• Factors Influencing Legislation:
    • Various factors influence health care legislation, including political, economic, social, and technological considerations.
    • Coordination of services under the Department of Health and Human Services (HHS) is crucial in shaping health policy at the federal, state, and local levels.
  • Government’s Role in Health Policy:
    • Local Level:
      • Local health departments (LHD) are funded through state allocations and local taxes, with federal support.
      • LHDs focus on community health, implementing programs and services tailored to the needs of local populations.
      • They work closely with local officials, businesses, and stakeholders to address public health concerns.
      • They are responsible for identifying health needs and intervening to protect the community’s health.
      • LHDs report communicable diseases to state health departments.
      • Nurses at the community level serve in multiple roles, such as caregivers, advocates, case managers, counselors, educators, outreach workers, disease surveillance experts, community mobilizers, and disaster responders.
    • State Level:
      • State health departments receive funding from state legislatures and federal public health agencies.
      • They manage programs like Women, Infants, and Children (WIC) and the Children’s Health Insurance Program (CHIP).
      • They establish public health policies and support local health departments.
      • State boards of nursing oversee the Nurse Practice Act, licensure of RNs and LPNs, and nursing education programs.
    • Federal Level:
      • Most health-related activities are administered by the United States Department of Health and Human Services (HHS), which consists of 11 major agencies.
      • The HHS operates under the Secretary of Health and is funded by federal taxes.
      • The Veterans Health Administration provides health services for active and retired military personnel and their dependents within the Department of Veterans Affairs.
    • National Level:
      • The World Health Organization (WHO) provides global health information, establishes standards for antibiotics and vaccines, and focuses on areas like healthcare workforce education, sanitation, infectious diseases, maternal and child health, and primary care.

Health Policy

  • Factors Affecting Policy:
    • Economic conditions, public opinion, lobbying efforts, and healthcare needs are key factors influencing health policy development.
  • Public vs. Private Policy:
    • Public health policies are typically formulated by government agencies and focus on population health, whereas private policies are developed by non-governmental organizations, including private companies and non-profits, and may focus on specific groups or health issues.
  • Nurse’s Role in Policy:
    • Nurses play a critical role in advocating for health policy changes at local, state, and national levels.
    • They engage in policy development, education, and advocacy to influence legislation and health outcomes.
  • Philanthropy and Volunteer Agencies:
    • These organizations play a significant role in healthcare funding and policy development, often supporting initiatives that government agencies cannot fully fund.

Economics

  • Funding of Health Policy:
    • Health policies are funded through various mechanisms, including taxes, grants, and private donations.
  • Government Efforts to Control Costs:
    • Efforts include implementing cost-saving measures, improving efficiency, and reducing waste in healthcare delivery.

Significant Findings from IOM Reports

  • Discussions in class have highlighted key findings from Institute of Medicine (IOM) reports that address healthcare quality, patient safety, and healthcare system improvements.

Healthcare System

  • Strengths and Weaknesses:
    • Strengths include advanced technology and a skilled workforce, while weaknesses may involve access disparities, high costs, and fragmented care.

Vulnerable Populations

  • Characteristics and Issues:
    • Elderly: Issues include chronic diseases, mobility challenges, and access to care.
    • Disabled: Challenges involve accessibility, discrimination, and healthcare needs.
    • Homeless: Issues include lack of access to healthcare, mental health problems, and substance abuse.
    • Mental Health: Stigma, inadequate resources, and disparities in care are significant concerns.
    • Rural and Migrant Populations: Barriers include distance, limited healthcare providers, and economic challenges.
    • Violence and Abuse: Legal issues, safety, and the need for protective services are critical concerns.
  • Legal Issues and Resources:
    • Vulnerable populations often face legal challenges related to access to care, discrimination, and protection from abuse. Various resources are available to assist these groups, including government programs, non-profits, and community organizations.