As noted, the Old CHHA definition was a contiguous area with a western boundary set in relation to a distance from the ocean for evacuation purposes.
The changes to Florida's CHHA delineation also offer an ideal case for application of GIS to evaluate impacts of changes in policy language given: (1) its geographic dimension (i.
GIS was a particularly effective tool for depicting the changes in the geographic expanse of the Old CHHA and New CHHA, and for mapping and analysis of the distribution and characteristics (e.
Knowing that the CHHA regulations were intended to limit development in areas proximate to the Atlantic Ocean or Gulf of Mexico, this key initial finding suggested that the boundary designation may not encompass the intended geography.
This three-mile area allows one to hone in on the impact of changing the CHHA definition because it eliminates areas that may be included in the "new" SLOSH-oriented definition, but would not experience significant surge water rise because of their inland location.
To better illustrate the implications of the new SLOSH-based policy language to hazard vulnerability, in Step 5 we compared the geography covered by New and Old CHHA to a widely accepted benchmark, the National Flood Insurance Program's VE flood zones (i.
The PPS, which is now expected to be implemented by October 1, 2000, will bring some relief to CHHAs as the payments will be specific to the diagnosis and professional disciplines needed rather than a per patient basis.
The cost of the personnel training and computer equipment necessary to begin OASIS data collection has placed even greater economic pressure on CHHAs as very little to no funding has been given to the states to assist individual CHHAs with their financial struggles (HCFA, 1998).
The effects of IPS and PPS will require CHHAs to find ways to assure positive patient outcomes with fewer patient visits.
With the decreased number of reimbursable visits, CHHAs are more likely to deny referrals if it is suspected that patients will require more care than their visit limits allow.