicted in 1982. A consumer-driven industry, assisted living offers a wide range of options, levels of care, and diversity of services (Lockhart, 2009) and is subject to state rather than federal regulatory oversight. What "Assisted living" means depends on both the state and provider in question: variations in state regulatory definitions are significant and provider variables include everything from philosophy, geographic location and auspice, to organizational size and structure. Assisted living evolved from small "board and care" or "personal care" homes and offers a "social model" of care (compared to the medical model of a skilled nursing facility). The assisted living industry is a segment of the senior housing industry. Assisted living services can be delivered in stand-alone facilities or as part of a multi-level senior living community. The industry is fragmented and dominated by for-profit providers. In 2010, six of the seventy largest providers were non-profit, and none of the top twenty were non-profit (Martin, 2010). Information in this edit is from an article published in 2012 that reviewed the industry and reports results of a research study of assisted living facilities. In 2012, the U.S. Government estimated that there were 22,200 assisted living facilities in the U.S. (compared to 15,700 nursing homes) and that 713,300 people were residents of these facilities. The number of assisted living facilities in the U.S. has increased dramatically since the early 2000s. In the U.S., ALFs can be owned by for-profit companies (publicly traded companies or limited liability companies [LLCs]), non-profit organizations, or governments. These facilities typically provide supervision or assistance with activities of daily living (ADLs); coordination of services by outside health care providers; and monitoring of resident activities to help to ensure their health, safety, and well-being. Assistance often includes administering or supervising medication or personal care services.

United States Within the United States assisted living spectrum, there is no nationally recognized definition of assisted living. Assisted living facilities are regulated and licensed at the US state level. These regulations include staffing, training, and quality and safety standards. This is differentiated from nursing homes, which are regulated on a federal level and are generally held to more stringent standards. More than two-thirds of the states use the licensure term "assisted living." Other licensure terms used for this philosophy of care include residential care homes, assisted care living facilities, and personal care homes. Each state licensing agency has its definition of the term it uses to describe assisted living. Because the term assisted living has not been defined in some states, it is often a marketing term used by various senior living communities, licensed or unlicensed. In Florida, for example, Adult Family Care Homes are limited to a maximum of five residents, while Assisted Living Facilities must have at least six and can have hundreds.

Typical resident An assisted living resident is a resident who needs assistance with at least one of the activities of daily living. A typical assisted living facility resident would usually be an older adult who does not need the level of care offered by a nursing home but prefers more companionship and needs some assistance in day-to-day living. Age groups will vary with every facility. There is currently a transformation occurring in long-term care. Assisted living communities are accepting higher and higher levels of care, and nursing homes are becoming a place for those undergoing rehabilitation after a hospital stay or needing extensive assistance. Many assisted living communities now accept individuals who need help with all activities of daily living. The "Overview of Assisted Living Report" from 2010 stated that 54 percent of assisted living residents are 85 years or older; 27 percent are 75–84 years old; 9 percent of residents are between 65 and 74 years; and 11 percent are younger than 65 years old.

-day healthcare given by a health care provider. Typically, this provider acts as the first contact and principal point of continuing care for patients within a healthcare system, and coordinates any additional care the patient may require. Patients commonly receive primary care from professionals such as a primary care physician (general practitioner or family physician), a physician assistant, a physical therapist, or a nurse practitioner. In some localities, such a professional may be a registered nurse, a pharmacist, a clinical officer (as in parts of Africa), or an Ayurvedic or other traditional medicine professional (as in parts of Asia).

of Africa), or an Ayurvedic or other traditional medicine professional (as in parts of Asia). Depending on the nature of the health condition, patients may then be referred for secondary or tertiary care. Background The World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary healthcare strategy. The WHO identifies five core functions of primary care: providing first-contact accessibility, continuity of care, coordinated integration of various patient services, comprehensive access to a full range of services, and finally people-centred care in which individual patient feedback is received. It aims to optimise population health and reduce disparities across the groups by ensuring equitable access to services for all subgroups. Primary care involves the widest scope of healthcare, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health, and patients with all manner of acute and chronic physical, mental and social health issues, including multiple chronic diseases. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care, health education, and every time they require an initial consultation about a new health problem. Collaboration among providers is a desirable characteristic of primary care. The International Classification of Primary Care (ICPC) is a standardized tool for understanding and analyzing information on interventions in primary care by the reason for the patient visit. Common chronic illnesses usually treated in primary care may include, for example: hypertension, angina, diabetes, asthma, COPD, depression and anxiety, back pain, arthritis or thyroid dysfunction. Primary care also includes many basic maternal and child health care services, such as family planning services and vaccinations. In context of global population ageing, with increasing numbers of older adults at greater risk of chronic non-communicable diseases, rapidly increasing demand for primary care services is expected around the world, in both developed and developing countries. Funding for primary care varies a great deal between different countries: general taxation, national insurance systems, private insurance and direct payment by patients are all used, sometimes in combination. The payment system for primary care physicians also varies.

Depending on the nature of the health condition, patients may then be referred for secondary or tertiary care. Background The World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary healthcare strategy. The WHO identifies five core functions of primary care: providing first-contact accessibility, continuity of care, coordinated integration of various patient services, comprehensive access to a full range of services, and finally people-centred care in which individual patient feedback is received. It aims to optimise population health and reduce disparities across the groups by ensuring equitable access to services for all subgroups. Primary care involves the widest scope of healthcare, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health, and patients with all manner of acute and chronic physical, mental and social health issues, including multiple chronic diseases. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care, health education, and every time they require an initial consultation about a new health problem. Collaboration among providers is a desirable characteristic of primary care. The International Classification of Primary Care (ICPC) is a standardized tool for understanding and analyzing information on interventions in primary care by the reason for the patient visit. Common chronic illnesses usually treated in primary care may include, for example: hypertension, angina, diabetes, asthma, COPD, depression and anxiety, back pain, arthritis or thyroid dysfunction. Primary care also includes many basic maternal and child health care services, such as family planning services and vaccinations. In context of global population ageing, with increasing numbers of older adults at greater risk of chronic non-communicable diseases, rapidly increasing demand for primary care services is expected around the world, in both developed and developing countries. Funding for primary care varies a great deal between different countries: general taxation, national insurance systems, private insurance and direct payment by patients are all used, sometimes in combination. The payment system for primary care physicians also varies.

A caregiver, care or support worker is a person who provides care for people struggling with their everyday activities due to age, long-term illness or disability. A caregiver can be either formal or informal. Formal caregivers (also known as paid caregivers) are trained professionals, including care workers at hospitals, day-care centers and nursing homes; home care and respite care providers; healthcare assistants; and other unlicensed assistive personnel.

Overview A primary caregiver is the person who takes primary responsibility for someone who cannot fully care for themselves. The primary caregiver may be a family member, a trained professional, or another individual. Depending on the culture, various members of the family may be engaged in care.

Basic principles A fundamental part of caregiving is effective communication with the person receiving care, including not only giving instructions but also actively listening, showing empathy, and ensuring the patient's health needs are understood. Care is given with respect for the dignity of the person receiving care while acknowledging the patient's feelings and values. The caregiver remains in contact with the patient's primary healthcare provider, often a doctor or nurse. They also help the person receiving care make decisions about their treatment, daily life, and healthcare plans while supporting them throughout the process. Caregivers often provide emotional support and comfort to their patients to help them maintain psychological well-being. In addition to communication, the caregiver is responsible for managing their own hygiene, that of the patient, and their living environment. Caregivers and care recipients wash their hands frequently. Caregivers often assist with the patient's personal hygiene through tasks like bathing, dressing, and grooming. If the person receiving care produces sharps waste from regular injections, the caregiver is tasked with managing it. Surfaces in the living area are regularly cleaned and wiped, and laundry is managed to ensure a healthy living environment. Caregivers may also help with household tasks such as cleaning and meal preparation to support daily living needs. Additionally, the caregiver helps organize the patient's daily agenda, including medical appointments, medication schedules, and daily living tasks. This includes coordinating healthcare visits and ensuring medications are taken as prescribed. Routine tasks of daily living are scheduled by the caregiver.

t an intervening health care provider." When rural settings, lack of transport, a lack of mobility, conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict access to care, telemedicine may bridge the gap and can even improve retention in treatment as well as provide distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration.

gration. EHealth encompasses a wide range of applications, including but not limited to the following: Two clinicians discussing a case via video conference; Robotic surgery performed through remote access; Physical therapy conducted using digital monitoring instruments, live feed, and application combinations; Diagnostic tests transferred between facilities for interpretation by a higher specialist; Home monitoring through continuous transmission of patient health data; Online consultations between patients and practitioners; Video remote interpretation services for clinical visits.

Telehealth versus telemedicine Telehealth is sometimes discussed interchangeably with telemedicine, the latter being more common than the former. Telehealth has been described as a disruptive innovation in healthcare because it enables medical services to be delivered remotely using communication technologies. The Health Resources and Services Administration distinguishes telehealth from telemedicine in its scope, defining telemedicine only as describing remote clinical services, such as diagnosis and monitoring, while telehealth includes preventative, promotive, and curative care delivery. This includes the above-mentioned non-clinical applications, like administration and provider education. The United States Department of Health and Human Services states that the term telehealth includes "non-clinical services, such as provider training, administrative meetings, and continuing medical education", and that the term telemedicine means "remote clinical services". The World Health Organization uses telemedicine to describe all aspects of health care including preventive care. The American Telemedicine Association uses the terms telemedicine and telehealth interchangeably, although it acknowledges that telehealth is sometimes used more broadly for remote health not involving active clinical treatments. eHealth is another related term, used particularly in the U.K. and Europe, as an umbrella term that includes telehealth, electronic medical records, and other components of health information technology. Methods and modalities Telehealth requires good Internet access by participants, usually in the form of a strong, reliable broadband connection, and broadband mobile communication technology of at least the fourth generation (4G) or long-term evolution (LTE) standard to overcome issues with video stability and bandwidth restrictions. As broadband infrastructure has improved, telehealth usage has become more widely feasible. Healthcare providers often begin telehealth with a needs assessment which assesses hardships that can be improved by telehealth such as travel time, costs or time off work. Collaborators such as technology companies can ease the transition. Delivery can come within four distinct domains: live video (synchronous), store-and-forward (asynchronous), remote patient monitoring, and mobile health. Audio-based telemedicine, primarily through telephone consultations, has been studied as a tool for managing chronic conditions.

ce portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States.

ry quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States. This includes maintaining the 5-Star Quality Rating System. Organization The agency carries out its responsibilities from its national headquarters located in Woodlawn, Maryland, and its 10 regional offices. It is organized around six centers to support its key functions.

Workforce CMS employs over 6,000 people, of whom about 4,000 are located at its headquarters in Woodlawn, Maryland. The remaining employees are located in the Hubert H. Humphrey Building in Washington, D.C., the 10 regional offices listed below, and in various field offices located throughout the United States. The head of CMS is the administrator of the Centers for Medicare & Medicaid Services. The position is appointed by the president and confirmed by the Senate. On May 27, 2021, Chiquita Brooks-LaSure was sworn in as administrator, the first black woman to serve in the role. History Originally, the name "Medicare" in the United States referred to a program providing medical care for families of people serving in the military as part of the Dependents' Medical Care Act, which was passed in 1956. President Dwight D. Eisenhower held the first White House Conference on Aging in January 1961, in which creating a health care program for social security beneficiaries was proposed. President Lyndon B. Johnson signed the Social Security Amendments on July 30, 1965, establishing both Medicare and Medicaid. Arthur E. Hess, a deputy commissioner of the Social Security Administration, was named as first director of the Bureau of Health Insurance in 1965, placing him as the first executive in charge of the Medicare program. At the time, the program provided health insurance to 19 million Americans. The Social Security Administration (SSA) became responsible for the administration of Medicare and the Social and Rehabilitation Service (SRS) became responsible for the administration of Medicaid. Both agencies were organized under what was then known as the Department of Health, Education, and Welfare (HEW), in 1965. Since then, HEW, has been reorganized as the Department of Health and Human Services (HHS) in 1980. This consequently brought Medicare and Medicaid under the jurisdiction of the HHS. In March 1977, the Health Care Financing Administration (HCFA) was established under HEW. HCFA became responsible for the coordination of Medicare and Medicaid. The responsibility for enrolling beneficiaries into Medicare and processing premium payments remained with SSA. HCFA was renamed the Centers for Medicare & Medicaid Services on July 1, 2001. This was later codified in law by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. In January 2018, CMS released guidelines for states to use to require Medicaid beneficiaries to continue receiving coverage. These guidelines came in response to then-President Trump's announcement that he would allow states to impose work requirements in Medicaid. In October, CMS reported a data breach of 75,000 people's personal data due to a hack. In February 2018, CMS removed a notice from its website that informed insurance companies they were not allowed to charge physicians a fee when the companies paid the doctors for their work. This has resulted in doctors being charged up to a 5% fee on their compensation, adding up to billions of dollars annually. In January 2021, CMS passed a rule that would cover "breakthrough technology" for four years after they received FDA approval. In September 2021, CMS submitted a proposal to repeal the rule based on safety concerns. On September 19, 2023, the Subcommittee on Health held a hearing titled "Examining Policies to Improve Seniors’ Access to Innovative Drugs, Medical Devices, and Technology." Dora Hughes, the acting director of the Center for Clinical Standards and Quality at the U.S. Centers for Medicare and Medicaid Services (CMS), defended the proposed Transitional Coverage for Emerging Technologies (TCET) pathway, which aims to restrict coverage for breakthrough medical devices to five reviews a year. Some lawmakers and medtech trade groups called for expanding the pathway to include diagnostics.

Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists. It focuses on promoting, maintaining, or restoring health through patient education, physical interventions, disease prevention, and health promotion. The term physical therapist or physiotherapist is used to represent the trained person providing physical therapy. The profession has many specialties including musculoskeletal, orthopedics, cardiopulmonary, neurology, endocrinology, sports medicine, geriatrics, pediatrics, women's health, wound care and electromyography. PTs practice in many settings, both public and private. In addition to clinical practice, other aspects of physical therapy include research, education, consultation, and health administration. Physical therapists provide primary care patient management in conjunction with other medical services.

physical therapy. The profession has many specialties including musculoskeletal, orthopedics, cardiopulmonary, neurology, endocrinology, sports medicine, geriatrics, pediatrics, women's health, wound care and electromyography. PTs practice in many settings, both public and private. In addition to clinical practice, other aspects of physical therapy include research, education, consultation, and health administration. Physical therapists provide primary care patient management in conjunction with other medical services.

both public and private. In addition to clinical practice, other aspects of physical therapy include research, education, consultation, and health administration. Physical therapists provide primary care patient management in conjunction with other medical services. In some jurisdictions, such as the United Kingdom, physical therapists may have the authority to prescribe medication. Overview Physical therapy addresses illnesses or injuries that limit a person's ability to move and perform functional activities in their daily lives. PTs use an individual's history and physical examination to arrive at a diagnosis and establish a management plan and, when necessary, incorporate the results of laboratory and imaging studies like X-rays, CT scans, or MRIs. Physical therapists can use sonography to diagnose and manage common musculoskeletal, nerve, and pulmonary conditions. Electrodiagnostic testing (e.g., electromyograms and nerve conduction velocity testing) may also be used. PT management commonly includes the prescription of, or assistance with, specific exercises, manual therapy, and bodily manipulation. Additional treatments include mechanical devices such as traction; education; electrophysical modalities which include heat, cold, electricity, sound waves, and radiation; assistive devices; prostheses; and orthoses. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness and wellness-oriented programs for healthier and more active lifestyles, and providing services to individuals and populations to develop, maintain, and restore maximum movement and functional ability throughout life. This includes providing treatment in circumstances where movement and function are threatened by aging, injury, disease, or environmental factors. Functional movement is central to what it means to be healthy. Physical therapy is a profession which has many specialties including musculoskeletal, orthopedics, cardiopulmonary, neurology, endocrinology, sports medicine, geriatrics, pediatrics, women's health, wound care and electromyography. PTs practice in many settings, such as privately owned physical therapy clinics, outpatient clinics or offices, hospitals, health and wellness clinics, rehabilitation hospitals, skilled nursing facilities, extended care facilities, private homes, education and research centers, schools, hospices, industrial workplaces or other occupational environments, fitness centers and sports training facilities. Physical therapists also practice in non-patient care roles such as health policy, health insurance, health care administration, and as health care executives. Physical therapists are involved in the medical-legal field serving as experts, performing peer review and independent medical examinations. Education varies greatly by country. The span of education ranges from some countries having little formal education to others having doctoral degrees and post-doctoral residencies and fellowships. Regarding its relationship to other healthcare professions, physiotherapy is typically one of the allied health professions.

onditions associated with older populations. Long-term care can be provided at home, in the community, in assisted living facilities or in nursing homes. Long-term care may be needed by people of any age, although it is a more common need for senior citizens. Types of long-term care Long-term care can be provided formally or informally. Facilities that offer formal LTC services typically provide living accommodation for people who require on-site delivery of around-the-clock supervised care, including professional health services, personal care, and services such as meals, laundry and housekeeping. These facilities may go under various names, such as nursing home, personal care facility, residential continuing care facility, etc. and are operated by different providers. While the US government has been asked by the LTC (long-term care) industry not to bundle health, personal care, and services (e.g., meal, laundry, housekeeping) into large facilities, the government continues to approve that as the primary use of taxpayers' funds instead (e.g., new assisted living). Greater success has been achieved in areas such as supported housing which may still utilize older housing complexes or buildings or may have been part of new federal-state initiatives in the 2000s. Long-term care provided formally in the home, also known as home health care, can incorporate a wide range of clinical services (e.g. nursing, drug therapy, physical therapy) and other activities such as physical construction (e.g. installing hydraulic lifts, renovating bathrooms and kitchens). These services are usually ordered by a physician or other professional. Depending on the country and nature of the health and social care system, some of the costs of these services may be covered by health insurance or long-term care insurance. Modernized forms of long-term services and supports (LTSS), reimbursable by the government, are user-directed personal services, family-directed options, independent living services, benefits counseling, mental health companion services, family education, and even self-advocacy and employment, among others. In home services can be provided by personnel other than nurses and therapists, who do not install lifts, and belong to the long-term services and supports (LTSS) systems of the US. Informal long-term home care is care and support provided by family members, friends and other unpaid volunteers.

Long-term services and supports "Long-term services and supports" (LTSS) is the modernized term for community services, which may obtain health care financing (e.g., home and community-based Medicaid waiver services), and may or may not be operated by the traditional hospital-medical system (e.g., physicians, nurses, nurse's aides). The Consortium of Citizens with Disabilities (CCD) which works with the U. S. Congress, has indicated that while hospitals offer acute care, many non-acute, long-term services are provided to assist individuals to live and participate in the community. An example is the group home international emblem of community living and deinstitutionalization, and the variety of supportive services (e.g., supported housing, supported employment, supported living, supported parenting, family support), supported education. The term is also common with aging groups, such as the American Association of Retired Persons (AARP), which annually surveys the US states on services for elders (e.g., intermediate care facilities, assisted living, home-delivered meals). The new US Support Workforce includes the Direct Support Professional, which is largely non-profit or for-profit, and the governmental workforces, often unionized, in the communities in US states. Core competencies (Racino-Lakin, 1988) at the federal-state interface for the aides "in institutions and communities" were identified in aging and physical disabilities, intellectual and developmental disabilities, and behavioral ("mental health") health in 2013 (Larson, Sedlezky, Hewitt, & Blakeway, 2014). President Barack Obama, US House Speaker John Boehner, Minority Leader Nancy Pelosi, Majority Leader Harry Reid, and Minority Leader Mitch McConnell received copies of the US Senate Commission on Long Term Care on the "issues of service delivery, workforce and financing which have challenged policymakers for decades" (Chernof & Warshawsky, 2013). The new Commission envisions a "comprehensive financing model balancing private and public financing to insure catastrophic expenses, encourage savings and insurance for more immediate LTSS (Long Term Services and Supports) costs, and to provide a safety net for those without resources." The direct care workforce envisioned by the MDs (physicians, prepared by a medical school, subsequently licensed for practice) in America (who did not develop the community service systems, and serve different, valued roles within it) were described in 2013 as: personal care aides (20%), home health aides (23%), nursing assistants (37%), and independent providers (20%) (p. 10). The US has varying and competing health care systems, and hospitals have adopted a model to transfer "community funds into hospital"; in addition, "hospital studies" indicate M-LTSS (managed long-term care services) as billable services. In addition, allied health personnel preparation have formed the bulk of the preparation in specialized science and disability centers which theoretically and practically supports modernized personal assistance services across population groups and "managed" behavioral health care "as a subset of" mental health services. Long-term services and supports (LTSS) legislation was developed, as were the community services and personnel, to address the needs of "individuals with disabilities" for whom the state governments were litigated against, and in many cases, required to report regularly on the development of a community-based system. These LTSS options originally bore such categorical services as residential and vocational rehabilitation or habilitation, family care or foster family care, small intermediate care facilities, "group homes", and later supported employment, clinics, family support, supportive living, and day services (Smith & Racino, 1988 for the US governments).The original state departments were Intellectual and Developmental Disabilities, Offices of Mental Health, lead designations in Departments of Health in brain injury for communities, and then, Alcohol and Substance Abuse dedicated state agencies. Among the government and Executive initiatives were the development of supportive living internationally, new models in supportive housing (or even more sophisticated housing and health), and creative plans permeating the literature on independent living, user-directed categories (approved by US Centers for Medicaid and Medicare), expansion of home services and family support, and assisted living facilities for the aging groups. These services often have undergone a revolution in payment schemes beginning with systems for payment of valued community options. then termed evidence-based practices. Interventions for preventing delirium in older people in institutional long-term care The current evidence suggests that software-based interventions to identify medications that could contribute to delirium risk and recommend a pharmacist's medication review probably reduces incidence of delirium in older adults in long-term care. The benefits of hydration reminders and education on risk factors and care homes' solutions for reducing delirium is still uncertain. Physical rehabilitation for older people in long-term care Physical rehabilitation can prevent deterioration in health and activities of daily living among care home residents. The current evidence suggests benefits to physical health from participating in different types of physical rehabilitation to improve daily living, strength, flexibility, balance, mood, memory, exercise tolerance, fear of falling, injuries, and death. It may be both safe and effective in improving physical and possibly mental state, while reducing disability with few adverse events. The current body of evidence suggests that physical rehabilitation may be effective for long-term care residents in reducing disability with few adverse events. However, there is insufficient to conclude whether the beneficial effects are sustainable and cost-effective.

Life expectancy is going up in most countries, meaning more people are living longer and entering an age when they may need care. Meanwhile, birth rates are generally falling. Globally, 70 percent of all older people now live in low or middle-income countries. Countries and health care systems need to find innovative and sustainable ways to cope with the demographic shift. As reported by John Beard, director of the World Health Organization's Department of Ageing and Life Course, "With the rapid ageing of populations, finding the right model for long-term care becomes more and more urgent." The demographic shift is also being accompanied by changing social patterns, including smaller families, different residential patterns, and increased female labour force participation. These factors often contribute to an increased need for paid care. In many countries, the largest percentages of older persons needing LTC services still rely on informal home care, or services provided by unpaid caregivers (usually nonprofessional family members, friends or other volunteers). Estimates from the OECD of these figures often are in the 80 to 90 percent range; for example, in Austria, 80 percent of all older citizens. The similar figure for dependent elders in Spain is 82.2 percent. The US Centers for Medicare and Medicaid Services estimates that about 9 million American men and women over the age of 65 needed long-term care in 2006, with the number expected to jump to 27 million by 2050. It is anticipated that most will be cared for at home; family and friends are the sole caregivers for 70 percent of the elderly. A study by the U.S. Department of Health and Human Services says that four out of every ten people who reach age 65 will enter a nursing home at some point in their lives. Roughly 10 percent of the people who enter a nursing home will stay there five years or more. Based on projections of needs in long-term care (LTC), the US 1980s demonstrations of versions of Nursing Homes Without Walls (Senator Lombardi of New York) for elders in the US were popular, but limited: On LOK, PACE, Channeling, Section 222 Homemaker, ACCESS Medicaid-Medicare, and new Social Day Care. The major argument for the new services was cost savings based upon reduction of institutionalization. The demonstrations were significant in developing and integrating personal care, transportation, homemaking/meals, nursing/medical, emotional support, help with finances, and informal caregiving.

Occupational therapy (OT), also known as ergotherapy in Europe, is a healthcare profession that helps people take part in the everyday activities, or occupations, that are important for daily life. These occupations include self-care tasks, work, school, social participation, and leisure activities. Occupational therapists work with people who experience illness, injury, disability, or age-related changes that limit their ability to function independently. They assess a person's needs, set goals, and use everyday activities as therapeutic tools. Therapists may also modify tasks, recommend adaptive equipment, or adjust the physical or social environment to support participation. Occupational therapy began developing into a formal health profession in the early twentieth century. Occupational science, the academic study of humans as 'doers' or 'occupational beings', was developed by interdisciplinary scholars, including occupational therapists, in the 1980s. The World Federation of Occupational Therapists (WFOT) defines occupational therapy as a "client-centred health profession concerned with promoting health and wellbeing through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment to better support their occupational engagement." Occupational therapy is classified as an allied health profession in many countries. In the United Kingdom, occupational therapists are regulated by the Health and Care Professions Council as part of a group of professions that form the third-largest clinical workforce in the National Health Service. In England, allied health professions (AHPs) are the third largest clinical workforce in health and care.

ort their occupational engagement." Occupational therapy is classified as an allied health profession in many countries. In the United Kingdom, occupational therapists are regulated by the Health and Care Professions Council as part of a group of professions that form the third-largest clinical workforce in the National Health Service. In England, allied health professions (AHPs) are the third largest clinical workforce in health and care.

group of professions that form the third-largest clinical workforce in the National Health Service. In England, allied health professions (AHPs) are the third largest clinical workforce in health and care.

[A]n approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual. Since the 1990s, many palliative care programs involved a disease-specific approach. However, as the field developed throughout the 2000s, the WHO began to take a broader patient-centered approach, suggesting that the principles of palliative care should be applied as early as possible to any chronic, ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients. Palliative care is appropriate for individuals with serious/chronic illnesses across the age spectrum and can be provided as the main goal of care or in tandem with curative treatment. It is ideally provided by interdisciplinary teams which can include physicians, nurses, occupational and physical therapists, psychologists, social workers, chaplains, and dietitians. Palliative care can be provided in a variety of contexts, including but not limited to hospitals, outpatient clinics, and home settings.

Scope Palliative care can improve healthcare quality in three sectors: Physical and emotional relief, strengthening of patient-physician communication and decision-making, and coordinated continuity of care across various healthcare settings, including hospital, home, and hospice. The overall goal of palliative care is to improve quality of life of individuals with serious illness, any life-threatening condition which either reduces an individual's daily function or quality of life or increases caregiver burden, through pain and symptom management, identification and support of caregiver needs, and care coordination. Palliative care can be delivered at any stage of illness alongside other treatments with curative or life-prolonging intent and is not restricted to people receiving end-of-life care. Historically, palliative care services were focused on individuals with incurable cancer, but this framework is now applied to other diseases, including severe heart failure, chronic obstructive pulmonary disease, multiple sclerosis and other neurodegenerative conditions. Forty million people each year are expected to need palliative care, with approximately 78% of this population living in low and middle income countries. However, only 14% of this population can receive this kind of care, with a majority in high-income countries, making this an important sector to pay attention to. Palliative care can be initiated in a variety of care settings, including emergency rooms, hospitals, hospice facilities, or at home. For some severe disease processes, medical specialty professional organizations recommend initiating palliative care at the time of diagnosis or when disease-directed options would not improve a patient's prognosis.

The distinction between palliative care and hospice differs depending on the global context. In the United States, the term hospice refers specifically to a benefit provided by the federal government since 1982. Hospice care services and palliative care programs share similar goals of mitigating unpleasant symptoms, controlling pain, optimizing comfort, and addressing psychological distress. Hospice care focuses on comfort and psychological support, and curative therapies are not pursued. Under the Medicare Hospice Benefit, individuals certified by two physicians to have less than six months to live (assuming a typical course) have access to specialized hospice services through various insurance programs (Medicare, Medicaid, and most health maintenance organizations and private insurers). An individual's hospice benefits are not revoked if that individual lives beyond six months. In the United States, to be eligible for hospice, patients usually forego treatments aimed at a cure, unless they are minors. This is to avoid concurrent care, where two different clinicians are billing for the same service. In 2016, a movement began to extend the reach of concurrent care to adults who were eligible for hospice but not yet emotionally prepared to forego curative treatments. Outside the United States, the term hospice usually refers to a building or institution that specializes in palliative care. These institutions provide care to patients with end-of-life and palliative care needs. In the common vernacular outside the United States, hospice care and palliative care are synonymous and are not contingent on different avenues of funding. Over 40% of all dying patients in the United States currently undergo hospice care. Most of the hospice care occurs in the home environment during the last weeks/months of their lives. Of those patients, 86.6% believe their care is "excellent". Hospice's philosophy is that death is a part of life, so it is personal and unique. Caregivers are encouraged to discuss death with the patients and encourage spiritual exploration (if they so wish). History The field of palliative care grew out of the hospice movement, which is commonly associated with Dame Cicely Saunders, who founded St. Christopher's Hospice for the terminally ill in 1967, and Elisabeth Kübler-Ross who published her seminal work "On Death and Dying" in 1969. In 1974, Balfour Mount coined the term "palliative care". and Paul Henteleff became the director of a new "terminal care" unit at Saint Boniface Hospital in Winnipeg. In 1987, Declan Walsh established a palliative medicine service at the Cleveland Clinic Cancer Center in Ohio which later expanded to become the training site of the first palliative care clinical and research fellowship as well as the first acute pain and palliative care inpatient unit in the United States. The program evolved into The Harry R. Horvitz Center for Palliative Medicine which was designated as an international demonstration project by the World Health Organization and accredited by the European Society for Medical Oncology as an Integrated Center of Oncology and Palliative Care. Women have played a central role in the historical development of palliative care, particularly through their work in hospice settings, which helped expand services beyond oncology to encompass frail elderly patients. These contributions established the foundation for geriatric palliative care as a distinct and expanding domain of global health. Advances in palliative care have since inspired a dramatic increase in hospital-based palliative care programs.

ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links health sciences with pharmaceutical sciences and natural sciences. The professional practice has become more clinically oriented as most drugs are now manufactured by pharmaceutical industries. Based on the setting, pharmacy practice is either classified as community or institutional pharmacy. Providing direct patient care in the community of institutional pharmacies is considered clinical pharmacy. The scope of pharmacy practice includes more traditional roles such as compounding and dispensing of medications. It also includes more modern services related to health care including clinical services, reviewing medications for safety and efficacy, and providing drug information with patient counselling. Pharmacists, therefore, are experts on drug therapy and are the primary health professionals who optimize the use of medication for the benefit of the patients. In some jurisdictions, such as Canada and Australia, Pharmacists may be able to prescribe or adapt/manage prescriptions, as well as give injections and immunizations. An establishment in which pharmacy (in the first sense) is practiced is called a pharmacy (this term is more common in the United States) or chemists (which is more common in Great Britain, though pharmacy is also used).

Pharmacists provide direct patient care services that optimize the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care settings, but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often collaborate with physicians and other healthcare professionals to improve pharmaceutical care. Clinical pharmacists are now an integral part of the interdisciplinary approach to patient care. They often participate in patient care rounds for drug product selection. In the UK clinical pharmacists can also prescribe some medications for patients on the National Health Services (NHS) or privately, after completing a non-medical prescribers course to become an Independent Prescriber. The clinical pharmacist's role involves creating a comprehensive drug therapy plan for patient-specific problems, identifying goals of therapy, and reviewing all prescribed medications prior to dispensing and administration to the patient. The review process often involves an evaluation of the appropriateness of drug therapy (e.g., drug choice, dose, route, frequency, and duration of therapy) and its efficacy. Research shows that pharmacist led strategies reduce errors related to medication use.

Environmental impacts In 2022 the Organisation for Economic Co-operation and Development (OECD) proposed that pharmaceutical companies should be required to collect and destroy unused or expired medicines that they have put on the market in order to reduce public health risks around the misuse of medicines obtained from waste bins, the development of antimicrobial resistant bacteria from the discharge of antibiotics into environmental systems and "economic losses" from wasted healthcare resources. Potentially harmful concentrations of pharmaceutical waste has been detected in more than a quarter of water samples taken from 258 rivers around the world. OECD recommend that medicines should be collected separately from household waste and that "marketplaces and redistribution platforms for unused close-to-expiry-date medicines" should be set up. Such extended producer responsibility schemes are already running in France, Spain and Portugal. The future of pharmacy In the coming decades, pharmacists are expected to become more integral within the health care system. Rather than simply dispensing medication, pharmacists are increasingly expected to be compensated for their patient care skills. In particular, Medication Therapy Management (MTM) includes the clinical services that pharmacists can provide for their patients. Such services include a thorough analysis of all medication (prescription, non-prescription, and herbals) currently being taken by an individual. The result is a reconciliation of medication and patient education resulting in increased patient health outcomes and decreased costs to the health care system. This shift has already commenced in some countries; for instance, pharmacists in Australia receive remuneration from the Australian Government for conducting comprehensive Home Medicines Reviews. In Canada, pharmacists in certain provinces have limited prescribing rights (as in Alberta and British Columbia) or are remunerated by their provincial government for expanded services such as medications reviews (Medschecks in Ontario). In the United Kingdom, pharmacists who undertake additional training are obtaining prescribing rights and this is because of pharmacy education. They are also being paid for by the government for medicine use reviews. In Scotland, the pharmacist can write prescriptions for Scottish registered patients of their regular medications, for the majority of drugs, except for controlled drugs, when the patient is unable to see their doctor, as could happen if they are away from home or the doctor is unavailable. In the United States, pharmaceutical care or clinical pharmacy has had an evolving influence on the practice of pharmacy. Moreover, the Doctor of Pharmacy (Pharm. D.) degree is now required before entering practice and some pharmacists now complete one or two years of residency or fellowship training following graduation. In addition, consultant pharmacists, who traditionally operated primarily in nursing homes, are now expanding into direct consultation with patients, under the banner of "senior care pharmacy". In addition to patient care, pharmacies will be a focal point for medical adherence initiatives. There is enough evidence to show that integrated pharmacy based initiatives significantly impact adherence for chronic patients.

A registered nurse (RN) is a healthcare professional who has graduated or successfully passed a nursing program from a recognized nursing school and met the requirements outlined by a country, state, province or similar government-authorized licensing body to obtain a nursing license or registration. An RN's scope of practice is determined by legislation and job role, and is regulated by a professional body or council. Registered nurses are employed in a wide variety of professional settings, and often specialize in a field of practice. Depending on the jurisdiction, they may be responsible for supervising care delivered by other healthcare workers, including student nurses, licensed practical nurses, unlicensed assistive personnel, and less-experienced RNs. Registered nurses must usually meet a minimum practice hours requirement and undertake continuing education to maintain their license.

council. Registered nurses are employed in a wide variety of professional settings, and often specialize in a field of practice. Depending on the jurisdiction, they may be responsible for supervising care delivered by other healthcare workers, including student nurses, licensed practical nurses, unlicensed assistive personnel, and less-experienced RNs. Registered nurses must usually meet a minimum practice hours requirement and undertake continuing education to maintain their license.

The registration of nurses by nursing councils or boards began in the early twentieth century. New Zealand registered the first nurse in 1901 with the establishment of the Nurses Registration Act. Nurses were required to complete three years of training and pass a state-administered examination. Registration ensured a degree of consistency in the education of new nurses, and the title was usually protected by law. After 1905 in California, for example, it became a misdemeanour to claim to be an RN without a certificate of registration. Today, typical requirements for an RN licence in the United States include earning either an associate degree (community college) or a baccalaureate degree (college or university) in nursing and passing an examination. Registration acts allowed authorities a degree of control over who was admitted to the profession. Requirements varied by location, but often included a stipulation that the applicant must be "of good moral character" and must not have mental or physical conditions that rendered them unable to practice. Before the 1870s, most people were cared for at home by family members. The view on nursing began to change as more medical advances were made during the end of the 19th century and leading into the beginning of the 20th century. Benefits of nursing When obtaining a nursing degree, personal benefits come with it. One personal benefit is that nursing is a highly respected position. Another personal advantage is the availability of jobs; nurses are in high demand. Nursing also provides many different possibilities of employment. Many positions fall under the category of nursing. Being able to explore multiple options gives someone the chance to find the most suitable job for themselves. Nurses are generally in demand around the world. The World Health Organization estimates that by 2030 there will be a worldwide shortage of 4.5 million nurses. Patients benefit from having a sufficient number of nurses to meet the clinic's or hospital's needs.

Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing taxpayer-funded health insurance to 85 million low-income and disabled people as of 2022; in 2019, the program paid for half of all U.S. births. In 2023, the total (federal and state) annual cost of Medicaid was $870 billion, with an average cost per enrollee of $7,600 for 2021. 37% of enrollees were children, but they only accounted for 15% of the spending, ($3,000 per person) while seniors and disabled persons accounted for 21% of enrollees and 52% of spending (more than $18,000 per person). In general, Medicaid recipients must be U.S. citizens or qualified non-citizens, and may include low-income adults, their children, and people with certain disabilities. Medicaid also covers long-term services and supports, including both nursing home care and home- and community-based services, for those with low incomes and minimal assets. Of the 7.7 million Americans who used long-term services and supports in 2020, about 5.6 million were covered by Medicaid. Along with Medicare, Tricare, ChampVA, and CHIP, Medicaid is one of the several Federal Government-sponsored medical insurance programs in the United States. Medicaid covers healthcare costs for people with low incomes; Medicare is a universal program providing health coverage for the elderly; and the CHIP program covers uninsured children in families with incomes that are too high to be covered by Medicaid. Medicaid offers elder care benefits not normally covered by Medicare, including nursing home care and personal care services. There are also dual health plans for people who have both Medicaid and Medicare. Research shows that existence of the Medicaid program improves health outcomes, health insurance coverage, access to health care, and recipients' financial security and provides economic benefits to states and health providers.

2025 Medicaid cuts in the second Trump administration In 2025, Republican Congressional leaders John Thune and Mike Johnson announced goals of cutting 1.5 to 2 trillion dollars of the US federal budget, with President Donald Trump stating that cuts to Medicaid would only include "abuse or waste". The 2025 budget resolution, which was passed by the House of Representatives with only Republicans votes, proposed cutting $880 billion from the Standing Committee for Energy and Commerce, which includes many areas, such as Medicaid and Medicare. On July 4, 2025, President Donald Trump signed the One Big Beautiful Bill Act, intended in part to implement this resolution. The act cut Medicaid in a number of ways: while it did not repeal the ACA's Medicaid expansion, it mandated work requirements for able-bodied Medicaid recipients. It also requires Medicaid recipients above the federal poverty line to pay more fees for coverage; adds new verification requirements; increases the number of times states need to check the eligibility of their Medicaid expansion recipients; prohibits Medicaid from funding nonprofits that provide abortion care; makes it harder for illegal immigrants to use Medicaid; bans pharmacy benefit managers from using spread pricing; and puts limits on so-called "provider taxes" that states impose on healthcare providers to fund their portion of Medicaid spending. The non-partisan Congressional Budget Office (CBO) estimated that it will reduce the number of people on Medicaid by several million.; the CBO estimates that the work requirements in particular will lead 11 million to lose their Medicaid coverage, many of whom already work or qualify for exemptions but will not be able to get through the red tape. The bill prompted claims that undocumented immigrants are on Medicaid. Undocumented immigrants are already ineligible for full Medicaid benefits, and many undocumented immigrants access state-funded health programs rather than federal Medicaid. According to a CBO analysis, the bill's provisions could lead some states to cut back those state-funded health programs, potentially causing an estimated 1.4 million people to lose state-level health coverage, including undocumented immigrants. When commenting on the Trump administration's One Big Beautiful Bill Act and the impact of the Medicaid provisions on the economy, USDA Secretary Brooke Rollins stated that 34 million able-bodied adults on Medicaid should be working.

Arizona: AHCCCS California: Medi-Cal Connecticut: HUSKY D Illinois: HealthChoice Illinois Iowa: Hawk-i Healthy and Well-Kids in Iowa Maine: MaineCare Massachusetts: MassHealth New Jersey: NJ FamilyCare Oregon: Oregon Health Plan Oklahoma: Soonercare Tennessee: TennCare Washington: Washington Apple Health Wisconsin: BadgerCare As of January 2012, Medicaid and/or CHIP funds could be obtained to help pay employer health care premiums in Alabama, Alaska, Arizona, Colorado, Florida, and Georgia. Differences by state While states have significant autonomy in implementing the Medicaid program, their flexibility is bounded by federal requirements designed to ensure a baseline of coverage and access. For example, federal law mandates that certain services, such as inpatient and outpatient hospital services, laboratory and X-ray services, and physician services, must be covered by all state Medicaid programs. Additionally, states must adhere to federal guidelines regarding beneficiary protections and quality standards.

, Arts & Sciences, and Education; MPA program in the School of Public Service; and the MPH program in the College of Health Sciences. It is classified among "R2: Doctoral Universities – High research activity".

Boise State University (BSU) is a public research university in Boise, Idaho, United States. Founded in 1932 by the Episcopal Church, it became an independent junior college in 1934 and has been awarding baccalaureate and master's degrees since 1965. It became a public institution in 1969. Boise State offers more than 100 graduate programs, including a variety of MBA programs and the MAcc program in the College of Business and Economics; master's and PhD programs in the Colleges of Engineering, Arts & Sciences, and Education; MPA program in the School of Public Service; and the MPH program in the College of Health Sciences. It is classified among "R2: Doctoral Universities – High research activity".

CAA Division I as a member of the Mountain West Conference. History The school became Idaho's third state university in 1974, after the University of Idaho (1889) and Idaho State University (1963). Boise State awards associate, bachelor's, master's, and doctoral degrees, and is accredited by the Northwest Commission on Colleges and Universities. As of 2010, it has over 75,000 living alumni. Campus The 285-acre (1.15 km2) campus is located near downtown Boise, on the south bank of the Boise River, opposite Julia Davis Park. With more than 170 buildings, the campus is at an elevation of 2,700 feet (825 m) above sea level, bounded by Capitol Boulevard on the west and Broadway Avenue to the east.

art B covers outpatient services. Part C is an alternative that allows patients to choose private plans with different benefit structures that provide the same services as Parts A and B, usually with additional benefits. Part D is for self-administered prescription drugs. In 2022, Medicare provided health insurance for 65.0 million individuals—more than 57 million people aged 65 and older and about 8 million younger people. According to annual Medicare Trustees reports and research by Congress' MedPAC group, Medicare covers about half of healthcare expenses of those enrolled. Enrollees cover most of the remaining costs by taking additional private insurance (medi-gap insurance), by enrolling in a Medicare Part D prescription drug plan, or by joining a private Medicare Part C (Medicare Advantage) plan. In 2022, spending by the Medicare Trustees topped $900 billion per the Trustees report Table II.B.1, of which $423 billion came from the U.S. Treasury and the rest primarily from the Part A Trust Fund (which is funded by payroll taxes) and premiums paid by beneficiaries.

to annual Medicare Trustees reports and research by Congress' MedPAC group, Medicare covers about half of healthcare expenses of those enrolled. Enrollees cover most of the remaining costs by taking additional private insurance (medi-gap insurance), by enrolling in a Medicare Part D prescription drug plan, or by joining a private Medicare Part C (Medicare Advantage) plan. In 2022, spending by the Medicare Trustees topped $900 billion per the Trustees report Table II.B.1, of which $423 billion came from the U.S. Treasury and the rest primarily from the Part A Trust Fund (which is funded by payroll taxes) and premiums paid by beneficiaries.

Financing Medicare has several sources of financing. Part A's inpatient admitted hospital and skilled nursing coverage is largely funded by revenue from a 2.9% payroll tax levied on employers and workers (each pays 1.45%). Until December 31, 1993, the law provided a maximum amount of compensation on which the Medicare tax could be imposed annually, in the same way that the Social Security payroll tax operates. Beginning on January 1, 1994, the compensation limit was removed. Self-employed individuals must calculate the entire 2.9% tax on self-employed net earnings (because they are both employee and employer), but they may deduct half of the tax from the income in calculating income tax. Beginning in 2013, the rate of Part A tax on earned income exceeding $200,000 for individuals ($250,000 for married couples filing jointly) rose to 3.8%, in order to pay part of the cost of the subsidies to people not on Medicare mandated by the Affordable Care Act. In 2011, Medicare spending was over $900 billion, near 4% of U.S. gross domestic product according to the Trustees Figure 1.1 and over 15% of total US federal spending. Because of the two Trust funds and their differing revenue sources (one dedicated and one not), the Trustees analyze Medicare spending as a percent of GDP rather than versus the Federal budget. The aging of the Baby Boom generation into Medicare is projected by 2030 (when the last of the baby boom turns 65) to increase enrollment to more than 80 million. In addition, the fact that the number of payroll tax payors per enrollee will decline over time and that overall health care costs in the nation are rising pose substantial financial challenges to the program. Medicare spending is projected to increase from near 4% of GDP in 2022 to almost 6% in 2046. Baby-boomers are projected to have longer life spans, which will add to the future Medicare spending. In response to these financial challenges, Congress made substantial cuts to future payouts to providers (primarily acute care hospitals and skilled nursing facilities) as part of PPACA in 2010 and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and individual Congresspeople have offered many additional competing proposals to stabilize Medicare spending further. Many other factors have complicated the forecasting of Medicare Trust Fund health and spending trends including but not limited to the Covid pandemic, the overwhelming preference of people joining Medicare this century for Part C, and the increasing number of dual eligible (Medicaid and Medicare eligibility) beneficiaries. In 2013 the Urban Institute published a report which analyzed the amounts that various households (single male, single female, married single-earner, married dual-earner, low income, average income, high income) contributed to the Medicare program over their lifetimes, and how much someone living to the statistically expected age would expect to receive in benefits. They found differing amounts for the different scenarios, but even the group with the "worst" return on their Medicare taxes would have concluded their working years with $158,000 in Medicare contributions and growth (assuming annual growth equal to inflation plus 2%) but would receive $385,000 in Medicare benefits (both numbers are in 2013 inflation adjusted dollars). Overall, the groups paid into the system 13 to 41 percent of what they were expected to receive. Cost reduction is influenced by factors including reduction in inappropriate and unnecessary care by evaluating evidence-based practices as well as reducing the amount of unnecessary, duplicative, and inappropriate care. Cost reduction may also be effected by reducing medical errors, investment in healthcare information technology, improving transparency of cost and quality data, increasing administrative efficiency, and by developing both clinical/non-clinical guidelines and quality standards.

ng home staff attends to the patients' medical and other needs. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day. In the United States, while nearly 1 in 10 residents aged 75 to 84 stays in a nursing home for five or more years, nearly 3 in 10 residents in that age group stay less than 100 days, the maximum duration covered by Medicare, according to the American Association for Long-Term Care Insurance. Some nursing homes also provide short-term rehabilitative stays following surgery, illness, or injury. Services may include physical therapy, occupational therapy, or speech-language therapy. Nursing homes also offer other services, such as planned activities and daily housekeeping.

Term Care Insurance. Some nursing homes also provide short-term rehabilitative stays following surgery, illness, or injury. Services may include physical therapy, occupational therapy, or speech-language therapy. Nursing homes also offer other services, such as planned activities and daily housekeeping. Nursing homes may offer memory care services, often called dementia care. History From before the 17th century to modern day, many families care for their elders in the family's home. While this is still common practice for many communities and families around the world, this has become increasingly more difficult over time as life expectancy increases, family size decreases, and increased expertise in caring for a person with a chronic disease is needed. In the late 20th century and 21st century, nursing homes have become a standard form of care for most aged and incapacitated persons to account for those complexities. Nearly 6 percent of older adults are sheltered in residential facilities that provide a wide range of care.

From before the 17th century to modern day, many families care for their elders in the family's home. While this is still common practice for many communities and families around the world, this has become increasingly more difficult over time as life expectancy increases, family size decreases, and increased expertise in caring for a person with a chronic disease is needed. In the late 20th century and 21st century, nursing homes have become a standard form of care for most aged and incapacitated persons to account for those complexities. Nearly 6 percent of older adults are sheltered in residential facilities that provide a wide range of care.

ho, Idaho State offers more than 250 programs at its main campus in Pocatello and locations in Meridian, Idaho Falls, and Twin Falls. It is classified among "R2: Doctoral Universities – High research activity ". More than 12,000 students attend Idaho State, with 57 percent of enrollment female and 43 percent male.

Student government is administered by the Associated Students of Idaho State University (ASISU). Each year a president and vice-president are elected by the student body to administer and oversee a variety of activities either partially or fully funded by tuition-based fees. The ASISU Senate is the association's legislative body. Made up of 20 student members elected by the students of each individual college (allocation of seats being based on enrollment of each college), the ASISU Senate is primarily responsible for allocating the ASISU budget. The Student Activities Board, formerly the ASISU Program Board, oversees most of the student activity programming on campus. The board plans concerts, movie showings, homecoming activities, athletic-related events and other activities generally associated with student life. Reed Gym features recreational facilities, including a climbing wall, swimming pool, tennis courts, and more. The Pond Student Union operates a movie theater, billiard room, and bowling alley, and hosts many student club activities. Fine arts events are regularly featured at the performing arts theater. ISU has more than 140 registered professional, academic, cultural, service and social student organizations. The cultural organizations host some of the largest events on campus with their "Cultural Nights" celebrations. There are currently four fraternity and sorority chapters that are recognized by the university. Students at ISU are represented by the Associated Students of Idaho State University (ASISU). Every year the students elect a president, vice-president, and 20 senators. ASISU has administrative oversight of the 140 student organizations and provides funding to various groups that provide student involvement, leadership and service opportunities and events. Student media on campus includes The Bengal, a weekly student-run newspaper and KISU-FM (91.1). KISU-FM broadcasts from the first floor of the Pond Student Union, serving the university and surrounding communities with alternative music, NPR programming, and live coverage of ISU women athletics. In 2010, KISU-FM and the university developed a monthly public affairs talk show FIRST MONDAY: Idaho State University Forum. The show provides insight into the university's programs, accomplishments and local interests. The Pond Student Union, or SUB, serves as the community center for the university. The SUB consists of three floors that house among other things the campus bookstore, student government and organization offices, Outdoor Adventure Center, craft shop, ISU Credit Union, offices of the Vice President for Student Affairs, bowling alley, movie theater, Veterans Sanctuary, LEAD Center and numerous conference/banquet rooms used for meeting and large scale campus events. The SUB is also home for Campus Connection, a one stop shop for event tickets, photo ID and campus information (282-INFO). The 255,000 square foot, five-level Rendezvous Complex built in 2007 is centrally located on the Idaho State University campus. The complex houses 50 classrooms, ranging from 15-seat seminar rooms to a 250-seat lecture hall. Other facilities in the Rendezvous include a large computer center and a large meeting room with partitions for conversion into three small meeting rooms, 80 student apartments with 301 beds and the Mind's Eye Art Gallery. The Cooperative Wilderness Handicapped Outdoor Group, otherwise known as CW HOG, is a regional self-help group that was formed in 1981 to provide recreational opportunities for people of all abilities. CW HOG is kept going through dedicated volunteers. In August 2010, Reed Gym announced the opening of a new addition, the Student Recreation Center, giving Reed nearly 100,000 square feet of recreational opportunities. Additions include added weight and endurance facilities, additional classrooms and teaching facilities, as well as open and window viewing areas to the four indoor tennis courts.

Established in 2011, the Career Path Internship (CPI) program provides students an opportunity to gain professional experience while in school. All CPI internships are paid positions that are aligned with the student's major or career goals. In 2016 the CPI program provided professional experience in approximately 1,000 internships both on and off campus. The CPI program has seen exceptional growth in past years with a 2016 budget estimated at $2.3 million. ISU offers two doctoral level nursing programs after the Idaho State Board of Education approved a doctoral degree in advanced nursing practice, which will now give ISU two doctoral-level nursing programs. The first offered is a Doctor of Philosophy (Ph.D.) degree in nursing beginning summer 2013 and the only one in the state. ISU received top designation for nuclear training and was tagged Regional Center of Excellence. The Energy Systems Technology and Education Center (ESTEC) at the ISU College of Technology will soon be coordinating the nuclear energy education and training for technicians in a nine-state region. The Nuclear Energy Institute (NEI) has designated ESTEC as the Northwest Regional Center of Excellence for Nuclear Education and Training. The top designation includes the states of Idaho, Montana, Washington, Oregon, South Dakota, North Dakota, Utah, and Nebraska. ESTEC is one of five regional NEI-designated centers in the country. ISU's new doctoral experimental psychology program, the only program of its type in Idaho, accepted its first three students fall 2011. The new experimental psychology doctoral program complements ISU's doctoral clinical psychology program, created in the early 1990s. Eventually, the experimental psychology program plans to accept six students annually. A new Idaho State University geosciences doctoral program is approved to begin in August 2013. The Center for Sports Concussion at ISU, opened in 2009, is housed within the Department of Sport Science and Physical Education. The purpose of the Center for Sports Concussion is to offer educational outreach on concussion identification and management practices to athletic administrators, coaches, and parent groups throughout Idaho in accordance with Idaho law and demonstrated need, and to facilitate baseline and post-concussion neuro-cognitive testing to athletes participating in sports programs throughout eastern Idaho. The university awards The Teaching Literature Book Award for the best book on teaching literature at the post-secondary or graduate level. The prize is conferred in odd numbered years, and the inaugural award was conferred in 2015.

ern Oregon to Boise, and is the most populated area in Idaho. Historically, the valley had been known as the Lower Snake River Valley or the Boise River Valley. Pete Olesen, president of the valley's association of local Chambers of Commerce, coined the name "Treasure Valley" in 1959 to reflect the treasure chest of resources and opportunities that the region offered. The valley has a very diverse terrain, from sage flatlands, to mesas, agricultural areas, and urbanized areas.

The Treasure Valley is a valley in the western United States, primarily in southwestern Idaho, where the Payette, Boise, Weiser, Malheur, and Owyhee rivers drain into the Snake River. It includes all the lowland areas from Vale in rural eastern Oregon to Boise, and is the most populated area in Idaho. Historically, the valley had been known as the Lower Snake River Valley or the Boise River Valley. Pete Olesen, president of the valley's association of local Chambers of Commerce, coined the name "Treasure Valley" in 1959 to reflect the treasure chest of resources and opportunities that the region offered. The valley has a very diverse terrain, from sage flatlands, to mesas, agricultural areas, and urbanized areas.

eflect the treasure chest of resources and opportunities that the region offered. The valley has a very diverse terrain, from sage flatlands, to mesas, agricultural areas, and urbanized areas. As the Boise Metropolitan Area grows, more and more undeveloped and agricultural land is being urbanized. History Settling the region The tribes that roamed the area, specifically, were the Northern Paiute and Shoshone. In 1834, Thomas McKay built the original Fort Boise, in the area near present-day Parma, which was run for a time by Francois Payette. It later was moved because of flooding troubles and was abandoned in 1854. The Oregon Trail runs through the Treasure Valley. The valley was settled for the most part by ranchers and farmers, initially to supply the gold and silver mining communities in the higher elevations nearby: Idaho City in the Boise Basin and Silver City in the Owyhees. A new Fort Boise was constructed by the U.S. Army in 1863 in present-day Boise, from which the city grew.

Homecare (also known as home care, in-home care, care at home, domiciliary care, personal care, community care, or social care) is health care or supportive care provided in the home of the individual where the patient or client is living, generally focusing on paramedical aid by professional caregivers, assistance with daily living for ill, disabled or elderly people, or a combination thereof. Depending on legislation, a wide range of other services can also be included in homecare.

ofessional caregivers, assistance with daily living for ill, disabled or elderly people, or a combination thereof. Depending on legislation, a wide range of other services can also be included in homecare. Homecare can be organised by national or local government, by volunteer organizations or on a market basis. Purpose Homecare is an alternative to institutional care such as that provided in group accommodations and nursing home.

egislation, a wide range of other services can also be included in homecare. Homecare can be organised by national or local government, by volunteer organizations or on a market basis. Purpose Homecare is an alternative to institutional care such as that provided in group accommodations and nursing home.

atient needs, order and interpret diagnostic and laboratory tests, diagnose disease, prescribe medications, and formulate treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion. History United States The present-day concept of advanced practice nursing as a primary care provider was created in the mid-1960s, spurred on by a national shortage of physicians. The first formal graduate certificate program for NPs was created by Henry Silver, a physician, and Loretta Ford, a nurse, in 1965. In 1971, the US Secretary of Health, Education and Welfare, Elliot Richardson, made a formal recommendation for expanding the scope of nursing practice to be able to serve as primary care providers.

e treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion. History United States The present-day concept of advanced practice nursing as a primary care provider was created in the mid-1960s, spurred on by a national shortage of physicians. The first formal graduate certificate program for NPs was created by Henry Silver, a physician, and Loretta Ford, a nurse, in 1965. In 1971, the US Secretary of Health, Education and Welfare, Elliot Richardson, made a formal recommendation for expanding the scope of nursing practice to be able to serve as primary care providers.

Training pathways There are many types of nurse practitioner programs in the United States, with the vast majority being in the specialty of a family nurse practitioner (FNP). There are also psychiatric, adult–geriatric acute care, adult–geriatric primary care, pediatric, women's health, and neonatal nurse practitioner programs. Many of these programs have their pre-clinical or didactic courses taught online with proctored examinations. Once the students start their clinical courses, they have online material but are required to perform clinical hours at an approved facility under the guidance of an NP or physician. Each clinical course has specific requirements that vary depending on the program's degree or eligibility for certification. For instance, FNPs are required to see patients across the lifespan during their training, whereas adult geriatric NPs do not see anyone below the age of 13. Nurse practitioners may pursue dual or multiple certifications by completing additional graduate-level training, such as post-master's certificates or Doctor of Nursing Practice (DNP) programs. Upon satisfying the educational and clinical requirements for these secondary specialties, they become eligible for further board certification and expanded clinical practice.

In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage. In addition to medical expense insurance, "health insurance" may also refer to insurance covering disability or long-term nursing or custodial care needs. Different health insurance provides different levels of financial protection and the scope of coverage can vary widely, with more than 40% of insured individuals reporting that their plans do not adequately meet their needs as of 2007. Major federal regulatory reforms, such as the enactment of Medicare and Medicaid in 1965 and the Affordable Care Act in 2010, have substantially reduced the number of uninsured Americans. In American politics, the Democratic Party tends to support public expansions in health insurance coverage while the Republican Party opposes it, with Republicans opposing Medicaid Expansion and supporting Affordable Care Act repeal. In 2023, it has been reported that approximately 25.3 million non-elderly Americans lacked health insurance, a decrease compared to 2019. The United States spends vastly more on health care than comparable countries, which has been attributed in large part to inefficiencies and anti-competitive practices in its health insurance system.

Gallup issued a report in July 2014 stating that the uninsured rate for adults 18 and over declined from 18% in 2013 to 13.4% by 2014, largely because there were new coverage options and market reforms under the Affordable Care Act. Rand Corporation had similar findings. Trends in private coverage The proportion of non-elderly individuals with employer-sponsored cover fell from 66% in 2000 to 56% in 2010, then stabilized following the passage of the Affordable Care Act. Employees who worked part-time (less than 30 hours a week) were less likely to be offered coverage by their employer than were employees who worked full-time (21% vs.

The social safety net The social safety net refers to those providers that organize and deliver a significant level of health care and other needed services to the uninsured, Medicaid, and other vulnerable patients. This is important given that the uninsured rate for Americans is still high after the advent of the Affordable Care Act, with a rate of 10.9%, or 28.9 million people in 2019. Not only is this because the ACA does not address gaps for undocumented or homeless populations, but higher insurance premiums, political factors, failure to expand Medicaid in some states, and ineligibility for financial assistance for coverage are just some of the reasons that the social safety net is required for the uninsured. Most people who are uninsured are non-elderly adults in working families, low income families, and minorities. Social safety net hospitals primarily provide services to these populations of uninsured. For example, California's Public Health Care Systems are only 6% of the hospitals in the state, yet provide care for 38% of all hospital care of uninsured in California- 123,000 of which are homeless, and 3.6 million of which live below the federal poverty line. One way in which the US has been addressing this need for a social safety net (other than formally/state recognized safety net hospitals) is through the advent of free clinics, an example of a Federally Qualified Health Center. A free clinic (for example, the Haight Ashbury Free Clinic and the Berkeley Free Clinic) is a clinic that provides services for free and target the uninsured, typically relying on volunteers and lay health workers.

The Affordable Care Act (ACA), formally the Patient Protection and Affordable Care Act (PPACA) and informally known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with amendments made to it by the Health Care and Education Reconciliation Act of 2010, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965. Most of the act remains in effect. The ACA's major provisions came into force in 2014. By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20 to 24 million additional people covered. The law also enacted delivery system reforms intended to constrain healthcare costs and improve quality. After it came into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans. The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and changes to individual insurance markets. Both received new spending, funded by a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office (CBO) reports stated that overall these provisions reduced the budget deficit, that repealing ACA would increase the deficit, and that the law reduced income inequality. The act largely retained the existing structure of Medicare, Medicaid, and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a monetary penalty) and that insurers cover a list of "essential health benefits". Young people were allowed to stay on their parents' insurance plans until they were 26 years old. Before and after its enactment the ACA faced strong political opposition, calls for repeal, and legal challenges. In the Sebelius decision, the U.S. Supreme Court ruled that Congress cannot use the Commerce Clause to compel individuals to buy health insurance but upheld the individual mandate by recharacterizing the penalty as a tax. The Court also held that states could opt out of the ACA's Medicaid expansion without losing existing federal Medicaid funding, while otherwise upholding the law. This led Republican-controlled states to not participate in Medicaid expansion. Polls initially found that 43% of Americans wanted to see the law repealed or scaled back and 49% wanted to see it expanded or enacted as is. By 2017, the law had majority support.

mendments made to it by the Health Care and Education Reconciliation Act of 2010, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965. Most of the act remains in effect. The ACA's major provisions came into force in 2014. By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20 to 24 million additional people covered. The law also enacted delivery system reforms intended to constrain healthcare costs and improve quality. After it came into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans. The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and changes to individual insurance markets. Both received new spending, funded by a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office (CBO) reports stated that overall these provisions reduced the budget deficit, that repealing ACA would increase the deficit, and that the law reduced income inequality. The act largely retained the existing structure of Medicare, Medicaid, and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a monetary penalty) and that insurers cover a list of "essential health benefits". Young people were allowed to stay on their parents' insurance plans until they were 26 years old. Before and after its enactment the ACA faced strong political opposition, calls for repeal, and legal challenges. In the Sebelius decision, the U.S. Supreme Court ruled that Congress cannot use the Commerce Clause to compel individuals to buy health insurance but upheld the individual mandate by recharacterizing the penalty as a tax. The Court also held that states could opt out of the ACA's Medicaid expansion without losing existing federal Medicaid funding, while otherwise upholding the law. This led Republican-controlled states to not participate in Medicaid expansion. Polls initially found that 43% of Americans wanted to see the law repealed or scaled back and 49% wanted to see it expanded or enacted as is. By 2017, the law had majority support.

A's major provisions came into force in 2014. By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20 to 24 million additional people covered. The law also enacted delivery system reforms intended to constrain healthcare costs and improve quality. After it came into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans. The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and changes to individual insurance markets. Both received new spending, funded by a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office (CBO) reports stated that overall these provisions reduced the budget deficit, that repealing ACA would increase the deficit, and that the law reduced income inequality. The act largely retained the existing structure of Medicare, Medicaid, and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a monetary penalty) and that insurers cover a list of "essential health benefits". Young people were allowed to stay on their parents' insurance plans until they were 26 years old. Before and after its enactment the ACA faced strong political opposition, calls for repeal, and legal challenges. In the Sebelius decision, the U.S. Supreme Court ruled that Congress cannot use the Commerce Clause to compel individuals to buy health insurance but upheld the individual mandate by recharacterizing the penalty as a tax. The Court also held that states could opt out of the ACA's Medicaid expansion without losing existing federal Medicaid funding, while otherwise upholding the law. This led Republican-controlled states to not participate in Medicaid expansion. Polls initially found that 43% of Americans wanted to see the law repealed or scaled back and 49% wanted to see it expanded or enacted as is. By 2017, the law had majority support.

Boise (locally also ) is the capital and most populous city in the U.S. state of Idaho. It is the county seat of Ada County. The population of the city was 235,685 at the 2020 census. The Boise metropolitan area, located in the Treasure Valley, includes five counties of Idaho with an estimated population of 846,000, the most populous metropolitan area in Idaho and 95th-most populous in the United States. Located on the Boise River in southwestern Idaho, it is 41 miles (66 km) east of the Oregon border and 110 miles (177 km) north of the Nevada border. Downtown Boise's elevation is 2,704 feet (824 m) above sea level. Boise is home to major employers in the technology, manufacturing, and service sectors, including companies such as Micron Technology and Hewlett-Packard.

an area in Idaho and 95th-most populous in the United States. Located on the Boise River in southwestern Idaho, it is 41 miles (66 km) east of the Oregon border and 110 miles (177 km) north of the Nevada border. Downtown Boise's elevation is 2,704 feet (824 m) above sea level. Boise is home to major employers in the technology, manufacturing, and service sectors, including companies such as Micron Technology and Hewlett-Packard.

...that the military should continue killing Indians 'until the last Indian in the Territories was either on his reservation or enriched the sagebrush with his decaying carcass.' ...if the Indians refused to move there, 'they will be killed or put on the reservation by force, and certainly shot if they don't stay there.' Furthermore, the editor continues, 'The idea that the Indians have any right to the soil is ridiculous. ...They have no more rights to the soil of the Territories of the United States than wolves or coyotes...' This would be our plan of establishing friendship upon an eternal basis with our Indians: Let all the hostile bands of Idaho Territory be called in (they will not be caught in any other manner) to attend a grand treaty; plenty of blankets and nice little trinkets distributed among them; plenty of grub on hand; have a real jolly time with them; then just before the big feast put strychnine in their meat and poison to death the last mother's son of them. At the same time, native warriors around the valley, under the leadership of Howluck also known as "Bigfoot" among white settlers, among others, waged an escalating and intensified guerrilla campaign of harassment of passerby caravans along the Oregon Trail. The United States Army also escalated and intensified "punitive expeditions" against formations of warriors and against civilian communities as well. This marked the start of the "unofficial" Snake War in 1866. This war lasted until 1868, and is statistically the deadliest of the Indian Wars in the West in terms of casualties. In the end, 1,762 men were counted as the casualties of this war from both sides. In 1868, Fort Hall Indian Reservation was established in Southeastern Idaho, about 220 miles upstream, according to the terms of Fort Bridger Treaty. The Boise Valley Shoshone and Bannock Tribes were not party to this treaty. Nevertheless, in April 1869, the United States Military embarked on a campaign of "Removal, rounding up of natives in the region including in and around Boise, and expelling them with cavalry escort to Fort Hall Indian Reservation. This period is known among the Shoshone and Bannock people as Idaho's Trail of Tears. Some of the natives managed to escape, and they ran to either Duck Valley or Fort McDermitt in Nevada. Incorporation and growth Boise's early growth was significantly driven by its role in supplying the nearby gold towns that sprung up in the 1860s northeast and then southwest of the town. Miners sometimes wintered in Boise and a number of early prominent businessmen were miners who settled in town in the years after the gold rush waned. By 1864 substantial agricultural production was underway on easily irrigated lands near the river and three canal companies had been incorporated. Early transportation improvements were largely a result of toll road franchises awarded by the territorial legislature starting in the 1860s. These first ran from Fort Boise to the mining centers in the Boise Basin and east to Rocky Bar and to Rattlesnake Station where they connected to the Oregon Trail. Territorial census records from a special 1864 enumeration list the population of Boise as 1,658, and an act of December 12, 1864, was the first attempt by the Idaho Territorial Legislature to incorporate the city. This was rejected by voters the following March. Two more unsuccessful attempts were made to organize a city administration by election before the 1866 version of the city charter was approved by voters on January 6, 1868. The growing number of homes and businesses, for which owners wanted proper legal title, may have contributed to the eventual success of incorporation. All of these rejected efforts to incorporate the city came after Boise had been controversially made the state capital in 1864 over strong opposition from northern Idaho interests. This decision reflected the rapid shift of population growth from north to south after the discovery of gold in southern Idaho. By 1868 Boise had over 400 permanent buildings with a wide range of commercial services. 1868 also marked the formal beginning of a long advocacy for railroad connections to other Idaho communities and, just as importantly, to other growing cities in the west such as Portland, Oregon. Competing railroad and western state government interests frustrated these efforts for many years. Designed by Alfred B. Mullett, the U.S. Assay Office at 210 Main Street was built in 1871 and today is a National Historic Landmark. It first began accepting gold and silver for purchase on March 2, 1872, largely eliminating the need to transport ore to the mint in San Francisco. A territorial penitentiary, now known as the Old Idaho State Penitentiary, opened the same month several miles east of town. Mining continued to be important to Boise's economic growth and periodic booms contributed to population growth as well, though production of gold and silver probably peaked in the 1860s. 1882's gold and silver production of $3,500,000 declined to $1,488,315 (including lead) by 1899. Boise began to earn its City of Trees nickname in this period with a popular focus on a range of tree planting projects. Thomas J. Davis planted several thousand fruit trees in 1864 and several other early businessmen either founded nurseries or orchards of their own. In the 1870s tree planting began in earnest in downtown Boise led by prominent hotels as well as businessmen and residents. In 1907 Davis donated 43 acres of his orchard property to the city for use as a park in the name of his wife Julia. Commercial agriculture continued to expand, but was slowed by the lack of reliable rail links to regional and national markets and by a lack of large scale irrigation projects, which themselves were often tied to hoped-for railroad projects for financing. A.D. Foote, a successful mining engineer, drew up plans to irrigate up to 500,000 acres immediately south of Boise in 1882, but progress was halting and smaller farms were the norm until after the turn of the century with most located near to the river bottom where soil was productive and irrigation more easily achieved. Fruit orchards proliferated and sugar beets, still an important agricultural industry in Idaho, began to be widely cultivated in the 1890s. Cattle and sheep farming became increasingly important as the century closed. With the exception of dairy, most livestock products were exported from Idaho, unlike other agricultural products which were still largely scaled to support local markets. The timber industry also increasingly thrived in the Boise market in the 1880s and 1890s. Large quantities of timber were exported from elsewhere in Idaho, but a growing Boise supported the expansion of Alexander Rossi's sawmill, first established in 1865. Prominent early Boisean William Ridenbaugh had inherited control of the canal now bearing his name from his uncle William Morris in 1878 and later partnered with Rossi to expand the sawmill capacity under the name Rossi and Ridenbaugh Lumber Company. Their materials supported bridge building and the rapid expansion of Boise in the 1890s. As with many early infrastructure ventures, electrification succeeded only after at least one false start. July 4, 1887, marked the start of electrical transmission from a plant located on the Bench. William Ridenbaugh provided expertise and manpower for the water supply and several months were spent rigging poles and lines from the Bench to the service area across the river. Additional electrical supplies allowed the building of an electric streetcar line in 1891. This ran without interruption until buses replaced the lines in 1927, tracking—and sometimes driving—the development of Boise and nearby communities. This system expanded over several decades, reaching into the North End, South Boise and across the river on Front St. A loop line, completed in 1912, ran as far as Caldwell and Nampa, providing transport throughout the valley. Three early trolley companies merged in 1912 to form the Idaho Traction Company with a depot at 7th and Bannock Streets downtown. Additional services and urban amenities arrived in the 1890s as Boise grew. Exploratory drilling for hot water was successful in 1890 and by the end of the decade many homes along Warm Springs avenue were being heated by this source. A natatorium was built in 1892 close to the source of the hot water near the Idaho State Penitentiary. Churches serving several denominations, a Jewish synagogue, a major hardware store and department store, a Masonic hall, the Columbia Theater, Saint Alphonsus' Hospital, a number of parochial and secular schools, a City Hall and a new Union Pacific passenger station, constructed when service was finally extended to downtown, were all built during the 1890s. Falk's Department Store sponsored a semi-professional baseball team representing Boise from at least 1892 and the city supported other organized sports as they became popular.

In the United States, poverty has both social and political implications. Based on poverty measures used by the Census Bureau (which exclude non-cash factors such as food stamps or medical care or public housing), America had 37 million people defined as living in poverty in 2023; this is 11 percent of the population. Some of the many causes include income, inequality, inflation, unemployment, debt traps and poor education. The majority of adults living in poverty are employed and have at least a high school education. Although the US is a relatively wealthy country by international standards, it has a persistently high poverty rate compared to other developed countries due in part to a less generous welfare system. Efforts to alleviate poverty include New Deal-era legislation during the Great Depression, to the national War on Poverty in the 1960s and poverty alleviation efforts during the 2008 Great Recession. The federal government has two departments which measure poverty. Under the Department of Commerce, the Census Bureau has been reporting the Official Poverty Measure (OPM) since the 1960s, while the Department of Health and Human Services defines income levels for which people are eligible for governmental anti-poverty assistance. The OPM includes cash assistance from programs like Supplemental Security Income and Temporary Assistance to Needy Families (welfare) as part of someone's income when reporting on how many people are in poverty. Since 2011 the Census Bureau has also been reporting a newer Supplemental Poverty Measure (SPM), which includes non-cash anti-poverty government assistance like Supplemental Nutrition Assistance Program (food stamps) and Medicaid (health care for the poor), and also accounts for regional differences in the cost of living. The SPM is considered a more comprehensive estimate of poverty. For 2021, the percentage of Americans in poverty per the SPM was 7.8%, and per the OPM was 11.6%. By the OPM, the poverty threshold for 2021 for a single person was $13,800, and for a family of four was $27,700. In 2020, the World Bank reported that 0.25% of Americans lived below the international definition of extreme poverty, which is living on less than $2.15 per day in 2017 Purchasing Power Parity dollars. The SPM increased by 4.6% in 2022 to 12.4%, due to the ending of pandemic stimulus payments and tax credits, with around 15.3 million Americans falling into poverty over this time period according to the Center on Budget and Policy Priorities. The 2020 assessment by the U.S. Census Bureau showed the percentage of Americans living in poverty for 2019 (before the COVID-19 pandemic) had fallen to some of the lowest levels ever recorded due to the record-long period of economic growth.

of economic growth. However, between May and October 2020, some eight million people were put into poverty due to the economic effects of the COVID-19 pandemic and the ending of funds from the CARES Act. History Progressive era 1890s-1920s Catalyzed by Henry George's 1873 book Progress and Poverty, public interest in how poverty could arise even in a time of economic progress arose in the 19th century with the rise of the Progressive movement. The Progressive American social survey began with the publication of Hull House Maps and Papers in 1895. This study included essays and maps collected by Florence Kelley and her colleagues working at Hull House and staff of the United States Bureau of Labor.

Great Depression A group especially vulnerable to poverty consisted of poor sharecroppers and tenant farmers in the South. These farmers consisted of around a fourth of the South's population, and over a third of these people were African Americans. Historian James T. Patterson refers to these people as the "old poverty," as opposed to the "new poverty" that emerged after the onset of the Great Depression. During the Depression, the government did not provide any unemployment insurance, so people who lost jobs easily became impoverished. People who lost their jobs or homes lived in shantytowns or Hoovervilles. Many New Deal programs were designed to increase employment and reduce poverty. The Federal Emergency Relief Administration specifically focused on creating jobs for alleviating poverty. Jobs were more expensive than direct cash payments (called "the dole"), but were psychologically more beneficial to the unemployed, who wanted any sort of job for morale. Other New Deal initiatives that aimed at job creation and wellbeing included the Civilian Conservation Corps and Public Works Administration. Additionally, the institution of Social Security was one of the largest factors that helped to reduce poverty. War on Poverty A number of factors helped start the national War on Poverty in the 1960s. In 1962, Michael Harrington's book The Other America helped increase public debate and awareness of the poverty issue. The War on Poverty embraced expanding the federal government's roles in education and health care as poverty reduction strategies, and many of its programs were administered by the newly established Office of Economic Opportunity. The War on Poverty coincided with more methodological and precise statistical versions of studying poverty; the "official" U.S.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA or the Kennedy–Kassebaum Act) is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1996. It aimed to alter the transfer of healthcare information and stipulated guidelines by which personally identifiable information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and addressed some limitations on healthcare insurance coverage. It generally prohibits healthcare providers and businesses called covered entities from disclosing protected information to anyone other than a patient and the patient's authorized representatives without their consent. The law does not restrict patients from accessing their own information, except in limited cases.

ormation however they choose, nor does it require confidentiality where a patient discloses medical information to family members, friends, or other individuals not employees of a covered entity. The act consists of five titles: Title I protects health insurance coverage for workers and their families if they change or lose their jobs. Title II, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. Title III sets guidelines for pre-tax medical spending accounts. Title IV sets guidelines for group health plans. Title V governs company-owned life insurance policies.

Title I protects health insurance coverage for workers and their families if they change or lose their jobs. Title II, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. Title III sets guidelines for pre-tax medical spending accounts. Title IV sets guidelines for group health plans. Title V governs company-owned life insurance policies.

gislation such as the Affordable Care Act of 2010 has sought to address some of these issues, though challenges and reform debate remain. Uninsured rates have fluctuated over time, and disparities in access to care exist based on factors such as income, race, and geographical location. The private insurance model predominates, and employer-sponsored insurance is a common way for individuals to obtain coverage. The complex nature of the system, as well as its high costs, has led to ongoing discussions about the future of healthcare in the United States. At the same time, the United States is a global leader in medical innovation, measured either in terms of revenue or the number of new drugs and medical devices introduced. The Foundation for Research on Equal Opportunity concluded that the United States dominates science and technology, which "was on full display during the COVID-19 pandemic, as the U.S. government delivered coronavirus vaccines far faster than anyone had ever done before", but lags behind in fiscal sustainability, with "government spending ... growing at an unsustainable rate." In the early 20th century, advances in medical technology and a focus on public health contributed to a shift in healthcare. The American Medical Association (AMA) worked to standardize medical education, and the introduction of employer-sponsored insurance plans marked the beginning of the modern health insurance system. More people were starting to get involved in healthcare, such as state actors, other professionals/practitioners, patients and clients, the judiciary, and business interests and employers. They had interest in medical regulations of professionals to ensure that services were provided by trained and educated people to minimize harm. The post–World War II era saw a significant expansion in healthcare where more opportunities were offered to increase accessibility of services.

sure that services were provided by trained and educated people to minimize harm. The post–World War II era saw a significant expansion in healthcare where more opportunities were offered to increase accessibility of services.

According to a statistical brief by the Healthcare Cost and Utilization Project (HCUP), there were 35.7 million hospitalizations in 2016, a significant decrease from the 38.6 million in 2011. For every 1,000 in the population, there was an average of 104.2 stays and each stay averaged $11,700 (equivalent to $15,696 in 2025), an increase from the $10,400 (equivalent to $14,585 in 2025) cost per stay in 2012. Approximately 7.6% of the population had overnight stays in 2017, each stay lasting an average of 4.6 days. A study by the National Institutes of Health reported that the lifetime per capita expenditure at birth, using the year 2000 dollars, showed a large difference between the healthcare costs of females ($361,192, equivalent to $675,272 in 2025) and males ($268,679, equivalent to $502,313 in 2025). A large portion of this cost difference is in the shorter lifespan of men, but, even after adjustment for age (assuming men live as long as women), there still is a 20% difference in lifetime healthcare expenditures. Health insurance and accessibility Unlike most developed nations, the US health system does not provide healthcare to the country's entire population. In 1977, the United States was said to be the only industrialized country not to have some form of national health insurance or direct healthcare provision to citizens through a nationalized healthcare system. A 1978 study argued that "Today every government in the world – including Red China with its squadrons of semi-trained 'barefoot doctors' – realizes it has a responsibility to keep its citizens in good physical and mental health. Unlike the U.S., nations like Scandinavia, the U.K., Ireland, Japan and others have opted for a universal health care system in which the state pays everyone's medical bills." Instead, most citizens are covered by a combination of private insurance and various federal and state programs. As of 2017, health insurance was most commonly acquired through a group plan tied to an employer, covering 150 million people. Other major sources include Medicaid, covering 70 million, Medicare, 50 million, and health insurance marketplaces created by the ACA covering around 17 million. In 2017, a study found that 73% of plans on ACA marketplaces had narrow networks, limiting access and choice in providers. Healthcare coverage is provided through a combination of private health insurance and public health coverage (e.g., Medicare, Medicaid). In 2013, 64% of health spending was paid for by the government, and funded via programs such as Medicare, Medicaid, the Children's Health Insurance Program, Tricare, and the Veterans Health Administration. People aged under 65 acquire insurance via their or a family member's employer, by purchasing health insurance on their own, getting government and/or other assistance based on income or another condition, or are uninsured. Health insurance for public sector employees is primarily provided by the government in its role as employer.

An adult daycare centre is typically a non-residential facility that supports the health, nutritional, social, and daily living needs of adults with disabilities including dementia, in a professionally staffed, group setting. These facilities can also provide adults with transitional care and short-term rehabilitation following hospital discharge. The majority of day centres provide meals, meaningful activities, and general supervision. The care provided is often a social model (focusing on socialisation and prevention services) or a medical model (including skilled assessment, treatment and rehabilitation goals) provided in order to improve participants health and guide their progress in the right direction.

ces) or a medical model (including skilled assessment, treatment and rehabilitation goals) provided in order to improve participants health and guide their progress in the right direction.

in old age or guidance to reintegrate into society after injury, illness or addiction, and accommodation to return to their former lives or improve upon their quality of life. Purpose and overview Adult daycare centres primarily focus on providing care for people with a specific chronic condition, including: Alzheimer's disease and other types of dementia; additionally, these services may be available for any adult with disabilities and also the elderly population. Numerous centres maintain a nurse on-site and devote a room for participants who require their vital signs to be checked and evaluated regularly; or needs other health services during their visit. Facilities may also provide transportation and personal care including support groups for caregivers. Attending an adult daycare centre can prevent people from needing to be re-hospitalised and may delay their admission to residential long-term care. For participants, who would otherwise stay at home alone, social stimulation and recreational activities have been known to improve or maintain physical fitness and cognitive function. The more severe the disease is, the greater the burden will be on the caregiver. Therefore, 19.1% of caregivers with clients made use of these services. Adult daycare centres may be able to provide respite care, enabling caregivers to work or have a break from their caregiving responsibilities. These facilities are beneficial to many as the activities accommodate stimulating interaction with other people, which has been known to improve the participant's health and emotional well-being. All certified adult daycare centres are monitored and staffed for the protection of participants as well as being a helping hand for new people having trouble connecting with others or do not feel comfortable in certain environments. This program aims to build up confidence and ability to maintain an independent lifestyle along with improving physical and mental health. Another important aspect of an adult daycare centre is the information about suitable healthy diet plans and exercise regimes. This can benefit health as some people lose the ability to maintain a healthy lifestyle, especially for participants coming from rehabilitation or dementia wards, who may forget what they have or have not done a particular day.

ternational Classification of Diseases (ICD), edited by the World Health Organization (WHO), and the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA). The fifth edition of the DSM (DSM-5) was published in May 2013. However, its release coincided with a statement by then-NIMH (National Institute of Mental Health) director Thomas Insel noting that the manual lacks validity compared to other medical specialties due to the absence of objective laboratory measures (biomarkers) for diagnosis. Treatment may include psychotropics (psychiatric medicines), psychotherapy, substance-abuse treatment, and other modalities such as interventional approaches, assertive community treatment, community reinforcement, and supported employment. Treatment may be delivered on an inpatient or outpatient basis, depending on the severity of functional impairment or risk to the individual or community. Research within psychiatry is conducted by psychiatrists on an interdisciplinary basis with other professionals, including clinical psychologists, epidemiologists, nurses, social workers, and occupational therapists.

Though the medical specialty of psychiatry uses research in the field of neuroscience, psychology, medicine, biology, biochemistry, and pharmacology, it has generally been considered a middle ground between neurology and psychology. Because psychiatry and neurology are deeply intertwined medical specialties, all certification in the United States for both specialties and for their subspecialties is offered by a single board, the American Board of Psychiatry and Neurology, one of the member boards of the American Board of Medical Specialties. Unlike other physicians and neurologists, psychiatrists specialize in the doctor–patient relationship and are trained to varying extents in the use of psychotherapy and other therapeutic communication techniques. Psychiatrists also differ from psychologists in that they are physicians and have postgraduate training called residency (usually four to five years) in psychiatry; the quality and thoroughness of their graduate medical training is identical to that of all other physicians. Psychiatrists can therefore counsel patients, prescribe medication, order laboratory tests, order neuroimaging, and conduct physical examinations. As well, some psychiatrists are trained in interventional psychiatry and can deliver interventional treatments such as electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation and ketamine. Ethics The World Psychiatric Association issues an ethical code to govern the conduct of psychiatrists (like other purveyors of professional ethics). The psychiatric code of ethics, first set forth through the Declaration of Hawaii in 1977 has been expanded through a 1983 Vienna update and in the broader Madrid Declaration in 1996. The code was further revised during the organization's general assemblies in 1999, 2002, 2005, and 2011. The World Psychiatric Association code covers such matters as confidentiality, the death penalty, ethnic or cultural discrimination, euthanasia, genetics, the human dignity of incapacitated patients, media relations, organ transplantation, patient assessment, research ethics, sex selection, coercion, torture, and up-to-date knowledge. In establishing such ethical codes, the profession has responded to a number of controversies about the practice of psychiatry, for example, surrounding the use of lobotomy and electroconvulsive therapy. Discredited psychiatrists who operated outside the norms of medical ethics include Harry Bailey, Donald Ewen Cameron, Samuel A.

The World Psychiatric Association issues an ethical code to govern the conduct of psychiatrists (like other purveyors of professional ethics). The psychiatric code of ethics, first set forth through the Declaration of Hawaii in 1977 has been expanded through a 1983 Vienna update and in the broader Madrid Declaration in 1996. The code was further revised during the organization's general assemblies in 1999, 2002, 2005, and 2011. The World Psychiatric Association code covers such matters as confidentiality, the death penalty, ethnic or cultural discrimination, euthanasia, genetics, the human dignity of incapacitated patients, media relations, organ transplantation, patient assessment, research ethics, sex selection, coercion, torture, and up-to-date knowledge. In establishing such ethical codes, the profession has responded to a number of controversies about the practice of psychiatry, for example, surrounding the use of lobotomy and electroconvulsive therapy. Discredited psychiatrists who operated outside the norms of medical ethics include Harry Bailey, Donald Ewen Cameron, Samuel A.

Idaho Department of Health and Welfare is a public health agency in the state of Idaho. History The department was founded in 1972. Functions The department provides healthcare services, records management, children and family services, food assistance programs, and healthcare services.

pa ( ) is the most populous city in Canyon County, Idaho, United States. The population was 100,200 at the 2020 census. It is Idaho's third-most populous city. Nampa is about 20 miles (32 km) west of Boise along Interstate 84, and 6 miles (9.7 km) west of Meridian. It is the second principal city of the Boise metropolitan area. The name "Nampa" may have come from a Shoshoni word meaning 'moccasin' or 'footprint'. According to toponymist William O. Bright, the name comes from the Shoshoni word /nampai/, meaning "foot".

History Nampa had its beginnings in the early 1880s when the Oregon Short Line Railroad built a line from Granger, Wyoming, to Huntington, Oregon, that passed through Nampa. In Nampa there is a history museum that marks the railroad's significance. More railroad lines sprang up through Nampa, making it an important railroad town. Alexander and Hannah Duffes established one of the town's first homesteads, eventually forming the Nampa Land and Improvement Company with the help of their friend and co-founder, James McGee. Despite the name, many early settlers called the town "New Jerusalem" because of its citizens' strong religious focus. After only a year the town grew from 15 homes to 50. As amenities were added, Nampa continued to grow, and it was incorporated in 1891. Downtown Nampa's street grid is oriented with the railroad tracks, which run northwest–southeast; this was done intentionally by Alexander Duffes to prevent accidents like one that occurred earlier in a town he had platted near Toronto, where a woman and her two children were killed by a train when their buggy wheel got stuck as they crossed the tracks. As the Oregon Short Line railroad originally bypassed Boise, Nampa has the fanciest of many railroad depots built in the area. Nampa gained attention in 1889 due to a purported archaeological discovery known as the Nampa figurine. George Frederick Wright wrote up details that year for the Boston Society of Natural History. The first elementary school was built in the 1890s. Lakeview School was on a hill on 6th Street and 12th Avenue North, with a view of Lake Ethel. Just after the school's centennial celebration, it was condemned as a school and sold to the First Mennonite Church. In 2008 the building was refurbished, and it is now used by the Idaho Arts Charter School. Lake Ethel, an irrigation reservoir, had long been the site of community picnics, and many citizens fished, swam, boated, and even hunted on it and its surrounding property. But the hunting didn't last long, as O. F. Persons, owner of the adjoining homestead, took offense when local hunters started shooting his pet ducks. The city later auctioned off the lake. E. H. Dewey (a former Nampa mayor) was the only bidder. But occasional flooding led to a series of lawsuits from neighbors. Dewey eventually drained Lake Ethel. Not long after, the city council became interested in buying back the Fritz Miller property as well as the Dewey home. Pressure had been building for more than four years. Nampa citizens wanted another park. On August 7, 1924, the city council passed an ordinance to purchase the Miller property and name it Lakeview Park. A bandstand was completed in 1928, and the municipal swimming pool opened on August 13, 1934. It is Nampa's largest park and many community celebrations are held there. Colonel William H. Dewey, a man who made a fortune mining in Silver City, built the Dewey Palace Hotel in 1902 for $250,000. He died in his hotel in 1903, leaving his son $1 million. The hotel survived the great fire of 1909, which burned several blocks of downtown Nampa, but was razed in 1963 after redevelopment plans failed. Relics from the hotel such as the chandelier and the hotel safe can be found at the Canyon County Historical Museum, which is in the old train depot on Front Street and Nampa City Hall. After demolition the location on First Street between 11th and 12th Ave. South was sold to private enterprise, including a bank and tire store, replacing this building with modern structures. A public-use postage stamp sized park was later placed across the street from the old palace property as a collaboration between the Downtown Alliance of Nampa (the local business council) and an Eagle Scout Project for the Boy Scouts of America. The park includes a large mural/wall sculpture of running horses commissioned for the project. A Carnegie library was built downtown in 1908; it burned down after the library moved in 1966. Nampa Public Library was then on the corner of 1st Street and 11th Avenue South in the old bank building. A new library, on 12th Avenue South, opened in 2015. Deer Flat Reservoir, an offstream irrigation storage reservoir, was constructed by the United States Bureau of Reclamation between 1906 and 1911. Known locally as Lake Lowell, it is surrounded by the Deer Flat National Wildlife Refuge, established in 1909 by President Theodore Roosevelt. The refuge is administered by the U.S. Fish and Wildlife Service. Lake Lowell is filled by the concrete New York Canal; the water is diverted from the Boise River a few miles below Lucky Peak Dam. In 1910, the Idaho State School and Hospital was built northwest of Nampa for the state's developmentally challenged population. It opened in 1918. The institution was largely self-sufficient, with a large farm staffed by the residents. The higher-functioning residents also cared for residents who could not care for themselves. The land for the farm was sold and is now golf courses (Centennial and Ridgecrest), and the residents no longer give primary care to other residents. The institution is modernized and remains in operation, though a few of the oldest buildings now house juvenile offenders. Nampa held an annual harvest festival and farmers' market from about 1908, a time of celebration and community fun. From this festival emerged the Snake River Stampede Rodeo in 1937, which continues to this day. It is one of the top 12 rodeos in the pro rodeo circuits. In 1913, a local congregation of the Church of the Nazarene built a small elementary school, which became to Northwest Nazarene College in 1915 and finally Northwest Nazarene University. As of 2025, the university has approximately 1,800 undergraduate and graduate students. Karcher Mall opened in 1965, the first enclosed shopping mall in the Treasure Valley. It was "the place to gather" for several decades until the Boise Towne Square mall was built in Boise in 1988, drawing business away. Karcher Mall was renamed District 208 in 2022. The Idaho Press-Tribune is the local newspaper for the Canyon County area.

Idaho Hispanic Community Center (IH2C) In 2003, the Hispanic Cultural Center of Idaho (HCCI) opened thanks to community support. It has recently transitioned back to the City of Nampa and was renamed the Idaho Hispanic Community Center (IH2C) and is home to the Idaho Hispanic Foundation. It hosts events, classes, and festivals, including Día de los Muertos, Hispanic Heritage Month, and Día Internacional de la Mujer. It serves as a meeting place for associations and groups. Displays of cultural history are available to the public. Nampa Train Depot Museum The Nampa Train Depot Museum is a historical depot with displays and archives of the area's railroad and cultural history. The Canyon County Historical Society saved the depot from demolition in 1972. Annual Festival of the Arts Nampa's Festival of the Arts, which began in 1987, is held in Lakeview Park every year and includes local art, music, dance, and food.

Ada County is located in the southwestern part of Idaho, United States. As of the 2020 census, the county had a population of 494,967, which by 2025 was estimated to have risen to 546,141. Ada County is by far the state's most populous county; it is home to 26.8% of the state's population. The county seat and largest city is Boise, which is also the state capital. Ada County is included in the Boise metropolitan area. The Ada County Highway District has jurisdiction over all the local county and city streets, except for private roads and state roads.

populous county; it is home to 26.8% of the state's population. The county seat and largest city is Boise, which is also the state capital. Ada County is included in the Boise metropolitan area. The Ada County Highway District has jurisdiction over all the local county and city streets, except for private roads and state roads.

ea. The Ada County Highway District has jurisdiction over all the local county and city streets, except for private roads and state roads. In the interior Pacific Northwest east of the Cascade Range, Ada County ranks second in population, behind Spokane County, Washington. History Ada County was created by the Idaho Territory legislature on December 22, 1864, partitioned from Boise County. It is named for Ada Riggs, the daughter of H. C. Riggs, a member of the legislature; he established the county and was a co-founder of Boise.

the county seat of Canyon County, Idaho, United States. Caldwell is the 5th most populous city in Idaho. As of the 2020 census, Caldwell had a population of 59,996. Caldwell is considered part of the Boise metropolitan area, and is the location of the College of Idaho. The city is located approximately 24 miles (39 km) west of Boise, and approximately 17 miles (27 km) east of the Oregon border. History The present-day location of Caldwell is along a natural passageway to the Inland and Pacific Northwest. Native American tribes from the west coast, north Idaho and as far away as Colorado came to the banks of the Boise River for annual trading fairs, or rendezvous. European and some Hawaiian explorers and traders soon followed the paths left by Native Americans and hopeful emigrants later forged the Oregon Trail and followed those paths to seek a better life in the Oregon Territory. Pioneers of the Trail traveled along the Boise River to Canyon Hill and forded the river close to the Silver Bridge on Plymouth Street. During the Civil War, the discovery of gold in Idaho's mountains brought a variety of new settlers into the area. Many never made it to the mines but settled along the Boise River and run ferries, stage stations, and freighting businesses. These early entrepreneurs created small ranches and farms in the river valleys. Caldwell's inception occurred largely as a result of the construction of the Oregon Short Line Railroad, which connected Wyoming to Oregon through Idaho. Robert E. Strahorn came to the Boise River Valley in 1883 to select a route for the railroad. He rejected the grade into Boise City as too steep and chose a site 30 miles to the west. He drove a stake into an alkali flat of sagebrush and greasewood and the City of Caldwell was platted. Caldwell was named after one of Strahorn's business partners, Alexander Caldwell, a former senator from Kansas. When Caldwell was platted in August 1883, its founder, the Idaho and Oregon Land Improvement Company, started persuading settlers and businessmen to move to the area. Within four months, Caldwell had 600 residents living in 150 dwellings, 40 businesses, a school, a telephone exchange, and two newspapers. On January 15, 1890, the Board of Commissioners of Ada County issued a handwritten order incorporating the City of Caldwell. The College of Idaho was founded in Caldwell in 1891. In 1892, Canyon County was established from a portion of Ada County, and Caldwell was named the county seat. Irrigation canals and waterways were constructed throughout Canyon County, providing the foundation for an agricultural economy. The Oregon Short Line Railroad became part of the larger Union Pacific Railroad network and in 1906 the Caldwell freight and passenger depot was constructed. Caldwell experienced moderate growth as an agricultural processing, commercial retail and educational center during the 20th century. In 2009, the City of Caldwell completed a revitalization project to restore Indian Creek, which runs through downtown Caldwell, but had been used for sewage disposal by local industries and been covered over.

History The present-day location of Caldwell is along a natural passageway to the Inland and Pacific Northwest. Native American tribes from the west coast, north Idaho and as far away as Colorado came to the banks of the Boise River for annual trading fairs, or rendezvous. European and some Hawaiian explorers and traders soon followed the paths left by Native Americans and hopeful emigrants later forged the Oregon Trail and followed those paths to seek a better life in the Oregon Territory. Pioneers of the Trail traveled along the Boise River to Canyon Hill and forded the river close to the Silver Bridge on Plymouth Street. During the Civil War, the discovery of gold in Idaho's mountains brought a variety of new settlers into the area. Many never made it to the mines but settled along the Boise River and run ferries, stage stations, and freighting businesses. These early entrepreneurs created small ranches and farms in the river valleys. Caldwell's inception occurred largely as a result of the construction of the Oregon Short Line Railroad, which connected Wyoming to Oregon through Idaho. Robert E. Strahorn came to the Boise River Valley in 1883 to select a route for the railroad. He rejected the grade into Boise City as too steep and chose a site 30 miles to the west. He drove a stake into an alkali flat of sagebrush and greasewood and the City of Caldwell was platted. Caldwell was named after one of Strahorn's business partners, Alexander Caldwell, a former senator from Kansas. When Caldwell was platted in August 1883, its founder, the Idaho and Oregon Land Improvement Company, started persuading settlers and businessmen to move to the area. Within four months, Caldwell had 600 residents living in 150 dwellings, 40 businesses, a school, a telephone exchange, and two newspapers. On January 15, 1890, the Board of Commissioners of Ada County issued a handwritten order incorporating the City of Caldwell. The College of Idaho was founded in Caldwell in 1891. In 1892, Canyon County was established from a portion of Ada County, and Caldwell was named the county seat. Irrigation canals and waterways were constructed throughout Canyon County, providing the foundation for an agricultural economy. The Oregon Short Line Railroad became part of the larger Union Pacific Railroad network and in 1906 the Caldwell freight and passenger depot was constructed. Caldwell experienced moderate growth as an agricultural processing, commercial retail and educational center during the 20th century. In 2009, the City of Caldwell completed a revitalization project to restore Indian Creek, which runs through downtown Caldwell, but had been used for sewage disposal by local industries and been covered over.

location of the College of Idaho. The city is located approximately 24 miles (39 km) west of Boise, and approximately 17 miles (27 km) east of the Oregon border. History The present-day location of Caldwell is along a natural passageway to the Inland and Pacific Northwest. Native American tribes from the west coast, north Idaho and as far away as Colorado came to the banks of the Boise River for annual trading fairs, or rendezvous. European and some Hawaiian explorers and traders soon followed the paths left by Native Americans and hopeful emigrants later forged the Oregon Trail and followed those paths to seek a better life in the Oregon Territory. Pioneers of the Trail traveled along the Boise River to Canyon Hill and forded the river close to the Silver Bridge on Plymouth Street. During the Civil War, the discovery of gold in Idaho's mountains brought a variety of new settlers into the area. Many never made it to the mines but settled along the Boise River and run ferries, stage stations, and freighting businesses. These early entrepreneurs created small ranches and farms in the river valleys. Caldwell's inception occurred largely as a result of the construction of the Oregon Short Line Railroad, which connected Wyoming to Oregon through Idaho. Robert E. Strahorn came to the Boise River Valley in 1883 to select a route for the railroad. He rejected the grade into Boise City as too steep and chose a site 30 miles to the west. He drove a stake into an alkali flat of sagebrush and greasewood and the City of Caldwell was platted. Caldwell was named after one of Strahorn's business partners, Alexander Caldwell, a former senator from Kansas. When Caldwell was platted in August 1883, its founder, the Idaho and Oregon Land Improvement Company, started persuading settlers and businessmen to move to the area. Within four months, Caldwell had 600 residents living in 150 dwellings, 40 businesses, a school, a telephone exchange, and two newspapers. On January 15, 1890, the Board of Commissioners of Ada County issued a handwritten order incorporating the City of Caldwell. The College of Idaho was founded in Caldwell in 1891. In 1892, Canyon County was established from a portion of Ada County, and Caldwell was named the county seat. Irrigation canals and waterways were constructed throughout Canyon County, providing the foundation for an agricultural economy. The Oregon Short Line Railroad became part of the larger Union Pacific Railroad network and in 1906 the Caldwell freight and passenger depot was constructed. Caldwell experienced moderate growth as an agricultural processing, commercial retail and educational center during the 20th century. In 2009, the City of Caldwell completed a revitalization project to restore Indian Creek, which runs through downtown Caldwell, but had been used for sewage disposal by local industries and been covered over.

Meridian is a city located in Ada County, Idaho, United States. The population was 117,635 at the 2020 census, making it the second most populous city in the county and Idaho, after Boise, the state capital.

Rail transportation (1908–28) Following the raising of $4,000 to lay the Interurban rail line from Onweiler (Meridian and Ustick Roads), the tracks were completed into the village center. Turning east on Broadway and ending at East Second, the last car would spend the night in Meridian before returning to Boise early the next morning with passengers and freight. The interurban Station and Generator building (west one-third of the old library at Meridian and Idaho Streets) was built in 1912, and the line continued on to Nampa via Meridian. The tracks down Broadway were not used after 1912. The Interurban Company entered into receivership and closed in 1928 after 20 years of providing continuous transportation to neighboring towns. It was Meridian's main connection to the area outside the local community. The Union Pacific Railroad spur opened in 1900 and is currently operated by the Boise Valley Railroad. Many industrial customers continue to ship forest, agricultural, and chemical products along this corridor. Creamery (1929–70) The city's official website describes the history of the Ada County Dairymen's cooperative creamery as follows:The lowest days of the Great Depression brightened for area dairymen when the Ada County Dairymen's cooperative creamery began operation in 1929. It provided milk checks to those who were members of the cooperative, enabling them to pay their taxes and provide food for their families. Other community members hauled milk to the creamery and were employed by the creamery, whose product was Challenge Butter. The creamery ran seven days a week for 40 years. Additions and improvements were made while the plant was in full operation. Later years saw the Wyeth Laboratories affiliate with the creamery to manufacture SMA baby formula.

Creamery (1929–70) The city's official website describes the history of the Ada County Dairymen's cooperative creamery as follows:The lowest days of the Great Depression brightened for area dairymen when the Ada County Dairymen's cooperative creamery began operation in 1929. It provided milk checks to those who were members of the cooperative, enabling them to pay their taxes and provide food for their families. Other community members hauled milk to the creamery and were employed by the creamery, whose product was Challenge Butter. The creamery ran seven days a week for 40 years. Additions and improvements were made while the plant was in full operation. Later years saw the Wyeth Laboratories affiliate with the creamery to manufacture SMA baby formula.

105, which by 2025 was estimated to have risen to 275,123, making it the second-most populous county in Idaho. The county seat is Caldwell, and its largest city is Nampa. Canyon County is part of the Boise metropolitan area. History Hudson's Bay Company established Fort Boise in 1834 near what is now Parma, but abandoned it in 1855. Emigrants traveled through Canyon County on the Oregon Trail. Discovery of gold in the Boise Basin in 1862 brought settlement to the region again. The lower Boise River was fully contained within Boise County from 1863 until the formation of Ada County in 1864. Settlement of the lower Boise River west of Boise City was limited prior to the completion of the Oregon Short Line Railroad. Middleton was the first European settlement of Canyon County, starting in 1863. The 1870 Census for Ada County listed 76 residents of the Boise Valley, excluding Boise City and the 1880 Census listed 44 residents at Middleton. The arrival of the railroad at Caldwell led to the establishment of a town there as of August 1883. Businessmen James A. McGee and Alexander Duffes filed the plat for nearby Nampa in 1886. Parma was settled around the same time, with the Old Fort Boise post office being moved to the town's location; it was incorporated in 1904. Ada County established precincts for each of the settlements with a combined 1890 Census population of 2,311. Significant settlement of Greenleaf and Notus started around 1904 with the two settlements listed as precincts at the 1910 census. Notus was incorporated in 1921 while Greenleaf was incorporated prior to 1980. Melba was incorporated in 1912 while Wilder was incorporated in 1919. The City of Star annexed a portion of territory in northeast Canyon County prior to 2007, becoming the county's ninth incorporated city. The majority of Star is located within Ada County. The Idaho Legislature created Canyon County from Ada County in an act approved March 7, 1891, effective at the November 26, 1892, election. Caldwell was established as the county seat. The county originally contained all of Canyon and Payette counties and part of Gem; Gem County formed in 1915 and Payette County in 1917.

History Hudson's Bay Company established Fort Boise in 1834 near what is now Parma, but abandoned it in 1855. Emigrants traveled through Canyon County on the Oregon Trail. Discovery of gold in the Boise Basin in 1862 brought settlement to the region again. The lower Boise River was fully contained within Boise County from 1863 until the formation of Ada County in 1864. Settlement of the lower Boise River west of Boise City was limited prior to the completion of the Oregon Short Line Railroad. Middleton was the first European settlement of Canyon County, starting in 1863. The 1870 Census for Ada County listed 76 residents of the Boise Valley, excluding Boise City and the 1880 Census listed 44 residents at Middleton. The arrival of the railroad at Caldwell led to the establishment of a town there as of August 1883. Businessmen James A. McGee and Alexander Duffes filed the plat for nearby Nampa in 1886. Parma was settled around the same time, with the Old Fort Boise post office being moved to the town's location; it was incorporated in 1904. Ada County established precincts for each of the settlements with a combined 1890 Census population of 2,311. Significant settlement of Greenleaf and Notus started around 1904 with the two settlements listed as precincts at the 1910 census. Notus was incorporated in 1921 while Greenleaf was incorporated prior to 1980. Melba was incorporated in 1912 while Wilder was incorporated in 1919. The City of Star annexed a portion of territory in northeast Canyon County prior to 2007, becoming the county's ninth incorporated city. The majority of Star is located within Ada County. The Idaho Legislature created Canyon County from Ada County in an act approved March 7, 1891, effective at the November 26, 1892, election. Caldwell was established as the county seat. The county originally contained all of Canyon and Payette counties and part of Gem; Gem County formed in 1915 and Payette County in 1917.

2000 census As of the 2000 census, there were 131,441 people, 45,018 households and 33,943 families living in the county. The population density was 223 people per square mile (86 people/km2). There were 47,965 housing units at an average density of 81 units per square mile (31 units/km2). The racial makeup of the county was 83.10% White, 0.32% Black or African American, 0.85% Native American, 0.80% Asian, 0.13% Pacific Islander, 12.17% from other races, and 2.62% from two or more races. Hispanic or Latino of any race were 18.61% of the population. 15.9% were of German, 12.7% English, 10.3% American and 7.6% Irish ancestry. There were 45,018 households, of which 39.80% had children under the age of 18 living with them, 60.70% were married couples living together, 10.10% had a female householder with no husband present, and 24.60% were non-families. 19.80% of all households were made up of individuals, and 8.40% had someone living alone who was 65 years of age or older. The average household size was 2.85 and the average family size was 3.28. 30.90% of the population were under the age of 18, 10.70% from 18 to 24, 28.30% from 25 to 44, 19.10% from 45 to 64, and 11.00% who were 65 years of age or older. The median age was 30 years. For every 100 females, there were 98.70 males. For every 100 females age 18 and over, there were 96.30 males. The median household income was $35,884 and the median family income was $40,377. Males had a median income of $29,418 compared with $22,044 for females. The per capita income for the county was $15,155. About 8.70% of families and 12.00% of the population were below the poverty line, including 14.50% of those under age 18 and 10.70% of those age 65 or over. Communities Cities Unincorporated communities Bowmont Huston Roswell Sunnyslope Walters Ferry, Idaho Politics Like the majority of Idaho, Canyon County is reliably Republican by comfortable margins. The last time a Democratic candidate carried the county was in 1936 by Franklin D. Roosevelt.

Eagle is a city in Ada County, Idaho, ten miles (16 km) northwest of downtown Boise. The population was 30,346 at the 2020 census. History 19th century Eagle Island in Idaho was settled in 1863 by Truman Coe Catlin, who later shifted from crop farming to dairy farming, starting the island's dairy tradition. He also pioneered irrigation in the area by constructing a wide irrigation ditch. The most notable early community developer was Thomas Hugh Aiken, a Canadian surveyor, who helped establish the Eagle community in the 1870s.

Parks and recreation The city features numerous parks, including Arboretum Park, Friendship Park, Heritage Park, Orval Krasen Park, Reid W. Merrill Sr. Community Park, and Stephen C. Guerber Park, among others. The Parks and Recreation department offers youth sports leagues, camps, special events (such as Eagle Fun Days), and maintains extensive trails. Nearby Eagle Island State Park provides a swimming beach, trails, disc golf, and winter sports. Education Most of Eagle is in the West Ada School District, with a small portion in the Boise School District.

20th century The Eagle Fish Hatchery, established in the late 1940s in Idaho, was originally part of a trout program until the 1980s. In 1991, it was restructured to support the conservation of Snake River sockeye salmon, an endangered species listed that year. The hatchery's mission shifted to preserving the species and its genetic diversity through the development of eight broodstocks derived from smolts, anadromous adults, and residual populations.