US Veterans Healthcare Access Policy

Group Assignment: WebQuestCourse outcomes addressed in this Assignment:Assess the legislative and policy-making strategies specific to scope of practice and nursing roles that influence health care services and practice.Utilize advocacy skills to foster participation of nursing in the development and implementation of health policy.Overview of AssignmentPlease take a moment to review this tutorial for assistance with creating your presentation. DirectionsWithin your group, you will work to create a WebQuest. A WebQuest is an inquiry-oriented assignment. Look at sample WebQuests (search online) to see how creative you can be. The format is divided into sections or independent pages. Think of each section as a section on a paper.For your WebQuest presentation, you will choose a problem that is a public policy issue. You will define the health care problem. You may be working in a certain clinical area and may see a need for more research or alternatives to treatment options. The problem may be a professional problem that you as an advance practice nurse are encountering in terms of autonomy or reimbursement for your services. It could be a workplace safety issue or a management issue. It could be a general societal problem that needs to be brought to the attention of the legislators.Your WebQuest Presentation:Most of the information for your WebQuest will come from the Web. However, you are expected to use the Library to supplement the information that you find on the Web.You must also use a minimum of three graphics or images to illustrate your points. The graphics can go on any of the pages in the WebQuest and you can use more if you like. The graphics do not substitute for the text that is to explain each section.You are expected to use analysis in each of the sections and provide details and explanations in each area. The Web resources are to validate what your position or argument is.You will use this MN506_Unit9_Template to build your WebQuest. Before you begin your work however, watch this video to learn how to edit the template to create your unique WebQuest.PresentationIn one section of your WebQuest, you will include a link to a presentation that you create. Your group will choose a presentation software to use. The presentation software should be one that is free such as a Voice-over PowerPoint or a Voice-over Prezi. You could also do a PowerPoint or Prezi and voice over in PowerPoint or with Snagit. You will combine slides (e.g., PowerPoint, Google Slides, or Prezi slides) and voice. In your voice-over presentation, you will give a 5-minute talk with slides, as if you were speaking at a press conference delivering your message to a politician or to the community as a whole about what you have identified as the problem. Your presentation should explain why your identified problem needs to be addressed.The following should be incorporated in your WebQuest:The health care problem/public policy issueA link to your presentationA transcript of the presentationWhat the government’s response to this problem has been previously (i.e., what has been done in terms of laws, rules, regulations, or programs; if the issue has never been addressed, you will discuss what needs to be done)Your assessment of the legislative and policy-making strategies that influence health care servicesYour proposed bill, either on the state or federal level, advancing your proposed changeWhy these changes are important and a discussion of what opportunities nurses have to become involved in the design of this programYour advice on how the program can be implementedA summary of the ProjectThe credits pageTo view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.Assignment Requirements:Before finalizing your work, you should:be sure to read the Assignment description carefully (as displayed above);consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; andutilize spelling and grammar check to minimize errors.Your writing Assignment should:follow the conventions of Standard English (correct grammar, punctuation, etc.);be well ordered, logical, and unified, as well as original and insightful;display superior content, organization, style, and mechanics; anduse APA 6th EditionHow to SubmitSubmit your Assignment to the unit Dropbox before midnight on the last day of the unit.
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WEBQUEST
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
Introduction
Introduction
Policy Issue
According to the National Center for Veterans Analysis and Statistics (2016), there
were approximately 20 million veterans in 2017â??which ultimately means at some point, 20
million doctorâ??s appointments are going to be needed. Currently, the US Department of Veteranâ??s
Affairs (2018e) reports that nationwide, there are 1,243 VA facilities available for veterans to
access for their healthcare needs.
Voice-over
Government
Response
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits
In 2013, Congress passed a bill for the Veterans Timely Access to Health Care Act
(2013) that requires veterans to receive â??timely accessâ? of an appointment scheduled within a 30day period from the time they first contact the VA to schedule an appointment. However, veterans
are reporting a wait-time of about 2-3 months until they can see their primary care provider (PCP)
at the VA clinic. In addition, the Veterans Choice Program, which is funded to assist eligible
veterans with their healthcare costs, specialty care needs, or inability to receive an appointment
within a timely manner has depleted its funds in January 2018, (US Department of Veterans
Affairs, 2018a).
Our policy proposal is that we reallocate the funds of the 2019 Veterans Affairs
Budget Request to increase facility development and provide veterans with the ability to see their
primary care provider in a true timely manner.
WEBQUEST
Introduction
Policy Issue
Voice-over
Government
Response
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
Policy Issue
Emergency Department Use
Due to the inability of receiving an appointment time that corresponds to the
Veterans Timely Access to Healthcare Act, veterans are utilizing emergency departments
for their urgent or primary care needs. Not only are the veterans spending countless hours
waiting in an emergency room (ER), but they are having to pay out of pocket for a
significantly higher cost of care and are approximately paying for an average ER visit
ranging from $740 to $3437, (Caldwell et al, 2013).
â??Wait-Timeâ? Calculation
Although Congressâ?? Statute § 241 requires that veterans receive â??timely
access� within a 30-day period from the time of contact to schedule an appointment, the
healthcare act is conflicting with the description of the Department of Veteran Affairsâ??
calculation for their â??wait-timeâ? period. For instance, if a veteranâ??s provider (whether
doctor, physicianâ??s assistant, or nurse practitioner) suggests an appointment time in 30
days, but the next appointment isnâ??t available until 45 days, then the â??wait-timeâ? period is
calculated as 45 minus 30 days, equaling a 15 day â??wait-timeâ? period, (US Department of
Veterans Affairs, 2018b). Which seems inappropriate to deem as a â??wait-time,â? because
regardless, it is still a longer wait than the amount of time the provider requested to reevaluate the patient. This could lead to unnecessary emergency department visits, or quite
possibly, result in hospital admissions secondary to their complications since their needs
were not tended to within a specific timeframe.
WEBQUEST
Introduction
Policy Issue
Voice-over
Presentation
Government
Response
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
Presentation softwareâ??voice-over
Press Conference (podcast with transcript and PowerPoint or Prezi or presentation
software of choosing).
WEBQUEST
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
Government Response
$88.9 Billion VA Budget for 2019
Introduction
Policy Issue
Voice-over
Government
Response
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits
As the new 2019 Veterans Affairs Budget Request is presented, it is noted that there is a
$88.9 billion request for increased funding for healthcare improvements. However, there is a lack of
suggestion for healthcare accessibility, (US Department of Veterans Affairs, 2018c).
$4.2 IT budget Reallocation
In the 2019 budget, there is an approximate $4.2 billion request suggested for Information
Technology (IT) (U.S. Department of Veterans Affairs, 2018c). This $4.2 billion is to enhance information
security, support top priority developments, and improve Veteran online access and experience, (US
Department of Veterans Affairs, 2018c). Technology is rapidly advancing, and Congress is attempting to
provide Veterans with the ability to access their healthcare online by viewing their results and scheduling
appointments online to improve their overall healthcare experience.
However, many of our male Veterans age until approximately 85 years or older–which is
8.5% higher than non-veterans who are only 0.8% alive during the years of 85 or older, (National Center
for Veterans Analysis and Statistics, 2018). Therefore, out of the 20 million Veterans in the US, those who
live in their elder years are not likely to be as techno logically savvy as younger veterans, (National Center
for Veterans Analysis and Statistics, 2016). Until our younger veterans who understand and utilize
technology more frequently than our older generation does, we should focus on facility development and
postpone the IT project.
WEBQUEST
Introduction
Policy Issue
Voice-over
Government
Response
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
Assessment
In 2014, a whistleblower brought light into the misconduct of the Phoenix VA Health Care
System that claimed 40 veterans died while waiting for an appointment. The VA Office of Inspector
General (OIG) revealed significant delays of access to patient care or appointment scheduling, including a
list of patients who have died while waiting for these services. In addition, they also uncovered
unacceptable staff behavior and lapses in patient continuity of care. They included that many veterans
who were recently hospitalized or treated in the emergency department (ED) were seeking care because
they had difficulty obtaining appointments, (Veterans Health Administration, 2014).
Their investigation identified over 3,500 additional veterans who were on an â??unofficial
wait lists.� This unofficial wail list was described by staff who stated that they either left printouts to
schedule their appointments on their desks for up to weeks at a time, intentionally used the wrong
desired date of care–which displayed a false 0-day wait time, or stated that they quote-unquote â??fixedâ? or
were instructed to â??fixâ? appointments with wait times greater than 14 days, (Veterans Health
Administration, 2014).
Fast-Forward to 2017, they conducted a new audit that displayed the average wait time of
59 days for 36% of veteran appointments. Typically they were ranging between 31 to 389 days. However,
the VAâ??s scheduling system only showed that 10% of veterans had a wait-time greater than 30 days.
Because of the inaccurate wait time, many veterans were not eligible for treatment through the Veterans
Choice Act. (Veterans Health Administration, 2017).
WEBQUEST
Introduction
Policy Issue
Voice-over
Government
Response
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
Proposed Bill
We are not requesting to increase the budget any further, but simply suggesting that
the federal government reallocate a portion of the budget from the $4.2 billion that is
designated for Information Technology (IT) to provide veterans with more access to VA
clinics by developing new facilities, developing urgent or emergency care services, or at the
minimum, increase healthcare staff which will provide additional appointment availability
(U.S. Department of Veterans Affairs, 2018c).
WEBQUEST
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
Advocacy
Advanced Practice Nurse Providers
Introduction
Policy Issue
Voice-over
Government
Response
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits
Nurse Practitioner Programs are generating nearly two out of three successful graduates
each year and the Bureau of Labor Statistics projects that the NP profession will have grown 35% by the
year 2024, (American Association of Nurse Practitioners, 2017). Therefore, if an average nurse practitioner
sees at least 24 patients in an 8-hour shift, and if a minimum of 2 newly licensed Nurse Practitioners were
hired at each of the 1,243 VA facilities, then that can provide another 59,664 or more veteran healthcare
visits, (American Association of Veterans Affairs, 2018; U.S. Department of Veterans Affairs, 2018e).
Increased Access = Decrease Wait-Times
It is our suggestion that we postpone the IT project for healthcare management online
systems and utilize the funding to provide a greater mean of healthcare access by developing new
healthcare facilities nationwide to decrease the amount of time our veterans are having to wait for an
appointment. In addition to developing new facilities, increasing the amount of healthcare professionals
(such as NPs) can help to see our veterans in a â??timelyâ? manner.
WEBQUEST
Introduction
Policy Issue
Voice-over
Government
Response
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
Implementation
You will discuss how the program can be implemented.
WEBQUEST
Introduction
Policy Issue
Voice-over
Government
Response
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
Summary
The policy aims at ensuring that the time taken for a veteran to receive hospital care and
medical service is drastically reduced by reallocating the funds of the 2019 Veterans Budget Request to
increase healthcare access.
The stipulated timeline between the date of veteran contact and the time for access to
care, will not only increase healthcare access, but also lead to the modernization of related infrastructure
and facilitate a unified veteran experience.
The improved access, in the long-term, will slow the growth of healthcare costs as a result
of improved infrastructure, which will also benefit the taxpayers since their taxes will be channeled in
other areas of concern such as security and better housing.
This new policy proposal would also boost employment of more medical professionals as a
provision of quality and timely care as the priority for our US veterans.
WEBQUEST
Introduction
Policy Issue
Voice-over
Government
Response
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
AD HOC
The findings of this study revealed that the major challenges in the provision of medical
care to the veterans was timely access to healthcare as well as the provision to quality care to the veterans
of all races. It implies that the Veterans Timely Access to Health Care Act will help solve this problem a
great deal.
Additional Research
An important research was carried out by Hebert & Hernandez (2016) who aimed at
investigating the major challenges and evidences of success in the provision of patient centered care to
veterans of all races.
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
Credits
WEBQUEST
â?¢
American Association of Nurse Practitioners. (2017). More than 234,000 licensed nurse practitioners in the
United States. Retrieved April 8, 2018 from: https://aanp.org/press-room/press-releases/173press-room/2017-press-releases/2098-more-than-234-000-licensed-nurse-practitioners-in-theunited-states
â?¢
American Association of Veterans Affairs. (2018). NP Fact Sheets. Retrieved April 8, 2018 from:
https://www.aanp.org/all-about-nps/np-fact-sheet
â?¢
Caldwell N, Srebotnjak T, Wang T, Hsia R (2013). How Much Will I Get Charged for This?� Patient Charges
for Top Ten Diagnoses in the Emergency Department. PLOS ONE 8(2): e55491.
https://doi.org/10.1371/journal.pone.0055491
â?¢
Hebert, P. L., & Hernandez, S. E. (2016). Providing patient-centered care to veterans of all races: challenges
and evidence of success.
â?¢
National Center for Veterans Analysis and Statistics. (2016). Veteran Population Projection 2017-2037.
Retrieved April 7, 2018 from:
https://www.va.gov/vetdata/docs/Demographics/New_Vetpop_Model/Vetpop_Infographic_Final
31.pdf
â?¢
National Center for Veterans Analysis and Statistics. (2018). Profile of Veterans: 2016 Data from the
American Community Survey. Retrieve April 7, 2018 from:
https://www.va.gov/vetdata/docs/SpecialReports/Profile_of_Veterans_2016.pdf
â?¢
U.S. Department of Veterans Affairs. (2018a). Exhaustion of Choice Funds Notice. Retrieved April 7, 2018 f
rom: https://www.va.gov/COMMUNITYCARE/programs/veterans/VCP/index.asp
â?¢
U.S. Department of Veterans Affairs. (2018b). Frequently Asked Questions. Retrieved April 7, 2018 from:
https://www.accesstopwt.va.gov/#
â?¢
U.S. Department of Veterans Affairs (2018c). Retrieved April 7, 2018 from:
https://www.va.gov/budget/docs/summary/fy2019VAsBudgetFastFacts.pdf
Introduction
Policy Issue
Voice-over
Government
Response
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits
US Veterans Healthcare Access Policy:
A Change for Wait-Time Improvement
Credits
WEBQUEST
â?¢
U.S. Department of Veterans Affairs. (2018e). Where Do I Get The Care I Need? Retrieved April 8, 2018
from: https://www.va.gov/health/FindCare.asp
â?¢
Veterans Health Administration. (2014). Veterans Health Administration: Review of Alleged Patient
Deaths, Patient Wait Times, and Scheduling Practices at the Phoenix VA Health Care System.
Retrieved April 25, 2018 from: https://www.va.gov/oig/pubs/VAOIG-14-02603-267.pdf
Voice-over
â?¢
Government
Response
Veterans Health Administration. (2017). Audit of Veteran Wait Time Data, Choice Access, and Consult
Management in VISN 6. Retrieved April 25, 2018 from: https://www.va.gov/oig/pubs/VAOIG16-02618-424.pdf
â?¢
Veterans Timely Access to Health Care Act 2013-2014, § 241, (2013). Retrieved April 7, 2018 from:
https://www.congress.gov/bill/113th-congress/house-bill/241
Introduction
Policy Issue
Assessment
Proposed Bill
Advocacy
Implementation
Summary
Ad Hoc
Credits

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