Category: Nursing

NURS FPX 6008 Assessment 4: Lobbying for Change

Lobbying for Change

To the Director

The state of Department for Health and Human Services

Xxx
State

Dear Sir/Madam,

RE
: The Burden of Ageing Population

My name is [Name & Position]. Having served in the healthcare sector for some years, I have observed a trend that needs your attention and input on how it burdens the current healthcare facilities, healthcare workers, and the entire community. As a healthcare worker and a nurse in a local healthcare facility, I know there has been a change in patients, demographics, and needs with strain on care providers and the hospital financially in the quest to meet the aging population’s health needs. While the state has worked hard to increase care accessibility among the diverse communities in the state, one area remains ineffectively addressed: providing ongoing care solutions to the ever-growing aging population. According to Fulmer et al. (2021), the aging population is linked to a host of adverse healthcare characteristics, including a high rate of chronic diseases, low income, lack of specialized care marginalization, and increasing demand for patient-based healthcare practices.

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As an elected member of the state, your input would be critical in developing policies and other measures to ensure healthcare organization has evolved to accommodate the aging population. On the other hand, with the aging population diversely impacting the healthcare sector, your input would be critical in identifying the relevant policymakers and stakeholders to help foster a change that would reverse the unwanted trend of marginalization of the aging population due to their status and lack of income to cater for their healthcare needs (Tang et al., 2022). Improving the healthcare status of the focus group (The Ageing Population) would mean a host of benefits, including the practices to bridge healthcare accessibility, marginalization, lack of healthcare insurance, and increased government support (Martinez-Lacoba et al., 2021). While healthcare facilities are expected to experience the burden of setting up facilities to hold up aging patients, the practice would give a foundation for the universal healthcare system in the country. With the united states’ lack of a uniform healthcare system, the effort to mitigate the issue can be used towards formulating effective and less costly healthcare plans to reduce healthcare disparity.

The government expenditure on healthcare will continue to rise unless the issue is amicably addressed through the participation of all the relevant stakeholders. This would provide lasting and practical strategies to mitigate the problem according to affordable, quality, and adequate healthcare intervention. Cristea et al. (2020) identified that inability to address healthcare disparities would continue to increase the cost of care while reducing quality and care accessibility among marginalized and minority groups. Through your office, the campaign for change would foster purposeful goals that would increase the revolution in the healthcare sector for a better tomorrow NURS FPX 6008 Assessment 4: Lobbying for Change.

While developing a remedy to address the financial burden connected to the changing population demographics, healthcare will benefit from developing lasting interventions to address the issue. According to Dall et al. (2018), a collaborative effort would mean a well-devised mitigation change process to foster positive growth and reduce negative aspects aligned with the aging population issue. As a nurse professional and having first experience in serving the patients, I foresee a case of uncontrollable influx of aged people with no access to healthcare services.

A lasting solution would be developed through your office support to address the issues. I look forward to hearing back from you, and anticipating a favorable response to address the issue. My best wishes as you continue serving our beloved state and the people.

Yours sincerely

[Name]

References

Cristea, M., Noja, G. G., Stefea, P., & Sala, A. L. (2020). The Impact of Population Aging and Public Health Support on EU Labor Markets. 
International journal of environmental research and public health
, 
17
(4), 1439.
https://doi.org/10.3390/ijerph17041439

Dall, T. M., Gallo, P. D., Chakrabarti, R., West, T., Semilla, A. P., & Storm, M. V. (2018). An aging population and growing disease burden will require a large and specialized health care workforce by 2025. Health Affairs, 32(11), 2013–2020.
https://doi.org/10.1377/hlthaff.2013.0714

Fulmer, T., Reuben, D. B., Auerbach, J., Fick, D. M., Galambos, C., & Johnson, K. S. (2021). Actualizing Better Health And Health Care For Older Adults.
Health Affairs
,
40
(2), 10.1377/hlthaff.
https://doi.org/10.1377/hlthaff.2020.01470
  NURS FPX 6008 Assessment 4: Lobbying for Change

Martinez-Lacoba, R., Pardo-Garcia, I., & Escribano-Sotos, F. (2021). Aging, Dependence, and Long-Term Care: A Systematic Review of Employment Creation. 
Inquiry : a journal of medical care organization, provision and financing
, 
58
, 469580211062426.
https://doi.org/10.1177/00469580211062426

Tang, B., Li, Z., Hu, S., & Xiong, J. (2022). Economic Implications of Health Care Burden for Elderly Population. 
Inquiry : a journal of medical care organization, provision and financing
, 
59
, 469580221121511.
https://doi.org/10.1177/00469580221121511

 

NURS FPX 6008 Assessment 4: Lobbying for Change

Write a letter to an official in your state or local government. (Choose the individual in the level of government that will best address your issue). The purpose of this letter is to advocate for action with regards to your chosen health care environment issue.

Introduction

Note: Each assessment in this course builds upon the work you have completed in previous assessments. Therefore, you must complete the assessments in the order in which they are presented.

As health care leaders, it is important to understand strategies for advocating and lobbying elected officials. This can lead to the development of policies or laws that can help drive improved equity and outcomes for all participants in the health care environment as well as a more sustainable financial future.

Background and Context

As a master’s-level health care practitioner, you may be expected to implement plans to ensure that initiatives designed to take advantage of economic opportunities for the organization are rolled out successfully and can be sustained over multiple years. Additionally, it is important to be able to envision how an initiative could be implemented in different contexts and for different purposes to ensure the investment remains a viable and positive asset to your organization or care setting.

As a master’s-level practitioner, you will often be challenged to influence the health care environment in a variety of ways. This influence can occur on a micro-level (implementing change on your unit, institution, community, or local organizations) or at a macro level (implementing change via state or federal regulations and policy). One way you can influence the health care environment is by lobbying an elected official at the local, state, or national level to adopt policies or legislation that would support positive economic and health outcomes for patients, practitioners, and organizations within the health care environment.

Instructions

For this assessment, you will develop a letter to an official in your state or local government (choose the individual in the level of government that will best address your issue). The purpose of this letter is to advocate for action with regards to your chosen health care environment issue. Remember, when writing the letter, you must use your personal address and telephone number unless you are exclusively representing a group or your organization.

Be sure to address each main point. Review the assessment instructions and scoring guide, including performance-level descriptions for each criterion, to ensure you understand the work you will be asked to complete and how it will be assessed. In addition, note the requirements for document format and length and for supporting evidence.

Overall, your assessment submission will be assessed on the following criteria:

Summarize the health care economic issue that you are addressing.

Keep this brief but try to include details about how the issue is currently impacting the elected officials’ constituents.

Explain the positive outcomes that will occur if the issue is addressed and the negative outcomes that will occur if the issue is not addressed.

Tailor this messaging to focus on the impacts in the communities and organizations that are relevant to the elected official you are writing to.

Summarize key information from scholarly sources to support the importance of addressing the issue; the issue’s overall impact on health care at the institutional, local, state, or national level; and proposed changes or actions to address the issue.

Cite at least five current, scholarly sources that support your argument and help provide the elected official (who may not have a detailed knowledge of the health care environment) with an understanding of the issues, changes, or actions that you are proposing to drive improved outcomes.

Identify the impact your issue has on health care institutions and health care providers at the local community, state, or national level.

Make sure to include information from both a health care and an economic perspective. An elected official may be more responsive to one perspective than another.

Incorporate social justice, structural racism, and inequity principles when picking resources and making recommendations for change in your assessment.

Explain how personal, professional, and organizational experiences have informed the resource planning and risk analysis for working toward addressing the economic issue.

Think about how your experiences (the experiences can be personal, professional, or from your team’s perspective or experience) affect how you have planned for the resources needed to implement your desired changes or actions. How did this impact your approach to conducting a risk analysis on the project?

Convey purpose, in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly communication standards.

Remember to conclude your letter with a summary of your position on the issue and a compelling reason that the elected official should act in your favor and support your issue or initiative.

Additional Requirements

Audience: Make sure you are addressing your letter to an actual local or state official.

For most states, you can use the following resource:

Assessment 4: Lobbying for Change.

For local officials, search your city’s government website for officials and their positions.

Length of Submission: 1–2 double spaced pages. Your letter needs to be succinct and persuasive.

Number of References: Cite at least five sources of evidence to support your identification of the gap. This could be public health data, a peer-reviewed journal article, or another scholarly source.

APA formatting: Resources and citations are formatted according to current APA style.

Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Analyze the effects of financial and economic factors (such as cost-benefit, supply and demand, return on investment, and risks) in a health care system on patient care, services offered, and organizational structures and operation.

Summarize the health care economic issue that you are addressing.

Competency 2: Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered.

Explain the positive outcomes that will occur if the issue is addressed and negative outcomes that will occur if the issue is not addressed.

Competency 3: Justify the qualitative and quantitative information used to guide economic decision making to stakeholders and colleagues.

Summarize key information from scholarly sources to support the importance of addressing the issue; the issue’s overall impact on health care at the institutional, local, state, or national level; and proposed changes or actions to address the issue.

Competency 4: Develop ethical and culturally equitable economic strategies to address dynamic environmental forces and ensure the future security of an organization’s resources and its ability to provide quality care.

Explain how personal, professional, and organizational experiences have informed the resource planning and risk analysis for working toward addressing the economic issue.

Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella writing standards NURS FPX 6008 Assessment 4: Lobbying for Change.

Convey purpose, in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly writing standards.

Population Health Using a Community Lens – NURS 4212: Population Health Nursing

Population health brings significant health problems into focus by evaluating health data and assessing for SDoH. In this way, resources can be properly allocated and interventions and policies put into place to address the underlying issues. Understanding the importance of population-focused nursing practice and developing the knowledge and skills to practice is critical to attaining a leadership role in healthcare regardless of the practice setting (Stanhope & Lancaster, 2020).

In this Assignment, you will share additional information about your
own community and chosen population
from Module 1. From the literature, you will identify and describe three primary-level interventions that apply to your population’s unique health needs. Additionally, you will consider how interventions are based in both theory and grounded in cultural sensitivity, compassion, or social justice.

 

Population Health Using a Community Lens – NURS 4212: Population Health Nursing

Population Health Using a Community Lens

 
Student Name

Institution Affiliation

Professor Name

Course

Due Date

Introduction

The concentration on population health functions to handle health disparities by creating data evaluation programs and applying specific intervention methods. This paper examines research-backed approaches to enhance health outcomes for specific community members in my area. The three essential steps for optimizing health equity include primary-level intervention implementation and service gap resolution while effectively employing local community resources. Such efforts establish enduring positive transformations that help all community members, including those with limited access to services.

Evidence-Based Community Interventions

The population’s essential health problems are managed through three established intervention methods. Through CDC support, community-based nutrition education programs provide healthy eating and physical activity education by delivering workshops and accompanying cooking classes for obesity prevention (Hunt, 2021) Population Health Using a Community Lens – NURS 4212: Population Health Nursing. The DPP delivers lifestyle coaching with group support to people with diabetes, focusing on risk reduction through weight loss and behavioral transformation. The community becomes able to spot mental health emergencies through mental health first aid training, which reduces stigma and promotes swift, responsive actions. Wealthy organizations implement these interventions through proven methods that adapt to different population requirements.

Explanation of Interventions

The implemented programs focus on resolving key health requirements. The educational programs about nutrition provide people with tools to select nutritious foods more effectively in environments where fresh produce remains scarce. The programs teach essential food-related abilities which serve as a fighting force against obesity. Diabetes prevention programs minimize the risk for diabetes development through behavioral changes, which simultaneously decrease healthcare expenses and enhance life quality. The structured support systems help participants develop better health habits by quickly adopting new behaviors. The training teaches participants how to support those who need mental health assistance, enabling more people to find available resources. It increases understanding, combats stigma, and establishes stronger communities for mental health support. The training establishes a mechanism to promptly deliver sympathetic assistance to people in emergencies.

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Empathy, Social Fairness, or Cultural Understanding

Access to mental health resources remains available to everyone through mental health first aid training, which promotes social justice among all socioeconomic groups. The program trains people to respond sensitively to mental health emergencies, thus creating supportive mental health environments. The program features cultural sensitivity since its content can be adjusted to handle unique requirements within various population groups. The intervention’s flexible approach guarantees it speaks to the needs of all people, thus creating an inclusive environment that respects equity.

Grounded in Health Promotion Theory

The diabetes prevention program derives its foundations from the HBM, which focuses on how people understand the risks they face and the potential benefits of their actions. The program teaches participants about diabetes risks and supplies prevention tools that drive behaviour modification. The HBM conceptual framework supports individual beliefs since the prevention program aims to enable people to manage their health independently. The theoretical framework guarantees that the intervention combines practicality with psychological appeal, which enhances participation duration and increases the chances of success.

Gaps in Service

The primary service shortage in my community stems from limited mental health services available to disadvantaged members of the community. A combination of extended waiting periods and steep health care prices prevents numerous people from obtaining prompt medical services, which results in worsening untreated mental health issues (Klein, 2024). The availability of preventive care services remains restricted for patients who have diabetes or obesity. Improving community health and eliminating health differences requires immediate resolution of these service deficiencies.

Community Resources

Two available resources can fill these gaps. Implementing a mobile screening clinic providing affordable tests for diabetes and obesity and mental health assessment would create additional preventive care opportunities for underserved communities. A mobile clinic would bring healthcare services to multiple neighborhoods through travel operations. A community center established to offer free fitness instruction, mental health workshops, and nutrition counselling functions as an essential health promotion center (Alegria et al., 2022). The proposed community center establishes a platform for community engagement, enabling people to obtain helpful resources to develop better lifestyles Population Health Using a Community Lens – NURS 4212: Population Health Nursing.

Conclusion

Deploying these research-backed interventions will substantially improve health results among my selected population (Sinha et al., 2024). Implementing community-centered strategies aimed at obesity control, diabetes management, and mental wellness improvement will establish an equitable, healthier community. Routine assessments and periodic intervention changes will support their sustained value and performance. The implemented initiatives provide both short-term healthcare solutions and develop lasting frameworks for community wellness and strength.

References

Alegría, M., Zhen-Duan, J., O’Malley, I. S., & DiMarzio, K. (2022). A new agenda for optimizing investments in community mental health and reducing disparities. 
American Journal of Psychiatry
, 
179
(6), 402-416.
https://psychiatryonline.org/doi/abs/10.1176/appi.ajp.21100970?af=R

Hunt, S. H. (2021). Multi-Project Report: Physical Activity and Nutrition Promotion in Riley County, Kansas.
https://krex.k-state.edu/bitstream/2097/41524/2/Hunt%20Report.pdf

Klein, M. (2024). 
Addressing Healthcare-Related Bankruptcy: A Comparative Analysis of Healthcare Systems in the United States, United Kingdom, Germany, the Netherlands, Japan, Australia, and Canada
 (Doctoral dissertation).
https://baylor-ir.tdl.org/items/b8391bc5-990a-47f7-ac19-ee0b05562201

Sinha, T. P., Bhoi, S., Sharma, D., Chauhan, S., Magan, R., Sahu, A. K., … & Jubair, N. (2024). Strengthening facility-based integrated emergency care services for time sensitive emergencies at all levels of healthcare in India: An implementation research study protocol. 
Health Research Policy and Systems
, 
22
(1), 125.
https://link.springer.com/article/10.1186/s12961-024-01183-x

 

 

Population Health Using a Community Lens – NURS 4212: Population Health Nursing

NURS 4212:
Population Health Nursing

Module 4 Assignment: Population Health Using a Community Lens

 
Student Name Here

Program Name or Degree Name, Walden University

Course Number, Section, and
Title

(Example: NURS 0000 Section 01, Title of Course)

Instructor Name

Month, Day, Year

(Enter the date submitted to Instructor.)

 

Population Health Using a Community Lens

Complete the following prompts. Cite and reference in APA format.

Identify
one evidence-based community intervention at the primary level
(from the literature that promotes health and prevents problems before they occur)
for each of 3 health problems
identified in your chosen population in Part I of this Assignment. (3 resources)

Explain how those three evidence-based interventions could be
helpful for your community and your target population
. (3 paragraphs, 1 paragraph for each intervention)

Describe how
one
of those three interventions
reflects social justice, compassion, or cultural sensitivity
. (1 paragraph)

Detail how
one
of those three interventions is grounded in a
health promotion or disease prevention theory or model
. (1 paragraph and 1 resource)

Consider your own community for a moment. What
gaps in service
do you see that affect your population’s health problems? (1 paragraph)

Provide
two examples of

community resources
that could be put into place to assist your population to meet their health needs. (1 paragraph)

 

References

Population Health Using a Community Lens – NURS 4212: Population Health Nursing

Planning for Community and Organizational Change Essay

Planning for Community and Organizational Change

Health discrepancies and poor ingress to healthcare services are serious issues in many areas of the United States. Notably, these discrepancies are preventable health situations linked to socioeconomic and environmental factors. Cost is the biggest driver of these issues, and some people and areas are exposed to illnesses because of a lack of insurance coverage. In a country where almost 28 million people had no insurance coverage during COVID-19 in 2020, much must be done to improve the healthcare system (Keisler-Starkey & Bunch, 2022). It is even more challenging for people in rural areas who must traverse long distances to access healthcare services. Thus, this paper will propose and solicit assistance from facility executives to transform Jordan’s healthcare system.

Summary

To foster the area’s population health, I suggest that St. Francis Health Center collaborate with the Health and Human Services Department to open a satellite healthcare institution at the core of downtown Jordan where patients can walk. This health department tries to offer critical human services and foster population health, mainly in marginalized areas. The HHS is collaborating with local facilities in different areas of the United States to coordinate and fund projects and invest in interpositions to reduce healthcare discrepancies; thus, when the local healthcare system in Jordan partners with HHS, funds to address some of the healthcare challenges impacting residents may be dispersed improving healthcare immensely.

Benefits and Implications

Located in Scott County, where the physician-to-patient ratio is 1:1935, the Jordan area may accrue several benefits if St. Francis sets up a satellite institution (Data USA, n.d). One fundamental benefit is enhanced access to healthcare since people do not have to travel long distances. Notably, improved access means decreased mortality because early detection and preventive care will decrease the threat of death from several conditions. Also, access to healthcare services means there will be equitable services that will tackle discrepancies among diverse racial and socioeconomic groups. A lack of access inordinately impacts vulnerable people in the Jordan region, elevating the current inequities in health results.

Another benefit is improved medical services. With more satellite institutions, the Jordan region will provide a wider cluster of clinical services, comprising surgeries and specialized care, leading to excellent healthcare results. Moreover, when medical services are improved, it implies the region gets a rapid emergency response. Proximity and distance to a facility can immensely decrease response periods during emergencies.

Lastly, the expansion of St. Francis means there will be more employment chances that positively change the physician-patient ratio. This expansion develops jobs for healthcare professionals and support and administrative employees, stimulating Jordan’s economy.

Remarkably, even with these positive benefits and effects, establishing this satellite institution may have an environmental effect. For example, land use changes and raised energy use may affect the environment where the facility will be established.

Potential Barriers to this Transformation

Even though the new satellite facility is supposed to ease access to healthcare services, there are several barriers that the change might face. One potential hurdle is community resistance because of concerns like increased noise and traffic (Rajhans, 2018). Most of the time, downtown areas are congested with traffic, and establishing the new facility might aggravate the situation.

Another barrier is land utilization regulation and zoning. Some areas possess particular zoning regulations that St. Francis must navigate before establishing the facility. For example, downtown Jordan might have laws that prescribe the type of complexes permitted, intended use, and size, affecting the practicality of building a new facility.

Proactive Strategies

A comprehensive communication plan is vital in making organizational stakeholders understand. This plan will have a key message that elucidates the reason behind these transformations, the gains, and how they will position the institutions’ values, mission, and objectives. The organization has different stakeholders, implying that communication must be tailored according to the needs of each stakeholder group. This is because each group has distinct interests and concerns. Further, the plan should also encompass regular updates on the project’s progress. These frequent briefs engage and keep them informed during the implementation process, decreasing resistance and doubt. These updates can be enhanced with visual aid of the project.

Changing Barriers into Opportunities

Furthermore, overcoming these barriers needs open communication and involving every stakeholder (Stouten et al., 2018). When open communication lines exist, it implies that resistance is drastically reduced because this communication tackles all concerns, dismisses all misapprehensions, and spotlights the positive consequences of having this facility in downtown Jordan. Further, open communication and involvement of stakeholders will help St. Francis and its partners to collect intuitions since these local stakeholders possess and bring diverse perspectives about the project. This means St. Francis can tap into their concepts and skills, leading to excellent solutions. Lastly, collaborating and coordinating solutions with locals is vital Planning for Community and Organizational Change Essay.

Conflicts are inevitable during the implementation of changes, and there is a need to establish feedback mechanisms that will allow everyone’s input to be considered; feedback allows frequent evaluation of the project and successful resolutions.

In summation, proposing strategies to enhance population health is massive. While the proposal can positively affect the local Jordan community and St. Francis Health Center, it might encounter resistance from diverse stakeholders. Thus, the facility must find ways to convince all internal and external stakeholders of the significance of this project. Overcoming hurdles and changing them into opportunities may be challenging if the organization needs to communicate with stakeholders effectively. Having a satellite healthcare facility downtown can help close the healthcare disparities experienced in this community.

References

Data USA. (n.d.).
Jordan, MN
. Data USA. https://datausa.io/profile/geo/jordan-mn/#health

Keisler-Starkey , K., & Bunch, L. N. (2022, August 22).
Health insurance coverage in the United States: 2020
. Census.gov. https://www.census.gov/library/publications/2021/demo/p60-274.html

Rajhans, K. (2018). Effective communication management: A key to stakeholder relationship management in project-based organizations. 
IUP Journal of Soft Skills
, 
12
(4), 47-66.

Stouten, J., Rousseau, D. M., & De Cremer, D. (2018). Successful organizational change: Integrating the management practice and scholarly literatures. 
Academy of Management Annals
, 
12
(2), 752-788.

Appendix 1: Grant Proposal

Need Statement
: Jordan residents have a challenge in accessing healthcare services fast. Setting up a satellite facility will ease screening and preventive care in this area, improving health outcomes. This proposal will benefit everyone in this downtown area and decrease any health discrepancies. Further, the project seems simple but it might face a myriad of issues that can be resolved via open communication with stakeholders.

Description of Program
: It is a satellite facility affiliated with St. Francis Health Center. The project aims to increase access and reduce healthcare costs like transportation. Also, it aims to decrease preventable mortalities. Furthermore, the execution of this project will be in 3 phases. Preparation for change will be the initial phase and it comprises setting objectives, formulating strategic plans, and allocating monies. The second step is the actual execution and it entail renting a complex, recruiting and hiring staff, and procuring every resource and equipment. Lastly, evaluation of all existing project gaps. 16-18 months is the estimated time of completing the project.

Summary

The project aims to increase access and reduce health disparities in the community.

Appendix II: Budget Estimates (All Amounts in $)

Item

1
st
Year

Other Sources of Income

Wages and Salaries

 

Donations 500000

Project Manager

120000

 

Support Employees (7)

62000

 

Physicians (2)

200000

 

Nurses (5)

200000

 

Margin Benefits

 

 

Health Insurance for workers

84000

 

Contract Services

 

 

IT Specialists

60000

 

Rent/Lease

150000

 

Equipment

 

 

Furniture

70000

 

Laptops and Tablets

85000

 

Materials

 

 

Medical equipment and Pharmaceuticals

200000

 

Others

 

 

Staff Training

60000

 

Internet

10000

 

Total

1301000

801000

 

Draft a 3-5 page change proposal to executive leaders, soliciting their support for a change to the health care system in the community you selected in the previous assessment.

Introduction

To improve health care outcomes within a community, leaders must understand the needs of specific populations. In addition, it is important that leaders are able to gather and present persuasive evidence to decision makers to obtain the necessary funding and establish these needs as priorities for budget and resource planning. Thus, proposed changes should support improved outcomes and align with the current or needed health care policy.

This assessment provides an opportunity to propose a community health care change that is based on the community health assessment you completed in Assessment 2.

Preparation

Your community health assessment was well received by the executives at Vila Health. Consequently, they have asked you to recommend a change in the community that will improve health outcomes. They have also asked you to submit your recommendation in a formal change proposal. You are confident that you can present a strong case for change, including a financial plan, that will ensure the success of this initiative.

In this assessment, you will draft a change proposal to executive leaders to solicit support for a change to the current community health care system. To prepare for the assessment, you are encouraged to begin thinking about your justification for establishing the recommended change as a priority, a strategy for leading change, and how the change will be funded. In addition, you may wish to:

Review the assessment requirements and scoring guide to ensure that you understand the work you will be asked to complete.

Review Guiding Questions: Planning for Community and Organizational Change [DOCX], which includes questions to consider and additional guidance on how to successfully complete the assessment.

Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.

The following resource is required to complete the assessment.

Vila Health: Planning for Change.

Vila Health is a virtual environment that simulates a real-world health care system. In the various Vila Health scenarios, you will apply professional strategies, practice skills, and build competencies that you can apply to your coursework and in your career. The information you gather in this scenario will help you to complete the assessment.

Templates

Use this template for your change proposal.

Change Proposal Template [DOCX].

Requirements

Complete this assessment in two steps:

If you have not already done so, complete the Vila Health: Planning for Change simulation.

Draft a change proposal to justify your recommendation for improving the health of the community and establish the change as a priority for the next budget cycle. Consider the feasibility of your proposed change, in terms of overall scope, funding, and timeframe Planning for Community and Organizational Change Essay.

The change proposal requirements outlined below, correspond to the grading criteria in the scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. The Guiding Questions: Planning for Community and Organizational Change document provides additional considerations that may be helpful in completing your assessment. In addition, be sure to note the requirements below for document format and length and for citing supporting evidence.

Identify the benefits of proposed health care system changes and its implications for a community.

Describe potential barriers to change in an organization or community.

Develop strategies for changing barriers into opportunities and resolving conflict.

Develop a strategy for helping organizational stakeholders understand and evaluate the proposed changes to an existing health care system.

Develop a grant proposal and associated budget for a proposed change to an existing health care system.

Write clearly and concisely in a logically coherent and appropriate form and style.

Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

Document Format and Length

Use the Change Proposal Template. This APA Style Paper Tutorial [DOCX] can help you in writing and formatting your assessment. If you would like to use a different template or document format for your change proposal, obtain prior approval from faculty.

Your change proposal should be 3–5 pages in length, not including the title page and references page.

Be sure to apply correct APA formatting to all source citations and references.

Supporting Evidence

Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your change proposal.

Additional Requirements

Proofread your change proposal before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your analysis.

Portfolio Prompt: You may choose to save your change proposal to your ePortfolio.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Identify the challenges and opportunities facing health care.

Identify the benefits of proposed health care system changes and its implications for a community.

Competency 2: Compare the effects of different health care finance models and policy frameworks on resources and patient outcomes.

Describe potential barriers to change in an organization or community.

Develop a grant proposal and associated budget for a proposed change to an existing health care system.

Competency 4: Develop proactive strategies to change the culture of the organization by incorporating evidence-based practices.

Develop a strategy for helping organizational stakeholders understand and evaluate the proposed changes to an existing health care system.

Develop strategies for changing barriers into opportunities and resolving conflict.

Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style consistent with applicable organizational, professional, and scholarly standards.

Write clearly and concisely in a logically coherent and appropriate form and style.

Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.

Scoring Guide

Use the scoring guide to understand how your assessment will be evaluated Planning for Community and Organizational Change Essay

Assessing a Healthcare Program/Policy Evaluation

Healthcare Program/Policy Evaluation Analysis Template

 

Use this document to complete the Module 5 Assessment
Assessing a Healthcare Program/Policy Evaluation

Joan Wade

 

 

 

Healthcare Program/Policy Evaluation

 

Massachusetts Health Policy Commission: Health Care Cost Growth Benchmark Policy Evaluation

Description

The Massachusetts Health Policy Commission (HPC) is a state agency created to address healthcare costs while maintaining quality. Massachusetts was the first state to use this approach in 2012, with the HPC being responsible for collecting data on health care costs and setting a yearly cost growth benchmark (Chen, 2025).

How was the success of the program or policy measured?

 

 

The primary indicator is keeping annual spending increases at or below the specified target. Secondary outcomes include increased transparency and greater accountability among payers and providers, and a shift toward prevention-focused care.

How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?

 

 

Because it applies to all payers and providers, the benchmark affects all 7 million Massachusetts residents, and since 2012, health care cost growth has remained at or near the benchmark in most years, which has resulted in slower premium growth in Massachusetts. For my patients, this means coverage has remained more stable than it would have been otherwise, and the HPC does ongoing evaluations through annual Cost Trends Reports, which represents more than ten years of data.

At what point in program implementation was the program or policy evaluation conducted?

 

The HPC measures have been in place since 2012, and the program has conducted evaluations on a yearly basis, using data submitted from many sources. The policy evaluations are provided annually in the HPC’s annual Cost Trends Reports and at public forums, during which stakeholder input is gathered. The reports themselves represent more than ten years of data.

What data was used to conduct the program or policy evaluation?

 

 

The HPC measures success by tracking whether total health care expenditures remain at or below the annual benchmark. Data sources include claims from commercial insurers, MassHealth, and Medicare, along with enrollment data, premium information, and prescription drug spending. The HPC also monitors quality indicators and regional variation in high-cost services (Berger & Czypionka, 2021). The HPC does ongoing evaluations through annual Cost Trends Reports.

What specific information on unintended consequences were identified?

 

Secondary outcomes include increased transparency and greater accountability among payers and providers, and a shift toward prevention-focused care. The HPC’s standards have unintended consequences, and some providers worry that cost containment limits investment in technology and workforce development. There is also the concern that cost pressures will reduce access in underserved areas if providers close clinics in lower-margin communities. Digital access is very important, and moving to online healthcare can harm equity if it goes forward without addressing the consumers’ access to online content, which requires planning (Lyles et al., 2021).

What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.

 

 

Stakeholders include state officials, insurers, hospital systems, physician groups, consumer advocates, employers, and patients. The HPC holds annual public hearings where these groups provide input. Those who benefit most from the results and reporting of health policy evaluation include consumer advocacy groups who can hold the system accountable. For example, Health Care For All used ConnectorCare program data showing average premium reductions of $150 per month and improved preventive care access to advocate for extending affordable coverage to over 40,000 residents (Health Care For All, 2026).

Did the program or policy meet the original intent and objectives? Why or why not?

 

 

The HPC has largely met its primary objective. Spending growth has remained at or near target since 2012, but the policy has been less successful in its secondary objectives. Some populations have disparities in access and affordability. Research shows that care that meets the guideline’s standards improves outcomes and reduces ineffective interventions (Lindqvist et al., 2022), but the benchmark alone does not ensure that providers follow evidence-based guidelines. Hospital spending still accounts for a large share of expenditures despite goals to shift care to community settings. However, the Massachusetts model shows that transparent, data-driven accountability can slow cost growth without necessarily reducing quality.

Would you recommend implementing this program or policy in your place of work? Why or why not?

 

 

The HPC’s program is already in place statewide and applies to my hospital by default. It has been successful in achieving its primary goal and has for the most part done so without compromising quality of care. For my patients, this means coverage has remained more stable than it would have been otherwise. However, my interest and that of my patients is more focused on the program’s secondary goals. Healthcare equity must be taken into consideration, not as a secondary goal but as a primary focus. Many patients suffer from disparities in access and affordability, and the policy benchmark does not ensure that providers follow evidence-based care guidelines. That is where I would focus my advocacy efforts.

Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation.

 

 

As a nurse advocate, I plan to participate in the HPC’s annual Cost Trends Hearing process by attending public hearings and submitting testimony that presents the perspectives of patients and front-line clinicians. The HPC actively solicits input from the public, and nurses have direct insight into how cost pressures affect care at the bedside. For example, I could testify about how my patients face barriers to access or affordability that the cost data does not capture.

 

I also plan to work with quality improvement teams in my organization to collect and analyze data on how the benchmark affects clinical outcomes and patients, especially among underserved populations. We could design surveys to assess whether patients have experienced changes in access to care or out-of-pocket costs since the benchmark was implemented. Data collection that tracks equity indicators would help ensure that vulnerable patients’ needs are reflected in the evaluation process.

General Notes/Comments

The Massachusetts HPC’s cost growth benchmark is a clear way to evaluate healthcare spending. It helps policymakers to track cost trends and provides a transparent view of how that control affects our patients. The benchmark has largely achieved its primary objective of cost control, but it’s important that we continue to pay attention to its effect on healthcare equity. As a nurse advocate, I am committed to ensuring that cost containment keeps patients at the center of policy decisions.

 

 

References

Berger, M., & Czypionka, T. (2021). Regional medical practice variation in high-cost healthcare services.
The European Journal of Health Economics, 22
(6), 917-929. https://doi.org/10.1007/s10198-021-01298-w

Chen, L. J. (2025). The problem with California’s plan to contain health care costs.
JAMA Health Forum, 6
(7), e253383. https://doi.org/10.1001/jamahealthforum.2025.3383

Health Care For All. (2026, January 29). Press statement: Health Care For All reacts to Governor Healey’s budget plan [Press release]. https://hcfama.org/press-statement-health-care-for-all-reacts-to-governor-healeys-budget-plan-january-29-2026/

Lindqvist, J., Jekunen, A., Sihvo, E., Johansson, M., & Andersén, H. (2022). Effect of adherence to treatment guidelines on overall survival in elderly non-small-cell lung cancer patients.
Lung Cancer, 171
, 9-17. https://doi.org/10.1016/j.lungcan.2022.07.006

Lyles, C. R., Wachter, R. M., & Sarkar, U. (2021). Focusing on digital health equity.
JAMA, 326
(18):1795-1796. https://doi.org/10.1001/jama.2021.18459 Assessing a Healthcare Program/Policy Evaluation

Benchmark – Part A: Population Health Research and PICOT Statement

Grand Canyon University

Translational Research and Population Health Management

NUR-550

Introduction

Health disparity is the difference in the occurrence, mortality and prevalence of diseases and the associated adverse health issues that exist among groups of the population. These specific groups within the population maybe depicted by age, ethnicity or race, gender, income, education, disability, social class, sexual orientation, or geographic location (Center for Disease and Prevention, 2020). This paper will discuss the noticeable difference in the Human Immunodeficiency Virus (HIV) rates within minority groups namely Blacks/ African Americans and Latinos/ Hispanics. The demographics along with health determinants, nursing science, genomic and genetic, and epidemiology will also be explained and how these factors may affect populations health management. An overview of a possible solution will also be provided for resolving this issue in the minority population along with a PICOT statement.

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Ethnicity and race are linked to human ancestry. Race is defined as a group of people who have specific distinctive common physical traits, such as hair texture and skin color. Ethnicity means  groups of people categorized according to a common language, race, tribe, religion, background or cultural origin (Blakemore, 2020). Ethnic and racial minorities is one of the fastest growing communities in the United States. Yet, figures on health status have revealed poorer health outcomes among racial and ethnic minorities regarding death and preventable diseases (National HIV Curriculum, 2021).

Population Demographic

Hispanics and Blacks noticeably out number all other racial and ethnic groups. In the year 2018 African American represented only 13% of the entire population but they accounted for 41% of people living with HIV. Latinos represent 15% of the population but they accounted for 23% of people living with HIV. Asians made up 6% of population and accounted for 1.5%.  This disparity also exists in the new HIV infection rates. Subpopulations within these ethnic groups are more adversely affected.  Men who have sex with men are affected the most. They represent 70% of all new HIV infections, even though they only make up 2% of the entire population. (National Curriculum of HIV, 2021).

Health Disparity

Health disparities are differences in injuries, violence, disease burden or experiences that prevent specific population from attaining maximum health and are experienced by populations that are socially disadvantaged. Despite medical advances in the treatment of HIV, minority groups continue to be one of public health biggest concerns. There are many variables that affect minority health. It is essential that practitioners of public health are aware of these disparities and how they affect these groups.

Nursing Science and Health determinants

Nursing actions and interventions focused on decreasing the inequalities that exist in health should be targeted at racial and ethnic minorities. These interventions should emphasize design and delivery to encourage and promote access and use of services and resources. Nursing science is crucial as it carries out research and apply the results to bridge the gap between clinical setting and specific populations (Grady, 2017). Numerous determinants do exist in understanding the distinctive and unique susceptibility to HIV in ethnic and racial minority populations. The determinants are trauma, poverty, and incarceration. These determinants are disproportionate in the minority groups especially Blacks and Latinos. For example, Latinos and Blacks are more likely to experiment with illegal substances or turn to sex work, both activities increase their vulnerability. The use of drugs and engaging in illegal activities can lead to increased incarceration rates, which damages the familial foundations and break up stable sexual partnerships increasing the vulnerability to HIV even more. These determinants are synergistic and reciprocal. Imprisonment may lead to unemployment and poverty. Poverty leads to increased risky behaviors and drug use. These behaviors increased the likelihood of them becoming infected. Research in social sciences has also correlated the experience of adverse health outcomes with stigma. Stigma and stress may contribute to increased numbers of depression, substance abuse, engaging in risky sexual behaviors which will increase the risk even more. For example, sex with multiple partners and condom less sex. (National Hiv Curriculum, 2021).

Epidemiolgy

Epidemiology continues to show that HIV infections rates are higher in minority groups. The estimated prevalence of HIV infection takes into consideration the entire population living with HIV, diagnosed and undiagnosed. In 2018, the Center for Disease Control and Prevention (CDC) reported that 1173,200 people 13 years and older were living with HIV of which 482,900 were Blacks and 274000 were Hispanics. Surveillance data also revealed that in 2018, 36,400 were newly infected of which 15,300 were black and 10,300 were Latinos. The projected overall lifetime risk of being infected with this virus in the U.S. is 0.94%-0.95%. This risk significantly varies by ethnic and racial groups and sex. Male has a lifetime risk of 1 in 68, however a black male is 1 in 22. Men who have sex with men from all ethnic/racial group are at a very high risk of becoming infected (1 in every 6). For black men it is  (1 in 2). This shows the significant disparity that must be addressed to meet the goal of healthy people 2030. (National HIV Curriculum, 2021).

Genomic and genetics

The death rates among blacks are 6.5 times higher than whites and 3.6 higher than Latinos. Retrospective studies analysis of insurance records and hospitals revealed that blacks were 6 times more likely than whites to need hospitalization. Achieving suppression of plasma RNA is very crucial in the fight against HIV. Studies showed that after giving antiviral regimen to different population, blacks had 40% more virologic failure than whites and this was seen when replicated with  multiple antiretroviral therapies medications. This is crucial when addressing disparity in fighting HIV in public health (National HIV Curriculum, 2021).

Potential Solutions and PICOT statement

A multidisciplinary approach will be needed to reduce the HIV disparity that exists in ethnic/racial groups. The structural and social drivers of HIV must be addressed and should be tailored to meet local and cultural needs of these populations. Community partnership will be needed, academic institutions, public and private players, media personnel and faith-based organizations can promote awareness, testing and prevention. For example, faith-based organization usually play a significant role with blacks. Faith based organizations can be used to promote Healthy People 2030 agenda-health for all with a specific focus on HIV. The HIV workforce should focus on the recruitment of minority practitioners as well as enhancing practitioner’s cultural competency. Racial concordance has shown to increase rates of testing for sexually transmitted disease among Black/American women and improve rates of adherence to medication regimen (National HIV Curriculum, 2021).

The PICOT statements. P- Ethnic and racial minority diagnosed with HIV. I- An analysis of the racial and ethnic health disparity that creates a barrier and increase the risk of minorities likelihood of getting infected. C-Promoting and enhancing equity to the access of quality healthcare to minorities living with HIV. O-Improved delivery and access to quality healthcare for minorities living with HIV; contributing to the 2030 healthy people goal whose mantra is building a healthier future for all. T 1-2 years.

Research carried out by academia should be translated to interventions that benefit minority communities. Results of these researches should also influence policies and programs that are specific to HIV and the minorities communities. Interventions that are replicable and sustainable should be implemented to stimulate innovation and research in meeting Healthy People 2030, health for all people. A foundational principle of healthy people 2030 is attaining well-being and health for everyone, which will require putting an end to health disparity, attaining health equity and accomplishing health literacy. For this to be achieved measurable national goal have to be set and guided by evidence-based programs and policies and provide factual, accessible and timely data that can guide selected interventions to address populations that are at high risks for poor health or have poor health outcomes (Office of Disease Prevention and Promotion, n.d.)

References

Blakemore, E., (2019). Race and ethnicity explained.
National Geographic.

 https://www.

HIV in Racial and Ethnic Minority Populations – Core Concepts (uw.edu)

Centers for Didease Control and Prevention, (2020).
African American Blacks.

 
https://www.
African Americans | Health Disparities | NCHHSTP | CDC

Grady P.A. (2017). Investigating the determinants of health: The role of nursing science. Official Journal of the American Academy of Nursing.
Nursing Outlook
. 
Official Journal of the council for the Advancement of Nursing Scien
ce
. Vol. 65
(5) , pp. 489-491.Retrieved June 8, 2019, from
https://www.nursingoutlook.org/article/S0029-6554(17)30189-6/fulltext

National HIV Curriculum, (2021).
Hiv in ethnic and racial minority populations.

 
https://
HIV in Racial and Ethnic Minority Populations – Core Concepts (uw.edu)

Office of Disease Prevention and Promotion, (n.d). Healthy people 2030 framework.

U.S.Department of Health and Human Services.

 
https://www.
Healthy People 2030 Framework – Healthy People 2030 | health.gov

Global Healthcare Comparison Matrix and Narrative Statement

Global Health Comparison Grid Template
 

Global Healthcare Issue

HIV/AIDS

 

Description

HIV/AIDS is a (World Health Organization (WHO) priority because approximately 40.8 million people were living with HIV at the end of 2024, and 630,000 people died from HIV-related causes that year (World Health Organization [WHO], 2025). HIV is also associated with chronic conditions such as metabolic syndrome, making it an ongoing healthcare problem (Asgedom et al., 2024).

Country

United States

 

Uganda

Describe the policy in each country related to the identified healthcare issue

The Ryan White HIV/AIDS Program (RWHAP), passed in 1990, finances HIV care and support services for low-income or uninsured people with HIV, including funding for community health workers and patient navigators (Shade et al., 2021; Davoust et al., 2021). Medicaid expansion has also improved care and helped patients to reduce their viral load (Basu et al., 2025), with expansion states showing greater PrEP uptake (Hatch et al., 2025).

Uganda’s National HIV Strategic Plan (NSP) uses WHO’s treat-all approach, and prioritizes adolescent viral suppression and TB-HIV integration (Oryokot et al., 2020). It also prioritizes service delivery tailored to patient needs (Wilkinson & Grimsrud, 2020) Global Healthcare Comparison Matrix and Narrative Statement.

What are the strengths of this policy?

Strong funding, advanced diagnostics, and 77% global ART coverage influenced by PEPFAR (WHO, 2025)

Task-shifting authorizes nurses to initiate ART, which expands access amid physician shortages (Davey et al., 2023).

What are the weaknesses of this policy?

Outcomes vary by race and geography, with the rural and Deep South non-expansion states showing lower rates of suppression (McClarty et al., 2021). AIDS Drug Assistance Program (ADAP) recertification requirements often interrupt treatment (Erly et al., 2022).

Dependence on donor funding creates a large vulnerability. TB stigma persists with sex disparities (Sekandi et al., 2024). Women with disabilities have lower HIV testing utilization (Zandam et al., 2021).

Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)

 

In the U.S., housing instability and inadequate insurance contribute to ART non-adherence, and racial disparities persist across the care continuum (Moroko et al., 2025) Global Healthcare Comparison Matrix and Narrative Statement.

In Uganda, poverty and rural residence reduce care access, while transportation costs cause treatment interruption, and adolescent girls carry disproportionate disease risk (Moroko et al., 2025)

How has each country’ government addressed cost, quality, and access to the selected global health issue?

U.S. annual HIV treatment costs approximately $28,950 per person, with lifetime costs of $1.08 million (HIV+Hepatitis Policy Institute, 2022). Medicaid expansion improves suppression but requires FQHC capacity and navigation supports (Sommers et al., 2024).

In Uganda, HIV services are free through donor programs. Dried blood spots expand rural viral load monitoring (Simushi et al., 2023). Globally, 87% know their status, 77% are on ART, and 73% achieved suppression (WHO, 2025).

How has the identified health policy impacted the health of the global population? (Be specific and provide examples)

The President’s Emergency Plan for AIDS Relief (PEPFAR) and Global Fund contributions have reduced HIV deaths 54% since 2010, from 1.4 million in 2010, to 630,000 in 2024 (WHO, 2025).

Retention interventions improve disease outcomes (Joaquim et al., 2023). To reach 95-95-95 targets, 3.2 million more people need diagnosis and 5.2 million more need treatment (WHO, 2025).

Describe the potential impact of the identified health policy on the role of nurse in each country.

In the U.S., nurses support screening, care coordination, and telehealth follow-up for adherence (Rutledge et al., 2021).

In Uganda, nurses are the primary HIV providers through task-shifting. Nurse Initiated Management of Anti-Retroviral Therapy (NIMART) has expanded coverage but increases nursing workload (Davey et al., 2023). Nurses lead QI initiatives and integrate HIV with cervical cancer screening, but there are large training gaps (Oryokot et al., 2020; Obol et al., 2021).

Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)

In the U.S., global rapid-ART initiatives have influenced hospital policies supporting same-day treatment starts

In Uganda, the National HIV and AIDS Strategic Plan (NSP) addresses global targets locally and facilities align with PEPFAR reporting. The system develops HIV estimates using Spectrum and Naomi tools (Eaton et al., 2021).

General Notes/Comments

 

 

 

Part 2: Plan for Social Change

 

Advocacy for Global Health

As a nurse leader, I would advocate for three strategies: 1) Routine screening to identify housing instability and insurance gaps (Moroko et al., 2025); 2) Protocols for treat-all service delivery (Wilkinson & Grimsrud, 2020); and 3) Nurse-led case management models that improve service uptake (El-Bassel et al., 2022).

Impact on Local Practice

I would support nurse-led discharge planning to address social barriers, and screening for housing and insurance before discharge, then use referrals to assistance programs. Evidence shows nurse-led interventions improve adherence (El-Bassel et al., 2022). I would advocate for telehealth follow-up for patients with transportation barriers (Rutledge et al., 2021) and work with community organizations that provide housing and food supports.

Social Change

By applying strategies used globally, like task-shifting and QI frameworks we can provide better, more equitable care. By advocating for nurses to initiate PrEP we would be using the effective examples of scope expansions that have increased access in resource-limited settings (Davey et al., 2023). Applying Uganda’s QI methods here would show how global learning can create local change (Oryokot et al., 2020).

References

Asgedom, Y., Kebede, T., Gebrekidan, A., Koyira, M., Azeze, G., Lombebo, A., Legesse, B., & Kassie, G. (2024). Prevalence of metabolic syndrome among people living with human immunodeficiency virus in sub-Saharan Africa: A systematic review and meta-analysis. Scientific Reports, 14(1), Article 12021. https://doi.org/10.1038/s41598-024-62497-y

Basu, S., Phillips, R., & Hoang, H. (2025). Impact of community health center losses on county-level mortality: A natural experiment in the United States, 2011–2019.
Health Services Research, 60
(5), Article e14648. https://doi.org/10.1111/1475-6773.14648

Davey, D., Wilkinson, L., Grimsrud, A., Nelson, A., Gray, A., Raphael, Y., Stein, D., & Bekker, L.-G. (2023). Urgent appeal to allow all professional nurses and midwives to prescribe pre-exposure prophylaxis (PrEP) in South Africa.
South African Medical Journal
, 113(8), 12–16. https://doi.org/10.7196/samj.2023.v113i8.1191

Eaton, J., Dwyer-Lindgren, L., Gutreuter, S., O’Driscoll, M., Stevens, O., Bajaj, S., Brazeau, N., Teng, Y., Fellows, I., Rumero, J., Francis, S., Ogungbenro, K., & Shiraishi, R. (2021). Naomi: A new modelling tool for estimating HIV epidemic indicators at the district level in sub-Saharan Africa.
Journal of the International AIDS Society, 24
(S5), Article e25788. https://doi.org/10.1002/jia2.25788

El-Bassel, N., McCrimmon, T., Wu, E., Chang, M., Terlikbayeva, A., Hunt, T., Primbetova, S., & Gilbert, L. (2022). Effectiveness of an intervention to improve HIV service delivery for people who inject drugs in Kazakhstan.
JAMA Network Open, 5(
12), Article e2244734. https://doi.org/10.1001/jamanetworkopen.2022.44734

Erly, S., Khosropour, C., Hajat, A., Sharma, M., Reuer, J., Grimm, M., Herbeck, J., & Dombrowski, J. (2022). Characterization of the population affected by the 6-month recertification criterion of the Ryan White HIV/AIDS Program’s AIDS Drug Assistance Program in Washington State, 2017–2019.
JAIDS Journal of Acquired Immune Deficiency Syndromes, 89
(1), 27–33. https://doi.org/10.1097/qai.0000000000002824

HIV+Hepatitis Policy Institute. (2022). U.S. PrEP cost analysis final report.
RTI International.
https://hivhep.org/wp-content/uploads/2022/11/PrEP_Cost_Final_Report_21November2022.pdf

Joaquim, L., Miranda, M., Pimentel, V., Martins, M., Nhampossa, T., Abecasis, A., Camacho, R., Viegas, S., & Pingarilho, M. (2023). Retention in care and virological failure among adult HIV-positive patients on first-line antiretroviral treatment in Maputo, Mozambique.
Viruses, 15
(10), Article 1978. https://doi.org/10.3390/v15101978

McClarty, L., Blanchard, J., & Becker, M. (2021). Leaving no one behind? An equity analysis of the HIV care cascade among a cohort of people living with HIV in Manitoba, Canada.
BMC

Public Health, 21
(1), Article 316. https://doi.org/10.1186/s12889-021-10225-w

Moroko, K., Rensburg, Z., & Jacobs, W. (2025). Experiences of nurses in patient adherence to antiretroviral therapy in Mpumalanga, South Africa.
African Journal of Primary Health Care & Family Medicine, 17
(1), Article 4841. https://doi.org/10.4102/phcfm.v17i1.4841

Oryokot, B., Miya, Y., Logose, B., Ajambo, E., Oluka, A., Odoi, C., Alege, J., & Mugisha, K. (2020). Interventions to improve HIV viral load suppression among the adolescents: Evidence of improvement science through a quality improvement approach in Eastern Uganda.
World Journal of AIDS, 10
(2), 94–106. https://doi.org/10.4236/wja.2020.102008

Rutledge, C., O’Rourke, J., Mason, A., Chike-Harris, K., Behnke, L., Melhado, L., Downes, L., & Gustin, T. (2021). Telehealth competencies for nursing education and practice.
Nurse Educator, 46
(5), 300–305. https://doi.org/10.1097/nne.0000000000000988

Sekandi, J., Quach, T., Olum, R., Nakkonde, D., Farist, L., Obiekwe, R., Turyahabwe, S., & Buregyeya, E. (2024). Stigma and associated sex disparities among patients with tuberculosis in Uganda: A cross-sectional study.
Therapeutic Advances in Infectious Disease, 11
, Article 20499361241305517. https://doi.org/10.1177/20499361241305517

Shade, S., Marseille, E., Kirby, V., Chakravarty, D., Steward, W., Koester, K., Storholm, E., & Myers, J. (2021). Health information technology interventions and engagement in HIV care and achievement of viral suppression in publicly funded settings in the US: A cost-effectiveness analysis.
PLOS Medicine, 18
(4), Article e1003389. https://doi.org/10.1371/journal.pmed.1003389

Simushi, P., Kalunga, M., Mwakyoma, T., Mwewa, M., Muchaili, L., Hazeemba, N., Ndhlovu, Z., & Kasonka, L. (2023). Verification of dried blood spot as a sample type for HIV viral load and early infant diagnosis on Hologic Panther in Zambia.
BMC Research Notes, 16
(1), Article 145. https://doi.org/10.1186/s13104-023-06344-9

Sommers, B., Gullett, L., & Hornstein, S. (2024). Medicaid’s edge case—Potential expansion and work requirements in Mississippi.
JAMA Health Forum, 5
(10), Article e244523. https://doi.org/10.1001/jamahealthforum.2024.4523

Wilkinson, L., & Grimsrud, A. (2020). The time is now: Expedited HIV differentiated service delivery during the COVID-19 pandemic.
Journal of the International AIDS Society, 23
(5), Article e25503. https://doi.org/10.1002/jia2.25503

World Health Organization. (2025).
HIV data and statistics.
https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/strategic-information/hiv-data-and-statistics

Zandam, H., Akobirshoev, I., Nandakumar, A., & Mitra, M. (2021). Utilization of HIV testing and counselling services by women with disabilities during antenatal care in Uganda: Analysis of 2016 demographic and health survey.
BMC Public Health, 21
(1), Article 1848. https://doi.org/10.1186/s12889-021-12045-4 Global Healthcare Comparison Matrix and Narrative Statement

Benchmark – Part B: Literature Review

Introduction

           
The selected clinical issue is the noticeable difference in the Human Immunodeficiency Virus (HIV) rates within minority groups, including Blacks/ African Americans and Latinos/ Hispanics. Ethnicity and race are linked to human ancestry. The race is defined as a group of people with specific distinctive common physical traits, such as hair texture and skin colour. Ethnicity involves categorizing various groups of people according to a common language, race, tribe, religion, background or cultural origin (Blakemore, 2020). Ethnic and racial minorities are one of the fastest-growing communities in the United States. Yet, figures on health status have revealed poorer health outcomes among racial and ethnic minorities regarding death and preventable diseases (National Curriculum of HIV, 2021) Benchmark – Part B: Literature Review.

Hispanics and Blacks noticeably outnumber all other racial and ethnic groups. In the year 2018, African American represented only 13% of the entire population, but they accounted for 41% of people living with HIV. Latinos represent 15% of the people, but they accounted for 23% of people living with HIV. Asians made up 6% of people and accounted for 1.5%.  This disparity also exists in the new HIV infection rates. Subpopulations within these ethnic groups are more adversely affected.  Men who have sex with men are affected the most. They represent 70% of all new HIV infections, even though they only make up 2% of the entire population (National Curriculum of HIV, 2021). Despite medical advances in the treatment of HIV, minority groups continue to be one of public health biggest concerns. The minority health is affected by several variables, thus causing the high rate of HIV infections among this ethnic group. Therefore, the proposed PICOT question focuses on addressing the high quality of HIV infection among minorities in the US.

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Methods

Various strategies were used to select articles for this study. First, major nursing databases and websites, including CINAHL, Cochrane, EMBASE, and PubMed, were searched for the required articles. Secondly, some keywords, including minorities, health disparity, the Human Immunodeficiency Virus (HIV), HIV prevalence among the minorities, Hispanics, Blacks, population demographics were used in the search process. A total of 100 studies, such as reviews, RCT, quasi-experimental, and meta-analysis, were reviewed for the study. Ten studies that met the selection criteria, including being conducted with the last five years, were selected for this study.

Synthesize the Literature

Part A: A Discussion of the Main Components of each Article

           
A study by Noonan et al. (2016) focuses on how social justice can improve African Americans’ health in the USA. The methodology of this study was a review of the national statistics and literature on African American health. The key findings indicate that the Blacks’ health can be improved through various factors, including social development programs, engaging African Americans in decision and policy-making, investing in their education, and enhancing their access to health care. This article supports the PICOT since it reveals that African Americans’ health can be improved by expanding access to quality care services in the US. Another study was conducted by Donna Hubbard McCree et al. (2016) focuses on strategies for attaining health equity goals among the racial/ethnic minority communities in the US. The authors reviewed previous articles, including RCT, quasi-experimental, and meta-analysis, in this study. The study findings indicate that the health equity goals among the racial/ethnic minority communities in the US can be attained through health equity efforts. This article supports the PICOT since it claims that health equity efforts can support achieving the health equity goals among the racial/ethnic minority communities in the US.

Furthermore, Lang and Bird (2015) conducted a study to examine the primary cause of racial health disparities concentration of the cases of HIV/AIDS and cardiovascular disease among African Americans. This study was based on reviews of previous literature. Study findings indicate that health disparities among socioeconomically disadvantaged individuals are attributed to some socioeconomic factors. Therefore, this article supports the PICOT since it reveals that health disparities among socioeconomically disadvantaged community members are attributed to socioeconomic factors such as lack of funds to cater to their out-off pocket and purchase health insurance covers. A study was conducted by Guilamo-Ramos et al. (2020) evaluated the HIV crisis among Hispanic/Latino in the US. The study involves reviewing statistics about HIV infections among Hispanics in the US. The study findings indicate that the US HIV epidemic can be addressed by reinforcing national efforts, particularly making HIV treatment available for HIV-positive Hispanics/Latinos. Therefore, this article supports the PICOT question since it points out that HIV treatment as the major strategy of improving HIV-positive Hispanics/Latinos’ health status.

Shrage (2016) also conducted a study to assess mass incarceration and HIV infections among African Americans. This study was based on the reviews of previous articles on this subject matter. The study findings indicate that HIV infection among African Americans is relatively high than that of other ethnic groups. Thus, this article supports the PICOT question since it reveals the high prevalence of HIV among African Americans. Moreover, Baciu (2017) conducted a study to evaluate the condition of health disparities in the US. Upon reviewing the previous studies on the subject matter, the author found that healthcare disparity among minorities is caused by provider-related discrimination. This article relates to the PICOT question since it indicates that health disparities among the minorities are caused by a lack of access to quality care due to provider-related discrimination. American Heart Association (2019) evaluated the dangers of health disparities in resolving them urgently in the US. The study was based on the available data about cardiovascular diseases among minorities. The study findings reveal that health disparities among minorities are associated with the high prevalence of cardiovascular diseases among these ethnicities. Therefore, this article supports the PICOT question since it attributes the high prevalence of cardiovascular diseases among minorities to health disparities.

Another study by Uluğ and Tropp (2020) focused on understanding how collective action could resolve racial discrimination by promoting racial justice in the US. They tested three studies to assess if Whites would be willing to participate in collective action to promote racial justice in the country. The study findings indicate Whites are willing to promote racial justice by engaging in collective action. This article supports the PICOT question since it reveals racial discrimination against minorities in the US. Causadias et al. (2019) in their studies assessed racial discrimination against minorities in the United States. The study findings indicate that racial discrimination in the US is relatively high, leading to poor health among these ethnic groups. It involved a review of previous studies on this subject. This article supports the PICOT question since it reveals the connection between racial discrimination against minorities and their poor health. Finally, Bleich et al. (2019) focused on discrimination experienced by black Americans in the United States. The study was based on the findings of previous randomized trials. The study findings indicate that black Americans experience racial discrimination in the United States Benchmark – Part B: Literature Review. Therefore, this article supports the PICOT question since it reveals racial discrimination against Blacks in the country.

Part B: Comparison of the Articles

These studies
are characterized by various aspects, including similarities, differences, limitations, and controversies. These ten articles are similar since they were based on racial discrimination experienced by minorities in the US. Additionally, their study findings support racial discrimination against minorities in the US, leading to health disparities. However, these articles differ in various aspects. First, some studies focus on the minority groups in general, such as Donna Hubbard McCree et al. (2016) and Uluğ and Tropp (2020). On the other hand, some studies focus on particular minority groups, such as Shrage (2016), Guilamo-Ramos ea al. (2020), and Lang and Bird (2015). On controversies, most articles indicate that whites cause discrimination against minorities in the US. On the contrary, some studies such as Uluğ and Tropp (2020) suggest that whites are against racial discrimination in the US and are willing to participate in collective action to promote racial justice in the country. Lastly, these studies have various limitations. The major limitation is the failure of the reviewed articles to provide the required data. Another critical limitation is basing the study on a particular minority group such as Bleich et al. (2020), Shrage (2016), and Guilamo-Ramos et al. (2020). In this case, it is relatively challenging to generalize study findings to account for other minority groups.

References

American Heart Association. (2019). The Dangers of Health Disparities and the Urgent Need to Address Them.
American Heart Association
.
https://www.hcplive.com/view/the-dangers-of-health-disparitiesand-the-urgent-need-to-address-them

Baciu, A. (2017).
The State of Health Disparities in the United States
.
https://www.ncbi.nlm.nih.gov/books/NBK425844/

Blakemore, E., (2019). Race and ethnicity explained.
National Geographic. https://
HIV in Racial and Ethnic Minority Populations – Core Concepts (uw.edu)

Bleich, S., Findling, M, G., Casey, L, S., & Blendon, R, J. (2019). Discrimination in the United States: Experiences of black Americans.
Health Services Research Suppl 2
(7)

Causadias, J, M., Korous, K, M., & Denny, T. (2019). Racial Discrimination in the United States: A National Health Crisis that Demands a National Health Solution.
Journal of Adolescent Health
; 64 (2019) 147e148.

Donna Hubbard McCree, P et al. (2016). An Approach to Achieving the Health Equity Goals of the National HIV/AIDS Strategy for the United States Among Racial/Ethnic Minority Communities.
Public Health Rep; 131
(4): 526–530. doi: 10.1177/0033354916662209

Guilamo-Ramos, V., Thimm-Kaiser, M., Benzekri, A., Chacón, G., López, O, R., Scaccabarrozzi, L., & Rios, E. (2020). The Invisible US Hispanic/Latino HIV Crisis: Addressing Gaps in the National Response.
American Journal of Public Health
.
https://ajph.aphapublications.org/doi/10.2105/AJPH.2019.305309

 

Lang, M, E & Bird, C, E. (2015). Understanding and Addressing the Common Roots of Racial Health Disparities: The Case of Cardiovascular Disease and HIV/AIDS in African Americans.
The Journal of Law-Medicine, 25 (1):
109-138.
https://scholarlycommons.law.case.edu/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=1020&context=healthmatrix

National HIV Curriculum, (2021
). HIV in ethnic and racial minority populations.

https:// HIV in Racial and Ethnic Minority Populations – Core Concepts (uw.edu)

Noonan, A, S., Velasco-Mondragon, H, E & Wagner, F, A. (2016). Improving the health of African Americans in the USA: an overdue opportunity for social justice.
Public Health Reviews
, 37 (12): 1-20. DOI 10.1186/s40985-016-0025-4

Shrage, L. (2016). African Americans, HIV, and mass incarceration.
The Lancet;
388 (10049). DOI:
https://doi.org/10.1016/S0140-6736(16)30830-3
.

Uluğ, O, M & Tropp, L, R. (2020). Witnessing racial discrimination shapes collective action for racial justice: Enhancing awareness of privilege among advantaged groups. Journal of Applied Social Psychology Benchmark – Part B: Literature Review

 

Course Code

Class Code

Assignment Title

Total Points

NUR-550

NUR-550-O502

Benchmark – Part B: Literature Review

250.0

Criteria

Percentage

Unsatisfactory (0.00%)

Less than Satisfactory (80.00%)

Satisfactory (88.00%)

Good (92.00%)

Excellent (100.00%)

Content

70.0%

Introduction

5.0%

An introduction is not included.

An introduction is present, but it lacks detail or is incomplete.

An introduction is present.

An introduction is clearly provided and well developed.

A comprehensive introduction is thoroughly developed with supporting details.

Methods

15.0%

A discussion of methods, including criteria used to select the articles, is not included.

A discussion of methods, including criteria used to select the articles, is present, but it lacks detail or is incomplete.

A discussion of methods, including criteria used to select the articles, is present.

A discussion of methods, including criteria used to select the articles, is clearly provided and well developed.

A comprehensive discussion of methods, including criteria used to select the articles, is thoroughly developed with supporting details.

Literature Synthesis, Part A

15.0%

A discussion of the main components of each article, including subjects, methods, key findings, and rationale for how the article supports the PICOT statement, is not included.

A discussion of the main components of each article, including subjects, methods, key findings, and rationale for how the article supports the PICOT statement, is present, but it lacks detail or is incomplete.

A discussion of the main components of each article, including subjects, methods, key findings, and rationale for how the article supports the PICOT statement, is present.

A discussion of the main components of each article, including subjects, methods, key findings, and rationale for how the article supports the PICOT statement, is clearly provided and well developed.

A comprehensive discussion of the main components of each article, including subjects, methods, key findings, and rationale for how the article supports the PICOT statement, is thoroughly developed with supporting details.

Literature Synthesis, Part B

15.0%

A discussion of the limitations, controversies, similarities, and differences of the studies is not included.

A discussion of the limitations, controversies, similarities, and differences of the studies is present, but it lacks detail or is incomplete.

A discussion of the limitations, controversies, similarities, and differences of the studies is present.

A discussion of the limitations, controversies, similarities, and differences of the studies is clearly provided and well developed.

A comprehensive discussion of the limitations, controversies, similarities, and differences of the studies is thoroughly developed with supporting details.

Areas of Further Study (C3.2)

15.0%

An analysis of evidence in the articles to identify what is known, unknown, and needed for further study is not included.

An analysis of evidence in the articles to identify what is known, unknown, and needed for further study is present, but it lacks detail or is incomplete.

An analysis of evidence in the articles to identify what is known, unknown, and needed for further study is present.

An analysis of evidence in the articles to identify what is known, unknown, and needed for further study is clearly provided and well developed.

A comprehensive analysis of evidence in the articles to identify what is known, unknown, and needed for further study is thoroughly developed with supporting details.

Required Sources

5.0%

Sources are not included.

Number of required sources is only partially met.

Number of required sources is met, but sources are outdated or inappropriate.

Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.

Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.

Benchmark – Part B: Literature Review

Organization and Effectiveness

20.0%

Thesis Development and Purpose

7.0%

Paper lacks any discernible overall purpose or organizing claim.

Thesis is insufficiently developed or vague. Purpose is not clear.

Thesis is apparent and appropriate to purpose.

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Argument Logic and Construction

8.0%

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis Benchmark – Part B: Literature Review.

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5.0%

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

Writer is clearly in command of standard, written, academic English.

Format

10.0%

Paper Format (Use of appropriate style for the major and assignment)

5.0%

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

5.0%

Sources are not documented.

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Benchmark – Part B: Literature Review

Total Weightage

100%

NURS-6050 Week 4: Assignment  – Legislation Grid and Advocacy Statement

Introduction

Shortages of healthcare staff create significant barriers to mental health service delivery, and these shortages are most severe in rural and underserved communities. The More Behavioral Health Providers Act of 2025 addresses this gap by expanding Medicare incentive payments to behavioral health clinicians, including nurse practitioners, who practice in Mental Health Professional Shortage Areas (HPSAs). As Short (2022) discusses in the chapter on healthcare financing, Medicare reimbursement structures influence where providers choose to practice and what services are prioritized. This paper examines the stakeholders and policy implications of S. 683, and provides testimony in support of its passage.

Purpose Statement

The purpose of this paper is to analyze the More Behavioral Health Providers Act of 2025 and advocate for its passage by showing how Medicare HPSA incentive expansion can improve workforce retention, increase access to mental health services, and address health inequities in underserved populations.

 

 

Legislation Grid Template

Legislation Grid Template

 

Use this document to complete Part 1 of the Module 2 Assessment
Legislation Grid and Testimony/Advocacy Statement

 

Health-related Bill Name

More Behavioral Health Providers Act of 2025

Bill Number

                     
   S. 683 (119th Congress)

Description

This bill expands eligibility for Medicare Health Professional Shortage Area (HPSA) bonus payments to include behavioral health providers—including psychiatrists, clinical psychologists, clinical social workers, psychiatric nurse specialists, and nurse practitioners—who provide mental health and substance use disorder services in designated shortage areas. Currently, only physicians providing primary care services are eligible for these incentive payments.

Federal or State?

Federal

Legislative Intent

To expand eligibility for Medicare Health Professional Shortage Area (HPSA) incentive payments to include behavioral health providers, including nurse practitioners, who provide mental health and substance use disorder services in designated shortage areas.

Proponents/ Opponents

Primary sponsors include Senator Gary Peters (D-MI) and Senator Steve Daines (R-MT). Professional organizations supporting the bill include the American Association of Nurse Practitioners (AANP) and mental health workforce advocacy groups.

Opponents: The bill is bipartisan and no formal opposition has been recorded as of December 2025, but the bill may face scrutiny from the Senate Finance Committee leadership, as chairs of committees with Medicare jurisdiction typically scrutinize proposals that increase federal healthcare expenditures carefully. Fiscal conservative legislators may raise concerns about expanding Medicare bonus payments without corresponding reductions elsewhere.

Target Population

Medicare beneficiaries who live in Mental Health Professional Shortage Areas (HPSAs), particularly older adults and individuals in rural or underserved communities. Behavioral health providers, including nurse practitioners, are also affected NURS-6050 Week 4: Assignment .

Status of the bill (Is it in hearings or committees?)

Introduced in the Senate on February 24, 2025, and read twice before being referred to the Senate Committee on Finance. As of December 2025, the bill is in committee with no hearings scheduled NURS-6050 Week 4: Assignment

General Notes/Comments

 

 

This bill addresses the severe shortage of mental health care by providing financial incentives to more providers. Understanding the legislative process, as Short (2022) describes in the chapter on policy enactment, will help nurses to identify where advocacy efforts are most effective. In this case, they can support the bill through the committee process. The bipartisan sponsorship suggests that the bill may be advanced, but fiscal concerns may delay its passage. The bill aligns with existing Medicare HPSA bonus structures, which provide 10% payment increases for services rendered in shortage areas. Expanding this to behavioral health providers could improve retention and access in underserved communities.

Legislative Testimony / Advocacy Statement

Title: In Support of the More Behavioral Health Providers Act of 2025

Name: xx

Date: xx

Introduction

As a nurse, I have often thought that if I had a role in shaping health policy, access to mental health care would work differently for patients living in underserved communities. In clinical practice, shortages of behavioral health providers delay care, worsen symptoms, and increase reliance on emergency services. I support the More Behavioral Health Providers Act of 2025 because it directly addresses workforce shortages by expanding Medicare incentive payments to behavioral health clinicians practicing in Mental Health Professional Shortage Areas (HPSAs).

Purpose Statement

The purpose of this legislation is to expand eligibility for Medicare HPSA incentive payments to include behavioral health providers, including nurse practitioners, who furnish mental health and substance use disorder services in shortage areas. Staff shortages in these regions significantly limits access to care, and behavioral health clinicians working in HPSAs report lower anticipated retention when financial and professional supports are insufficient (Pathman et al., 2025). By strengthening financial incentives, this bill promotes workforce stability and improved access for underserved populations.

 

 

Position Statement

I support this bill because it addresses a structural policy barrier that patients deal with every day. Inadequate access to mental health services is not just a clinical issue, it is a workforce and reimbursement problem. Using Medicare incentives to promote behavioral health service delivery will improve practice and continuity of care in underserved areas.

Social Determinants of Health

Income, age, education, and location affect the impact of this legislation. Medicare beneficiaries with limited income often face transportation issues and reduced provider access. Older adults are especially vulnerable to untreated mental health conditions, which increase hospitalization risk and disease severity. Lower educational attainment can further reduce health literacy, making consistent access to providers very important. Gender also plays a role. Women, who represent the majority of Medicare beneficiaries over age 75, experience high rates of depression and anxiety, but have greater barriers to accessing specialized mental health care in rural areas where this workforce shortage is most acute. By incentivizing clinicians to practice in shortage areas, this bill addresses inequities tied to these social determinants.

Addressing Opposition

This legislation has bipartisan support, but opposition to this legislation is most likely to focus on concerns about increased Medicare spending. In response, I would emphasize that workforce incentives represent a targeted investment. Financial incentives are associated with improved provider retention in underserved areas, which supports earlier intervention and reduces reliance on much more expensive emergency and inpatient care (Russell et al., 2021). This bill builds on an existing Medicare incentive framework rather than creating a new entitlement, which will improve workforce stability while containing costs.

Conclusion

The More Behavioral Health Providers Act of 2025 aligns Medicare policy with evidence-based strategies and the realities of clinical practice. Expanding HPSA incentives to behavioral health providers strengthens the workforce, improves access to care, and supports equitable mental health services for underserved populations. Nurses play a critical role in advocating for policies that reflect patient needs and system sustainability.

References

Centers for Medicare & Medicaid Services. (2025).
Physician bonuses in health professional shortage areas (HPSAs)
.
https://www.cms.gov/medicare/payment/fee-for-service-providers/physician-bonuses-health-professional-shortage-areas-hpsas

Pathman, D., Zerden, L., Konrad, T., Shafer, A., Harrison, J., Fannell, J., & Lombardi, B. (2025). Job assessments and the anticipated retention of behavioral health clinicians working in U.S. Health Professional Shortage Areas.
BMC Health Services Research, 25
(1).
https://doi.org/10.1186/s12913-025-12698-6

Russell, D., Mathew, S., Fitts, M., Liddle, Z., Murakami-Gold, L., Campbell, N., & Wakerman, J. (2021). Interventions for health workforce retention in rural and remote areas: A systematic review.
Human Resources for Health, 19
(1).
https://doi.org/10.1186/s12960-021-00643-7

Short, N. M. (2022).
Milstead’s health policy and politics: A nurse’s guide
(7th ed.). Jones & Bartlett Learning. NURS-6050 Week 4: Assignment

U.S. Congress. (2025). S. 683 –
More Behavioral Health Providers Act of 2025
. Congress.gov. https://www.congress.gov/bill/119th-congress/senate-bill/683/all-info

Topic 4 DQ 2 – Research a health concern that impacts a population with which you are familiar. How do biostatistics affect the research focus? How do you define the population as your patient? Make sure to include the population and health concern.

 

Topic 4 DQ 2

Diabetes is a health concern among elderly populations. That is because it increases the risk of other serious health concerns that include eye problems, kidney disease, heart disease as well as nerve damage that could result in amputation. In addition, it increases the risk of Alzheimer’s disease and cancer (Yamagishi, 2018).

Diabetes is of particular concern for the elderly population in El Paso, Texas, since they comprise 11% of the persons living in the area. 23% of this elderly population lives alone. 16% of them have an annual income of less than $10,000, 38% have an annual income of less than $20,000, and 33% of them receive food stamps. This is an indication that they may have difficulty paying for health care (Senior Care, 2020). Health statistics reveal that 12% of adults in El Paso have ever been diagnosed with diabetes, a value that is significantly higher that 11.4% reported for Texas State (Paso del Norte, 2020a). In addition, the death rate due to diabetes in El Paso stands at 34.1 deaths per 100,000 population, a figure that is significantly higher than Texas value at 20.9 and US value at 21.3 (Paso del Norte, 2020b). These statistics are worrying and they indicate a need to address the issue of diabetes among the elderly population in El Paso, Texas.

Biostatistics affects research focus on diabetes among elderly populations in two ways. Firstly, it helps in establishing the population demographics that characterize the disease in terms of incidence and risk as well as fatalities and comorbidities. This helps in identifying the specific populations that warrant an intervention, rather than applying the intervention to populations who may not need it thereby resulting in the limited resources being wasted. Secondly, it helps in understanding clinical research that acts as the foundation of evidence-based practice (EBP). Biostatistics helps in understanding prior research on the same subject and influencing recommendations for EBP (Rosner, 2016).

References

Paso del Norte (2020a).
Adults with Diabetes
.
http://www.healthypasodelnorte.org/indicators/index/view?indicatorId=81&localeId=2645&localeTypeId=2&periodId=241

Paso del Norte (2020b).
Age-Adjusted Death Rate due to Diabetes
.
http://www.healthypasodelnorte.org/indicators/index/view?indicatorId=100&localeId=2645

Rosner, B. (2016).
Fundamentals of Biostatistics
(8
th
ed.). Cengage Learning.

Senior Care (2020).
El Paso, Tx Senior Guide
.
https://www.seniorcare.com/directory/tx/el-paso/

Yamagishi, S. (Ed.) (2018).
Diabetes and Aging-related Complications
. Springer Nature.

care setting environmental analysis STRATEGIC PLANNING

Strategic Planning

A strategic plan is an instrument elucidating an institution’s guidelines, vision, objectives, and goals for the mid-to-long term. The tool delineates the phases or endeavors to accomplish them, and depending on the scope and context, this plan can differ in complexity and size. Further, strategic planning involves developing achievable objectives via resource allocation and time management. When conducted excellently, strategic planning can offer focus, enhance functionality, raise partnerships, and set priorities. This planning assists an institution in determining what direction to follow with its business objectives. Moreover, the plan sets measurable goals that delineate the phases management and workers must follow to accomplish the projected growth for the organization. The goals can be minute things that transform day-to-day or massive objectives that impact the company’s direction. In this paper, the strategic plan will center on the significance of client safety and endeavors that affect quality care at the Southern Texas Health Clinic by utilizing an Appreciative Inquiry perspective.

Short and Long-term Goals

These goals assist the organization in moving forward. Short-term goals elucidate organizational goals the firm wants to accomplish soon (week, month, or even year) depending on preferences or projects. These goals are easily actionable and precise. Long-term goals are high-level strategies an institution wants to achieve in the coming years. They propel the organization toward its vision. In this paper, the strategic plan will have one short-term and one long-term goal. Notably, the short-term objective aids the long-term objective by permitting the achievement of endeavors that impact the long-term aim of continued quality and safety of care. This goal develops the institution into what it wants to become while moving to the long-term purpose. For instance, the short-term aim of this strategic plan is to execute high-quality care to patients, leading to the long-term objective of raising care ratings.

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Goal statement 1: Sustaining high conduct standards, including certainty, respect, fairness, justice, and ethical procedure that encompasses all cultures by Dec 2023.

Results of short-term goal:

Exhibits care that demonstrates sympathy, humanism, and empathy to clients, healthcare providers, and families.

Creates an all-inclusive team that influences safety rates emphatically and offers required resources and assistance to patients

Exhibits successful leadership in safety and quality comprising productively challenging unsafe and high-cost conduct by using training programs for workers

Goal 2: Adherence to quality in all organization endeavors via innovation and accomplishment, always bestowing client satisfaction and excellent care by Dec 2027.

Results:

Accomplishing comprehensive quality care (above 75 percentile) and HCAGPS general rating

No avoidable healthcare-linked illnesses

The Influence and Applicability of Strategic Goals and Results

These short and long-term goals position themselves with Southern Texas Health Clinic’s central values of honesty, quality, partnership, and sympathy. The suggested strategic plan impacts cultural and ethical-sensitive objectives and results by executing EBP and schemes, creating professional and culturally proficient healthcare organization leaders. EBP utilizes contemporary technology and proven techniques to enhance organizational and patient outcomes. For example, offering specialized care to patients using new technology and drugs to avert infections minimizes healthcare-associated illnesses and fosters reduced facility stays. People must comprehend and adhere to the processes and policies set by the institution. These processes and schemes offer direction, continuity, and standardization in practice. Further, professional and culturally competent organizational leaders comprehend that every person is distinct and possesses certain objectives. Remarkably, these outcomes and goals impact cultural recognition to maintain the facility as culturally inclusive and accomplished in managing clients with varying cultural backgrounds. Thus, these goals and outcomes can be applied because they align with Southern Texas Health Clinic values.

Leadership Expertise and Theories

In nursing, many leadership theories and styles have been examined. Southern Texas Health Clinic plans to utilize techniques that impact the continuation and progression of the plan. Transformational leadership is one ideal style. This style can encourage positive modifications; leaders who adopt it are passionate, enthusiastic, and energetic (Ferreira et al., 2020). They help everyone on the team succeed. Further, after adopting this leadership style, the Southern Texas Health Clinic leaders will be in charge of situations by communicating the plan. Moreover, they will focus on assisting team members and offer direction and inspiration needed to achieve the strategic plan’s short- and long-term goals. Notably, these leaders can be found at each level of the clinic and are risk-takers, visionary, daring, excellent communicators, authentic and inspiring. Further, to differentiate these leaders from others, there are various elements of transformational leadership style. One component is intellectual stimulation meaning these leaders challenge and question the status quo and foster creativity among team members. This means the leader persuades team members to examine contemporary ways of operating. Another component is personalized consideration. This leader encourages and helps followers. Also, they keep open communication lines to promote supportive relationships.

One advantage of this leadership style is that it gets workers engaged. Getting employees engrossed and stimulated is critical to achieving high productivity and performance. This type of leader has skills that help discern team members’ needs. By recognizing these needs, these leaders find new ways of inspiring employees to pursue their best. Another benefit of adopting transformational leadership is that it drives organizational changes. For institutions like the Southern Texas Health Clinic to remain functional, they must realize that change is inevitable. This leadership gets each stakeholder onboard by selling ideas that will bring needed transformation to the firm.

Furthermore, situational leadership can assist in achieving the strategic plan’s goals. This type of leader acclimatizes their leadership style to fit the existing work setting/task or team needs (Walls, 2019). It does not rely on the skills of leaders skills; instead, it is founded on their capability to transform to the prevailing environment or needs of employees. Leaders using this style can adopt a telling, selling, delegating, and participating behavioral style. Additionally, these leaders possess certain traits. Direction is one attribute; these leaders are excellent at giving guidelines and supervision. Also, they are flexible, meaning they can modify their style to fit the prevailing situation. Lastly, they encourage participation by asking team members to become self-reliant.

A benefit of utilizing this leadership style is that leaders can use any technique they believe fits a specific setting. Also, the style accounts for several levels of growth in workers and assists in tackling every worker’s needs and expertise level.

Significance of Leadership Qualities and Expertise

Excellent leadership skills and qualities can assist the Southern Texas Health Clinic in executing and maintain the proposed strategic plan. When an organization views leadership as a skill instead of a role, achieving the intended change becomes easy. These transformational and situational leaders must be risk-takers and excellent communicators to achieve the set objectives. Communication is the backbone of any successful strategy or project while working as a group. When these leaders adopt excellent, open communication, they open a pathway where team members express their ideas and offer feedback without fear of condemnation. Further, this communication helps every stakeholder in the facility to comprehend what the scheme is and whether it aligns with overall goals. Successful and honest communication between leaders and employees creates a strong team because of the heightened consultations and sharing of opinions.

Moreover, as risk-takers, these leaders find new prospects that may help accomplish an organization’s vision (Shafique & Kalyar, 2018). Any leader at the clinic who can point subordinates in the right direction assists them in balancing and dealing with any pressure that can grow between the short and long-term objectives. Objective-aligned leaders with excellent skills drive team members to achieve the purpose and finish tasks. The responsibilities of these leaders comprise planning, making resolutions, setting preferences, and facilitating transformation. Most successful leaders are comfortable with risk-taking because it allows them to explore unchartered waters for new opportunities. Further, executing new plans makes people uncomfortable initially, but risks must be taken to achieve the facility’s vision. This needs a leader who does not fear exploring new areas care setting environmental analysis STRATEGIC PLANNING. Risk-taking can help rekindle a team’s values, vision, beliefs, and aims.

In conclusion, strategic planning needs substantial planning and thought by an institution’s leadership. Company leadership must weigh many possibilities before settling on one option. Thus, an organization should adopt one that has a positive impact and can be implemented cost-effectively. Short- and long-term goals aligning with the organization’s vision are vital. The Southern Texas Health Clinic wants a strategic plan for client safety and actions that affect quality care.

References

Ferreira, V. B., Amestoy, S. C., Silva, G. T. R. D., Trindade, L. D. L., Santos, I. A. R. D., & Varanda, P. A. G. (2020). Transformational leadership in nursing practice: challenges and strategies. 
Revista Brasileira de Enfermagem
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73
.

Shafique, I., & Kalyar, M. N. (2018). Linking transformational leadership, absorptive capacity, and corporate entrepreneurship. 
Administrative Sciences
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8
(2), 9.

Walls, E. (2019). The value of situational leadership. 
Community practitioner: the journal of the Community Practitioners’& Health Visitors’ Association
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care setting environmental analysis STRATEGIC PLANNING

Develop a 5-10 year strategic plan for achieving specific health care quality and safety improvements, based on the analysis you completed in Assessment 1. Use your previous SWOT analysis and a chosen strategic planning model.

Introduction

Evaluation of strategic choices is important. The methods for selecting strategic alternatives help leaders organize significant issues to support decision making. However, it is important that the techniques do not make the decision. Rather, leaders should use the techniques to reveal the inherent situation and to organize their thought processes. This assessment provides you with an opportunity to evaluate and apply some of the techniques for successful strategy development and implementation.

Note: You will use your
care setting environmental analysis
as the basis for developing your strategic plan in this assessment.

Preparation

The feedback you received on your care setting environmental analysis has been positive. Consequently, you have been asked to select one of the potential improvement projects you noted in your analysis and create a full, 5–10-year strategic plan to achieve the desired quality and safety improvement outcomes. You will develop your strategic plan, using either an AI approach (addressing the design stage), or by building on your SWOT analysis and applying a strategic planning model of your choice.

How you structure your plan should be based on whether you are taking an appreciative inquiry approach or using a specific strategic planning model. Regardless of the approach you choose, the requester of the plan has asked that you address the key points outlined below in the strategic plan requirements. In addition, your plan should be 5–8 pages in length.

Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

Strategic planning models aid in setting goals, establishing time frames, and forging a path toward achieving those goals. Consider the strategic planning models you are familiar with:

Which model would you choose to create goals and outcomes that could address the area of concern you identified in your Assessment 1 SWOT analysis?

Why is this model the best choice among alternatives?

How does goal setting through appreciative inquiry provocative propositions differ from goal setting in the strategic planning model you selected?

Additional Requirements

Note: The requirements outlined below correspond to the grading criteria in the scoring guide, so at a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed.

Writing, Supporting Evidence, and APA Style

Write clearly, with professionalism and respect for stakeholders and colleagues.

Integrate relevant sources of evidence to support your assertions.

Cite at least 3–5 sources of scholarly or professional evidence.

Format your document using APA style. Use the APA Style Paper Tutorial [DOCX]. Be sure to include:

A title page and reference page. An abstract is not required.

A running head on all pages.

Appropriate section headings.

Properly formatted citations and references.

Proofread your writing to minimize errors that could distract readers and make it more difficult to focus on the substance of your analysis.

Strategic Plan

Develop strategic goal statements and outcomes that reflect specific quality and safety improvements for your care setting. *****You should have at least one short-term goal (just-in-time to one year) and one long-term goal (five years or longer)*****.

Determine realistic timelines for achieving your goals.

Explain how your short-term goals support your long-term goals.

Note: For plans based on an AI approach, the goal statements and outcomes are provocative propositions that may be refinements of the positive, yet attainable, goals that you proposed during the dream phase of your inquiry. For plans based on a SWOT analysis, the goal statements and outcomes are specific, measurable, and applicable to the area of concern in your analysis for which you proposed pursuing improvements.

Justify the relevance of your proposed strategic goals and outcomes in relation to the mission, vision, and values of your care setting.

Analyze the extent to which your strategic goals and outcomes, and your approach to achieving them, address:

The ethical environment.

The cultural environment. care setting environmental analysis STRATEGIC PLANNING

The use of technology.

Applicable health care policies, laws, and regulations.

Explain, in general, how you will use relevant leadership and health care theories to help achieve your proposed strategic goals and outcomes.

Consider whether different theories are more applicable to the short-term or long-term goals of your strategic plan.

Evaluate the leadership qualities and skills that are most important to successfully implementing your proposed plan and sustaining strategic direction.

Identify those leadership qualities and skills that are essential to achieving your goals and outcomes and sustaining strategic direction.

Identify those leadership qualities and skills that will have the greatest effect on the success of your plan.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Evaluate qualities and skills that promote effective leadership within health care organizations.

Evaluate the leadership qualities and skills that will be most important to successfully implementing a strategic plan and sustaining strategic direction.

Competency 2: Apply strategies to lead high-performing health care teams to meet organizational quality and safety goals.

Develop strategic goal statements and outcomes that support the achievement of specific quality and safety improvements for a care setting.

Justify the relevance of proposed strategic goals and outcomes in relation to the mission, vision, and values of a care setting.

Competency 3: Apply cultural, ethical, and regulatory considerations to leadership decision making.

Analyze the extent to which strategic goals and outcomes address the use of technology and the ethical, cultural, and regulatory environments.

Competency 4: Integrate leadership and health care theories into the role of the nurse leader.

Explain how relevant leadership and health care theories will be used to help achieve proposed strategic goals and objectives.

Competency 5: Communicate with stakeholders and constituencies to build collaborative partnerships and create inclusive work environments.

Communicate analyses clearly and in a way that demonstrates professionalism and respect for stakeholders and colleagues. care setting environmental analysis STRATEGIC PLANNING

Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.