PPY 731: Fundamentals of Writing Policy Briefs (Stream): Health

Policy Issue: Focusing on social needs care in Nevada health systems (urban/rural)

• Research national level impact--then narrow it down to state of NV

• Investigate ACA Funding in NV; our financial picture

• Extent of social needs including the following:

• What does that look like for patients?

  • Food insecurity

  • Social isolation—mental health

  • Housing instability

  • Covid-19

  • Transportation

• Where is the network of the capture points for social needs support in the state of NV?

  • Emergency Department physicians; primary care physicians (intervention-element of stability) 

  • Currently, medical students are doing the social needs screenings

  • Software Chaos: Hospitals in Las Vegas (e.g., UMC &  Dignity) all use different software programs

  • What about funding? Where do the funds from the federal government go? What about private insurers? 

Policy  Area: Improving insurance coverage education for impoverished children in Clark County, NV

Is it a knowledge or resource problem? It’s a knowledge problem

GAPS:

• Health insurance: What is the actual process?

• How is NV using their allocated funds?

• Actual cost of insurance plans?

• Are there other government options besides CHIPS or Medicaid?

• African Americans, minorities, or all children? 

• What do you  do if you are undocumented in Southern NV?

• What is the uninsured population? Both: Adults/kids?

• Why was it so successful earlier? Stopped/went south in 2018. Is it a communication/campaign strategy?

• What’s causing it? Resource issue? Lack of Education?  What is the disconnect?

Bruner’s question: What’s the status quo in NV? What about the undocumented kids?

Toni Arcadipane PPY 731/781

Policy Issue: High long-term care costs for those 65 & over; lower/lower middle income; information & statistics

• Status Quo: Las Vegas; NV; 50 states; need to know; revisit Medicaid policy on LTC; 5 year lookback period; dive into Medicaid rules

• # of seniors in long-term care; how many are Medicaid;

• Private pays; Long-term care insurance; alternatives to financing long term care

• Impact on an individuals--single vs. married

• What about national level? What other states are doing? 

• Federal level; Affordable Care Act; Medicare Advantage Plans

• Need national statistics: LTC; skilled nursing; nursing homes; assisted living; adult daycare; group homes; in-home healthcare 

• Trends/costs of the above

• What organizations (such as AARP) are lobbying?

• Current legislative actions

• GOAL: Financing Alternatives—Look at Other States;

• 2-3 years Long Term Care….short survival rate;

• What are options? Medical crises?

Topic: Rural NV Cancer Patients

• What is the status quo of cancer in rural NV?

• Rural vs. urban environments

• Proving significance of NV rural cancer issues: Need to understand Demographic/Geographic region

• Is the population growing? Do they need additional services?

• Increasing healthcare NV rural cancer treatment; looking at NV cancer statistics; # of diagnoses; tumor site; survivor/death statistics

• NV Cancer Registry

• Information Needed:

  • Number of healthcare facilities; hospitals; private centers; rural vs. urban; # of providers—specialties; in providing cancer treatments

• Investigate various categories that the rural cancer patients may be facing:

  • Socioeconomic status: Able to afford treatment; education; Employment: complicated hours; not enough pay; insurance coverage

  • Transportation services; rural/urban/look at public / private; American Cancer Society; Disabled Veterans organizations; How many patients utilize travel services?

  • Culture/language barriers

  • Expenses associated w/cancer treatment: social services--cancer/radiation/housing expenses/

  • **Specific policies –funds/state of NV—Can Medicaid/can provide some funds/assistance?

  • Investigate existing organizations/nonprofits/NV Cancer Coalition/Rural Health Council

1.  Transportation Services (public/private and the extent that rural patients have access to it)

2. Employment Rates of rural NV Cancer Patients (Do they work or don't work during treatment)

3. Socioeconomic status of rural NV Cancer Patients (Income/personal funds)

4. Insurance status of  rural NV Cancer Patients (insured/uninsured)

5. Distance to Cancer Treatment (Distance to closest hospital/treatment facility from their rural residence)

Focus Area: Obesity/firefighters; Narrowing: Physical health/well-being of firefighters

Obesity focus/standards: Shortened lifespan; Heart issues/diabetes; Body fat percentage/BMI; Mental health/depression

• What is the current status quo on wellness for Las Vegas, NV firefighters?

• Obesity: mental & physical

• Knees/hips/back; CCMI (Insurance company that takes care of on the job injuries [OJI])

• Costs are going up

• PTSD/Depression: Is there a correlation?

• Health/Fitness Exercise/lower body fat--to combat obesity/prevent injuries City of LV Fire & Rescue

• Although average age of firefighters have decreased by 5 years--they have more obesity/health issues & injuries

• Information Needed

  • Digging into overall wellness programs; outside physical standards/overall causes/medical issues/psychological issues of firefighters & obesity

  • Information for a cost-benefit analysis