NURS 6050 Evidence Base in Design
NURS 6050 Evidence Base in Design
The health policy selected is the Health Equity and Accountability Act (HEAA) of 2020. A brief background about this act is (congress.gov, 2020) “this bill directs the Department of health, and human services (DHHS) and others to undertake efforts to reduce disparities”. These are disparities that exist particularly in health care.
It has been reported since 2007, HEAA has been introduced by Congressional Tri-Caucus, comprised of the Congressional Asian Pacific American Caucus (CAPAC), the Congressional Black Caucus (CBC), and the Congressional Hispanic Caucus (CHC).
The development of HEAA builds on the gains made under the Affordable Care Act (ACA) and lays out a vision of additional investments Congress should make to respond to the policy threats against the health and well-being of the underserved communities, address health disparities and ensure access to quality, affordable health care for all.
In (The health equity and accountability act, n.d.) “Over 300 racial, and health equity organizations, researchers, provider groups, and community-based organizations have contributed to the development of HEAA since its inception”.
I believe there is evidence to support the proposed policy because being a woman of color working in the behavioral health emergency department within a large metropolitan health system, and as a board certified psychiatric, and mental health registered nurse, I have experienced the disparities when providing care to people of color, health care professionals are often dismissive, and or mental health patients are provided less resources than white people. Therefore, the proposed HEAA is needed to overturn systemic disparities in mental health care.
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Supporters of HEAA point to statistics that demonstrate the current lack of health equity. HEAA specifically addresses multiple issues such as (Walden University, 2021) “culturally, and linguistically appropriate care, health workforce diversity, and mental health” to mention a few.
For instance, expanding mental, and behavioral services targeting low-income, communities of color because “mental health research has found that while mental health illness is more or less equally prevalent in all groups, members of minority groups enter treatment later and have worse outcomes” (Walden University, 2021). This policy affects me personally and professionally and as a result I am a strong supporter of the health equity and accountability act.
The Health Equity and accountability act – unidosus.org. (n.d.). Retrieved January 9, 2022, from https://www.unidosus.org/wp-content/uploads/2021/07/unidosus_heaafactsheet_10819.pdf
H.R.6637 – 116th Congress (2019-2020): Health Equity and … (n.d.). Retrieved January 9, 2022, from https://www.congress.gov/bill/116th-congress/house-bill/6637
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide. Jones & Bartlett Learning.
Walden University. (2021, November 4). The-facts-behind-the-health-equity-and-accountability-act-HEAA. Walden University. Retrieved January 9, 2022, from https://www.waldenu.edu/online-doctoral-programs/phd-in-public-health/resource/the-facts-behind-the-health-equity-and-accountability-act-heaa
This legislation caught my eye and it is unfortunate that we still have to deal with so much disparities at this time. The COVID-19 pandemic has not only exposed the glaring and ever-present structural racism in the United States, but it has also exposed racial/ethnic tensions, resulting to national protests for racial and social justice (Norris & Gonzalez, 2020).
The Health Equity and Accountability Act (HEEA) provides an opportunity to address this long-persisting disparities that have hindered progress towards achieving this goal of Health Equity. Looking at the provisions, this should correct deficiencies in data collection and reporting, advocate for culturally appropriate health care, improve health workforce diversity, improve health care access, address mental health and take many more actions to improve health equity (Congress.gov, n.d.).
In addition, according to Keith & Gonzalez (2020), while working on structural inequalities, it is important to improve people’s living and working environments so that they can reach their maximum potential. The United States is known for diversity but serious structural inequalities persist which has been more exposed with the current health situation in the country
Congress.gov. (n.d) retrieved on 1/11/2022 from https://www.congress.gov/bill/116th-congress/house-bill/8200/text
Keith Norris, & Cynthia Gonzalez. (2020). COVID-19, health disparities and the US election. EClinicalMedicine, 28(100617-). https://doi.org/10.1016/j.eclinm.2020.100617
Thank you for talking about this as a discussion. I also work at what the world considers a top 5 hospital in the Nation which is also located in the inner city. I have witnessed disparities in the health care of people of color. And as you stated “health care professionals are dismissive” to care of people of color. I have also witnessed social work rounding groups offer fewer resources made available to people of color vs other cultural groups. Often, I do have to advocate for people of color and other minority groups to help connect the lines of education if there are health care disparities involved. The Henrietta Lacks Enhancing Cancer Research Act is also a bill in which I support and feel there is evidence to support this act. The family of Henrietta Lacks is still fighting presently for compensation due to the family for which the family feel samples were used without permission of the patient. This bill requires the Government Accountability Office to complete a study reviewing how federal agencies address barriers to participation in federally funded cancer clinical trials by individuals from underrepresented populations and provide recommendations for addressing such barriers. Here is a link below to the bill.
Congress. Gov (n.d.). Henrietta Lacks Enhancing Cancer Research Act.
It is very unfortunate that even with the current advancements in healthcare that disparities in health status still exist. I support the Health Equity and Accountability act. Particularly the expansion of mental health services. There is a degree of distrust in the medical community amongst African Americans partially due to historical reasons. A study done at the George Warren Brown School of Social Work suggested that 56-74% of African American men who have experienced trauma have an unmet need for mental health services. (Motley & Banks, 2018). This shows the need for expansion of mental health services. The HEAA also coincides with the president’s agenda to “reduce health disparities in all healthcare programs” and “Provide additional funding to expand access to culturally competent care.” (Building Back Better, 2021). The current administration recognizes a need to decrease disparities amongst impoverished communities, and I support it.
Building back better [PDF]. (2021). https://www.govinfo.gov/content/pkg/BUDGET-2022-BUD/pdf/BUDGET-2022-BUD-3.pdf Motley, R., & Banks, A. (2018). Black males, trauma, and mental health service use: a systematic review. Perspectives on social work : the journal of the doctoral students of the University of Houston Graduate School of Social Work, 14(1), 4–
Quality and affordable healthcare is a major concern for all Americans. Healthcare is a multifaceted issue involving cost, accessibility, safety and quality. Even though many healthcare bills are introduced into the U.S Congress, few receive the necessary support required to enact them into law. One of the pending healthcare bills in Congress is the Lower Health Care Costs Act of 2019. Senators Lamar Alexander and Patty Murray sponsored this bill. If enacted, it will lower healthcare costs. This bill aims to make changes related to healthcare costs, services and coverage. It will require health insurance providers to make certain information such as out-of-pocket spending accessible to beneficiaries through technology such as mobile applications, among other provisions to reduce healthcare costs (Congress.gov, 2019).
This bill will aim to reduce out of pocket spending. This bill will eliminate surprise medical bills. Out-of-network charges expose patients to medical bills that they did not expect. In the last two years, one out of five insured adults has had unexpected surprise medical bills (Pollitz et al., 2020). This bill will aim to protect consumers from these out-of-network provider charges. This bill will create more transparency on healthcare services. Healthcare practitioners will be mandated to give their patients a list of services they received upon discharge and bill for such services within forty-five days (Congress.gov, 2019). This bill will address drug price issues. There has been a significant increase in drug prices in the United States. Approximately 25% of Americans find it hard to afford prescription medications due to high out-of-pocket spending (Rajkumar, 2020). This shows the high cost of prescription medications in the United States. This is because manufacturers keep generic drugs off the market. This bill will change requirements to expedite the production of biosimilar and generic drugs.
Congress.gov. (2019, July 8). S.1895 – 116th Congress (2019-2020): Lower Health Care Costs Act. Congress.gov | Library of Congress. https://www.congress.gov/bill/116th-congress/senate-bill/1895
Pollitz, K., Lopes, L., Kearney, A., Rae, M., Cox, C., Fehr, R., & Rousseau, D. (2020). US statistics on surprise medical billing. JAMA, 323(6), 498.
Rajkumar, S. V. (2020). The high cost of prescription drugs: causes and solutions. Blood Cancer Journal, 10(6), 1-5.
Evidence to Support Good Samaritan Health Professionals Act of 2021
The healthcare policy selected to review is the Good Samaritan Health Professionals Act of 2021. This proposed policy aims to decrease the liability of healthcare professionals who volunteer services during a declared disaster (Congress.gov. n.d.). This liability protection would only apply under specific circumstances. The healthcare provider would be protected as long as they are practicing within their scope of practice, as a volunteer, during a declared emergency, and practicing in good faith. The protection will not apply if the healthcare worker causes harm willfully or is practicing under the influence of drugs and/or alcohol. It is important to note that this is for a volunteer who is providing services without any compensation. The Good Samaritan Health Professionals Act of 2021 is a policy that has been introduced to the House.
There is an evidence base to support the proposed policy of Good Samaritan Health Professionals Act of 2021. According to Medical Professional Liability Association (2021), the policies that are already in place are “ambiguous and inconsistent” and may even deter medical professionals from volunteering services during a disaster. In times of disaster (such as the current COVID crisis), it is imperative for healthcare workers to feel safe from lawsuit and liability when abiding by their scope of practice. Milstead & Short (2019) describe how “policies reflect public opinion as well as evidence-based data (p. 90).” The Good Samaritan Health Professionals Act of 2021 would be in the interest of public opinion as disasters can affect anyone at any given time. Hoffman, Goodman, & Stier (2009) explain how healthcare volunteers could still be in danger of liability because of primary job payment and may not be covered depending on the location of practice. They also point out how healthcare providers may be deterred from volunteering in an emergency because of unclear guidance regarding their liability. The Good Samaritan Health Professionals Act of 2021 can be backed by evidence-based data and also support from healthcare workers who would like to volunteer in emergency but need clearer liability protection.
Congress.gov. (n.d.). Text: H.R.5239 — 117th Congress (2021-2022). Retrieved
Hoffman, S., Goodman, R. A., & Stier, D. D. (2009). Law, Liability, and Public Health
Emergencies. Disaster Medicine and Public Health Preparedness, 3(2), 117–125.
Medical Professional Liability Association. (2021). Good Samaritan Health Professionals
Act Would Offer Protections for Medical Volunteers and Preserve Patient Access to Care. Retrieved on January 10, 2022 from https://www.mplassociation.org/Web/Resources/News/Good_Samaritan_Health_Professionals_Act_Would_Offer_Protections_for_Medical_Volunteers.aspx
Milstead, J.A., & Short, N.M. (2019). Health Policy and politics: A nurse’s guide (6th ed).
Burlington, MA: Jones & Bartlett Learning
Health Care Provider Protection Act
This bill was introduced under H.R 8094 titled Dr. Lorna Breen Health Care Provider Protection Act “to address behavioral health and well-being among health care professionals” (Congress.gov, n.d).
This bill creates a number of grants programs and mandates the Department of Health and Human Services (HHS) to take steps to improve mental and behavioral health and prevent burnout among health-care workers. The bill further advocates that HHS must also research and make policy recommendations on issues such as minimizing burnout and enhancing mental and behavioral health among health care providers, removing barriers to care and treatment. The bill also stipulated that the Centers for Disease Control and Prevention must also launch a campaign to urge health-care practitioners to seek help and treatment for mental and behavioral health issues (Congress.gov, n.d).
According to Jimenez et al (2021), the well-being of health care providers is at stake at these unprecedented times which may lead to a vicarious trauma. These disorders might be seen as a typical reaction to clients’ stressful events, and they can result in decreased motivation, efficacy, and empathy. These changes are problematic because they have negative effects on providers’ well-being, self-esteem, some people may sense impatience or anger. Some people become easily distracted, feel frightened, or have mood swings or lose their sense of humor. intimacy, safety, and trust, and they can affect the client’s well-being and quality of care. Recently, there has been news of health care workers particularly nurses leaving the hospital and choosing to work from home. All these, post Covid 19 pandemic. Frontline healthcare workers are reporting rising levels of anxiety linked to functional impairments, alcohol or drug coping, depressive symptoms such as acute hopelessness, and passive suicide ideation (Prekazi, et al, 2021).
In addition, increased workload, related to acute shortage of nurses, nurses being out sick with Covid, a shortage of medical supplies, a lack of safety for infection prevention, unfamiliarity with proper infection protocols, a lack of agreement on treatment protocols, and inconsistent organizational support were all creating anxiety and generalized stress in health care workers (Magill et al, 2020).
Frontline healthcare personnel who have been infected with COVID-19 and have been exposed to danger in the workplace are constantly exposed to potentially traumatic situations while supporting COVID-19 patients. This has created work-related trauma. A lot of nurses who used to be so excited about caring for patients are demoralized, unhappy and some even find it difficult to get up and go to work.
Congress.gov (n.d) Retrieved January 11, 2022 from
Elizabeth Magill, B. ., Zoe Siegel, B. S., & Kathleen M. Pike, P. D. (2020). The Mental Health
of Frontline Health Care Providers During Pandemics: A Rapid Review of the Literature. Psychiatric Services, 71(12), 1260–1269. https://doi.org/10.1176/appi.ps.202000274
Jimenez, R. R., Andersen, S., Song, H., & Townsend, C. (2021). Vicarious trauma in mental
health care providers. Journal of Interprofessional Education & Practice, 24. https://doi.org/10.1016/j.xjep.2021.100451
Lulejete Prekazi, Vjosa Hajrullahu, Shegë Bahtiri, Blerta Kryeziu, Blertë Hyseni, Besarta
Taganoviq, & Florim Gallopeni. (2021). The Impact of Coping Skills in Post-traumatic Growth of Healthcare Providers: When Mental Health Is Deteriorating Due to COVID-19 Pandemic. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.791568