Order Number |
636738393092 |
Type of Project |
ESSAY |
Writer Level |
PHD VERIFIED |
Format |
APA |
Academic Sources |
10 |
Page Count |
3-12 PAGES |
Part 1: In reading Chapter 14 of the Buchbinder and Shanks (2017) text you now have a broad overview of a health care manager’s role in improving cultural proficiency and the important role that administrators can serve in creating a positive change.
Additionally, as read in Turnock (2015), one of the U.S. Public Health Agencies discussed was Indian Health Services or IHS, who are federally responsible for providing health services to American Indians and Alaskan Natives. Unfortunately, this agency has been severely underfunded, consistently overlooked, and publicly ridiculed. All of this has led to the significant marginalization of our countries native populations.
In addition to the two chapters you have read, read Terry Anderson’s brief 2009 article titled “Native Americans and the Public Option (Links to an external site.)” and view the following two short films:
We Are Still Here (Links to an external site.)
Poverty USA (Links to an external site.)
The recommended video by Billy Mills shows Billy Mills, a powerful figure in the American Indian community, expressing his goals of increasing feelings of empowerment within the community.
After reading this information and viewing the videos, conduct a search identical to the ones you did for the Health Service Agencies assignment to explain
The role that Indian Health Services (IHS) is supposed to serve in the greater health system.
The year they were established/created.
Their 2015 Fiscal Budget.
The relationship they have with local health offices (In your explanation of the chosen agencies interactions with local health offices, explain the mechanism of this interaction and its frequency).
The approximate number of employees.
The estimated size of the population they serve.
How your chosen agencies were impacted by the Affordable Care Act.
After presenting your initial research, answer the following:
How does the budget compare to that of other agencies?
How does the number of employees compare to other agencies?
In your personal background, whether that be through race, religion, or orientation, have you ever seen/experienced marginalization at this level? There is no wrong answer, the idea behind this question is to spur your emotions so that ideas for real improvement can be offered. What methods in your experience could be offered to increase self-empowerment in this population?
Explain in your view, supported by outside sources, what has gone wrong with Indian Health Services in terms of caring for and treating the population it was created to serve? What role can you see public health providing to this population given their notable health issues (Note: Native Americans lead the United States in rates of alcoholism, depression, suicide, diabetes, and unemployment).
OPINION: CROSS COUNTRY AUGUST 28, 2009, 6:44 P.M. ET
Native Americans and the Public Option After decades of government-run care, some Indians are finally saying enough. By TERRY ANDERSON Bozeman, Mont. Montana Sen. Max Baucus, a leading architect of national health-care reform, visited the Flathead Indian Reservation near Pablo, Mont., in May, and he was confronted with a surprising critique. “I hope any [new health-care] plan does not forget the nation’s first people,” Dr. LeAnne Muzquiz told the senator. Another person in the audience, according to the newspaper the Missoulian, followed up by telling the senator that the legislation pending in Congress would in fact do just that.
Native Americans have received federally funded health care for decades. A series of treaties, court cases and acts passed by Congress requires that the government provide low-cost and, in many cases, free care to American Indians. The Indian Health Service (IHS) is charged with delivering that care.
The IHS attempts to provide health care to American Indians and Alaska Natives in one of two ways. It runs 48 hospitals and 230 clinics for which it hires doctors, nurses, and staff and decides what services will be provided. Or it contracts with tribes under the Indian Self-Determination and Education Assistance Act passed in 1975. In this case, the IHS provides funding for the tribe, which delivers health care to tribal members and makes its own decisions about what services to provide.
The IHS spends about $2,100 per Native American each year, which is considerably below the $6,000 spent per capita on health care across the U.S. But IHS spending per capita is about on par with Finland, Japan, Spain and other top 20 industrialized countries—countries that the Obama administration has said demonstrate that we can spend far less on health care and get better outcomes.
In addition, IHS spending will go up by about $1 billion over the next year to reach a total of $4.5 billion by 2010. That includes a $454 million increase in its budget and another $500 million earmarked for the agency in the stimulus package. Associated Press Sells Hospital on the Tohono O’odham reservation in Sells, Arizona.
http://online.wsj.com/public/search?article-doc-type=%7BCross+Country%7D&HEADER_TEXT=cross+country
Unfortunately, Indians are not getting healthier under the federal system. In 2007, rates of infant mortality among Native Americans across the country were 1.4 times higher than non-Hispanic whites and rates of heart disease were 1.2 times higher. HIV/AIDS rates were 30% higher, and rates of liver cancer and inflammatory bowel disease were two times higher. Diabetes-related death rates were four times higher. On average, life expectancy is four years shorter for Native Americans than the population as a whole.
Rural Indians fare even worse, as data from Sen. Baucus’s home state show. According to IHS statistics, in Montana and Wyoming, Indians suffer diabetes at rates 20% higher, heart disease 12% higher, and lung cancer rates 67% higher than the average across all IHS regions in the country. A recent Harvard University study found that life expectancy on a reservation in neighboring South Dakota was 58 years. The national average is 77.
Personal stories from people within the system reveal the human side of these statistics. In 2005, Ta’Shon Rain Little Light, a 5-year-old member of the Crow tribe who loved to dress in traditional clothes, stopped eating and complained that her stomach hurt. When her mother took her to the IHS clinic in south central Montana, doctors dismissed her pain as depression. They didn’t perform the tests that might have revealed the terminal cancer that was discovered several months later when Ta’Shon was flown to a children’s hospital in Denver. “Maybe it would have been treatable” had the cancer been discovered sooner, her great- aunt Ada White told the Associated Press.
Such horror stories are common on reservations, where the common wisdom is “don’t get sick after June”— the month when the federal dollars usually run out. Late last year, the Montana Quarterly interviewed Tommy Connell, a member of the Blackfeet tribe and a worker in the IHS hospital in Browning, Mont. He didn’t pull any punches in his assessment of the IHS. “They’re lying to us,” he said of promises over the
years of more funds and better care. “You can pass just about any bill you want, but to appropriate money to that bill, that’s another thing.”
Dismal statistics prompted Mr. Baucus to declare a “health state of emergency” on the Fort Peck Reservation in northeastern Montana and to order an investigation of the IHS’s use of funds. In July 2008, the Government Accountability Office reported that the IHS simply lost $15.8 million worth of equipment such as trucks and Jaws of Life machines between 2004 and 2007. It also found that $700,000 worth of computers were ruined by bat dung.
Tribal contracting—the alternative to IHS-run hospitals and clinics—offers some hope for improvement by giving tribes more flexibility in administering their own hospitals and clinics. Kelly Eagleman, vice- chairman of the Chippewa Cree Band on Montana’s Rocky Boy’s Reservation, understands the effect of a top-down bureaucracy. Of his tribe, he says, “We tend to want to blame a system, but we don’t look at ourselves. We all smoke. We lay on the couch. But when something happens to us, we’re the first to point and say that the clinic should have fixed us.”
The Chippewa Cree Band has opted to provide its own health care with funding from the IHS. Dr. Dee Althouse, a physician at the Rocky Boy’s Reservation, is still frustrated by funding constraints. She told the Montana Quarterly that she often finds herself working to save lives and limbs, deferring routine health care until there is money available. Yet even with limited funds, ongoing research by the Native Nations Institute reported earlier this year that tribal management leads to better access and better quality care than relying on the IHS-run system.
The Chippewa Cree Band runs its own hospital and has hired a registered dietician who has gotten the local grocery store to implement a shelf-labeling system to improve consumer nutritional information. They’ve also built a Wellness Center with a gym, track, basketball court, and pool. These are small steps that won’t immediately eliminate heart disease or diabetes. But they move in the direction of local control and better health.
At a time when Americans are debating whether to give the government in Washington more control over their health care, some of the nation’s first inhabitants are moving in the opposite direction.
Mr. Anderson is executive director of the Property and Environment Research Center in Bozeman, Mont., and a senior fellow at Stanford University’s Hoover Institution.
Native Americans and the Public Option
After decades of government-run care, some Indians are finally saying enough.
Roles of Nurse Leaders Paper
RUBRIC | |||
Excellent Quality
95-100%
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Introduction
45-41 points The context and relevance of the issue, as well as a clear description of the study aim, are presented. The history of searches is discussed. |
Literature Support
91-84 points The context and relevance of the issue, as well as a clear description of the study aim, are presented. The history of searches is discussed. |
Methodology
58-53 points With titles for each slide as well as bulleted sections to group relevant information as required, the content is well-organized. Excellent use of typeface, color, images, effects, and so on to improve readability and presenting content. The minimum length criterion of 10 slides/pages is reached. |
Average Score
50-85% |
40-38 points
More depth/information is required for the context and importance, otherwise the study detail will be unclear. There is no search history information supplied. |
83-76 points
There is a review of important theoretical literature, however there is limited integration of research into problem-related ideas. The review is just partly focused and arranged. There is research that both supports and opposes. A summary of the material given is provided. The conclusion may or may not include a biblical integration. |
52-49 points
The content is somewhat ordered, but there is no discernible organization. The use of typeface, color, graphics, effects, and so on may sometimes distract from the presenting substance. It is possible that the length criteria will not be reached. |
Poor Quality
0-45% |
37-1 points
The context and/or importance are lacking. There is no search history information supplied. |
75-1 points
There has been an examination of relevant theoretical literature, but still no research concerning problem-related concepts has been synthesized. The review is just somewhat focused and organized. The provided overview of content does not include any supporting or opposing research. The conclusion has no scriptural references. |
48-1 points
There is no logical or apparent organizational structure. There is no discernible logical sequence. The use of typeface, color, graphics, effects, and so on often detracts from the presenting substance. It is possible that the length criteria will not be reached. |
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