Achieving Universal Health Coverage Discussion

RESPOND to 2 students’ Discussions Evidence Base in Design When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety. In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy. To Prepare: • • • Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy. Review the health policy you identified and reflect on the background and development of this health policy. Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. One page long to each discussion student 1 CB, and student 2 AA. See below for the 2 discussions that you will respond. Student 1 CB discussion Mental Health Access Mental health access through the emergency department is a problem throughout the United States. Many people with acute mental health issues seek care through the emergency department simply because they have no other options for immediate help. The proposed bill H.R. 2519, addresses the problem of EDs not having enough resources to manage and treat patients with acute mental health episodes affectively. This bill would provide funding to aid in additional inpatient psychiatric beds, crisis clinics, and emergency psychiatric units for mental health patients with an acute episode. (Actions – H.R.2519 – 116th Congress (20192020): Improving Mental Health Access from the Emergency Department Act of 2020, n.d.). The issue remains that people come into the ED for suicidal or homicidal ideation, and we have no inpatient psych beds available to get them the help they desperately need. I have personally witnessed having to hold a suicidal patient in the ED for over 24 hours until either a bed becomes available, or released back on the street, only because we do not have the resources necessary to accommodate them. I believe there is significant evidence to support this policy and the need for increased resources for mental health patients. Acute mental health patients are seeking emergency care at an alarming rate. One in eight patients in the emergency department seeks help for acute mental health issues or substance abuse. (Laderman et al., 2018). This number continues to grow despite the lack of resources emergency departments have to hand out. Lack of resources for these patients also results in increased wait times and delays in emergency care that they need. Mental health patients simply do not get the treatment they require by sitting in the emergency department for hours or even days. (PR Newswire, 2017). Acute mental health issues are a growing concern in emergency departments across the U.S., and something needs to be done. Achieving Universal Health Coverage Discussion

References Actions – h.r.2519 – 116th congress (2019-2020): Improving mental health access from the emergency department act of 2020. (n.d.). Congress.gov. Retrieved October 12, 2020, from https://www.congress.gov/bill/116th-congress/housebill/2519/actions Laderman, M., Dasgupta, A., Henderson, R., & Waghray, A. (2018, January 26). Tackling the mental health crisis in emergency departments: Look upstream for solutions. healthaffairs.org. Retrieved October 12, 2020, from https://www.healthaffairs.org/do/10.1377/hblog20180123.22248/full/ PR Newswire. (2017). Waits for care and hospital beds growing dramatically for psychiatric emergency patients. PR Newswire US. Student 2 AA Discussion S.4210-115th Congress (2019-2020) desires for the Department of Homeland Security to transfer personal protective equipment or medically necessary equipment to the Department of Health and Human Services (HHS) during a declared public health emergency. These transfers must be made at the request of HHS and on a reimbursable basis (Congress.Gov., 2020). Achieving Universal Health Coverage Discussion

The proposer of this bill was Senator Ron Johnson, Republican party for Wisconsin 112th116th (2011-present) (Congress.Gov, n.d.). Before the equipment would be able to be requested, the Secretary of Health and Human Services would need to determine whether the personal protection equipment or medically necessary equipment would be available. The Secretary will also determine whether the personal protection equipment requested is excess equipment (Govtrack, 2020). Association of State and Territorial Health Officials (2020), explains that the “Public Health Service Act (PHSA) provides the legal authority for the Department of Health and Human Services (HHS), among other things, to respond to public health emergencies”. The act authorizes the HHS secretary to guide federal public health as well as medical response to public health emergencies, determine if a public health emergency exists, and assists in states during their response activities. Seeing the responsibility HHS has in public health emergencies, it would be critical for them to have on hand the supplies needed for any type of declared emergency. This bill would address this critical need and heed the call of obtaining the equipment needed. Hospitals discussed how there were many challenges with obtaining personal protective equipment (PPE), testing, staffing, supplies and durable equipment, during our recent public health crisis of COVID-19 (U.S. Department of Health and Human Services, 2020). This is an example of where we need to support and have the assistance of all federal entities. The above proposed bill would be a resource much needed when public disasters occur. Refer ences Association of State and Territorial Health Officials. (2020). Public Health Service Act, Section 319 Public Health Emergencies. Retrieved from https://www.astho.org/Programs/Preparedness/Public-Health-EmergencyLaw/Emergency-Authority-and-Immunity-Toolkit/Public-Health-Service-Act,-Section319-Fact-Sheet/ Congress.Gov. (2020). S.4210 – SHARE Act of 2020. Retrieved from https://www.congress.gov/bill/116th-congress/senate- bill/4210?q=%7B%22search%22%3A%5B%22S.+4210%3A+SHARE+Act+of+2020%22%5D %7D&s=4&r=1 Congress.Gov. (n.d.). Senator Ron Johnson. Retrieved from Achieving Universal Health Coverage Discussion https://www.congress.gov/member/ronjohnson/J000293?q={%22search%22:[%22S.+4210:+SHARE+Act+of+2020%22]}&r=1&searchResultVi ewType=expanded Govtrack. (2020). S. 4210: SHARE Act of 2020. Retrieved from https://www.govtrack.us/congress/bills/116/s4210/text U.S. Department of Health and Human Services. (2020). Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23–27, 2020. Retrieved from https://www.oig.hhs.gov/oei/reports/oei-06-20-00300.pdf 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 Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning. • Chapter 5, “Public Policy Design” (pp. 87–95 only) • Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146) • Chapter 9, “Interprofessional Practice” (pp. 152–160 only) Achieving Universal Health Coverage Discussion

• Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only) American Nurses Association (ANA). (n.d.). Advocacy. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advocacy/ Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementation. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a.pdf Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/ Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementation. Academy of Management Review, 21(4), 1055–1080. doi:10.5465/AMR.1996.9704071863 Note: You will access this article from the Walden Library databases. Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patient. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017. doi:10.1111/jep.12350 Note: You will access this article from the Walden Library databases. Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretion. Public Management Review, 16(4), 527–547. doi:10.1080/14719037.2013.841978. Note: You will access this article from the Walden Library databases. Rubric Detail Select Grid View or List View to change the rubric’s layout. Name: NURS_6050_Module04_Week07_Discussion_Rubric First Response 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Achieving Universal Health Coverage Discussion

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Response is effectively written in standard, edited English. Second Response 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Response is effectively written in standard, edited English. …Achieving Universal Health Coverage Discussion