Agenda Comparison Grid and Fact Sheet or Talking Points Brief

NURS 6050 Week 2 Assignment Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

Access to Mental Healthcare

Walden University

Introduction

Public policies structured and passed by governmental units play a significant role in the public’s access to healthcare and clinical professionals and practitioners’ relative delivery. Health policies that the U.S. government has approved must be carried out to establish effective healthcare services and regulations that benefit the country’s citizens. The U.S. healthcare system heavily relies on nurses’ service as they have adept skills in communication, biomedical science, education, psychology, and direct patient care (Milstead & Short, 2019). Thus, nursing is a critical stage in carrying out health and social policies for the public’s benefit. One of the country’s healthcare system’s significant concerns is delivering adequate and accessible mental healthcare services. According to Russell (2010), one in four Americans aged 18 and above have a mental illness or diagnosable mental disorder. This rate tallies to around 26% of Americans who are diagnosed within a given year. The prevalence of such mental illnesses calls for more health policies to address the public health issue and provide adequate care to those with such illnesses.

The purpose of this paper is to underscore the significance of health policies relating to mental healthcare and dissection of possible mental healthcare agendas that can help provide effective nursing care. Tangent to this, the paper compares the mental healthcare policies that were addressed over three presidential terms. This paper also intends to discuss and compare the agendas, and budget allocation accomplished by former U.S. Presidents Trump, Obama, and Bush and establish which policies were most effective under the three political reigns. From this information, the paper gathers an in-depth analysis of mental healthcare and nurses’ role in helping political bodies provide the most effective healthcare services and agendas.

Agenda Comparison Grid

Identify the Population Health concern you selected.
Access to Mental Healthcare

Describe the Population Health concern you selected and the factors that contribute to it. The need for healthcare accessibility is a necessity for any given population. Thus, the government’s policies should cover the support for all individuals who require medical attention and treatment. That said, the recipients of healthcare should include individuals who suffer from mental illnesses. According to Russell (2010), 44 million adults and 13.7 million children suffer from mental health disorders each year, caused by psychological, physiological, and social factors. Individuals who suffer from these disorders have a higher risk of committing suicide by up to 80 to 90 percent. Russell (2010) further stressed that healthcare systems must provide equal and quality services for these individuals, similar to general medical healthcare provisions.
Administration (President Name) President Trump President Obama President Bush
Describe the administrative agenda focus related to this issue for the current and two previous presidents. Upon the republican party representative President Trump’s election, the administration stressed the reformation or entire replacement of ACA, which was passed in the former term by former democrat President Obama (Milstead & Short, 2019). Contrary to this, the recent COVID-19 pandemic and its effects drove the administration to sign Executive Order 13594, Saving Lives Through Increased Support for Mental and Behavioral Health Needs, to ameliorate mental healthcare services in the country (SAMHSA, 2020). Consequently, the Department of Health and Human Services (2021) revealed the fiscal year 2021 budget to increase for SAMHSA to address substance abuse illnesses and mental health issues. In comparison with two other terms, the Obama administration’s agenda was to provide adequate mental healthcare in parity with the general medical care through health insurance. In President Obama’s term from 2009 to 2017, he promoted his goal to provide healthcare access for all citizens. Thus, his main objective was to mandate the Patient Protection and Affordable Care Act or otherwise known as Obamacare and ACA (Milstead & Short, 2019), which was ordered to regulate health insurance provisions. President Bush’s main agenda towards mental healthcare was the establishment of the President’s New Freedom Commission on Mental Health, with which he signed an Executive Order to discuss the parameters and responsibilities of the commission (Hogan, 2003). After passing the Executive Order and pushing the commission’s agenda, former President Bush was commended by mental health associations and organizations for its initiative. While the initiative to bring mental healthcare to the youth and break the stigma surrounding the relative mental health conditions began as a notable goal for the commission, the agenda was surrounded by the debate on the addition of promotional, supposedly ineffective, and expensive medication.
Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue. Since the Trump administration aimed to reduce the expansion of ACA due to the spike in taxes for middle-class earners, the budget proposal made last 2020 revealed a significant decline in the budget for mental healthcare, as discussed by Canady (2019). The report revealed a 1.5 trillion-dollar budget cut for Medicaid alone and 845 billion dollars for Medicare. Canady (2019) further discussed these concerns as National Alliance on Mental Illness grew concerned over the number of insurance beneficiaries who will lose their coverage due to limited budget allocation. However, the latest fiscal year report of 2021 shows that the administration provides 5.7 billion dollars to SAMHSA to cover substance abuse control, mental health services and prevention, and mental health needs for students (Department of Health and Human Services, 2021). Other budget allocations were provided to cover the support for mental health accessibility. As the Obama administration was focused on providing medical health insurance for all, the Medicare and Medicaid budget in 2015 increased by up to 3.2 trillion dollars or around 9,990 dollars per person or beneficiary, which also covers those who receive health insurance for mental illness (Milstead & Short, 2019). According to the study conducted by Frank, Beronio, and Glied (2014), this agenda made for the enhancement of Medicare and Medicaid significantly increased resources needed to provide enough mental health and substance use care for the majority of the population. However, Milstead and Short (2019) discussed the cons of such an agenda, not only for mental healthcare but for the general provisions of ACA. Concerns were raised concerning insurance funding by former premium holders and its effects on the raised collection of taxes. This debate became the primary hurdle for financing the agenda and encouraging its objective. Apart from developing the New Freedom Commission on Mental Health, the Bush administration also passed SAMHSA in 2000 to enhance the care given for mental health patients. According to Sundararaman (2009), the National Health Expenditure Account (NHEA) reported an expenditure of 142 billion dollars in 2005 to deliver mental healthcare. However, the report shows that health insurance coverage was lesser among the patients with mental health conditions, which is in large disparity with the insurance coverage received by general medical patients. Although, it is essential to note that the administration increased the budget allocation for mental healthcare services by over 20 billion dollars from 1996 to 2006, which covered training of mental health professionals, primary and specialty care in community mental health institutions, facilities, equipment, education, medication, and treatment (Russell, 2010).
Explain how each of the presidential administrations approached the issue. The current administration dedicated much of the budget for Medicare and Medicaid to be reduced, affecting the insurance holders that were initially supported during the previous administration. Although the repeal or reformation of Obamacare and ACA was to correct the gaps and missteps in the executive order, the Trump administration continuously made significant budget cuts and limitations to the accessibility of health insurance (Milstead & Short, 2019). These were made to address concerns by middle-wage earners who were subject to higher tax fees due to higher funding for health insurance. Concerning the recently passed executive order, the agenda covers services to care for the accessibility of prevention and treatment services for individuals with mental health and substance abuse concerns within community-based institutions and school settings (SAMHSA, 2020). In line with the efforts for making health insurance more accessible, President Obama passed the Mental Health Parity and Addictions Equity Act (MHPEA) in 2010 to provide mental health services at par with other healthcare services for almost 103 million individuals of the population (Executive Office of the President, 2016). The motion by this administration effectively made insurance accessible to those who were formerly non-holders of health insurance. Along with providing these individuals with healthcare, medication, premiums, and insurance coverage, the ACA, in partnership with MCPHEA, extended its service to provide the same benefits for insurance holders diagnosed with mental illness and substance use disorders. The commission’s agenda was to pursue mental health promotion among the youth in school settings to provide them healthcare services that are inaccessible to them (Mills et al., 2006). The commission intended to provide easier access to mental health services such as screening, suicide prevention, proper medication. The purpose of President Bush’s agenda was initially acclaimed as he appointed a whole commission to carry out the regulations and recommendations for mental healthcare. However, Bush received backlash for the commission after other researchers claimed that the agenda was used to promote ineffective and harmful pharmaceutical medications such as those pushed by the Texas medication algorithm project (TMAP) (Lenzer, 2004).

Agenda Comparison Analysis

After analyzing all three administrations, it was observed that the three presidents were able to pass agendas that were inclined towards providing mental healthcare services to address the rise in the prevalence of this health issue among the U.S. population. Although the initiative of former President Bush to carry out a governing commission to regulate the provision of mental healthcare services (Hogan, 2003), the target of the commission was less inclusive of the more significant population as it focused mainly on treatment through pharmaceutical medication (Mills et al., 2006).

The best possible administrative agency most likely to address the healthcare issue is the Obama administration basing on the number of ameliorated mental health cases alone. According to the Executive Office of the President (2016), mental healthcare services became more accessible to the population, rounding up to about 15 million people more because of the ACA. The budget allocated for promoting low-cost, accessible health insurance through the ACA and the MHPEA allowed an estimated 62 million people for mental healthcare (Frank, Beronio, & Glied, 2014). However, it is essential to note that there were several gaps in delivering mental healthcare insurance as many individuals suffered from the consequences of higher tax payments and mandated insurance.

The issues raised during the Trump administration concerning the need for a reform of the ACA were relevant to addressing these concerns. However, drastic changes were made by the Trump administration, which caused a significant decline in the budget for mental healthcare (Milstead & Short, 2019) and an overall decreased accessibility ruling out the initial objectives of ACA.

Overall, the Obama administration was closer to providing mental healthcare and thus is the most likely responsible for carrying out services for the issue. However, the Trump administration’s points must be addressed to devise budget solutions that anticipate budgeting concerns and alleviate the probability of higher tax collection. Taken from the agenda of President Bush (Hogan, 2003), the best possible sponsor for the success of tackling mental healthcare issues is a governing commission that can integrate the help of mental health organizations and institutions in devising the provisions and regulations for the benefit of the patients and beneficiaries without monetizing any service or support.

Narrative

Healthcare policies legislated by the government have significant impacts on citizens’ individual lives, especially those having limited access to proper healthcare. One of the country’s recent health issues today is the prevalence of mental health illness and inadequate support and healthcare service. Earlier data from 2010 showed about 40 million adults suffering from mental health disorders (Russel, 2010). Last 2019, the rate was observed to increase as the National Institute of Mental Health reports that almost one out five adults in the U.S. have a mental illness, which correlates to about 51.5 million adults in the population (NIMH, 2019). This data alone suggests the need for more support, medication, treatment, and other health services to alleviate the prevalence of such conditions. Providing a specific agenda for advancing mental healthcare can steadily provide millions from the population with adequate mental healthcare to improve the mental health state of these patients and decrease the increasing rate of suicide.

Mental healthcare requires the skills and expertise of mental health professionals trained to provide care and treatment for their patients. Among these professionals are nurses who directly contact these patients and have professional communication, education, medical training, psychology, and patient care (Milstead & Short, 2019). Because of this, nurses play a critical role in carrying out policies that can discuss regulations, provisions, and enhancements tailored to patient needs. According to Mrayyan and Huber (2003), nurses are actively committed to ensuring their patients’ health, which is supported by the statement of the president of the American Nurses Association, saying that “nurses are the quality and safety monitors.” Since nurses carry the responsibility of improving patient outcomes, they can directly observe which policies pose optimal care delivery effectiveness. Through this observation, Ellenbecker and Edward (2016) suggest that nurses conduct research that can present evidence for policy-makers to be well-informed and knowledgeable about patient conditions.

Conclusion

Legislators hold a critical responsibility to deliver policies and agendas that can benefit the entire population. Policies made for healthcare have a significant role for the country as citizens push the need for accessible medical service (Milstead & Short, 2019). The effects of proper healthcare predetermine the effectiveness of serving citizens of the country. The government must adhere to policies and agendas that can deliver optimal healthcare for patients without compromising the country’s socioeconomic aspects. In line with this, mental health is one of the public and global health issues that require further analysis and support as it continues to increase in rate (Department of Health and Human Services, 2021). Mandating medical and mental healthcare policies requires the help of legislators and the aid of medical health professionals, especially nurses, who have firsthand knowledge of the needs of patients. Through this inclusive, multidisciplinary approach in policy-making, the government can improve solutions and responses to citizens’ needs for medication, treatment, support, education, and care.

References

Canady, V. A. (2019). Proposed FY 2020 budget reveals critical cuts in MH supports. Mental Health Weekly, 29(11), 4–5. https://doi.org/10.1002/mhw.31819

Department of Health and Human Services. (2021). FY 2021 President’s Budget for HHS.

Ellenbecker, C. H., & Edward, J. (2016). Conducting Nursing Research to Advance and Inform Health Policy. Policy, Politics, & Nursing Practice, 17(4), 208–217. https://doi.org/10.1177/1527154417700634

Executive Office of the President. (2016). The Mental Health and Substance Use Disorder Parity Task Force.

Frank, R. G., Beronio, K., & Glied, S. A. (2014). Behavioral Health Parity and the Affordable Care Act. Journal of Social Work in Disability & Rehabilitation, 13(1-2), 31–43. https://doi.org/10.1080/1536710x.2013.870512

Hogan, M. F. (2003). The President’s New Freedom Commission: Recommendations to Transform Mental Health Care in America. Psychiatric Services.

Lenzer, J. (2004). Bush plans to screen whole US population for mental illness. BMJ, 328(7454). https://doi.org/10.1136/bmj.328.7454.1458

Lenzer, J. (2005). Bush unveils mental health action plan. BMJ, 331(7517). https://doi.org/10.1136/bmj.331.7517.592-a

Mills, C., Stephan, S. H., Moore, E., Weist, M. D., Daly, B. P., & Edwards, M. (2006). The President’s New Freedom Commission: Capitalizing on Opportunities to Advance School-Based Mental Health Services. Clinical Child and Family Psychology Review, 9(3-4), 149–161. https://doi.org/10.1007/s10567-006-0003-3

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: a nurse’s guide. Jones & Bartlett Learning.

Mrayyan, M. T., & Huber, D. L. (2003). The Nurse’s role in Changing health policy related to patient safety. JONA’s Healthcare Law, Ethics, and Regulation, 5(1), 13–18. https://doi.org/10.1097/00128488-200303000-00006

NIMH. (2019). Mental Illness. National Institute of Mental Health.

Russell, L. (2010). Mental Health Care Services in Primary Care: Tackling the Issues in the Context of Health Care Reform. Center for American Progress.

SAMHSA. (2020). Executive Order Saving Lives Through Increased Support for Mental and Behavioral Health Needs. Substance Abuse and Mental Health Services Administration.

Sundararaman, R. (2009). The U.S. Mental Health Delivery System Infrastructure: A Primer. Congressional Research Service.

Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief
It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember.

Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since.

As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news.

In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy.

To Prepare:

Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations.
Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.
Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.
Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.
The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page narrative) with a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.

Part 1: Agenda Comparison Grid

Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:

Identify and provide a brief description of the population health concern you selected and the factors that contribute to it.
Describe the administrative agenda focus related to the issue you selected.
Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.
Explain how each of the presidential administrations approached the issue.
At least 3 resources must be used
Part 2: Agenda Comparison Grid Analysis

Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:

Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?
Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?
Part 3: Narrative

Using the information recorded on the template in Parts 1 and 2, develop a 1-page narrative that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following:

Summarize why this healthcare issue is important and should be included in the agenda for legislation.
Justify the role of the nurse in agenda setting for healthcare issues.
The response fully integrates at least 2 outside resources and 2-3 course specific resources that fully supports the summary provided.

NURS_6050_Module01_Week02_Assignment_Rubric

Grid View
List View
Excellent Good Fair Poor
Part 1: Agenda Comparison Grid-
-Identify a population health concern

-Describe the Population Health concern you selected and the factors that contribute to it.

5 (5%) – 5 (5%)
The response clearly and accurately identifies and describes a population health concern.
4 (4%) – 4 (4%)
The response vaguely identifies and describes a population health concern.
3.5 (3.5%) – 3.5 (3.5%)
The response inaccurately identifies and describes a population health concern.
0 (0%) – 3 (3%)
Identification and description of a population health concern is missing or incomplete.
Part 1: Agenda Comparison Grid-
– Describe the administrative agenda focus related to this issue for the current and two previous presidents.

– Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.

– Explain how each of the presidential administrations approached the issue.

18 (18%) – 20 (20%)
The response clearly and accurately describes the presidential administrations’ focus related to the concern, the financial and resource allocation dedicated to the concern, and explains how each of the presidential administrations approached the issue. At least 3 resources are used.
16 (16%) – 17 (17%)
The response vaguely describes the presidential administrations’ focus related to the concern, the financial and resource allocation dedicated to the concern, and explains how each of the presidential administrations approached the issue. Only 2 resources are used.
14 (14%) – 15 (15%)
The response inaccurately describes the presidential administrations’ focus related to the concern, the financial and resource allocation dedicated to the concern, and how each of the presidential administrations approached the issue. Only 1 resource is used.
0 (0%) – 13 (13%)
The description of the presidential administrations’ focus related to the concern, financial and resource allocation dedicated to the concern, and explanation for how each of the presidential administrations approached the issue is missing. No resources are used.
Part 2: Agenda Comparison Grid Analysis- Address the following:
-Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?

-How do you think your selected healthcare issue might get on the agenda? How does it stay there?

-Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?

23 (23%) – 25 (25%)
-The response clearly and accurately identifies an administrative agency most likely to be responsible for addressing the selected healthcare issue.
-Response clearly and accurately explains how the healthcare issue gets on the agenda and remains there.
– The response clearly and accurately identifies the entrepreneur/champion/sponsor of the healthcare issue selected.
20 (20%) – 22 (22%)
-The response vaguely identifies an administrative agency which may be responsible for addressing the selected healthcare issue.
-Response adequately explains how the healthcare issue gets on the agenda and remains there.
-Identification of the entrepreneur/ champion/sponsor of the healthcare issue selected is vague.
18 (18%) – 19 (19%)
-Identification of an administrative agency responsible for addressing the selected health care issue is inaccurate.
-Explanation of how the healthcare issue gets on the agenda and remains there is vague or inaccurate.
-Identification of the entrepreneur/ champion/sponsor of the healthcare issue selected is inaccurate or does not align with the healthcare issue.
0 (0%) – 17 (17%)
-Identification of an administrative agency responsible for addressing the selected healthcare issue is missing.
-Explanation of how the healthcare issue gets on the agenda and remains there is vague and inaccurate or is missing.
-Identification of the entrepreneur/ champion/sponsor of the healthcare issue selected is vague and inaccurate or is missing.
Narrative:
Based on your Agenda Comparison Grid for the healthcare issue you selected, develop a 1-2-page narrative that you could use to communicate with a policy-maker/legislator or a member of their staff for this healthcare issue.

-Summarize why this healthcare issue is important and should be included in the agenda for legislation.

-Justify the role of the nurse in agenda setting for healthcare issues

32 (32%) – 35 (35%)
Creates a well-developed, accurate, and narrative.
The response provides a complete, detailed, and specific synthesis of two outside resources reviewed on why this healthcare issue is important and should be included in the agenda for legislation. The response fully integrates at least 2 outside resources and 2-3 course specific resources that fully supports the summary provided.
Responses accurately and thoroughly justify in detail the role of the nurse in agenda setting for healthcare issues.

28 (28%) – 31 (31%)
Creates an accurate and thorough narrative.
The response provides an accurate synthesis of at least one outside resource reviewed on why this healthcare issue is important and should be included in the agenda for legislation. The response integrates at least 1 outside resource and 2-3 course specific resources that may support the summary provided.Responses accurately justify the role of the nurse in agenda setting for healthcare issues.
25 (25%) – 27 (27%)
Creates a narrative that is partially accurate or incomplete.
The response provides a vague or inaccurate summary of outside resources reviewed on why this healthcare issue is important and should be included in the agenda for legislation. The response minimally integrates resources that may support the summary provided.The responses partially justifies the role of the nurse in agenda setting for healthcare issues.
0 (0%) – 24 (24%)
The response provides a vague and inaccurate summary of no outside resources reviewed on why this healthcare issue is important and should be included in the agenda for legislation, or is missing. The response fails to integrate any resources to support the summary provided.

Responses justifying the role of the nurse in agenda setting for healthcare issues is inaccurate and incomplete or is missing.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.
Purpose, introduction, and conclusion of the assignment is vague or off topic.
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.
No purpose statement, introduction, or conclusion was provided.
Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation

5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
4 (4%) – 4 (4%)
Contains a few (1-2) grammar, spelling, and punctuation errors.
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) grammar, spelling, and punctuation errors.
0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.

5 (5%) – 5 (5%)
Uses correct APA format with no errors.
4 (4%) – 4 (4%)
Contains a few (1-2) APA format errors.
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) APA format errors.
0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors.
Total Points: 100
Name: NURS_6050_Module01_Week02_Assignment_Rubric

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