1. Copyright © 2008 Delmar. All rights reserved. Part II Health Care Delivery and Financing

2. Copyright © 2008 Delmar. All rights reserved. Chapter 6 Law, Health Policy, and Public Health Nursing

3. Copyright © 2008 Delmar. All rights reserved. 3 Politics and Health Policy Politics –Art of influencing allocation of resources Public policy –Formed by governmental bodies at all levels –Affect individual and institutional behavior

4. Copyright © 2008 Delmar. All rights reserved. 4 Politics and Health Policy Healthy public policy Creates healthy supportive environments

5. Copyright © 2008 Delmar. All rights reserved. 5 Models of Policy Formation Kingdom –Three streams 1.Policy 2.Problem 3.Political –Window of opportunity

6. Copyright © 2008 Delmar. All rights reserved. 6 Models of Policy Formation Schneider and Ingram –Social construction Population classification –Advantaged –Contenders –Dependents –Deviants

7. Copyright © 2008 Delmar. All rights reserved. 7 Models of Policy Formation Cobb and Elder –Systemic agenda items –Institutional agenda items

8. Copyright © 2008 Delmar. All rights reserved. 8 Models of Policy Formation Cobb and Elder –Identifies six traits: 1.Specificity of issue 2.Social significance on society 3.Relevance of issue 4.Complexity of issue 5.Precedence 6.Interval of time

9. Copyright © 2008 Delmar. All rights reserved. 9 Models of Policy Formation Political development in nursing –Stages provide framework for nursing involvement in politics

10. Copyright © 2008 Delmar. All rights reserved. 10 Stages Stage I –Buy-in Stage II –Self-interest Stage III –Political sophistication Stage IV –Leadership

11. Copyright © 2008 Delmar. All rights reserved. 11 Models of Policy Formation Legislative process –Ideas for policy can come from anywhere –Analyze issues after formulating idea –Identify legislative contacts

12. Copyright © 2008 Delmar. All rights reserved. 12 Models of Policy Formation Follows legislative process after policy draft –Drafted by member of congress –Placed on agenda –Amendments to bill –House and Senate vote –Bill enrollment –Ratified –Appropriations

13. Copyright © 2008 Delmar. All rights reserved. 13 Regulatory Process Regulation –Rules based on legislation begins when signed into law –Regulatory agency assigned Regulatory process for nursing practice –Boards of nurse examiners –Boards of nursing

14. Copyright © 2008 Delmar. All rights reserved. 14 Role of lobbyists –Persuade an official to comply with request –Represent interest groups Role of public health nurse –Involvement in legislative process Identify issue and become an expert Build support and outline a plan Regulatory Process

15. Copyright © 2008 Delmar. All rights reserved. 15 Enforcement of Laws and Legislation Liability or Tort –Intentional Tort Assault Battery False imprisonment Conversion of property Intentional infliction of emotional distress

16. Copyright © 2008 Delmar. All rights reserved. 16 Enforcement of Laws and Legislation Negligence –Deviation from standard of care Malpractice –Deals with professional standard of care Elements of negligence/malpractice –Duty owed person because of reliance on the relationship

17. Copyright © 2008 Delmar. All rights reserved. 17 Enforcement of Laws and Legislation Breach of duty owed the person Foresee ability of events expected to cause specific results Injury related to breach of duty Injury or harm may be physical, psychological, emotional, or financial Damages may be awarded for injury

18. Copyright © 2008 Delmar. All rights reserved. 18 Laws Related to Public Health Nurse Practice Laws related to health of children: –Minor consent –Statutes of limitation –Surgery on minor –Immunity –Communicable diseases

19. Copyright © 2008 Delmar. All rights reserved. 19 Laws Related to Public Health Nurse Practice Minor consent for treatment of venereal disease Pregnancy Substance abuse/emotional disturbance Child abuse and neglect

20. Copyright © 2008 Delmar. All rights reserved. 20 Laws Related to Public Health Nurse Practice Laws related to adults: –Informed consent –Blood alcohol level –Organ procurement –Good Samaritan Laws –Patient’s rights

21. Copyright © 2008 Delmar. All rights reserved. 21 Laws Related to Public Health Nurse Practice Communicable diseases Durable power of attorney Living wills Gunshot wounds and poisonings

22. Copyright © 2008 Delmar. All rights reserved. 22 Laws Related to Public Health Nurse Practice Public health nurses in varied settings –Clinics –Schools –Occupational settings

23. Copyright © 2008 Delmar. All rights reserved. 23 Laws Related to Public Health Nurse Practice Home Health Care –Omnibus Reconciliation Act 1986 –Patient Self-Determination Act 1991 –Outcome and assessment information set More autonomy Increased likelihood of malpractice and negligence

24. Copyright © 2008 Delmar. All rights reserved. 24 Laws Related to Public Health Nurse Practice Public Health Departments –Work with varied populations –Increased risk of litigation Abuse STDs Elderly neglect