Please provide a response to the discussion posted below. Thank you
How health policy initiatives are used to guide and direct your clinical practice as an Advanced Practice Nurse.
Health policy initiatives directs that path for Advanced Practice Nurses to follow. Within the nation, each state, local government and even private operating healthcare facilities, policies are created in order to improve provision of care for patients & improving patient outcomes. Advanced Practice Nurses can impact these outcomes by using new health policies and providing perspective on old policies that could use modification (Coloff, 2020). Their direct contact with patients allows them to advocate for change or modification of policies as they are witnesses on the direct impact that is a direct result of changes in legislation or policy changes.
Advanced Practice Nurses have a unique position. They are direct caregivers for patients that policies may affect. They can serve a consultants for policymakers, reviewing any changes and advocating for opportunities to improve patient care, encourage policies that push for patient safety and encourage policies that are based on evidence based research (Coloff, 2020). Using the information that was received from the result of the policy changes, they can continuously advocate for improved policies that will positively impact patient outcomes and improve direct & indirect nursing care.
Locate the Medicaid eligibility criteria for 3 different states. Compare and contrast the eligibility criteria, then discuss the implications of the criteria for people in each state.
Medicaid coverage varies from state to state. Florida eligibility requires several criteria in order to even consider applying for Medicaid services. The first tier requires anyone applying to be a “resident, U.S. National, citizen, permanent resident, and a legal alien” (U.S. Department of Health & Human Services [USDHHS], n.d.). The next tier requires the applicant to be in need of aid and living below the poverty line followed by the third tier which requires the applicant to be “pregnant, caregiver of a child younger than 18 years old, blind, disabled or residing with a family member who is disabled, and be 65 years or older (USDHHS, n.d). For example a family of 4 should make no more than $39,900 before taxes (USDHHS, n.d.) This is just the basic eligibility requirements to apply.
Medicaid in Georgia requires the applicant to “think” that they are pregnant, be under 18 or 65 years old or older, be blind “legally disabled” and requires extended care (i.e. ALF, SNF) (Georgia Medicaid, n.d.). The income limits vary from eligibility. For example, in order to be able to receive benefits as a blind or disabled person, they can make no more than $317 per month, while if the applicant is “Medically needy, pregnant or a child can make no remorse than $442 per month” (Georgia Medicaid, n.d.). They also offer two main types of Medicaid: Fee-for-Service (FFS) and Managed Care Plan. Within the FFS, Georgia will pay the provider for services for a patient that has been approved while the Managed Care Plan receives payment from Georgia then pays the plan for the applicant was eligible for (Georgia Medicaid, n.d.).
South Carolina requires the applicant to “be pregnant or think they are, be child, have a child younger than 19, have been adopted or reside in foster care, have a diagnosis of breast or cervical cancer, blind, be disabled, requires extended care, be older than 65, and have limited or no income” (South Carolina Department of Health & Human Services (SCDHHS, n.d). South Carolina is different as it provides Medicaid coverage for services outside the norm. They offer a Covid-19 limited, Family Planning and a Breast and Cervical Cancer Program. The applicant must be screened by a physician or the states early detection program, have been diagnosed with breast, cervical or precancerous lesions. They must also have no other insurance, live below or at 200% the poverty line (SCDHHS, n.d.).The Breast & Cervical Cancer Program offers full benefits for applicants who meet their eligibility standards (SCDHHS, n.d.).
While the criteria are similar, they are also very different from state to state. This variance of criteria may also cause a problem for a resident who really does needs the assistance, but may make “too much” but not enough to afford medical coverage. Just from observing, South Carolina extends eligibility for coverage for their residents, while Florida & Georgia only offer limited Medicaid services. This lack of expansion of services is preventing those who actually may need coverage from receiving it, adding to the weight of the health determinants within their respective states.
References
Coloff, K. (2020). Be the change: NPs in health policy development. Minority Nurse. Springer Publishing Company. https://minoritynurse.com/be-the-change–in-health…
Georgia Medicaid. (n.d). Basic Eligibility. https://medicaid.Georgia.gov/how-apply/basic-eligi…
South Carolina Department of Health & Human Services. (n.d.). Health Connections Medicaid program. https://www.scdhhs.gov/members/program-eligibility
U.S. Department of Health & Human Services. (n.d.). Florida Medicaid. https://www.benefits.gov/benefit/1625
