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

Ethical and Policy Factors in Care Coordination

Slide 1: Title Slide

Greetings, everybody. My name is ___________, and I work as a care coordinator at the community care center in our locality. It is a privilege to be present today to examine the ethical and policy concerns that are vital in managing care, particularly about homeless shelters.

Slide 2: Introduction

Care for the Homeless has received official recognition from the National Committee for Quality Assurance (NCQA) as a Level 3 Patient-Centered Medical Home (PCMH) (Treglia et al., 2019). A more profound understanding of these difficulties is crucial for improving the health and welfare of susceptible groups, such as homeless persons, and guaranteeing fair and equal access to high-quality healthcare treatments (Chen et al., 2021). This analysis will explore the effects of several policies and ethical factors on care coordination. Additionally, we will discuss how experts in this area may work together to tackle these challenges and foster beneficial transformations in our community.

Slide 3: Governmental Policies and Their Impact on Care Coordination

Treglia et al. (2019) have supposed that government policies have a significant effect on the health and safety of our communities, and they also directly influence the coordination of care for those who are vulnerable. An example of this would be the “Health Insurance Portability and Accountability Act (HIPAA),” which safeguards the privacy of individuals’ health information and ensures that it is kept secure (Chen et al., 2021). This policy affects homeless shelters since it requires them to preserve the personal health information of their residents and coordinate treatment with other healthcare experts while maintaining confidentiality (Benavides & Nukpezah, 2020). This policy influences shelters for people experiencing homelessness.

Slide 4: Affordable Care Act (ACA)

Consider the “Affordable Care Act (ACA),” which expands access to medical coverage for millions of individuals in the United States, including those who are homeless (Chen et al., 2021). This is an additional example of a policy that impacts the coordination of treatment. According to Benavides and Nukpezah (2020), the Affordable Care Act (ACA) includes a variety of initiatives, one of which is the expansion of Medicaid. This makes it possible for states to give health insurance coverage to more individuals with low incomes, including those who are homeless. As a consequence of increased access to insurance, it is now possible for homeless shelters to better coordinate treatment with healthcare specialists. This ensures that the people in these shelters get the necessary medical treatments.

Slide 5: McKinney-Vento Homeless Assistance Act

Furthermore, the “McKinney-Vento Homeless Assistance Act” allocates funds for services and housing programs to assist the homeless population, directly impacting the resources accessible for coordinating care in homeless shelters (Chen et al., 2021). This legislation assists the “Continuum of Care (CoC)” Program, which seeks to advance community-wide initiatives to eradicate homelessness by allocating financial resources to charitable organizations, states, and local governments. The CoC Program enhances care coordination for homeless persons by facilitating access to mainstream services and maximizing their self-reliance. These policies exemplify the interdependence of health and safety in communities since they immediately impact the accessibility and organization of healthcare for homeless persons. To effectively address the difficulties of delivering comprehensive care to vulnerable people, care coordinators may enhance their ability by comprehending the consequences of these policies.

Slide 6: Ethical Questions and Dilemmas in Care Coordination Policies

When navigating the many different policies that exist at the national, state, and local levels, we could come into ethical concerns or difficulties that directly influence the coordination of care. According to Benavides and Nukpezah’s research from 2020, the Affordable Care Act (ACA) creates ethical difficulties because it allows for variations in Medicaid expansion at the national level. As some states have opted to expand Medicaid while others have not, there is a coverage gap for those with low incomes who do not qualify for Medicaid and who cannot buy private insurance (Paat et al., 2021). People who are homeless are particularly affected by this imbalance, which raises issues about the equality of access to healthcare services and resources.

Slide 7: Ethical Questions and Dilemmas in Care Coordination Policies

Different ways of financing and providing mental health services at the state level might lead to moral conundrums for care coordination. According to Treglia et al. (2019), states that have restricted financing for mental health care services may find it difficult to provide sufficient assistance to homeless people who need mental health treatment. This discrepancy may prolong cycles of homelessness and poor health outcomes by increasing dependence on emergency services and providing insufficient long-term care.

Local laws that criminalize homelessness—for example, by making it illegal to sleep in public places, loiter, or panhandle—present moral dilemmas (Clifford et al., 2019). Due to the possibility of penalties or even imprisonment, these regulations may make it more difficult for homeless people to get shelter and healthcare services. Potential infringement of human rights and a worsening of health inequities among the homeless population are two ethical ramifications of these municipal policies.

Slide 8: Ethical Questions and Dilemmas in Care Coordination Policies

These instances demonstrate tangible moral ramifications and outcomes of specific policy measures in care coordination at the national, state, and local levels. The national-level discrepancies in Medicaid expansion under the Affordable Care Act (ACA) create a gap in coverage for low-income individuals who are ineligible for Medicaid and cannot afford private insurance. This disproportionately impacts homeless individuals and raises concerns about fairness in accessing healthcare services and resources (Clifford et al., 2019). Insufficient financing for mental health care services at the state level poses ethical challenges for coordinating treatment, which may result in insufficient assistance for homeless persons with mental health issues and perpetuate cycles of unfavorable health outcomes. Local policies that criminalize homelessness may result in human rights abuses and worsen health inequalities among the homeless community, making it more difficult for them to receive healthcare services and shelter.

Slide 9: Impact of the Code of Ethics for Nurses on Care Coordination

The Code of Ethics for Nurses significantly influences the coordination and continuity of care, offering guidance to nursing practitioners in delivering services to vulnerable populations, including homeless shelters. By following the Code of Ethics, nurses guarantee fair and excellent care to all persons, irrespective of their social or economic standing.

The Code of Ethics places significant emphasis on the socioeconomic determinants of health, as emphasized in Healthy People 2030 (Treglia et al., 2019). These variables include socioeconomic status, education, physical environment, employment, social support networks, and access to healthcare. Nursing practitioners may identify and address the root causes of health disparities by considering these aspects. This will eventually improve care coordination and overall health outcomes for vulnerable groups. Research suggests that homeless persons often encounter obstacles when trying to receive healthcare services, including limited transportation options, lack of insurance coverage, and absence of identification. Nurses demonstrate their commitment to the Code of Ethics and enhance care coordination by acknowledging these obstacles and promoting legislative reforms that target these hindrances.

Slide 10: Impact of the Code of Ethics for Nurses on Care Coordination

Furthermore, the Code of Ethics for Nurses underscores the significance of cultural competency in care coordination. It is necessary to comprehend and respect the varied cultural origins of patients and customize healthcare to suit their distinct requirements (Clifford et al., 2019). According to research by Benavides and Nukpezah (2020), patients who received treatment from culturally competent healthcare practitioners reported higher satisfaction levels and better health outcomes. Nurses can enhance the coordination and continuity of care for vulnerable people by promoting cultural competency, which helps overcome communication and comprehension barriers (Paat et al., 2021).

Slide 11: Conclusion

It is essential to tackle the intricate ethical and regulatory challenges that affect the structure and uniformity of healthcare for those experiencing homelessness in order to enhance their health outcomes and overall welfare. As proponents of homeless shelters and nurse practitioners, we must consider the determinants that impact health outcomes, fight for equitable legislation, and adhere to the Code of Ethics for Nurses. By engaging in partnership, we can effectively tackle the inequalities in healthcare and establish a more robust and all-encompassing community for individuals. We value your dedication to this important undertaking, and let us continue our collaborative endeavors to enhance the well-being of the folks we support.

Slide 12: References

Benavides, A. D., & Nukpezah, J. A. (2020). How Local Governments Are Caring for the Homeless During the COVID-19 Pandemic. The American Review of Public Administration, 50(6-7), 650–657. https://doi.org/10.1177/0275074020942062

Chen, K. L., Chen, K., Holaday, L. W., & Lopez, L. (2021). Assessing Concordance Across Nonprofit Hospitals’ Public Reporting on Housing as a Community Health Need in the Era of the Affordable Care Act. Journal of Public Health Management and Practice, Publish Ahead of Print. https://doi.org/10.1097/phh.0000000000001357

Clifford, B., Wilson, A., & Harris, P. (2019). Homelessness, health, and the policy process: A literature review. Health Policy, 123(11), 1125–1132. https://doi.org/10.1016/j.healthpol.2019.08.011

Paat, Y.-F., Morales, J., Escajeda, A. I., & Tullius, R. (2021). Insights from the shelter: Homeless shelter workers’ perceptions of homelessness and working with people experiencing homelessness. Journal of Progressive Human Services, 32(3), 1–21. https://doi.org/10.1080/10428232.2021.1969719

Treglia, D., Johns, E. L., Schretzman, M., Berman, J., Culhane, D. P., Lee, D. C., & Doran, K. M. (2019). When Crises Converge: Hospital Visits Before And After Shelter Use Among Homeless New Yorkers. Health Affairs, 38(9), 1458–1467. ‌https://doi.org/10.1377/hlthaff.2018.05308