Learning Objectives

Students will:

• Compare U.S. presidential agenda priorities
• Evaluate ways that administrative agencies help address healthcare issues
• Analyze how healthcare issues get on administrative agendas
• Identify champions or sponsors of healthcare issues
• Create fact sheets for communicating with policymakers or legislators
• Justify the role of the nurse in agenda setting for healthcare issues

 Required Readings

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

• Chapter 1, “Informing Public Policy: An Important Role for Registered Nurses” (pp. 11–13 only)
• Chapter 2, “Agenda Setting: What Rises to a Policymaker’s Attention?” (pp. 17–36)
• Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 171–180)
• Chapter 12, “An Insider’s Guide to Engaging in Policy Activities”
  • “Creating a Fact Sheet” (pp. 217-221)

USA.gov. (n.d.). A-Z index of U.S. government departments and agencies. Retrieved September 20, 2018, from https://www.usa.gov/federal-agencies/a

USA.gov. (n.d.). Executive departments. Retrieved September 20, 2018, from https://www.usa.gov/executive-departments

The White House. (n.d.). The cabinet. Retrieved September 20, 2018, from https://www.whitehouse.gov/the-trump-administration/the-cabinet/

Document: Agenda Comparison Grid Template (Word document)

 

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Discussion: Presidential Agendas

Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.

Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

To Prepare:

• Review the Resources and reflect on the importance of agenda setting.
• Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.

By Day 3 of Week 1

Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?

By Day 6 of Week 1

Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

*Note: Throughout this program, your fellow students are referred to as colleagues.

 Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

 It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember.

Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since.

As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news.

In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy.

To Prepare:

• Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations.
• Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.
• Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.
• Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.

The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet)

Part 1: Agenda Comparison Grid

Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:

• Identify and provide a brief description of the population health concern you selected and the factors that contribute to it.
• Describe the administrative agenda focus related to the issue you selected.
• Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.
• Explain how each of the presidential administrations approached the issue.

Part 2: Agenda Comparison Grid Analysis

Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:

• Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
• How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?
• Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?
• At least 2 outside and 2-3 course resources are used.

Part 3: Narrative

Using the information recorded on the template in Parts 1 and 2, develop a 1-page narrative that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following:

• Summarize why this healthcare issue is important and should be included in the agenda for legislation.
• Justify the role of the nurse in agenda setting for healthcare issues.
• At least 3 resources are used.

By Day 7 of Week 2

Submit your final version of Part 1: Agenda Comparison Grid, Part 2: Agenda Comparison Grid Analysis, and Part 3: Narrative.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
• Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

 

 Sample Module 1: Agenda Setting (Weeks 1-2)

 Policy and Advocacy for Improving Population Health

Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

Mental health is a critical component of population health. It received considerable attention from different Presidents. However, in recent times the need for mental health improvement initiatives has accelerated. The policy makers need to have a new focus on mental health policies to help population improve their well being. This paper will focus on how different presidents addressed mental health.

 Agenda Comparison Grid and Fact Sheet or Talking Points Brief Assignment Template for Part 1 and Part 2

 Part 1: Agenda Comparison Grid

 Use this Agenda Comparison Grid to document information about the population health/healthcare issue your selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas.

 You will use the information in the Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your Assignment.

Identify the Population Health concern you selected.	Mental health of US citizens
Describe the Population Health concern you selected and the factors that contribute to it.	Along with physiological health, mental health should receive crucial attention from healthcare providers. People go through various stressful situations which has a direct impact on their health. There can be both personal and global factors contributing to mental health issues.   Considering the interdependence between physiological and mental health, the topic should receive presidential attention. If the majority of population face mental health issues then the country’s economy and people’s social life will be highly impacted. Consequently, the government has two responsibilities – enact policies that will help people facing mental health issues and develop mechanisms to minimize factors that have direct negative impact on population mental health.
Administration (President Name)	President Trump	President Obama	President Bush
Describe the administrative agenda focus related to this issue for the current and two previous presidents.	Up till 2019, President Trump was decreasing funding for Substance Abuse and Mental Health Services Administration’s program directed to Mental health, directed focus to other healthcare areas. However, COVID-19 pandemic and related lockdown has brought public mental health to the attention of president. He signed an Executive Order which allocated funds and established a working group to assess mental health challenges and take action for improvement (White House, 2020).	President Obama paid considerable attention to population mental health. He extended federal mental health parity to Medicaid plans and to insurance place marketplaces. Additionally, he enacted federal policy which provided housing to individuals who have mental illnesses and disabilities (Hart, 2016).	Population mental health was one of the major focuses for President Bush. He provided funds and enacted laws and policies. One of the major steps was establishing a federal law according to which health insurance for mental health became equivalent for other medical conditions. Additionally, the policies prohibited discrimination towards people who have a mental illness.
Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.	According to recent report of White House, the president allocated around $425 million to emergency funds for people with mental disorders.	The president allocated around $500 million in funding for mental health issues.	Around $126 million was used for Center for Substance Abuse Treatment. There were other programs involving more money, too (Lake, 2017).
Explain how each of the presidential administrations approached the issue.	President Trump cut the budget for mental health in the beginning of his Administration. However, in later period it became clear that mental health has critical importance, thus leading the President to pay more attention to it.	President Obama highlighted the importance of mental health in his activities, thus supporting any initiative aimed at improving population mental health. He generally continued (instead of cutting) the budget allocation for mental health.	President Bush considered mental health to be crucially important, as he aimed to screen whole US population for mental health.

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Part 2: Agenda Comparison Grid Analysis

 

Using the information you recorded in Part 1: Agenda Comparison Grid, complete the following to document information about the population health/healthcare issue your selected

 

Administration (President Name)	President Trump	President Obama	President Bush
Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?	Substance Abuse and Mental Health Services Administration would most likely be responsible for addressing mental health issues (White House, 2020).	National Alliance on Mental health had a major influence on President Obama’s decisions regarding mental health.	New Freedom Commission on Mental Health was established by Bush to conduct study and create action plan for mental health assessment (Lenzer, 2004).
How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?	President Trump would consider the issue if people forced him to do so using various tools One of the most trendy tools is the use of social media as a way to lead Presidents to take action. The issue would stay on agenda as long as people keep requiring the government to take action.	Population mental health issue might get on the agenda of President Obama if his team provided a recommendation, like in the case of Bush.	President Bush very well understood the importance. It would be enough for his team to provide a recommendation and the President would consider the issue for his agenda. It would stay on agenda by the time there was an improvement in population mental health.
Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?	Thalia Catherine Eley, who is professor of developmental behavioral genetics.	Steven Pinker, who is cognitive psychologist and has been recognized as one of the global leaders understanding human nature.	Martin Elias Pete Seligman, who is psychologist, educator and author of numerous books and theories.

 

Narrative with the Facts

Policy makers and legislators spend time, finances and human resources to develop policies that aim to improve population health. The polices generally include healthcare insurance, cost mechanisms, healthcare system functions etc. However, the changes in social and economic life has made policy makers to reconsider the scope of policies. One of the most popular scholars in healthcare system Richard Saltman has questioned whether traditional pillars of healthcare system are in need of fundamental restructuring.

COVID-19 pandemic once again provided the need for mental health initiatives and policies. The focus of policy makers should expand to include mental health. Along with physiologic health, mental health is important for population to function in a way that will benefit the country and society. Lake and Turner (2017) consider that current treatments of mental health do not sufficiently address the mental health issues, leading to increase in the number of people facing numerous problems. Consequently, there should be a new and updated focus on mental health and policy initiatives that improve it. It should be included in the agenda for legislation as the population has suffered from the pandemic and many other historic events, having severe negative impact on overall well-being of people.

Nurses have critical role in all activities of patient care. They not only perform basic activities of care, but also provide emotional support to patients. They are very close to patients, which allows them to understand patient needs better than anyone else in the value chain of healthcare system. It will be very important and impactful to involve nurses in decision making, as they can provide advice on types of mental health issues faced by patients and probable ways of addressing these issues. Nurses have abilities and increasing enthusiasm that can contribute to the overall improvements in healthcare system (Dickens, Ion, Waters, Atlantis & Everett, 2019).

 Conclusion

            While Bush and Obama paid considerable attention and allocated resources to mental health, Trump cut budget on initiatives aimed at improving mental health. However, COVID-19 has lead Trump to understand that population mental health is critically important and allocated more funds. During Presidency of each President, there were events and situations that highlighted the need for mental health. In any case, the presidents should be involved in policy initiation and use their teams to improve population mental health.

References

Chinitz D. (2019). The more health policies change, the more they change the same way. Israel journal of health policy research, 8(1), 36.

            https://doi.org/10.1186/s13584-019-0308-6

Dickens, G. L., Ion, R., Waters, C., Atlantis, E., & Everett, B. (2019). Mental health nurses' attitudes, experience, and knowledge regarding

            routine physical healthcare: systematic, integrative review of studies involving 7,549 nurses working in mental health settings. BMC   nursing, 18, 16. https://doi.org/10.1186/s12912-019-0339-x

Lake, J., & Turner, M. S. (2017). Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care. The Permanente

            journal, 21, 17–024. https://doi.org/10.7812/TPP/17-024

Lenzer J. (2004). Bush plans to screen whole US population for mental illness. BMJ (Clinical research ed.), 328(7454), 1458.            

            https://doi.org/10.1136/bmj.328.7454.1458

Hart, J.W. (2016). How Presidents Have Shaped Mental Health Care. NAMI. https://www.nami.org/Blogs/NAMI-Blog/February-2016/How-      Presidents-Have-Shaped-Mental-Health-Care

President Donald J. Trump Is Safeguarding Americans’ Mental Health and Preventing The Tragedy of Suicide (2020). White House. https://www.whitehouse.gov/briefings-statements/president-donald-j-trump-safeguarding-americans-mental-health-preventing-tragedy-            suicide/