Ethical and Policy Factors in Care Coordination
Hi! Walid here. Today, I will give you a quick rundown of the moral and legal considerations that influence how treatment is coordinated in Dallas’s homeless shelters, particularly the Dallas Life Foundation. Before this discussion, I will briefly introduce healthcare coordination and explain how it influences health problems among Dallas’s homeless population.
Next, I will discuss the moral and policy considerations that impact how care is coordinated for homeless people in shelters. Finally, we will discuss the reasons that might lead to health inequalities and restrict the availability of healthcare. I will also examine the societal issues that impact healthcare delivery.
As most of us know, homelessness is a complicated problem, and provision and stability of care coordination are not very simple in shelter homes. People are exposed to several dangerous illnesses by living in these overcrowded shelters. Chronic disease management becomes challenging, mainly when we consider that homeless people will be concentrated on their lifelong struggle for food and housing, pushing their medical requirements to the background. Homeless individuals are more likely to experience discomfort, mental health, and drug use issues (Bahrami et al., 2020).
Effect of Policies on Specific Communities
Accessibility is one of the main problems faced by homeless people. The nation’s medical system has a long history of being very fragmented. This implies that individuals must visit several locations or clinics for various ailments. Finding care for alcoholism, mental illness, and other disorders under one shelter is challenging. According to the Health Coverage for Homeless Clinicians (HCH) Association, this scenario is worrisome for homeless people, who may struggle to navigate these complicated systems and locate trustworthy professionals to manage each problem. As a result, homeless shelters need a strategy that provides support services (Benavides & Nukpezah, 2020).
NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination
Continuity of care and adherence to treatment are interrelated; I will discuss both in this session. For homeless people, integrated treatment that takes place on a continuity basis implies less complicated transportation and schedule considerations. Numerous mental and physical health concerns are handled at one location, and therapy is tailored to each individual’s specific requirements. Let us discuss the regulations that the Dallas Life Foundation has implemented that impact care coordination (Giesler, 2019).
Example – Effect of HIPPA Policy on Care Coordination
A state policy known as the Health Insurance Portability and Accountability Act (HIPAA) tries to prevent the disclosure of private patient records to unauthorized parties. Consequently, HIPAA has not made it simple to provide homeless people with integrated treatment. According to a study, complete medical treatment requires various patient assessments, including physical, emotional, and interpersonal assessments. A patient’s history comprises details from several previous physicians and details about their relatives, previous medical care, and economic standing.
Due to HIPAA’s strict restrictions, physicians find it challenging to share this crucial data, which forces them to treat the symptoms rather than find a solution merely. Quality care depends heavily on healthcare professionals such as nurses, psychologists, physicians, general practice providers, and others exchanging truthful data. Social groups like the Dallas Life Foundation must become engaged when assisting people experiencing homelessness. Social welfare groups may ask patients for permission to access their data, but doing so might postpone healthcare quality since the person often has to get permission directly at a provider’s appointment. Again, this is incredibly challenging for homeless communities with little access to travel and transit to acquire permission, and social care agencies must complete documentation, resulting in life-threatening complications (Jang et al., 2021).
Ethical Questions or Dilemmas for Care Coordination with the Policy Provision
Like several local charities, homeless shelters deal with ethical and regulatory challenges that may take money away from addressing poverty. Notwithstanding ethical and legal problems, homeless shelters continue to serve as an essential commodity for those who need them, and many actively promote various initiatives to help people experiencing homelessness. Sometimes, homeless shelters do not have sufficient money to improve their premises or employ the appropriate number of administrators, lawyers, or mental health workers (Petrovich et al., 2019).
Since many soldiers experience prolonged homelessness and are equally affected within the homeless community, numerous ethical questions accompany the veteran homeless population. Many times, according to studies, an absence of federal initiatives to assist veterans in their transition back into civilian life following duty may be a factor in their homelessness. Sadly, incidents are discovered yearly in which homeless shelters for soldiers have abused different types of government and state support provided to the homeless veteran community, even going so far as to steal money meant for people in need (Jang et al., 2021).
Implications and Consequences of Policy Provisions
HIPAA offers four different types of policy frameworks:
- This clause’s primary goal is to preserve health insurance for employees and their families who move or leave their jobs.
- This clause’s primary goals are to reduce medical responsibility and stop healthcare scams and abuse. Under this article, regulatory requirements for the transmission of patient data are created.
- The subject of this clause is healthcare and insurance coverage.
- This clause regulates life insurance products from various firms (Poku et al., 2019).
The second clause is particularly crucial since it safeguards patient confidentiality while sometimes compromising provider communications and impeding the delivery of comprehensive care. Everyone has to be aware of one crucial aspect of the law: HIPAA does not regard the information on social assistance providers’ homeless programs to be safeguarded. Only information generated by healthcare institutions about people experiencing homelessness is secure. At this point, you understand the issues that hinder care coordination, particularly concerning HIPAA. On the one hand, prompt delivery of integrated care is directly advantageous to patients who are homeless. Conversely, if social service providers grant private companies access to patient information, coordinated care delivery under present rules may result in leakage of patient information (Reingle Gonzalez et al., 2018).
Nursing Code of Ethics and Coordinated Care
The ANA’s (American Nursing Association) ethical standards apply to nursing staff. The Nursing provisions outline how nursing staff are devoted to people’s well-being and granted decision-making autonomy. Delivering the best care and collaborating with other specialists to eliminate health inequities is essential. Integrated care has been affected by the code of ethics for nurses. The guideline requires nurses to treat the conversation respectfully while providing patient care. In order to give any essential partnerships that might serve the patient, they must cooperate with the patient’s families (Shi et al., 2020).
NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination
Nursing staff must comprehend the elements of nonmaleficence, autonomy, beneficence, justice, and privacy that influence healthcare access to provide the most managed care possible. As more studies work to understand why long-term health issues persist, psychosocial factors that impact disease are becoming more and more prominent. The strongest social predictor of health for homeless people is their ability to find homes. According to research, homeless people seem more likely to visit emergency departments often. Finding them rental accommodation may ease their demand for emergency care (Reingle Gonzalez et al., 2018).
The situation of homelessness, which is intrinsically socially driven, is caused by socioeconomic, psychosocial, and interpersonal instability. Because people wait to go to the doctor until a particular medical issue becomes life-threatening and more severe than the lack of other difficulties linked with being homeless, these difficulties significantly worsen health inequalities for homeless individuals. Nursing staff needs to deliver effective care for homeless patients by researching each human component and making an attempt to deal with the issue at its source rather than provide short-term comfort (Petrovich et al., 2019).
Conclusion
I hope you found this discussion to be helpful. Utilizing HIPAA as a key example, we learned about the regulations that might impact care coordination in the homeless population. We also deduced many ethical concerns from these regulations. Finally, we discovered the nursing staff’s role in providing integrated care following the ANA ethical framework. If nursing staff want to enhance the coordination of their services and lessen health inequities, they must be able to recognize social issues that impact health. I appreciate you taking the time to listen to this session.
Read more about our sample NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan for complete information about this class.
References
Bahrami, S., Chang, C., Alvarez, K. S., Lutek, K., Nguyen, S., & Hegde, A. (2020). Pharmacist impact on health outcomes in a homeless population. Journal of the American Pharmacists Association.
Benavides, A. D., & Nukpezah, J. A. (2020). How local governments are caring for the homeless during the COVID-19 pandemic. The American Review of Public Administration, 50(6-7), 650–657.
Giesler, M. A. (2019). The collaboration between homeless shelters and public libraries in addressing homelessness: A multiple case study. Journal of Library Administration, 59(1), 18–44.
Jang, H. S., Shi, Y., Keyes, L., Dicke, L. A., & Kim, J. (2021). Responding to the needs of the homeless in the COVID-19 pandemic: A review of initiatives in 20 major U.S. cities. International Journal of Public Administration, 44(11-12), 1006–1017.
Petrovich, J. C., Hunt, J. J., North, C. S., Pollio, D. E., & Roark Murphy, E. (2019). Comparing unsheltered and sheltered homeless: Demographics, health services use and predictors of health services use. Community Mental Health Journal.
Poku, M. K., Kagan, C. M., & Yehia, B. (2019). Moving from care coordination to care integration. Journal of General Internal Medicine, 34(9), 1906–1909.
Reingle Gonzalez, J. M., Businelle, M. S., Kendzor, D., Staton, M., North, C. S., & Swartz, M. (2018). Using mHealth to increase treatment utilization among recently incarcerated homeless adults (link2care): Protocol for a randomized controlled trial. JMIR Research Protocols, 7(6), e151.
Shi, Y., Jang, H. S., Keyes, L., & Dicke, L. (2020). Nonprofit service continuity and responses in the pandemic: disruptions, ambiguity, innovation, and challenges. Public Administration Review, 80(5), 874–879.
