1. Why Protecting Tribal Rights Is Key to Fighting Climate Change
Why did you choose your report?
This article is very important because it talks of home-grown problems that are directly as a result of climate change. It literally tells us that climate change effects are here with us. The writer also focused on the indigenous community who have been around in this country more than us. Through information passed through their forefathers, there are a better place to inform of the drastic changes in climate in areas they use to dwell and in the areas that they are dwelling in now. Indigenous people write to a clean environment has been continuously violated through pollution (Deaton, 2021). Deaton indicates that the decline in environmental conditions to the worse has led to the decline of the sockeye salmon which is a strategic nutritional supplement for the tribal people (2021). This has subsequently led to the decline in health for the tribal people.
Why is this particular report important to society and how it fits in the Dahlgren-Whitehead model?
These article fits perfectly with the Dahlgen- Whitehead rainbow model. This is because economic, environmental and social inequalities can determine people’s risk of getting ill, their ability to prevent sickness, or their access to effective treatments. The tribal communities are directly affected by the environmental degradation around them. Deaton writes that the decline of the sockeye salmon which is a main source of food for the tribal community is caused by ocean acidification and about warming ocean temperatures (2021). This means that the degradation of the environment directly affects the quality of life of the tribal community.
Using what you have learned through your nursing education, what are your thoughts about how you might affect legislation around this issue at the local level or above?
Apart from championing ways to reduce environmental degradation, I would use my nursing education to educate the tribal community alternative nutritional supplements. These will be vital in improving their quality of life. As a nurse, I can also liaise with social workers and the local administration implement rights of indigenous people in a way that respects tribal sovereignty, then tribes will be fully armed and able to adopt both adaptation and mitigation strategies to defend their people, their homelands, and their traditional ways of life against the imminent threat of climate change (Deaton, 2021).
Reference
Deaton, J. (2021, October 27) Why Protecting Tribal Rights Is Key to Fighting Climate Change. Yale Environment https://e360.yale.edu/features/why-protecting-tribal-rights-is-key-to-fighting-climate-change
2. Bill Title: Public Employee Employment Retention and Benefit
Why did you choose this legislation?
I choose this legislation because it is a very important legislation when it comes to health care and Covid-19. After COVID-19 hit the nation, many employers laid off their workers or put them on furlough effectively cutting off their employment retention and benefits. This means many people slid to unemployment and could not afford to pay for their medical insurance. This statute legislation passes by the state of New Jersey was very important in ensuring that employers could continue to pay benefits and employment retention for their employees (Public Employee Employment Retention and Benefit, 2020). It was an act concerning the hiring, retention, and benefits of certain public employees during the public health hazard posed by coronavirus disease 2019 (COVID-19).
What does the legislation provide for?
The legislation provided that reenrollment in the Public Employees’ Retirement System shall not be a condition of full-time employment with a public agency or other participating employer for a retired member who retired for any reason other than disability, has had a bona fide severance from employment, and is returning to work on a temporary basis in response to the Public Health Emergency or State of Emergency. (Public Employee Employment Retention and Benefit, 2020) This legislation was important in protecting employees to be laid off due to COVID-19. The legislation provided them protection. Other category of employees that the legislation directly protected included police, firemen, full-time officer, non-commissioned officer, or trooper, health care workers, and COVID-19 care givers (Public Employee Employment Retention and Benefit, 2020). Importantly, the legislation also provided for a federal stimulus program in response to the coronavirus disease 2019 (COVID-19) pandemic for the frontline workers.
Reference
Public Employee Employment Retention and Benefit, 2020 NJ A 3914 (2020, Oct 30) https://www.ncsl.org/research/health/state-action-on-coronavirus-covid-19.aspx
2. 1) Opioid Treatment Scam May Be Coming to Your State
This Stateline report from PewTrusts.org begins as storyline perspective from a Mother of an opioid addict son who sought treatment and was caught up in drug treatment fraud surfacing as “patient brokers.” The incentive for the patient brokers is to have the addict in “treatment” relapse and by the laws of the federal Affordable Care Act are obliged to pay again (Vestal, 2019). So the cycle continues. The addict relapses after fake treatment, and the insurance pays the fraudulent patient brokers. This is an important issue because the reality of seeking help demands vulnerability and seeking help from strangers online offering help seems more appealing. The cultural stigma of having addiction deters people from asking for help. In terms of the Dahlgren-Whitehead model, it is apparent that there is a lack of treatment in local surrounding areas and that providers may need to consider the unwillingness of people getting help because of stigmas. In this situation, legislation should consider scrutinizing treatment qualified facilities before treatment is provided. The incentive for legislation to make a change should not just be because of the immorality and inhumanity of taking advantage of vulnerable populations, but also because this fraudulent business cost insurance companies a lot of money. In June of 2018, $106 million was discovered as fraudulent Obamacare insurance spending to treatment centers related to this type of scheme (Luthi, 2018).
https://www.cdc.gov/phlp/news/current.html
Luthi, S. (2018). Opioid crisis fuels patient-brokering fraud. Modern Healthcare, 48(31), 8–8.
Vestal, Christine. “Opioid Treatment Scam May Be Coming to Your State.” Opioid Treatment Scam May Be Coming to Your State, The Pew, 17 Oct. 2019, https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2019/10/07/opioid-treatment-scam-may-be-coming-to-your-state.
2) CA ACR 30
In March of 2020 California passed a legislation act commencing the first monday in March as Victims and Survivors Memorial Day and to further urge the public to follow health orders to mitigate the spread of the virus such as social distancing. I chose this because I live in California, and as a healthcare worker, providing education to patients regarding the virus and how to stay safe is not just patient centered care, it’s lawful.
NCSL. (2021, April, 26). State Action on Coronavirus (COVID-19). National Conference of State Legislatures
3. For my Health IT evaluation of MyChart, an online patient portal, it will be important to obtain input from healthcare clinicians, administrative personnel, and patients. Since these individuals will be accessing the patient portal the most, getting their buy-in will highly influence the implementation of this new piece of healthcare technology.
According to Heath (2017), patient portals can have different features and functions, so “clinics should consider their current EHR vendor, interoperability, budget, and patient priorities to develop portal adoption goals.” Thankfully, MyChart is a designed by our current EHR vendor, but it will still be critical to evaluate the needs of the portal, since this may differ between clinics, such as pediatrics vs. urgent care.
The goals of my stakeholders include improving clinical care efficiency and streamlining clinical processes. For example, the portal can help save clinician’s time by providing a platform to quickly message patients. Rather than having to call patients to discuss normal test results, they can simply send a message stating everything was normal. In addition, the portal can streamline services, since patients can pay their medical bills online or request prescriiption refills. Another major goal of this project’s implementation is to meet the requirements of meaningful use set by the Centers for Medicare and Medicaid Services ([CMS], 2013) in their EHR incentive program. In the stage 2 objectives of meaningful use, one objective is to “provide patients with the ability to view online, download and transmit their health information” (p. 14). By utilizing MyChart, this objective can be met and we can demonstrate to CMS that we are using our EHR in a way that positively impacts patient care.
References
Centers for Medicare and Medicaid Services. (2013). Eligible professional’s guide to stage 2 of the EHR incentive programs. https://www.cms.gov/regulations-and-guidance/legislation/ehrincentiveprograms/downloads/stage2_guide_eps_9_23_13.pdf
Heath, S. (2017, June 6). 4 steps to successful patient portal adoption, integration. Xtelligent healthcare media. https://patientengagementhit.com/news/4-steps-to-successful-patient-portal-adoption-integration
4. The stakeholders for the project, evaluating if there is increased revenue after EPIC implementation at Central Vermont Medical Center (CVMC) would include leadership, including IT leadership. The finance department for CVMC and the University of Vermont Medical Center that is the CVMC affiliate, along with the end users of the EPIC application would also be key evaluators.
There was buy in from leadership at this time as it was a goal of implementing the EPIC application. Examining the benefits and drawbacks from getting feedback from the end user staff is part of the social theory and human factors. Leadership has been selected so that they can relay the concerns and issues of end users to a team that can alter the application and make changes. These changes could augment the application for improved end user use. End users are using the application and can determine what improvements can be made. Leadership and end users were chosen as evaluators as they are using and supporting the application. If the EPIC application is optimized, revenue can be captured and hopefully increased.
Financial leaders within the organization can evaluate the clinical outcome measures and financial impact measures. Compiling data will help those throughout the organization see that improvement is apparent, that utilizing EPIC to its full potential is worthwhile.
References
Lee, T-T. (2016). Evaluation of health information technology: Key elements in the framework. Journal of Nursing Research, 24(4).
Cusack, C. M., Byrne, C. M., Hook, J. M., McGowan, J., Poon, E., & Zafar, A. (2009). Health information technology evaluation toolkit: 2009 update (PDF). AHRQ.
