Questions and Topics We Can Help You Answering; 
Application Assignment 2: Part 2 - Developing an Advocacy Campaign
The following application, Part 2, will be due in Week 7.
To prepare:
•    Review Chapter 3 of Milstead, J. A. (2012). Health policy and politics: A nurse’s guide (Laureate Education, Inc., custom ed.). Sudbury, MA: Jones and Bartlett Publishers
•    In the first assignment, you reflected on whether the policy you would like to promote could best be achieved through the development of new legislation, or a change in an existing law or regulation. Refine as necessary using any feedback from your first paper.
•    Contemplate how existing laws or regulations may affect how you proceed in advocating for your proposed policy.
•    Consider how you could influence legislators or other policymakers to enact the policy you propose.
•    Think about the obstacles of the legislative process that may prevent your proposed policy from being implemented as intended.
To complete:
Part Two will have approximately 3–4 pages of content plus a title page and references. Part Two will address the following:
•    Explain whether your proposed policy could be enacted through a modification of existing law or regulation or the creation of new legislation/regulation.
•    Explain how existing laws or regulations could affect your advocacy efforts. Be sure to cite and reference the laws and regulations using primary sources.
•    Provide an analysis of the methods you could use to influence legislators or other policymakers to support your policy. In particular, explain how you would use the “three legs” of lobbying in your advocacy efforts.
o    Summarize obstacles that could arise in the legislative process and how to overcome thes



NURS 6050: Policy and Advocacy for Improving Population Health “Health Policy and Politics” Program Transcript [MUSIC] NARRATOR: Crafting policy to address health care issues. MARY WAKEFIELD: Now let's think about that public policy maker who is trying to fashion a solution to one of those challenges of cost access or quality. What is it that determines what the solution is that gets put on the table and how that solution moves through the policy-making process? NARRATOR: The important role nurses play in health care policy. KATHLEEN M. WHITE: Every nurse should care about being involved in the policy process because we are the experts in health care. NARRATOR: And a perspective that is critical. DEBORAH TRAUTMAN: I was told when I was on the Hill that all politics is local and all health care is personal. And I think that, as nurses, we understand that. NARRATOR: Getting started in the policy process. CARMELA COYLE: Policy begins with a good idea. The problem is to try to move from an idea and a concept and good research to a piece of legislation that can actually pass can be a long and winding road. NARRATOR: This week, are experts share insights into the policy process, the politics of health care policy, and the invaluable role of the professional nurse. MARY WAKEFIELD: When I first moved to Washington, D.C. and worked in the public policy arena, I was a bit of a policy purest, if you will. It was my belief that public health policies crafted to address access cost or quality were designed based on, for example, good research, on doing the right thing, if you will. And it didn't take me very long to figure out that in fact it's not just about good research or what I might view as an obvious solution to a particular problem associated with quality of health care. In fact, there are a number of factors that influence what solution gets put on the agenda, how that solution moves through the policy-making process, and whether, in fact, it even survives through to the end of that policy-making process. © 2012 Laureate Education, Inc. 1 There are a number of factors that influence health policy. Health policy can be influenced by crises. Media can influence what gets put on the policy-making agenda or how it's treated once it gets there. Political ideology. Personal experiences of members of Congress can influence how they respond to a particular health care challenge. Research findings also can be influential. Special interest groups can exert a lot of influence on what gets put on the health policy agenda. Constituents like each of you who might draw the attention of your policymakers. It might be that you'll draw the attention of your congressional delegation to a particular problem the you're saying. So constituents can be a factor that influences health policy. Market forces can also be a driver of health policy. In addition, fiscal pressures. So you have a number of different factors then that can influence both what gets put on the policy-making table and how it's treated once it gets there. In terms of personal experience, there was a congresswoman, now elected, from the state of Florida who had a close personal friend with a particular disease. And she was pretty public about introducing legislation that would be designed to cover pharmaceuticals that were important to addressing that disease. So here is a member of Congress who has a personal experience that's influencing what, in this case, she did to address that particular problem of access to pharmaceuticals to treat a particular health care problem. So personal experiences matter on the part of members of Congress, believe it or not. It's not all just about research findings. In addition, constituents' voices matter. If individuals express their views about a particular health care problem to their elected officials, it behooves elected officials to pay attention. A lot of times nurses and others think that the only influence that's exerted or factor that exerts influence in Washington or in a state capital is a special interest influence. I'd suggest to you that's not really true. There are all the factors that I've mentioned. And constituents, that is your own voice, is an extremely important one. So don't dismiss out of hand the impact that you can have as a factor, if you will, in influencing what gets put on the policy-making table and how it's treated once it's there. Because at the end of the day, guess what? Policymakers or elected officials are either voted into office or they're voted out. They are ill-prepared to be unresponsive to what is that their constituents are telling them. So do all the other factors matter? You bet they do. But your voice matters too. KATHLEEN M. WHITE: In designing health care policies, nurses have traditionally wanted to be involved. It's been a great experience for me over 30 some years being a nurse. I think I got actively involved in health care policy and © 2012 Laureate Education, Inc. 2 politics very early in my career. And it's just always been something that has fascinated me and something I've wanted to be interested in. And yet, we're constantly amazed in trying to get a policy either changed or on the public agenda that is new for nursing, is good for health care, or at least as nurses we think it's good for health care, and something that we think the public would benefit from. And I can tell you that over the years in trying to get legislation either, first on the public agenda, and then being considered, often it takes two, three, four, go arounds before a piece of legislation actually even makes it out of a committee. And it's surprising that you think, wow, this is a great idea. This will improve things. And yet when it's new to a group of legislators who are teachers or bankers or real estate agents or lawyers that really have no expertise in health care whatsoever, they don't always see the importance of a policy. And so just the fact that you have to introduce what seems to be a really good piece of legislation that will improve things two, three, even sometimes four times, before it even gets to that public agenda, I think is something that continues to surprise me over the years. A second thing that surprises me continually is that legislation often gets introduced when one person has a problem. And they go to their legislator and they say, this needs to get corrected. And the legislator meets the need of a constituent. And so when you think about elected officials, they can be in one of two camps. They can either what they call pleasing their constituents or pleasing their conscience. And so when you have one person's interests being represented, you really have to think about whether or not that policy is a good one for all, for all of society. And so certainly that evaluation of the good of society comes in looking at that. DEBORAH TRAUTMAN: When we think about, what does it mean to influence policy, I think of it quite simply as-- influencing health policy I think of three factors. And one is first in my mind is that evidence matters. That in order to effectively influence policy, it should be evidence-based. Additionally, I think that communications matter and relationships matter. And that as a profession when we think about being involved in advancing better policy that if we start with evidence-- our evidence coupled with stories-- and we share those with whomever it is that we're trying to educate about and/or work with shaping new policy, that's where we first start. But that communication is very important in that we need to be clear and articulate in what it is that we're trying to address. In addition, when we were talking about influencing policy, the policy, the politics, and the process are what folks will frequently talk about as the three P's. I would suggest that in addition © 2012 Laureate Education, Inc. 3 there's the press, the public, and personalities, and that when we're trying to move policy forward, we need to think about each of those. In our organizations we currently participate in many of the key committees and/or task force that are leading the direction for our institutions. And I think that we also should be thinking about this not just on the federal level because a lot of policy is also very state. I was told when I was on the Hill that all politics is local and all health care is personal. And I think that, as nurses, we understand that. We get what it means to advocate for better health and health care. So there is opportunity for us to think about, then what does that mean in driving some of these next steps to getting us to be a healthier America? And that not every nurse needs to go visit their member of Congress. But every nurse should know who their member of Congress is. Not every nurse needs to, in my mind, be the extrovert who is speaking on a large platform, but we have opportunities to talk to on an individual basis to the patients and to their families. And what we should be helping do is continue to think about what services and resources are necessary to help us move, again, to being healthier. CARMELA COYLE: As I think of major influences affecting health care policy, I tend to think of it as a three-legged stool. You've got the legislative process that's affecting health care policies. The laws that we shape, the laws that we enact. There's a second leg of the stole which is the regulatory process. It's the thousands of pages of detail that have to be written to clarify what it is our lawmakers had in mind. And there's a third leg of the stool. And that is the special interest groups. The special interest groups play a very, very important role by informing legislators and regulators, from the front line perspective of health care delivery, of what the implications of a new law or a new regulation might be. I think if there are forces affecting those, there are several. One is, I think, our elected officials. Our legislators are certainly being held more accountable by the voters for making certain that we've got the kind of health care system that people want to see in the United States. I think that we're also seeing consumer expectations on the rise. And more pressure, I think, today than we certainly saw at 10 or 20 years ago from a broader array of special interests to make certain that the policy we've got in place is really serving every one, not just what we've traditionally viewed as the key stakeholders in the health care system. But I think we've seen greater accountability. I think we see greater engagement and involvement. From my perspective a strength of our system, but it makes the creation of health care policy that much more challenging, © 2012 Laureate Education, Inc. 4 And I think one of the new entrants is we really are more focused on measuring how we've done at the end of the day. There's been policy that's been put into place, and we don't really know if it works or if it doesn't. I see much more emphasis in new laws and new regulations on evaluating three years out, five years out. Is it working? And if not, come back and report it and we'll have to revisit the legislation. So I think all of that is a set of new forces really helping to shape policy and refine it in ways we haven't seen before. DEBORAH TRAUTMAN: Nurses sometimes say they don't like politics. I don't disagree with them. Politics is probably the least desired part of the process. But you can't divorce policy from politics. But I believe-- especially now because we have some pretty partisan times in our federal government, at least, and maybe even at the state and local levels-- that if you could have the voice of health care professionals ringing through that partisan divide that we may be able to make more progress that we can't otherwise because of ideologies. I have never known the nursing profession to make clinical decisions and care and judgment based on someone's political ideology. But politics is a part and we have to recognize that. But what I would suggest to us as professionals is that we need to just increase our effectiveness in managing some of the politics, or at least acknowledging and addressing them. So who are the stakeholders that we should bring along with us? Who's going to be in favor and helpful to us in advancing policies? And who are those that are opposed? And we need to educate ourselves on what their positions may be. So that's a part of it and a part of, what I would say, the evidence. The communication, again. In thinking through our message and being able to be clear and succinct and brief. Because the effectiveness of getting our point across is based upon not just what we want to do but how well we communicate that. And then relationships are incredibly important. Not only building relationships within the profession of nursing, but outside. And with our elected members of Congress as well as with others. And in particular I would say for state and federal policy it's important to know who are the committees of jurisdiction that are working on policy? Who are the staffs? Some folks have said that they thought if they try to set up a meeting with their elected member and are referred instead to a staff person, that that's not as good. And I would say that that's incorrect, that many times it is the staff who are the source of information and the filter of information that goes to our elected members. And so it's as important to have relationships with those individuals as it is with members themselves. © 2012 Laureate Education, Inc. 5 The advantage that we all have is that very few of our elected members will turn down their own constituent. It may be harder to get in to see someone from another office or state. And not all of our states have representatives on some of the key health committees. But most all of the staff that I met when I was in the Speaker's office and the committee staff that work both on the minority and majority side, were very open to listening to perspectives that were being brought forward by health care professionals. Because many times what others know about health care is from their own personal experience or what someone tells them. Health care professionals, nurses in particular, have firsthand experience and know not only what might work best, but have stories to tell that help make it real beyond just a theory or a proposed solution or alternative.

Example of part one
Financing of Health Care    part one
Course Nursing 6050










Financing in health care is the allocation of funds to cover various medical expenses that incurred in the delivery of health care services in both public and private sector. Health economics are always applied in determination what programs are by covered by the government  financing program. Since resources have scarce and wants are very many, the decision has to be made to arrive at a consensus on what is to be covered and what is not going to be covered.
One of the major determinant in the evaluation of what of what is to be covered by the government program is the procedures and the treatment that is involved.  Treatment that involves so many procedures are not included on the list in which the government should fund. This is the reason why there was a debate concerning the coverage of the ventricular devices and the bariatric surgery and the drug proving 2010.
The cost of the treatment is another factor which is being used in the evaluation whether the treatment will be covered or not. For treatments which involve drugs which are too expensive are being excluded in the list of program that should be covered. A good example is the treatment of prostate cancer which involving a vaccine which is extremely expensive.
However Medicare is not supposed to put a lot of costs consideration in making its ruling, and this has raised concerns among the cancer experts, drug companies among other.
Ethical issues have to be considered while determining which program should be funded. For example, if the consequences of failing to cover a certain treatment would lead to death because the victim could not meet the cost. In such a circumstance it would be considered ethical if the life of the human being is saved without necessary considering the costs involved.


References
Washingtonpost.com. (2016). Review of prostate cancer drug Provenge renews the medical cost-benefit debate. [online] Available at: http://www.washingtonpost.com/wp-dyn/content/article/2010/11/07/AR2010110705205.html [Accessed 10 Dec. 2016].
(2016). Hard Economic and Finance Choices in US Healthcare - KEEN ESSAYS BLOG. [online] KEEN ESSAYS BLOG. Available at: http://blog.keenessays.com/2014/12/hard-economic-finance-choices-us-healthcare/ [Accessed 10 Dec. 2016].

Evaluation Criteria for Applications and Formal Papers 

    Levels of Achievement
Criteria    Outstanding Performance    Excellent Performance    Competent Performance    Proficient Performance    Room for Improvement
QUALITY OF WORK SUBMITTED - 
1. The extent to which work meets the assigned criteria and work reflects graduate level critical and analytic thinking (0-30 Points)    30 to 30 points
Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics    25 to 29 points
Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics    20 to 24 points
Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics.    16 to 19 points
Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed.    0 to 15 points
Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.
QUALITY OF WORK SUBMITTED: Purpose of the paper is clear (0-5 Points)    5 to 5 points
A clear and comprehensive purpose statement is provided which delineates all required criteria.    5 to 5 points
A clear and comprehensive purpose statement is provided which delineates all required criteria.    4 to 4 points
Purpose of the assignment is stated, yet is brief and not descriptive.    1 to 3 points
Purpose of the assignment is vague.    0 to 0 points
No purpose statement was provided.
ASSIMILATION AND SYNTHESIS OF IDEAS 
The extent to which the work reflects the student’s ability to- 
1. Understand and interpret the assignment’s key concepts (0-10 Points)    10 to 10 points
Demonstrates the ability to critically appraise and intellectually explore key concepts.    9 to 9 points
Demonstrates the ability to critically appraise and intellectually explore key concepts.    8 to 8 points
Demonstrates a clear understanding of key concepts.    5 to 7 points
Shows some degree of understanding of key concepts.    0 to 4 points
Shows a lack of understanding of key concepts, deviates from topics.
 
ASSIMILATION AND SYNTHESIS OF IDEAS 2. Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources (0-20 Points)    20 to 20 points
Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 3-4 course resources to support point of view.    15 to 19 points
Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 3-4 course resources to support point of view.    10 to 14 points
Integrates specific information from 1 credible outside resource and 3 to 4 course resources to support major points and point of view.    3 to 9 points
Minimally includes and integrates specific information from 2-3 resources to support major points and point of view.    0 to 2 points
Includes and integrates specific information from 0 to 1 resource to support major points and point of view.
ASSIMILATION AND SYNTHESIS OF IDEAS 3. Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, and textbook) by comparing different points of view and highlighting similarities, differences, and connections. (0-20 Points)    20 to 20 points
Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.    18 to 19 points
Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.    16 to 17 points
Summarizes information gleaned from sources to support major points, but does not synthesize.    14 to 15 points
Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped.    0 to 13 points
Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.
WRITTEN EXPRESSION AND FORMATTING 1. Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused--neither long and rambling nor short and lacking substance. (0-5 Points)    5 to 5 points
Paragraphs and sentences follow writing standards.    5 to 5 points
Paragraphs and sentences follow writing standards.    4 to 4 points
Paragraphs and sentences follow writing standards 80% of the time.    3 to 3 points
Paragraphs and sentences follow writing standards 70% of the time.    0 to 2 points
Paragraphs and sentences follow writing standards < 70% of the time.
 
WRITTEN EXPRESSION AND FORMATTING 2. English writing standards: Correct grammar, mechanics, and proper punctuation (0-5 Points)    5 to 5 points
Uses correct grammar, spelling, and punctuation with no errors.    5 to 5 points
Uses correct grammar, spelling, and punctuation with no errors.    4 to 4 points
Contains a few (1-2) grammar, spelling, and punctuation errors.    3 to 3 points
Contains several (3-4) grammar, spelling, and punctuation errors. 3    0 to 2 points
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
WRITTEN EXPRESSION AND FORMATTING 3. The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list (0-5 Points)    5 to 5 points
Uses correct APA format with no errors.    5 to 5 points
Uses correct APA format with no errors.    4 to 4 points
Contains a few (1-2) APA format errors.    3 to 3 points
Contains several (3-4) APA format errors.    0 to 2 points
Contains many (≥ 5) APA format errors.









Discussion: Health Care Policy
In this week’s media presentation, Dr. Trautman, Dr. Wakefield, and Ms. Coyle discuss how public policies initiated at the national or state level ultimately influence what occurs at the institutional and local level of nursing practice and health care delivery. Health care policy usually is developed to address health care cost, quality, or access, or a combination of the three. Due to the nature of their interaction with patients, nurses are well situated to be effective, knowledgeable advocates for their patients.
In this week’s Discussion, you will examine how current policies impact how you as a nurse provide health care. You will then select an issue of interest and determine how you could advocate for policy in that area.
To prepare:
•    Select one public policy that currently is impacting you and your practice. Consider the following:
o    What health care driver was the policy designed to address: cost, quality, access, or a combination?
o    Does the policy appear to be achieving its intended results? On what data are you basing your assumption?
o    What have been the effects (adverse or positive) of this policy on health care cost, quality, and access?
o    How is this policy affecting your nursing practice?
•    Next, select a health care issue—something you see or experience on a daily basis—about which you would like to influence a practice change through the policy process.
•    Review the Learning Resources, focusing on Kingdon’s Model. How would you utilize this model to guide your policy development?
By Day 3
Post a brief description of a public policy that is having an impact on your practice; summarize your analysis of the policy using the bulleted list above as a guide. Then, summarize the issue you would like to influence though a change in public policy, and outline how you would utilize Kingdon’s Model to guide your policy development.