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Phillip September 17, 2023 No Comments

NURS FPX 4050 Assessment 2 – Ethical and Policy Factors in Care Coordination

NURS FPX 4050 Assessment 2 – Ethical and Policy Factors in Care Coordination (Script)

Name

Capella university

NURS FPX4050 Coordinating Patient-Centered Care

Prof. Name

Date

Ethical and Policy Factors in Care Coordination

Good morning! I appreciate you being here today. I’ll talk about some laws and regulations that deal with the security and health of homeless people. Additionally, I will discuss some of the moral points that result from these care coordination rules, including the ethics code for care coordinators and nurses. To preserve care continuity through efficient coordination, the presentation’s objective is to help you all grasp the significance of ethical concerns and health policies for patients in a community environment. Before going into detail about care coordination for the homeless and policies affecting this care coordination, I would define care coordination as the planning of patient care tasks and data sharing among every party who participates in a patient’s care to deliver safer and more effective treatment. This presentation focuses on homeless shelters and the policies influencing care coordination for homeless people.

The most vulnerable individuals in our community are those who are homeless, and they frequently have complex medical and psychological needs that demand organized care. A person is regarded as homeless by the Housing and Urban Development (HUD) if they “do not have a stable, permanent, and adequate overnight shelter.”. Over 500,000 individuals are currently homeless in the US, with 35% living without shelter or in locations not intended for habitation (Kurata et al., 2020). However, providing coordinated care for homeless people can be difficult due to limited resources, lack of access to healthcare services, and the stigma attached to homelessness. The talk will discuss how governmental regulations, moral problems, and the nursing ethical code impact care coordination for homeless individuals in our society.

Governmental Policies Affecting the Coordination of Care

Government policies about homeless shelters can significantly impact care coordination for those experiencing homelessness. Effective care coordination can be hampered by these policies, ultimately affecting how homeless people fare. Obamacare, commonly known as the Affordable Care Act (ACA), was enacted in 2010 to enhance all Americans’ access to healthcare. While the primary focus of the ACA was health insurance reform and the expansion of Medicaid and other health care programs, it also indirectly affected laws related to homeless shelters. The ACA developed Health Home programs to coordinate care for those with chronic diseases. These initiatives are helpful for homeless people who frequently struggle with serious health issues (Dickins et al., 2020). The ACA placed a strong emphasis on preventive programs, many of which are helpful for those who are homeless. Services like vaccinations and health screenings can help homeless people prevent and manage health conditions.

The ACA created the “Homeless Health Care (HCH)” program. This indicates that healthcare workers who work with the homeless are more likely to recognise their particular needs and experiences and to deliver care that considers their cultural and language requirements. Another essential component is the HCH program’s dedication to case management and care management. This requires close collaboration with other health professionals, social services organisations, and community groups to ensure that homeless people receive comprehensive, coordinated treatment that meets all their health and social needs (Lanese et al., 2021). The Health Insurance Portability and Accountability Act (HIPAA) was enacted in 1996 by USA. Its main emphasis is on protecting the privacy and confidentiality of individual health information. People who are homeless may have particular health issues, such as problems with their mental health or their use of drugs or alcohol. Under HIPAA, these conditions are regarded as sensitive health information; thus, extra precautions must be taken to safeguard this information and avoid stigmatisation. HIPAA standards require training for those who work in homeless shelters and medical facilities, particularly concerning handling sensitive health information and maintaining confidentiality.

Policies Raising Ethical Dilemmas for Care Coordination

Some policies can raise ethical dilemmas in the treatment of the homeless. Healthcare providers must ensure that moral principles are pursued in utilising healthcare policies. Most of the time, such policies can raise ethical dilemmas, and in these situations, healthcare providers are trapped in ethical and legal conflicts. I will discuss the Documentation Requirement Policy under HIPPA as the bearer of a moral dilemma. According to this policy, residency and citizenship documents are required to access complete healthcare. Homeless individuals may face difficulties in the provision of such necessary documents. Healthcare providers must ensure the proper implementation of policies. Documentation policies are stuck between legal and ethical boundaries because homeless people are often unable to provide required documents, thus, are prevented from utilising healthcare services (Tønnessen et al.). 

Ethical and Policy Factors in Care Coordination

Affordable Care Act is another policy that results in a moral dilemma for healthcare providers. Medicaid expansion under the ACA is refused by many states, developing a coverage gap for low-income groups involving homeless people. Low-income people are denied access to insurance and Medicaid services because both programs only cover people who make up between 100 and 400 percent of the federal poverty line.  Homeless individuals do not have permanent home addresses. Thus, they often encounter problems enrolling in health insurance plans.  Moreover, illegal immigrants are also denied access to Medicaid services (Adashi et al.). Healthcare institutions face a moral choice between upholding the law and the ethical principle of fair and justice. Another ethical dilemma can be the right to privacy and safety concerns which are ensured by HIPPA policy. This policy was synthesised in 1996. For example, employing surveillance or data-collecting techniques to keep track of homeless people in public areas raises concerns about individual privacy and potential discrimination. It can be difficult to establish a middle ground that upholds privacy rights and addresses the particular difficulties experienced by homeless people (Tiderington, 2019).

Code of Ethics Impact on Nurses 

The Nursing Code of Ethics provides a solid ethical model for the continuum of care and care coordination for homeless people. A nurse’s code of ethics may, directly and indirectly, affect homeless people, depending on how nurses understand and implement the code’s guiding principles in their daily work. It highlights the value of protecting patients’ rights, health, and safety, which is particularly crucial when working with vulnerable populations. It is important for nurses to follow the ethical principles and address healthcare disparities based on various social health determinants like food, housing instability, poverty, and healthcare difficulties that have continuously impacts the homeless population, especially unlawful immigrants and undocumented populations. The racism, marginalisation, and deportation problems that homeless population encounter needs nurses and other healthcare professionals to acknowledge these social factors and offer complete care to these people under consideration of justice and fair treatment (Chang, 2019). Nurses must follow ethical principles to offer caring, respectful, and patient-centred care regardless of a person’s housing situation. The obligation of nurses to promote, support, and protect the patient’s autonomy, wellness, and safety is highlighted in Provision 3 of the Code. In addition, Provision 8 acknowledges the value of working with the general public and other healthcare professionals to support neighbourhood activities to address health needs, which is crucial for efficient care coordination (Hankset et al., 2019). 

Nursing organisations and professionals must address healthcare inequities and promote legislation changes that will assist homeless populations. Ethics are equally important to coordinate treatment and maintain the continuum of care. They give nurses and other healthcare professionals a chance to develop a patient-centred approach to give them full power to select their plan of care and treatment and take actions that are in their best interests. Nurses who stick to the Code of Ethics also expressed greater job satisfaction and a sense of greater patient safety (Monroe, 2019).  

Conclusion

To conclude my presentation, I want to summarise what was discussed today. Starting with care coordination, we discussed how providing care coordination is necessary for homeless people. we moved on to discuss homeless people and the policies established in the US for homeless people, like ACA, HIPPA, and Healthcare for Homeless (HCH). Next, We discussed major healthcare policies giving birth to healthcare dilemmas for professionals. We discussed three major dilemmas arising from various healthcare policies. After assessing the impact of the code of ethics on nurses, we discussed nurses’ role in coordinating care and preserving the continuity of care utilising ethical principles and policies. 

References

Adashi, E. Y., O’Mahony, D. P., & Cohen, I. G. (2022). Stamping out the medicaid coverage gap: An ACA imperative. The American Journal of Medicine135(8). https://doi.org/10.1016/j.amjmed.2022.03.033    

Chang, C. D. (2019). Social Determinants of health and health disparities among immigrants and their Children. Current Problems in Pediatric and Adolescent Health Care, 49(1), 23–30. https://doi.org/10.1016/j.cppeds.2018.11.009 

Davis, C. R., Decker, K., Delaney, C., & Jahn, P. (2021). The impact of a nursing ethics education program on job satisfaction, ethical conflict, and patient safety. Nursing Ethics, 28(4), 474-486. https://doi.org/10.1177/0969733017742959 

Dickins, K. A., Buchholz, S. W., Ingram, D., Braun, L. T., Hamilton, R. J., Earle, M., & Karnik, N. S. (2020). Supporting primary care access and use among homeless persons. Social Work in Public Health, 35(6), 335–357. https://doi.org/10.1080/19371918.2020.1809589 

Hanks, R. G., Eloi, H., & Stafford, L. (2019). Understanding how advanced practice registered nurses function as patient advocates. In Nursing Forum, 54-2(213-219). https://doi.org/10.1111/nuf.12319 

Kurata, N., Minton, L., Del Priore, D., Merino, D., Miller, C., & Lee, M.-J. (2020). An interim report on the provision of prenatal care for pregnant mothers experiencing homelessness in hawai‘i. Hawai’i Journal of Health & Social Welfare, 79(5 Suppl 1), 118–121. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260861/ 

NURS FPX 4050 Assessment 2 – Ethical and Policy Factors in Care Coordination

Lanese, B. G., Birmingham, L., Alrubaie, N., & Hoornbeek, J. (2021). Healthcare for the homeless (HCH) projects and medicaid expansion. Journal of Community Health, 46(6), 1139–1147. https://doi.org/10.1007/s10900-021-01000-4 

Monroe, H. A. (2019). Nurses’ professional values: Influences of experience and ethics education. Journal of Clinical Nursing, 28(9-10), 2009–2019. https://doi.org/10.1111/jocn.14806 

NURS FPX 4050 Assessment 2 – Ethical and Policy Factors in Care Coordination

Tiderington, E. (2019). Practice dilemmas, successes, and challenges in the delivery of homeless services: Voices from the frontline. Homelessness Prevention and Intervention in Social Work, 379–394. https://doi.org/10.1007/978-3-030-03727-7_18 

Tønnessen, S., Christiansen, K., Hjaltadóttir, I., Leino‐Kilpi, H., Scott, P. A., Suhonen, R., Öhlén, J., & Halvorsen, K. (2020). Visibility of nursing in policy documents related to health care priorities. Journal of Nursing Management, 28(8), 2081–2090. https://doi.org/10.1111/jonm.12977 

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