NURS 8100 Week 8: Federal Role in Health Care Policy
A Sample Answer For the Assignment: NURS 8100 Week 8: Federal Role in Health Care Policy
For many years, as advanced as the State of Massachusetts was on many fronts, the profession of nursing was not one of them. Up until January 6, 2021, ARNP’s we had be given temporary (full) practice authority due to the Covid Pandemic. When signed in January 2021, we were the last New England State to give ARNP’s full practice authority, and the 23rd State to pass this regulation across the United States (Health Leaders, 2021).
The Health System I work for is woefully behind adjusting policies and procedures to reflect this new amendment to ARNP’s practice authority within the state. We have a significant need for primary care providers within the Commonwealth and with this change, ARNP’s can practice independently and as primary care providers with their own panel of patients (AANP, 2021, Mass.gov, 2021).
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Up until a few months ago, I had to have the physician I work with listed as my supervising provider. Other policies came to question as they were completely unnecessary. According to the medical groups administrative leadership, primary care panels by APRN’s is in the works, but likely won’t occur system wide for 18-24 months (Personal Communication, April 24, 2022).
There is significant variability across the United States regarding practice Authority. According to AANP (2021), 29* states (*including Guam, Northern Marina Islands and Washington, DC) have full practice authority, 16* states (*including American Samoa, Puerto Rico and US Virgin Islands) have reduced practice authority and 11 have restricted practice authority (Nurse Journal, 2022.
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Full practice authority is defined as an NP practicing to the full scope of licensure without a supervising physician. Reduced practice authority means NP’s can perform parts of their scope independently and parts with supervision. Rarely does this include diagnostic testing and diagnosis and treatment but more often medication oversight. Restricted practice authority states require NP’s to work solely under the supervision of a physician (AANP, 2021, Nurse Journal, 2022).
Professional nurses, regardless of area of practice, have demonstrated competencies to be able to practice in a full scope capacity without supervision. By minimizing scope across the United States, we are ultimately denying access to healthcare by a qualified provider (AANP, 2021). Most advanced practice nurses, especially if they have Doctorate level education, have more years of school and clinical than that of their physician colleagues (Nurse Journal, 2022). Lack of recognition and utilization of our extensive capabilities, may undermine the professions’ ability for growth and respect.
References
American Academy of Nurse Practitioners (AANP). (2021). Information and resources for Massachusetts NPs. https://www.aanp.org/advocacy/massachusetts
Health Leaders (2021). Massachusetts is the 23rd state to allow NPs to practice independently. https://www.healthleadersmedia.com/nursing/nurse-practitioners-massachusetts-granted-full-practice-authority
Mass.gov. (2022). 244 CMR 4.00: Advanced practice registered nursing. https://www.mass.gov/doc/244-cmr-4-advanced-practice-registered-nursing/download
Nurse Journal. (2022). Nurse practitioner practice authority: A state-by-state guide. https://nursejournal.org/nurse-practitioner/np-practice-authority-by-state/
Federalism’s Impact on Policy
The fragmentation of the U.S. health care system, with its differing modes of financing and service delivery, is a reflection of a dispersed government structure. Policy making is shared and distributed across various branches and levels of government. As a result, policy making processes can be slow to respond, manipulated towards personal interests, and often redundant.
Consider, for example, the public entitlement programs such as Medicaid, Medicare, the State Children’s Health Insurance Program (SCHIPS), and the PPACA of 2010. Where is there overlap between these policies? How do they demonstrate a dispersed government structure?
This week, you will analyze the role of the federal government in health care policy making.
To prepare:
- Review this week’s Learning Resources focusing on the France article and the textbook readings.
- Identify two nursing or health care policies that address similar needs, one passed at the federal level and the other at another level of government (state or local).
By Day 3
Post a cohesive response that addresses the following:
- Provide an example of two policies that address similar needs, passed at two levels of government (i.e., federal, state, or local).
- What are the advantages and/or disadvantages of this duplication? How does this example reflect the implications of federalism? Provide support from the literature for your position.
- To what degree should the federal government get involved in health care policy making? Provide concrete examples to support your position.
Read a selection of your colleagues’ postings.
By Day 6
Respond to at least two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
NURS 8100 Week 8: Federal Role in Health Care Policy
How does the organization and structure of government, including the existence of multiple levels (federal, state, local), promote or hamper effective policy making and implementation? What role does the federal government, in particular, play in the development of policies that affect nursing practice in today’s health care organizations? This week, you will examine how federalism has influenced the current health care system. You will consider the positive, or negative, implications of redundancy in health policy resulting from different levels of government.
Learning Objectives
Students will:
- Assess the implications of federalism in health care policy making
- Analyze the politics and issues surrounding a current health care policy
Photo Credit: [Anuska Sampedro]/[Moment]/Getty Images
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.
- Chapter 15, “Health Care Reform and National Health Insurance”
Chapter 15 discusses the history of legislating national health care insurance in the United States. The chapter focuses on the different methods of financing a national health care reform, from a single-payer government fund to employer and individual mandates.
- Chapter 16, “Conflict and Change in America’s Health Care System”
Chapter 16 highlights the historical relationships between health care purchasers, insurers, providers, and suppliers. Over the decades, these stakeholders have battled for control of the U. S. health care system, as health care costs increase and more people remain uninsured.
France, C. (2008). The form and context of federalism: Meaning for health care financing. Journal of Health Politics, Policy & Law, 33(4), 649–705. doi: 10.1215/03616878-2008-012
Note: You will access this article from the Walden Library databases.
The author argues that the United States’ unique form of federalism works negatively within a fragmented societal context to create an equally fragmented and dispersed health care system. The article highlights the United States health care system by comparing it with systems in Canada, Germany, and Australia.
Frankel, M. S. (2009). Commentary: Public outreach by the FDA: Evaluating oversight of human drugs and medical devices. Journal of Law, Medicine & Ethics, 37(4), 625–628.
Note: You will access this article from the Walden Library databases.
Kennedy, E. M. (2005). The role of the federal government in eliminating health disparities. Health Affairs, 24(2), 425–428.
Note: You will access this article from the Walden Library databases.
In this article, the late Senator Kennedy discusses health care disparities among marginalized groups in the United States. He proposes the expansion of Medicaid and State Children’s Health Insurance Program (SCHIP), increased cultural competency among health care providers, health care research related to marginalized groups, and an increased public health investment by the United States. He includes a brief history of government involvement in reducing health care disparities.
Assignment 1: Issues in Health Care Reform (Interview)
Continue to work on this Assignment, assigned in Week 2 and due in Week 9.
By Day 7 of Week 9
Submit this Assignment.
Assignment 3: Policy Analysis Paper
[Major Assessment 2]
Continue to work on this Assignment, assigned in Week 4 and due in Week 11. Analyze the politics and issues surrounding your selected health care policy. This information should be included in Part 1 of your analysis paper.
By Day 7 of Week 11
Submit this Assignment.
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
| Excellent | Good | Fair | Poor | |
|---|---|---|---|---|
| RESPONSIVENESS TO DISCUSSION QUESTION
Discussion post minimum requirements: *The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct. |
8 (26.67%) – 8 (26.67%)
Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.
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7 (23.33%) – 7 (23.33%)
Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.
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6 (20%) – 6 (20%)
Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.
|
0 (0%) – 5 (16.67%)
Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.
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| CONTENT KNOWLEDGE |
8 (26.67%) – 8 (26.67%)
Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.
|
7 (23.33%) – 7 (23.33%)
Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.
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6 (20%) – 6 (20%)
Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course
|
0 (0%) – 5 (16.67%)
Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.
|
| CONTRIBUTION TO THE DISCUSSION |
8 (26.67%) – 8 (26.67%)
Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.
|
7 (23.33%) – 7 (23.33%)
Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature
|
6 (20%) – 6 (20%)
Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.
|
0 (0%) – 5 (16.67%)
Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas
|
| QUALITY OF WRITING |
6 (20%) – 6 (20%)
Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.
|
5 (16.67%) – 5 (16.67%)
Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.
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4 (13.33%) – 4 (13.33%)
Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.
|
0 (0%) – 3 (10%)
Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.
|
| Total Points: 30 |
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Week 8: Federal Role in Health Care Policy
How does the organization and structure of government, including the existence of multiple levels (federal, state, local), promote or hamper effective policy making and implementation? What role does the federal government, in particular, play in the development of policies that affect nursing practice in today’s health care organizations? This we