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ntroduction to Policy Development and Analysis
1. Who regulates a federal policy, a state policy, a local policy? (Selina)
Although federal policy and laws are created and passed by Congress, the regulation of these laws is dependent upon the General Services Administration (GSA) (U.S. General Services Administration, 2021). The GSA is one of fifteen executive branches of government and functions as one of the pivotal management agencies. Similar to the federal government, state policies are created and passed by elected representatives within that state. Any of these elected representatives or the state governor themselves may bring about some form of legislation that then later may become law (The White House: President Barack Obama, 2016). Meanwhile, the local government can be divided into two ranks: counties and municipalities. Municipalities are typically led by mayors or city managers elected by members of the population within that city. Municipalities have some degree of “granted power” provided to them by the state, which supplies them with the ability to control some aspects of policy making (The White House: President Barack Obama, 2016).
2. As a RN or APRN how can you begin to change a policy? Name 2 nursing speciality organizations that can assist with a policy change. (Selina & Sherray)
Any healthcare professional can impact policy within a certain community or government. For example, leading community initiatives to include disease screening or vaccination events can impact local government by demonstrating the vast importance of achieving and maintaining a healthy community. An additional example includes advocating for patient safety. Extremely relevant in nursing as we know it today, healthcare professionals can advocate for patient safety by raising concerns regarding understaffing and increasing nurse-to-patient ratios. Policy changes in nursing may begin at a local and seemingly insignificant level, but if proven effective, may reach state and federal levels. As a registered nurse, such changes can be enacted by expressing concern and contacting department charge nurses and managers, house supervisors, and ultimately directors of nursing. Once the concern is communicated, suggestions on how to address these concerns can be made. One nursing speciality organization that can assist with policy change includes the Emergency Nurses Association (ENA). Influential in both the state and federal levels, the ENA has had a significant impact on both emergency nursing and healthcare as a whole. At the state level, the ENA supports and encourages the passage of laws that make assaulting an emergency nurse a felony (Emergency Nurses Association, 2023). The American Nurses Association (ANA) is another specialty organization that can support policy changes. For more than 100 years this organization has been pivotal in creating legislative changes. At the state level, the ANA’s Policy & State Government Affairs assists with monitoring and reviewing bills that are introduced into the state legislation (ANA, 2023). The ANA also advocates federally by ensuring that the voices of nurses are heard by lobbying executive and congressional agencies (ANA, 2023).
3. Name 2 non nursing organizations that have assisted nursing in making policy changes. (Sherray)
The American Bar Association (ABA) is one organization that has assisted with nursing policy changes. The ABA commission on law and aging advocates for older adults by identifying law related issues on autonomy, quality of life, and care. This organization has helped to create change with Congress regarding safety issues in nursing homes (ABA, 2023). Another organization which has contributed to making policy changes is The Commonwealth Fund. The Commonwealth Fund has specific programs which focus on creating change on healthcare policy practices. Particularly, this organization funds and/or sponsors projects that will assist with improving healthcare practices through evidence-based research and analysis (The Commonwealth Fund, 2023). On the federal level, this group has worked with policymakers on the Affordable Care Act to ensure that all Americans have access to affordable healthcare (The Commonwealth Fund, 2023).
4. Provide one example of the policy that was changed from a nursing organization and 1 from the nonnursing organization. (Tara & David)
The American Nurses Association (ANA) was one of many nursing organizations in support of the Title VIII Nursing Workforce Reauthorization Act. H.R.728 (2019) bill reauthorizes (1) loan repayment and scholarships for nurses; (2) loans for nursing faculty development; (3) advanced education nursing grants; (4) grants for increasing nursing workforce diversity; and (5) nurse education, practice, quality, and retention grants. The bill will continue to be in effect until the end of 2024.Â
While not a nursing organization directly, the American Heart Association (AHA) is a well known organization that most healthcare workers are familiar with. They advocate for heart health and education, provide medical education and certificates to healthcare workers, and to the public as well. When a nurse had received a bill that was almost seven times the estimated amount for her child’s medical care, the AHA launched a campaign that would later turn into the No Surprises Act. “The bill requires insurers offering plans that cover emergency services to bill plan holders no more than the median in-network rate for a particular emergency service, even if the service provider is out of network. The bill further prohibits insurers from billing plan holders more than the median in-network rate for nonemergency services provided by out-of-network providers at in-network facilities” (H.R.3630 – No Surprises Act, 2020).
5. What was the actual length of time to make the change? (David)
The Nursing Workforce Reauthorization Act was introduced in January of 2019, and the bill was not passed by the House until October 28, 2019, totaling 9 months in between. Whereas the No Surprises Act was introduced in July of 2019 and was signed into law in December of 2020, over a year and a half later (H.R. 3630 – No Surprises Act, 2020).
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