What are the important policy decisions?
It follows that the important policy decisions are to determine how far it is practicable and wise to delegate both responsibility and funds to provincial, district and local bodies, including local community groups.
How do you implement a change of policy?
It requires a policy decision in favour of following that route, then that decision to be put into effect, with the necessary reorientation of activities and approaches. Implementation will need to include providing staff with the appropriate training and incentives.
How can the federal government change healthcare policy?
A number of routes could be taken that could impact federal healthcare policy. Primarily, healthcare laws can be changed by the legislative process, through which Congress passes a law and the president signs it. In this way, the federal government could, for example, alter some of the provisions of the Affordable Care Act or repeal it entirely.
What is an example of command and control policy?
These policies utilize: (i) command and control (effected, for example, by prohibiting or limiting certain resource uses or establishing limits on emissions, with penalties for non-compliance); (ii) economic incentives such as taxes and subsidies; and (iii) persuasive measures such as education and advertising.
How does policy affect healthcare?
Healthcare policy is important because it helps establish guidelines that benefit patients, healthcare organizations, and our healthcare system. Having protocols in place can help prevent human error and poor communication around medical decisions.
What are examples of health care policies?
Examples of health-related policies include:Policies prohibiting tobacco and alcohol use at the workplace.Policies requiring healthy foods to be served at company meetings and events.Policies allowing for flextime to exercise or attend health programs.
How does healthcare policy impact the nursing profession?
Through policy work, nurses can and should influence practice standards and processes to assure quality of care. Nurses who influence policy help shape the care that will be provided today and tomorrow. Policies also impact resource allocation to support delivery of healthcare.
What methods can nurses use to actively influence health policies and legislation?
Locally, nurses can become politically active by assuming leadership positions in the healthcare system or contacting elected officials about legislation affecting the industry. Nurses can obtain formal training in politics, become involved in city councils and committees, or even run for local office.
What are health policy policies?
What Is Health Policy? Health policy is legislation or other government action that deals with the influences that help, or interfere with, reaching health goals on a public level. Examples of health policies include Social Security regulations, labor policy, immigration laws, and standards related to national defense.
What is the main purpose of a health policy?
Goal: Use health policy to prevent disease and improve health. Health policy can have a major impact on health and well-being. Healthy People 2030 focuses on keeping people safe and healthy through laws and policies at the local, state, territorial, and federal level.
Why are policies important in health and social care?
Agreed policies and procedures provide a framework in which decisions can be made. They help us to standardise clinical practice, test and improve our services, and achieve greater understanding and co-operation among our staff.
Why are policies and procedures important in nursing?
Policies and procedures for hospitals help hold employees accountable for following the right steps when caring for patients. They standardize practices across the organization and ensure that every patient receives the same level of care. Standardized practices across the hospital keep patients safe.
What is health care policy in nursing?
Health policy is best understood as a set of overarching principles and goals that dictate how care is delivered and accessed. Health care policy can be codified at a national or state level, and then more finely honed in a hospital or clinical environment.
How are nurses active in policy making?
Different factors affect nurses' ability to be active in health policy development including gaining experience in policy development process, gaining knowledge on health systems, policy research and developing leadership skills [1, 16].
How do government policies affect coordination of care?
The Affordable Care Act (ACA) policy is an example of a government policy that is implemented to promote the coordination of care. Also, Medicare and Medicaid reforms are useful to encourage the success of the healthcare system. The reforms are crucial to elevate patients' safety and improve the nursing practice.
How will understanding health policy improve your professional practice?
With in-depth knowledge of healthcare policy, you can better understand the administrative side of your field. Your employer will value your ability to implement prevention strategies and interventions.
Why should medical groups recognize the avoidance of real or perceived legal and financial risk in providing home visit care to patients?
In particular, the medical group should recognize that the avoidance of real or perceived legal and financial risk in providing home visit care to patients may compromise individual patient-doctor relationships and induce physicians to consider less ideal or ethically defensible treatment options.
Why did the clinic temporarily suspend home visits?
Why did the clinic temporarily suspend home visits? Perhaps the clinical administration sought to protect patients from further clinical boundary violations by physicians. If it is to serve the highest number of patients—a utilitarian argument—the clinic must not put its malpractice coverage or sustainability at risk. Assuming that the practice group’s policy change was not legally mandated, the policy was most likely developed to mitigate risk. In this case, the ongoing threat of lawsuits against the medical group’s clinicians, frivolous or otherwise, has shifted the usual way some patients receive care. Ongoing legal proceedings, judicial mandates, recommendations from legal counsel, and pressure from malpractice insurance providers may each restrict the clinicians’ options. This organizational decision seems unduly restrictive and cautious, given the likelihood that certain patients need the home-based care that they receive and may be harmed by the policy.
Can psychiatrists see patients in the office?
In the interim, the clinic psychiatrists were advised to see patients in the office or link them to emergency services if an office visit was not possible. All of the practice’s clients received notices, and verbal and written consent were obtained to ensure that they understood the temporary change in the policy.
Is it ethical to make a home visit to a patient?
Making a home visit to the patient may be ethically sound but is in conflict with a utilitarian view of justice toward the other patients served by Dr. Rekai, due to her medical group’s policy prohibiting home visits.
What is the definition of treatment in healthcare?
The core health care activities of “Treatment,” “Payment,” and “Health Care Operations” are defined in the Privacy Rule at 45 CFR 164.501. “Treatment” generally means the provision, coordination, or management of health care and related services among health care providers or by a health care provider with a third party , ...
What is the importance of access to treatment and efficient payment for health care?
Ready access to treatment and efficient payment for health care, both of which require use and disclosure of protected health information, are essential to the effective operation of the health care system. In addition, certain health care operations—such as administrative, financial, legal, and quality improvement activities—conducted by or ...
What is a covered entity's notice of privacy practices?
A covered entity is required to provide the individual with adequate notice of its privacy practices, including the uses or disclosures the covered entity may make of the individual’s information and the individual’s rights with respect to that information.
What is the right to request privacy protection?
Individuals have the right to request restrictions on how a covered entity will use and disclose protected health information about them for treatment, payment, and health care operations. A covered entity is not required to agree to an individual’s request for a restriction, ...
What is the minimum necessary requirement for a covered entity?
A covered entity must develop policies and procedures that reasonably limit its disclosures of, and requests for, protected health information for payment and health care operations to the minimum necessary . A covered entity also is required to develop role-based access policies and procedures that limit which members of its workforce may have access to protected health information for treatment, payment, and health care operations, based on those who need access to the information to do their jobs. However, covered entities are not required to apply the minimum necessary standard to disclosures to or requests by a health care provider for treatment purposes.
What is consent in healthcare?
A covered entity that chooses to have a consent process has complete discretion under the Privacy Rule to design a process that works best for its business and consumers. A “consent” document is not a valid permission to use or disclose protected health information for a purpose that requires an “authorization” under the Privacy Rule (see 45 CFR 164.508), or where other requirements or conditions exist under the Rule for the use or disclosure of protected health information. Right to Request Privacy Protection.
What is the HIPAA Privacy Rule?
The HIPAA Privacy Rule establishes a foundation of Federal protection for personal health information, carefully balanced to avoid creating unnecessary barriers to the delivery of quality health care. As such, the Rule generally prohibits a covered entity from using or disclosing protected health information unless authorized by patients, except where this prohibition would result in unnecessary interference with access to quality health care or with certain other important public benefits or national priorities. Ready access to treatment and efficient payment for health care, both of which require use and disclosure of protected health information, are essential to the effective operation of the health care system. In addition, certain health care operations—such as administrative, financial, legal, and quality improvement activities—conducted by or for health care providers and health plans, are essential to support treatment and payment. Many individuals expect that their health information will be used and disclosed as necessary to treat them, bill for treatment, and, to some extent, operate the covered entity’s health care business. To avoid interfering with an individual’s access to quality health care or the efficient payment for such health care, the Privacy Rule permits a covered entity to use and disclose protected health information, with certain limits and protections, for treatment, payment, and health care operations activities.
How do drug treatment agencies maintain financial solvency?
To maintain financial solvency in this new era of policy and funding shifts, alcohol and drug treatment agencies must forgo their traditional independence and focus on building collaborative partnerships to meet their clients' needs. Substance abuse treatment must become an integral component of a community-based, collaborative network of services, including welfare, primary health care, mental health, vocational, and family support services. Some of the public funding sources that treatment providers and their community partners can use to support the range of services that clients with substance abuse disorders need were described above. The potential of managed care contracts as a funding source was also discussed.
What is the role of a provider in substance abuse treatment?
Providers must clarify their mission, understand their clients' needs, develop a client-centered focus, and become full partners in a collaborative service network that endeavors to meet the multiple needs of clients recovering from substance abuse disorder. This represents nothing less than a transformation of the substance abuse treatment field.
What funding sources are available for substance abuse treatment?
Public substance abuse treatment programs have traditionally relied on three funding streams: Federal substance abuse block grants, Medicaid reimbursement, and State general funds. These traditional funding sources have now been joined by new potential funding sources at both the Federal and State levels. Most of these provide funding for substance abuse treatment within the context of other services such as job training, child protective services, or criminal justice.
What is Title IV funding?
Title IV funds represent a large, open-ended potential funding source for substance abuse treatment for women who are involved in the child welfare system, an underserved population. Women with children may be unlikely to enter residential treatment if the facility cannot accommodate their children, if adequate child care is not available, or if doing so means giving up their children to foster care (Strawn, 1997). For more information on child abuse and neglect issues and substance abuse treatment, see the TIP, Substance Abuse Treatment for Persons with Child Abuse and Neglect Issues ( CSAT, 2000a ).
What services are eligible for funding?
Services eligible for funding include substance abuse prevention, intervention, referral, and treatment as well as job training (aime d at assisting prevention efforts), and security improvements in public housing complexes. Funds are channeled to local public housing authorities, which contract with service providers.
What is Title IV?
Title IV of the Social Security Act (42 U.S.C. §1862) provides funding for foster care and services to prevent child abuse and neglect. Eligible services include substance abuse treatment for parents who are ordered by a court to obtain treatment and are at risk of losing custody of their children, and child care while a parent is in residential treatment. The estimated overlap between clients of child protective services agencies and parents with a substance abuse disorder is 60 to 80 percent (National Center on Addiction and Substance Abuse at Columbia University [CASA], 1999; Young et al., 1998 ). Title IV funds are usually administered by State social services departments.
Is evidence of effectiveness a prerequisite for continued funding?
There has been a trend in recent years toward demanding greater accountability by all kinds of publicly funded programs, including substance abuse treatment programs. Evidence of effectiveness is frequently a prerequisite for continued funding. Federal agencies such as the Department of Health and Human Services (DHHS) are known to be interested in offering more grants that are linked to performance.
What are some policies that target the poor?
Policies can also be adopted that specifically target the poor, such as famine relief programs, food for work schemes, or provision of free or subsidized services. Most industrialized countries have extensive social welfare programs in place to help the disadvantaged, such as the sick, the old or the unemployed. Because such programs are very expensive, in most less developed countries they are of much more limited scope, or are even totally absent.
What are fiscal policies?
Fiscal policies include government expenditure, taxes and subsidies. Direct impacts on SARD arise from expenditure on such things as agricultural research and extension, and public works in rural areas. Taxes, on the other hand, may be targeted to help regulate resource use, such as resource rent taxes or taxes on polluters. Some specific examples of targeted expenditures and taxes are discussed under later sub-headings.
Why is taxation important?
The importance of taxation in affecting incentives to use resources in a more or less sustainable way has been discussed in 6.1.1 above. A second consideration in setting taxes, however, relates to the distribution of income and wealth. Taxing the rich and stripping them of some of their assets to meet the needs of the poor of this generation, or to invest for the benefit of poor people in the future, can obviously be one way of attaining the goal of sustainable development. Unfortunately, it is seldom politically feasible on any substantial scale! However, where wealth or income comes from economic rents that result from public investments, such as increased value or productivity of land due to public infrastructure construction, it may be more acceptable to tax away at least a part of those gains.
How can improved technology contribute to SARD?
The contribution of improved technology to SARD has already been emphasized. Policy issues relate to how the development of such improved and sustainable technologies is to be encouraged. At issue in the public sector will be the level of funding for agricultural research and the allocation of those funds between research organizations, commodities, disciplines and projects. The merits of a farming systems approach versus a more traditional disciplinary division of activity needs to be examined. Whatever approach is taken, mechanisms for setting research priorities that are relevant and responsive to the needs and circumstances of rural producers need to be in place. The research done also needs to be reviewed regularly to ensure that funds are being used wisely and well, and that progress towards the intended goals is being attained.
How does rural infrastructure improve SARD?
Rural infrastructure improvements contribute to SARD by improving the availability of services or other facilities that enhance the productivity of private rural capital. A tarmac road that lowers travel time and reduces vehicle running costs, also lowers the costs of marketing agricultural produce and reduces the delivered cost of farm and household requisites. Similarly, an irrigation system raises the productivity of farmland while a telephone system lowers transaction costs in agricultural marketing and improves efficiency by giving producers better access to price information.
Why is investment policy important?
Given that the goal of sustainability policy is to transfer the equivalent of the current resource base to the next generation, investment policy is obviously crucial. In part, this is a matter of creating an environment that is 'friendly' towards private investors. Too many barriers for the entry of foreign investors will deter the international flow of capital, as will too strict rules on the repatriation of profits. Similarly, both economic instability and social unrest will deter all investors, foreign or local.
Do wage policies affect SARD?
In many less developed countries, the proportion of the labour force in such employment is small, so that wage policies have limited impact on either overall wage levels or SARD. (The same may not be true for the industrialized countries.) However, wage policies may affect the allocation of labour between sectors. Moreover, if large differentials between urban and rural wages result, they may lead to an unwanted acceleration of rural-urban migration, with concomitant problems of urban congestion and pollution.
Why is randomized experimental design considered the gold standard for conducting an impact evaluation?
randomized experimental design is sometimes considered the gold standard for conducting an impact evaluation because it produces the strongest evidence that a project, program, or policy contributed to changes in behavior or other outcomes. 3,4,5 However, when you are evaluating the impact of a policy on a population, randomization may be unethical or impossible, not to mention costly or time-consuming. Quasi-experimental designs can be used to evaluate changes in indicators over time or compared to a group not affected by the policy. Refer to Appendix O for further description of these methods. 6
When to use non-experimental design?
When the evaluation question focuses on identifying changes in the indicators, regardless of whether or not the changes were necessarily a result of the policy itself , the team can use non-experimental or descriptive designs. However, be sure to represent accurately what the results of this analysis demonstrate. Non-experimental designs are unable to clearly link the impacts to the policy because they are unable to rule out alternative explanations for the impacts.1 These types of designs are most appropriate when it is impossible or impractical to compare changes over time or to use a comparison group. Two potential non-experimental designs for impact evaluation are cross-sectional and case study.2
How does healthcare policy change?
In this way, the federal government could, for example, alter some of the provisions of the Affordable Care Act or repeal it entirely. Another way healthcare policy could be changed is through the regulatory process, whereby federal agencies write rules for how laws are implemented . Healthcare could also be impacted by administrative action. For example, Republican administration may be more likely to approve state proposals to expand Medicaid using an alternative method that the Obama administration had rejected. Finally, healthcare could be impacted through the court system via lawsuits. For instance, the federal government could withdraw its appeal in House v. Burwell, which would end reimbursements to insurers for reducing costs for low-income consumers.
What is healthcare policy?
Healthcare policy involves the creation and implementation of laws, rules, and regulations for managing nation's healthcare system. The healthcare system consists of services provided by medical professionals to diagnose, treat, and prevent mental and physical illness and injury.
What is the difference between acute care and long term care?
Acute care services are those that are typically provided within a short time frame, such as inpatient hospital stays, lab tests and prescription drugs. Long-term care services, on the other hand, are those provided over a long period of time, such as home care and mental health treatment. Disproportionate Share Hospital (DSH) payments are funds given to hospitals that tend to serve more low-income and uninsured patients than other hospitals. In 2013, most Medicaid spending was, on average, toward acute care services. The portion of spending for DSH payments was 4.1 percent, and the remaining 29.5 percent was on long-term care services. For added context, these figures are compared below with those in Massachusetts and Utah, the states with the highest and lowest levels of total healthcare spending per capita, respectively.
What is the dominant source of health insurance?
In general, employers have been the dominant source of health insurance for individuals since the late 1940s and 1950s. This can be at least partially attributed to the income tax exemption granted to employers for payments made toward health insurance for employees. The second major sources of health insurance are the state and federal governments, which jointly provide Medicaid for low-income individuals while the federal government sponsors Medicare for the elderly and disabled.
What was the role of the federal government in the healthcare industry?
In that time, the National Institutes of Health and the Centers for Disease Control, the Food and Drug Administration, and the Department of Health and Human Services were established. Toward the ends of expanding insurance coverage and controlling costs, the federal government also enacted a number of pieces of legislation during the second half of the century:
How does economic health affect health care?
The economic health of a state can significantly affect its healthcare costs, insurance coverage, access to care, and citizens' physical and mental health. For instance, during economic downturns, employers may reduce insurance coverage for employees, while those who are laid off may lose coverage altogether.
How does the manner in which states manage prison health care services affect inmates?
The manner in which states manage prison health care services that meet these legal requirements affects not only inmates' health , but also the public's health and safety and taxpayers' total corrections bill.
Case
Commentary
- Dr. Rekai’s available options for a plan of care are intertwined with external arrangements that force her to consider factors outside of the patient-doctor relationship. Without necessarily intending to do so, a clinical practice’s policies may oppose the ethical standards of individual clinicians’ practice of medicine. These ethical standards may be dictated by oaths or codes cent…
Treating The Patient While Abiding by The Policy
- Assess risk of harm. One of Dr. Rekai’s first challenges concerns assessing her patient by telephone for risk of suicide and of harm to others. Although a single systematic and predictive suicidality assessment method has not been endorsed at this time, a form of systematic assessment protocol is now commonplace in most psychiatric practices. Evidence-based risk fa…
Recommendations For The Practice
- Why did the clinic temporarily suspend home visits? Perhaps the clinical administration sought to protect patients from further clinical boundary violations by physicians. If it is to serve the highest number of patients—a utilitarian argument—the clinic must not put its malpractice coverage or sustainability at risk. Assuming that the practice group’s policy change was not legally mandate…