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

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

    Name

    Capella university

    NURS FPX4050 Coordinating Patient-Centered Care

    Prof. Name

    Date

    Ethical and Policy Considerations in Coordinating Care

    Good morning, and thank you for joining us today. I’ll be delving into laws and regulations that pertain to the well-being of homeless individuals and exploring the ethical aspects arising from these regulations, particularly focusing on the ethical code for care coordinators and nurses. The aim of this presentation is to highlight the importance of ethical considerations and health policies in maintaining seamless care for patients within a community setting. Before delving into the specifics of care coordination for the homeless and the policies affecting it, let’s first define care coordination as the organized planning of patient care tasks and information exchange among all involved parties to ensure safer and more effective treatment. This presentation concentrates on homeless shelters and the policies shaping care coordination for this vulnerable population.

    The most at-risk members of our community are those experiencing homelessness, often with complex medical and psychological needs that necessitate well-coordinated care. The U.S. Department of Housing and Urban Development (HUD) defines an individual as homeless if they “do not have a stable, permanent, and adequate overnight shelter.” Currently, over 500,000 individuals are homeless in the U.S., with 35% living without shelter or in unsuitable locations (Kurata et al., 2020). However, providing coordinated care for the homeless is challenging due to resource limitations, restricted access to healthcare services, and the stigma associated with homelessness. This presentation will explore how governmental regulations, ethical dilemmas, and adherence to the nursing ethical code impact care coordination for homeless individuals.

    Governmental Policies Impacting Care Coordination

    Government policies related to homeless shelters can significantly influence the coordination of care for those experiencing homelessness, potentially hindering effective care coordination. The Affordable Care Act (ACA), enacted in 2010, aimed to improve healthcare access for all Americans, primarily focusing on health insurance reform and Medicaid expansion. The ACA indirectly influenced laws related to homeless shelters, introducing Health Home programs designed to coordinate care for individuals with chronic diseases, which is particularly beneficial for the homeless population facing serious health issues (Dickins et al., 2020). Emphasizing preventive programs, the ACA supports services like vaccinations and health screenings that aid homeless individuals in preventing and managing health conditions.

    The ACA also gave rise to the “Homeless Health Care (HCH)” program, enhancing healthcare workers’ ability to recognize and address the specific needs and experiences of the homeless. The program emphasizes case management and care coordination, necessitating collaboration with various healthcare professionals, social services organizations, and community groups to ensure comprehensive and coordinated treatment for homeless individuals (Lanese et al., 2021). The Health Insurance Portability and Accountability Act (HIPAA), enacted in 1996, focuses on safeguarding the privacy and confidentiality of individual health information. Given the unique health issues faced by homeless individuals, HIPAA standards require special precautions in handling sensitive health information, such as mental health problems or substance use issues, to avoid stigmatization.

    Policies Presenting Ethical Dilemmas in Care Coordination

    Certain policies can give rise to ethical dilemmas in the care of homeless individuals, requiring healthcare providers to balance legal and ethical considerations. One such policy is the Documentation Requirement Policy under HIPAA, mandating residency and citizenship documents for complete healthcare access. Homeless individuals often struggle to provide these required documents, creating a dilemma for healthcare providers who must ensure policy implementation. The ethical predicament arises from the tension between legal requirements and the practical challenges faced by homeless individuals in meeting documentation criteria (Tønnessen et al.).

    The Affordable Care Act also poses a moral dilemma for healthcare providers, especially in states that refuse Medicaid expansion, creating a coverage gap for low-income groups, including the homeless. Denying access to insurance and Medicaid services based on income criteria can disadvantage low-income individuals, and the lack of a permanent home address further complicates enrollment in health insurance plans for the homeless. Healthcare institutions are thus confronted with a moral choice between upholding the law and adhering to ethical principles of fairness and justice. Additionally, privacy rights and safety concerns ensured by HIPAA create ethical challenges when employing surveillance or data-collection techniques to monitor homeless individuals in public areas, raising concerns about privacy infringement and potential discrimination (Tiderington, 2019).

    Impact of Code of Ethics on Nurses

    The Nursing Code of Ethics provides a robust ethical framework for the continuum of care and care coordination for homeless individuals. The code directly and indirectly influences how nurses navigate ethical considerations when working with homeless populations. Emphasizing the importance of protecting patients’ rights, health, and safety, the code becomes particularly crucial when dealing with vulnerable populations. Nurses are urged to follow ethical principles that address healthcare disparities stemming from various social determinants of health, such as food, housing instability, poverty, and healthcare challenges persistently impacting the homeless population, including undocumented individuals.

    The code underscores nurses’ obligations to promote, support, and protect patients’ autonomy, wellness, and safety, as outlined in Provision 3. Provision 8 recognizes the value of collaboration with the public and other healthcare professionals to support community activities addressing health needs, a vital aspect for effective care coordination (Hanks et al., 2019).

    Conclusion

    To summarize today’s presentation, we began with the importance of care coordination for homeless individuals, emphasizing the necessity of organized care. We then explored policies in the U.S., including the ACA, HIPAA, and the Healthcare for Homeless (HCH) program, which significantly impact homeless populations. Subsequently, we delved into healthcare policies posing ethical dilemmas for professionals, highlighting three major dilemmas arising from these policies. After examining the influence of the code of ethics on nurses, we discussed the role of nurses in coordinating care and maintaining care continuity through 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 Medicine, 135(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

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

    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/

    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