nitiatives and health policies are very crucial when it comes to the health sector’s progress. They are the key things, which usually ensure the health services delivery by the APNs. The health initiatives also play a crucial role in implementing the policies, and they provide that essential health practices are practised. The three major initiatives and policies that impact the advanced practice nurse are the Affordable Care Act and Patient protection, the Consensus Model for APRN Regulations, and the Institute of Medicine report.
One of the policies that are being used to direct and guide my work as an APN is ACA. Some interventions were made by the policy that affected the APNs practice. Health insurance guidelines and reimbursement are one of the policy aspects that cause APNs to be reimbursed at a lower rate as compared to physicians (Lanford & Quadagno, 2021). Expansion of the nurses’ scope and limiting the scope of APNs is another issue with ACA law. Only very few states do allow APNs to operate independently. The law also expanded health services generally hence increasing workload to the duties of APNs.
Secondly, the Institute of Medicine recommendation is another initiative policy. One of the recommendations was for the nurses to advance their studies up to the doctorate level. The policy raised the alarm on whether the APNs entry point is raised (Lanford & Quadagno, 2021). The second recommendation was that the limited and scope barriers should be removed hence gagging APNs in their services delivery. This recommendation will affect my practice positively since it will allow me to conduct several health services, which I am able to do without any boundaries. The Consensus Model has also impacted APRN nature of practice for APRN Regulation. Its recommendation states that APRNs are supposed to be allowed to operate independently. This independent practice regulation is vital in guiding how we should collaborate with our fellow health practitioners to achieve interprofessionalism.
2. Medicaid eligibility criteria for three different states.
Medicaid is referred to the federal program and joint state; they come together with the Health Insurance Program of children intending to offer health coverage to several American citizens like children, pregnant women, seniors, people with disabilities, and parents. Some policies are regulating participation in Medicaid programs. However, there are some policies that are the same in all states, whereas some of the policies differ as per the state.
In this discussion, we will focus on Montana, Wisconsin, and Alaska. We will contrast and compare the Medicaid eligibility and the Medicaid eligibility policy implication for these states’ residents. In both three countries, for one to be eligible for Medicaid coverage, the person must be a legal alien, a citizen and a resident of that particular state, and a permanent resident of the United States of America. In addition, the person must also have the need a healthcare cover or healthcare insurance cover.
The person who requires the coverage must also be confirmed that their financial status cannot manage to afford covers such as private insurance or Medicare, which is being offered by the private sector. This means that the individual must be categorized among those people with low income (O’connor, 2017). The individual must also be in categories of pregnant women, blind, and those children below the age of 18, disabled persons, and those in the age of 65 years old and above.
Being that some of the regulatory policies for eligibility are common in these states, there are still other differences. For instance, in Wisconsin, the individual’s household income should not be more than $ 17,131 per year. While in Montana, they require that the individual’s household should not have an income of more than $ 12 880. In addition, in Alaska, the maximum income requirement for the individual’s household is $ 21 400. The criteria of the eligibility of these states have several implications. This is to ensure that the services of Medicaid are offered to those who deserve it the most (O’connor, 2017). However, because the insurance policy mostly depends on taxpayers’ contributions, it would be better if it were rendered even to those who believe that they are not able to afford the Medicare cover. This is because there are some individuals whose income is above the maximum, but they are not able to afford expensive health care insurance.
Lanford, D., & Quadagno, J. (2021). Identifying the Undeserving Poor: The Effect of Racial, Ethnic, and Anti-Immigrant Sentiment on State Medicaid Eligibility. The Sociological Quarterly, 1-20.
O’connor, S. (2017). Using social media to engage nurses in health policy development. Journal of nursing management, 25(8), 632-639.
Health initiatives have long served as a guide for nursing care practice. Health care initiatives seek to wisely minimize the burden of disease, injury, and disability, as well as to improve the population’s health and functioning (Medicine & Committee on Enhancing Federal Healthcare Quality Programs, 2003). A variety of initiatives aimed at enhancing the health of the American population were established and put into motion as a result of the Patient Protection and Affordable Care Act of 2010 (Nash & Fabius, 2019) and date back to the Florence Nightingale era. Health policies, initiatives, and programs are critical in assisting APNs in carrying out their professional obligations.
Several significant programs establish a framework for innovation with the goal of making population health efforts the norm rather than the exception. In health care, like in many businesses, clear goals and objectives, as well as rules and standards, give an understanding of expectations and drive efforts to provide safe, high-quality care (Nash & Fabius, 2019). Initiatives to promote healthy living, for example, began in 1990. Since Healthy People 1990, the United States has made substantial progress on important public health issues, as organizations at the local, state, territorial, tribal, and national levels have directed their resources and efforts toward improving the health and well-being of all people. Reductions in major causes of death, such as heart disease and cancer, as well as improvements in preventative behaviors, such as childhood vaccines, and reductions in risk factors, such as smoking, high blood pressure, and high cholesterol, are examples of accomplishments (History of healthy people, n.d.).
The Health People 2030 iteration of the Healthy People project builds on knowledge accumulated over the last four decades. According to History of Healthy People (n.d.), one of the most important lessons learned from these projects over the last 40 years is that a widely accessible plan with attainable goals can help individuals, organizations, communities, and other stakeholders enhance population health (History of healthy people, n.d.). If APNs use this framework to guide patient care and treatment, as well as the data gained from this program over the last 40 years and other similar programs, it is possible to enhance healthcare, as well as overall patient health and quality of life.
2. Please 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 is a federal-state partnership that, in conjunction with the Children’s Health Insurance Program (CHIP), covers about 72.5 million Americans, including children, pregnant women, parents, seniors, and people with disabilities. Medicaid is the United States’ single largest source of health coverage.
Federal law compels states to cover certain groups of people in order to participate in Medicaid. Low-income families, pregnant women and children who meet certain criteria, and those receiving Supplemental Security Income (SSI) are all mandatory eligible groups. States have additional coverage options and may elect to cover other categories, such as persons receiving home and community-based services and children in foster care who would not be eligible otherwise (Medicaid, n.d.).
The baseline eligibility requirements for Medicaid in Georgia Florida, and California are as follows: applicants must be residents of the respective states or legal aliens, must be in need of health care/insurance assistance, and must demonstrate a financial situation that is deemed or described as low income or very low income (Medicaid States Fact Sheets, 2019).
In addition to meeting the basic eligibility requirements, one may qualify for Medicaid in Georgia if pregnant, a child or teenager, 65 years of age or older, legally blind, disabled, or in need of nursing home care. Additional situations that may make an individual eligible include: if you are leaving Temporary Assistance for Needy Families (TANF) and need health coverage, a family with children under 19 and have very low or no income, an income higher than the limits and you have medical bills you owe (and you are pregnant, under 18 or over 65, blind, or disabled), or caring for a child who is in foster care or has been adopted. An individual is also encouraged to apply if someone in their family needs health care, even if the individual is not certain they will qualify. Some income and resources, according to the Georgia Medicaid eligibility page, do not count as income and may not be counted against you (Medicaid fact sheets, n.d.).
In addition to meeting the basic eligibility requirements individuals may qualify if they are pregnant, responsible for a child 18 years of age or younger, blind, have a disability or a family member in your household with a disability, or are 65 years of age or older m (Florida Medicaid, n.d.)
In addition to meeting the basic eligibility requirements, one may qualify for Medicaid in California if pregnant, responsible for a child 21 years of age or younger, blind, have a disability or a family member in your household with a disability, or 65 years of age or older (California Medicaid, n.d.)
Income Eligibility per State
The Federal Poverty Level (FPL) is an income measure published annually by the Department of Health and Human Services (HHS). The federal poverty level is used to determine your eligibility for various programs and benefits.
2021 Federal Poverty levels: 100% of FPL: $21,960 for a family of three; $12,880 for an individual
Seniors & People w/ Disabilities
Eligibility Levels (as a % of FPL)
(Medicaid States Fact Sheets, 2019)
California Medicaid. (n.d.). Benefits. Retrieved December 6, 2021, from https://www.benefits.gov/benefit/1620
Federal poverty level. (n.d.). HealthCare.gov. Retrieved December 6, 2021, from https://www.healthcare.gov/glossary/federal-poverty-level-fpl/
Florida Medicaid. (n.d.). Benefits. Retrieved December 6, 2021, from https://www.benefits.gov/benefit/1625
History of healthy people. (n.d.). Health. Retrieved December 7, 2021, from https://health.gov/our-work/national-health-initiatives/healthy-people/about-healthy-people/history-healthy-people
Medicaid. (n.d.). Medicaid. Retrieved December 6, 2021, from https://www.medicaid.gov/medicaid/index.html
Medicaid fact sheets. (n.d.). Georgia Medicaid. Retrieved December 6, 2021, from https://medicaid.georgia.gov/organization/about-georgia-medicaid/medicaid-fact-sheets
Medicaid states fact sheets. (2019, October 17). Kaiser family foundation. Retrieved December 6, 2021, from https://www.kff.org/interactive/medicaid-state-fact-sheets/
Medicine, I. O., & Committee on Enhancing Federal Healthcare Quality Programs. (2003). Leadership by example: Coordinating government roles in improving health care quality (1st ed.). National Academies Press. https://www.nap.edu/read/10537/chapter/4
Nash, D., & Fabius, R. (2019). Population health: Creating a culture of