Advocacy and Leadership Demonstrated: A Case to Cause Letter
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Dear Senator Casey
Subject: Advocacy for Mandatory Training Programs to Prevent Elder Abuse and Neglect
I am writing to bring to your attention the issue of elderly abuse and neglect as it has become a common occurrence in our society, and yet it remains significantly underdressed. The issue of elderly abuse includes physical, emotional, financial, and sexual abuse, and also neglect by caregivers with devastating impacts on the individuals affected, their families, society, and the government. The National Council for Aging (2024) estimates that the financial exploitation of the elderly leads to a loss of over $28.3 billion annually. Besides, financial and other modes of abuse lead to the loss of dignity of older people and may exacerbate some of the conditions they may be facing, including health complications. Therefore, this matter deserves immediate legislative action to protect vulnerable older adults.
The aging population is increasing at a high rate, and a failure to eliminate the challenge of elderly abuse and neglect will create a significant social problem in the future. One of the approaches that could be used to reduce the cases of elder abuse and neglect is implementing mandatory training programs for caregivers and healthcare professionals. Being in a legislative position, you have the resources, authority, and capability to push for this policy, making it a crucial step toward eradicating elder abuse and ensuring a safer and more respectful environment for our older citizens.
The proposed policy approach will have multiple benefits in the war against elder abuse and neglect. For instance, it will help caregivers develop communication and interpersonal skills to leverage when interacting with older adults and help manage stressful situations to achieve meaningful and positive outcomes. Additionally, caregivers must understand when an older adult is undergoing abuse since many of the affected people are reluctant to open up. Gaining such skills will improve the safety, well-being, and quality of life for elderly individuals. The effectiveness of this policy will be subject to the reduction of cases of elderly abuse, improvements in caregiver knowledge and skills through pre- and post-training evaluations, and satisfaction of the elderly population regarding their safety and well-being.
Thank you for considering this critical issue. I look forward to your support and action on this matter.
Reference
The National Council on Aging. (2024). Get the Facts on Elder Abuse. https://www.ncoa.org/article/get-the-facts-on-elder-abuse
Program Evaluation Methods
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Program Evaluation Methods
10 New Lessons Learned
Public Health Ontario et al. (2016) provide a structured framework for evaluating healthcare programs. After reading this source, I learned the following ten lessons that will be useful in my future program evaluation efforts:
1. Gathering comprehensive information regarding a program before initiating the evaluation process can improve the overall outcomes.
2. Stakeholders can cause success or failure of a project evaluation exercise and should, therefore, be involved in every process.
3. Before embarking on the evaluation process, it is prudent to assess whether the program’s design provides enough resources, including time, money, and personnel, to complete it.
4. The evaluation questions must align with the program’s objectives to guarantee that the evaluation results are meaningful and valuable.
5. Using qualitative and quantitative data collection methods will provide a comprehensive understanding of the program’s impact and make achieving short-, medium, and long-term objectives easier. The data collection and expected outcomes should have clear indicators.
6. The evaluation plan must be comprehensive, including the scope of the evaluation, timeline, resources, and responsibilities for those involved.
7. Incentives provided during data collection should follow ethical considerations, including cultural values and traditions.
8. The implications of the evaluation process are subject to a proper reporting and dissemination approach.
9. Program evaluation is not a one-time process but a continuous method of examining healthcare programs and seeking room for improvement. The process should be customized based on the goals in each evaluation cycle.
10. It is essential to cultivate a shared understanding among all the parties involved to minimize resistance and streamline the adoption of the evaluation outcomes.
Two Important Lessons in Social Work
The two lessons that will be valuable in my future as a social worker are stakeholder engagement and developing a comprehensive plan. I will closely engage different stakeholders, including clients, community members, and healthcare providers, to ensure that the programs I am implementing are inclusive and effective. Moreover, having a comprehensive plan will help in systematically assessing the programs and interventions being implemented. Applying these two lessons will streamline my work and guarantee that the targeted population derives maximum benefits from health programs.
Reference
Ontario Agency for Health Protection and Promotion (Public Health Ontario), Snelling S, Meserve A. (2016). Evaluating health promotion programs: introductory workbook. Toronto, ON: Queen’s Printer for Ontario pages 30-41
POLICY DEVELOPMENT AND ADVOCACY PRACTICE IN ACTION
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Policy Development and Advocacy Practice in Action
Introduction
Elder abuse stands out as a pervasive issue that continues to affect millions of older adults from around the world. This social issue takes different forms and may include emotional, physical, financial, and sexual abuse, as well as abandonment and neglect (Sadrollahi et al., 2020). The issue of elder abuse is concerning as it not only inflicts significant harm on older adults but also poses a significant challenge to societal well-being and public health. Therefore, addressing elder abuse is crucial as this directly impacts the safety, dignity, and quality of life of vulnerable older adults, many of whom do not have the power or ability to protect themselves due to cognitive or physical impairments. Further, the significance of tackling this social issue stems from the statistics that show a significant global increase in aging populations, translating into a corresponding rise of older adults at risk of elder abuse (NCEA, 2024). This policy development and advocacy practice in action paper on elder abuse will open by shedding light on the gravity of elder abuse, highlighting current efforts to address the problem, and proposing a comprehensive policy solution. Therefore, by systematically addressing these issues, the paper aims to contribute to the development of robust strategies to prevent elder abuse and offer much-needed support to survivors of this vice.
Description of the Problem and Population
As hinted above, elder abuse presents different forms of harm directed toward older adults and might inflict profound psychological and physical damage. This kind of abuse is more traumatic and challenging to address because it occurs in trusted relationships. According to Weissberger et al. (2021), vulnerable populations, including those suffering from cognitive and physical impairments, are at higher risk, and this is worsened by the fact that they also face barriers to seeking help and justice. The impact of elder abuse on vulnerable populations includes chronic health issues, anxiety, depression, and a loss of self-worth and trust. Historically, the problem of elder abuse has persisted due to underreporting and the fact that it has been inadequately addressed due to societal attitudes that tend to view older adults as being less valuable (Teaster et al., 2020). It is this historic neglect that continues to compound the trauma experienced by the vulnerable population, as most have been forced to endure extended periods of abuse and neglect with little to no intervention. Further, Storey (2020) avers that the problem of elder abuse has a ripple effect in that it goes past those exposed to it and imparts a significant burden on social services and healthcare, underscoring the need to comprehensively design and implement intervention strategies to address this social issue. Therefore, addressing the issue of elder abuse requires acknowledging its historical roots and the various systemic factors that tend to perpetuate it, thereby making sure that vulnerable populations receive the protection and respect that they deserve.
Description of the Agency
For this project, the selected Agency or partner is the National Center for Elder Abuse. NCEA was selected because it is central to addressing elder abuse through education, research, and advocacy. The center works by collaborating with other organizations to implement programs targeting the prevention of elder abuse, raising public awareness, and supporting victims of this social vice. Some of their notable programs include public education campaigns, training for professionals, and the development of resources for elder abuse victims and caregivers (NCEA, 2024). However, despite the efforts made by NCEA and its partners, significant gaps remain in current policies. For instance, many existing systems lack comprehensive data collection, hindering the understanding of elder abuse prevalence and trends.
Additionally, there are often insufficient legal protections and enforcement mechanisms, leaving many victims without adequate recourse. Limited funding and resources further exacerbate these challenges, preventing the widespread implementation of practical support and intervention programs. Therefore, addressing these gaps in policy is crucial for designing a more robust and responsive system that can be applied to combat elder abuse.
Action Plan and What Worked
The action plan designed to counter elder abuse entails developing a comprehensive policy solution integrating victim support, preventive measures, and legal protections. The policy development process began with extensive research and stakeholder consultations meant to identify potential intervention points and critical areas of need. Steps to implement the policy included legislative advocacy to strengthen legal frameworks, training programs for professionals such as healthcare workers, law enforcement, and social service providers, and public awareness campaigns to educate communities about elder abuse and reporting mechanisms. One of the notable successes of the implementation was the establishment of multidisciplinary teams that coordinated efforts across the various sectors, thereby ensuring a holistic approach to intervention and prevention. Another effective strategy was the creation of elder abuse support centers and 24/7 support hotlines, both of which provided victims with immediate assistance.
Development of the Policy Solution
The Trauma-Informed Policy Solution to Address Elder Abuse and Neglect was crafted by rigorously applying the Policy Process Model, ensuring a structured and comprehensive approach. It helped to direct the process in problem identification, policy formulation, adoption, implementation, evaluation, and revision of this model (Weible, 2023). Another very helpful direction was the recommendations by the Centers for Disease Control and Prevention for evidence-based practices on multisectoral collaboration models (CDC, 2024). The purpose of the policy is to prevent elder abuse, provide timely support and resources to the victims, and enhance legal protections for older adults. The benefits include improved safety and well-being for older persons, reduced healthcare costs resulting from abuse injuries, and increasing awareness.
Trauma-Informed Policy Solution to Address Elder Abuse and Neglect
Policy Goals:
Prevent Elder Abuse and Neglect: Reduce the incidence of elder abuse and neglect by ensuring caregivers and healthcare professionals are adequately trained.
Improve Caregiver Competence: Enhance the knowledge and skills of caregivers and healthcare providers in trauma-informed care and elder abuse prevention.
Enhance Elder Well-being: Improve the safety, well-being, and quality of life for elderly individuals.
Raise Public Awareness: Increase public awareness about the prevalence and impact of elder abuse and neglect.
Forms of Benefit:
Educational Benefits: Mandatory training programs for caregivers and healthcare professionals on elder abuse prevention and trauma-informed care.
Support Services: Access to resources and support services for caregivers, healthcare professionals, and elderly individuals.
Legal Protection: Stronger legal framework and protections for elderly individuals against abuse and neglect.
Community Engagement: Enhanced community support and engagement through partnerships with elder care advocacy groups and public awareness campaigns.
Eligibility Criteria:
Caregivers and Healthcare Providers: All professional caregivers and healthcare providers who work with elderly individuals must complete the mandatory training program.
Elderly Individuals: Elderly individuals, particularly those who are vulnerable due to physical or cognitive decline, social isolation, or dependence on others for care.
Advocacy Groups: Elder care advocacy groups that collaborate on awareness campaigns and training programs.
Administrative Considerations:
Development and Implementation: Collaboration with community colleges, healthcare institutions, elder advocacy groups, and policy experts to develop and implement training modules.
Certification and Compliance: Establish a certification process for caregivers and healthcare providers who complete the training program. Ensure compliance through regular assessments and audits.
Monitoring and Evaluation: Regularly monitor and evaluate the effectiveness of the training programs and the impact on the incidence of elder abuse and neglect. Collect data on reported cases, caregiver competence, and elder satisfaction.
Legislative Support: Work closely with legislators and policymakers to draft and enact legislation that mandates the training program and provides legal protections for elderly individuals.
Financing and Sustainability:
Federal and State Grants: Secure federal and state grants to fund the development and implementation of the training programs.
Public-Private Partnerships: Form partnerships with private organizations, healthcare institutions, and elder advocacy groups to share costs and resources.
Continuous Funding: Allocate a portion of state budgets specifically for elder abuse prevention and training programs. Explore additional funding sources such as philanthropic organizations and corporate sponsorships.
Ongoing Support: Ensure long-term sustainability by regularly updating training modules, providing refresher courses, and maintaining support services for caregivers and elderly individuals.
Elements of the Social Policy Solution:
Legislation Draft:
Title: Elder Abuse Prevention and Trauma-Informed Care Training Act
Purpose: To reduce the incidence of elder abuse and neglect by mandating trauma-informed care training for all professional caregivers and healthcare providers.
Scope: Applicable statewide to all licensed caregivers and healthcare providers who work with elderly individuals.
Training Requirements: Detailed guidelines for mandatory training programs, including the duration, content, and certification process.
Funding and Resources: Provisions for securing federal and state grants, public-private partnerships, and continuous funding for the training programs.
Monitoring and Evaluation: Establishment of a monitoring and evaluation framework to assess the impact of the training programs and ensure compliance.
Implementation Plan:
Phase 1: Development of training modules in collaboration with community colleges, healthcare institutions, and elder advocacy groups.
Phase 2: Pilot implementation of the training programs in select regions, followed by statewide rollout.
Phase 3: Continuous monitoring and evaluation, regular assessments, and refresher courses to maintain high standards of care.
Phase 4: Ongoing public awareness campaigns and community engagement activities to raise awareness about elder abuse and the importance of trauma-informed care.
By following the CDC’s policy analysis framework and incorporating trauma-informed care principles, this policy solution aims to effectively address the issue of elder abuse and neglect, ensuring the safety and well-being of elderly individuals.
Policy Amendments to Address Re-traumatization
To address re-traumatization, several policy amendments have been made. That is, the amendments should incorporate trauma-informed care practices that will ensure a responsive and sensitive approach toward interventions for the survivors and establish some safe and confidential channels for reporting such cases so as to protect the victims from further impacts. On the other hand, they should also incorporate strategies for reduction in victimization, re-traumatization, and oppression by continuous training of the professionals on how to adopt trauma-informed approaches and provide support that is culturally sensitive. Further, the amendments should also look for ways of enhancing care and social services, especially for older elderly and marginalized communities. These policy areas need to be closely monitored and improved upon as and when needed to ensure that the vulnerable populations receive the support and care they need.
How Policy Amendment Will Increase Access to Care
The proposed policy changes make access to care vastly more available to those affected by trauma under the assumption that trauma-informed practices are the norm and improve the manner in which services are delivered. Educating professionals in health and social services and law enforcement around trauma-informed responses ensures that services for elder abuse are sensitive, supportive, and non-retraumatizing. Safe and confidential reporting channels will encourage many more people to come forward with a view to seeking help without the fear of re-victimization. The diversity of needs among the older population can adequately be catered for through the establishment of a network of culturally friendly and easily approachable services that will ensure timely and proper care to all victims. Additionally, regular service delivery assessment through evaluation and feedback from stakeholders will help in improving service delivery by addressing the challenges or gaps arising with time. These amendments will create a system more responsive and inclusive, ultimately improving the quality of life of older adults affected by trauma.
Discussion of Policy Weakness
Despite its comprehensive framework, the elder abuse policy suffers from some weaknesses. On the first account, limited data collection may limit the understanding of the problem in society and its prevalence and trends, leaving gaps in addressing the social issue. Secondly, though this policy is directed at elder abuse among physically and cognitively impaired older adults, the narrow view may end up bypassing other vulnerable groups of older adults, including those of diverse cultural backgrounds or those living in rural settings. There still is also a concern that the legal enforcement becomes insufficient in many regions due to the lack of will and resources to implement the policy efficiently. Recommendations for better performance in the future entail extending data collection to all older adults who are at risk of becoming victims of elder abuse and increasing outreach and services in support of those who remain underserved and unrepresented.
Self-Reflection
The entire process of developing and implementing the elder abuse policy has been quite enlightening. It has afforded me significant opportunities to learn and, at the same time, glean lasting insights My deep engagement with stakeholders, including but not limited to healthcare professionals, victims, legal experts, and social workers, has instilled in me the importance of a collaborative approach to solving social issues. Interaction with these professionals also revealed the multifaceted nature of the problem of elder abuse, which required the development of holistic solutions covering legal, social, and psychological dimensions. Furthermore, this project has contributed immensely to my understanding of the policy development process from the inception of the idea and research, through stakeholder consultations, to its final implementation, monitoring, and evaluation. At a personal level, it has inspired empathy toward older adults and the role taken in advocating for them to ensure their rights are not infringed upon. The project has been instrumental in improving my skills of communication with stakeholders, managing the project, and policy analysis. Personally, satisfying to me was the fact that I just witnessed the real impact that this project had on the targeted population. It affirms the worth and effectiveness of well-coordinated efforts in combating elder abuse. Lessons from this project will be important in informing my future work. They will ensure I prioritize adaptability, inclusivity, and sustainability in policy development and advocacy.
Conclusion
In sum, the abovementioned policy addresses the multifaceted nature of elder abuse through comprehensive prevention, legal protection, and intervention strategies. Some of the key points include the development of a multidisciplinary approach, the establishment of robust support networks, and the incorporation of trauma-informed care practices. As has been demonstrated, addressing elder abuse is crucial to safeguarding the safety, dignity, and well-being of older adults, most of whom are often vulnerable and unable to stand up for their rights. This policy can potentially enhance and support victims. Refining the policy through the proposed amendments will address most of the identified weaknesses, and the targeted population will continue to receive the respect and care they deserve.
References
CDC, (2024). About Abuse of Older Persons. Retrieved from https://www.cdc.gov/elder-abuse/about/index.html
NCEA, (2024). Elder Justice NCEA: What We Do. Retrieved from https://ncea.acl.gov/about#gsc.tab=0
Sadrollahi, A., Khalili, Z., Ghorbani, M., & Mahmoodi, M. (2020). The prevalence of various abuse types and their associated factors in the elderly. Journal of Research and Health, 10(1), 59-66.
Storey, J. E. (2020). Risk factors for elder abuse and neglect: A review of the literature. Aggression and violent behavior, 50, 101339.
Teaster, P. B., Lindberg, B. W., & Zhao, Y. (2020). Elder abuse policy, past, present, and future trends. Advances in Elder Abuse Research: Practice, Legislation and Policy, 53-71.
Weible, C. M. (Ed.). (2023). Theories of the policy process. Taylor & Francis.
Weissberger, G. H., Goodman, M. C., Mosqueda, L., Schoen, J., Nguyen, A. L., Wilber, K. H., … & Han, S. D. (2021). Elder abuse characteristics based on calls to the National Center on Elder Abuse resource line. Journal of Applied Gerontology, 39(10), 1078-1087.
| Goal 1: Reduce PTSD symptoms | |||
| Objective 1.1: Implement mindfulness practices for 10 minutes daily as self-reported in a journal for 90 days, missing no more than 10 days in that timeframe. | |||
| What data must be collected for this objective? | Data must be collected on the daily self-reported mindfulness practices of the veterans. This includes the number of days the practice was completed and any self-reported notes on the experience. | ||
| How does this data indicate progress toward the goal? | This information shows progress in adherence to the mindfulness practice regimen. Steady practice is expected to correlate with a reduction in PTSD symptoms. | ||
| Data Collection Tool: | Journals or logs kept by the participant, in which they documented their practice of mindfulness on a daily basis. | ||
| From whom or where will the data be collected? | This information will come from veterans who attend the program and are actively using daily mindfulness skills. | ||
| Who will collect the data? Why this person? | This will be done through the program director. The reason for this choice is mainly that the director of the program oversees adherence of participants with the program and has the expertise to interpret the data accurately. | ||
| When will it be collected? What is the timeline for data collection? | This information will be gathered daily for a period of 90 days. | ||
| How will it be collected? On paper, on a computer, verbally, etc. | Data collection will be collected on paper, with self-report journals maintained by participants. | ||
| How will data be kept secure once collected? | Research data will be stored in a locked filing cabinet in the office and on a secure, password-protected database after being computerized. | ||
| Who will be responsible for entering the data? | The administrative assistant and the support staff. | ||
| How will the data be analyzed? | This can be assessed by the frequency and consistency of the mindfulness practices recorded in journals as a measure of adherence, correlating that with changes in subsequent PTSD symptoms. | ||
| What do you consider a good outcome? What would be a poor outcome? | A good outcome will be if, out of the 90 days, on at least 80 days, subjects practice their daily mindfulness. Outcomes will be poor if participants practice fewer than 50 days of mindfulness exercises out of the 90 days. | ||
| Goal 1: Reduce PTSD symptoms | |||
| Objective 1.2: Clients will reduce their PTSD symptoms as measured by a score reduction of at least 10 points on the PTSD checklist for DSM-5 (PCL-5) within 8 months, ensuring at least 95% of sessions are attended. | |||
| What data must be collected for this objective? | Data on the severity of PTSD symptoms as measured by the Pre- and Post Intervention PCL-5. | ||
| How does this data indicate progress toward the goal? | This indicates progress, by qualitatively measuring changes in PTSD symptoms and showing the effectiveness of the intervention. | ||
| Data Collection Tool: | PTSD Checklist for DSM-5 (PCL. | ||
| From whom or where will the data be collected? | The data will be collected from the veterans participating in the program. | ||
| Who will collect the data? Why this person? | Licensed psychologists or counselors will collect the data, as they have the necessary expertise to administer the checklist and interpret the results accurately. | ||
| When will it be collected? What is the timeline for data collection? | Data will be collecting data monthly over a period of 8 months. | ||
| How will it be collected? On paper, on a computer, verbally, etc. | These data will be collected on paper during scheduled assessment sessions. | ||
| How will data be kept secure once collected? | Information collected will be stored in a locked filing cabinet and transferred onto a password-protected database. | ||
| Who will be responsible for entering the data? | The data entry shall be carried out by the information technology specialist or the administrative assistant. | ||
| How will the data be analyzed? | Data will be analyzed by comparing pre- and post-PCL-5 intervention scores to document changes in severity of symptoms for PTSD. | ||
| What do you consider a good outcome? What would be a poor outcome? | Good Outcome will be a drop of 10 or more points in their PCL-5 scores. Poor Outcome will be no significant departure, or even an increased level, in their PCL-5 scores. | ||
| Goal 1: Reduce PTSD symptoms | |||
| Objective 1.3: Clients will reduce their PTSD symptoms as measured by a score reduction of at least 15 points on the PTSD checklist for DSM-5 (PCL-5) within 12 months, ensuring at least 95% of sessions are attended. | |||
| What data must be collected for this objective? | Data on coping ability scores using the IES-R self-report measurement scale before and after the intervention period. | ||
| How does this data indicate progress toward the goal? | This data shows progress, with the PTSD symptoms reduced over a longer time frame, thus proving the effectiveness of the intervention. | ||
| Data Collection Tool: | PTSD Checklist for DSM-5 (PCL-5). | ||
| From whom or where will the data be collected? | Information will be obtained from the veterans who participate in the program. | ||
| Who will collect the data? Why this person? | Licensed psychologists or counselors since they have the skills in administering and interpreting the checklist. | ||
| When will it be collected? What is the timeline for data collection? | The data will be collected monthly for 12 months. | ||
| How will it be collected? On paper, on a computer, verbally, etc. | Data collection will be paper-based, occurring in scheduled assessment sessions. | ||
| How will data be kept secure once collected? | The information gathered will be stored in a locked filing cabinet and computerized into a password-protected database. | ||
| Who will be responsible for entering the data? | The administrative assistant and IT specialist | ||
| How will the data be analyzed? | The analysis will be done by comparing the pre-intervention and post-intervention PCL-5 scores to calculate the change in PTSD symptom severity. | ||
| What do you consider a good outcome? What would be a poor outcome? | A good outcome will indicate a 15-point or more decrease in the PCL-5 score. The bad outcome would show no change that occurred or a better, increased scoring on the PCL-5. | ||
| Goal 2: Increase Veteran’s coping strategies | |||
| Objective 2.1: Objective #1: Clients will improve their ability to cope with PTSD symptoms as measured by an increase of at least 7 points using the IES-R self-report measurement scale within 4 months. | |||
| What data must be collected for this objective? | Descriptive of Coping Ability Scores: IES-R Before and After the Intervention Period. | ||
| How does this data indicate progress toward the goal? | These data indicate progress through improvements in the veterans’ coping abilities, thus demonstrating that the coping strategies taught were indeed effective. | ||
| Data Collection Tool: | IES-R self-report measurement scale. | ||
| From whom or where will the data be collected? | The data will be collected from the veterans participating in the program. | ||
| Who will collect the data? Why this person? | The data will be collected by licensed psychologists or counselors due to their expertise in administering and interpreting the scale. | ||
| When will it be collected? What is the timeline for data collection? | The data will be obtained for a period of 4 months on a monthly basis. | ||
| How will it be collected? On paper, on a computer, verbally, etc. | Data collection will be performed using paper questionnaires in assessment sessions. | ||
| How will data be kept secure once collected? | Information gathered will be kept in a locked filing cabinet at all times and transferred onto a password-protected database. | ||
| Who will be responsible for entering the data? | The administrative assistant and IT specialist. | ||
| How will the data be analyzed? | The data will be analyzed by comparing pre-intervention and post-intervention IES-R scores to measure changes in coping abilities. | ||
| What do you consider a good outcome? What would be a poor outcome? | A good outcome will be at least a 7-point increase in IES-R scores. The poor outcome will show no change or decrease in IES-R scores. | ||
| Goal 2: Increase Veteran’s coping strategies | |||
| Objective 2.2: Clients will improve their ability to cope with PTSD symptoms as measured by an increase of at least 10 points using the IES-R self-report measurement scale within 8 months, ensuring at least 95% of sessions are attended. | |||
| What data must be collected for this objective? | Coping Ability Scores Using IES-R Self-Report Measurement Scale Before and After the Intervention Period. | ||
| How does this data indicate progress toward the goal? | The information shows progress, where there is a great improvement in the veterans in terms of coping abilities over a longer period, thus showing sustained effectiveness of the taught coping strategies. | ||
| Data Collection Tool: | IES-R Self-Report Measurement Scale. | ||
| From whom or where will the data be collected? | The data will be obtained from the veterans participating in the program. | ||
| Who will collect the data? Why this person? | This will be done by licensed psychologists or counselors since they are the ones qualified to administer and interpret the results of this kind of scale. | ||
| When will it be collected? What is the timeline for data collection? | The data would be collected on a monthly basis for 8 months. | ||
| How will it be collected? On paper, on a computer, verbally, etc. | The data will be collected on paper during scheduled assessment sessions. | ||
| How will data be kept secure once collected? | Information that is collected will be stored in a locked filing cabinet. It will also be transferred to an electronic database that is password protected. | ||
| Who will be responsible for entering the data? | The administrative assistant and IT specialist. | ||
| How will the data be analyzed? | Analysis will be achieved by comparing the pre-intervention and post-intervention IES-R scores to measure changes in coping abilities. | ||
| What do you consider a good outcome? What would be a poor outcome? | A good outcome will consist of at least a 10-point increase in the IES-R. A poor outcome will indicate no significant change or a decrease in the IES-R score. | ||
| Goal 2: Increase Veteran’s coping strategies | |||
| Objective 2.3: Clients will identify (self-report) at least 3 PTSD triggers within 3 weeks. | |||
| What data must be collected for this objective? | Data on the identification of PTSD triggers, self-reported by the veterans. | ||
| How does this data indicate progress toward the goal? | This data indicates progress by showing an increased awareness and understanding of individual PTSD triggers, which is essential for developing effective coping strategies. | ||
| Data Collection Tool: | Self-report forms used by participants for documenting identified PTSD triggers. | ||
| From whom or where will the data be collected? | Veterans participating in the program. | ||
| Who will collect the data? Why this person? | Licensed psychologists or counselors will collect the data to ensure accurate and professional documentation of the identified triggers. | ||
| When will it be collected? What is the timeline for data collection? | The data will be collected within 3 weeks. | ||
| How will it be collected? On paper, on a computer, verbally, etc. | Data will be collected on paper during pre-arranged meetings. | ||
| How will data be kept secure once collected? | Information collected will be securely kept in a locked filing cabinet and on a password-protected database. | ||
| Who will be responsible for entering the data? | The administrative assistant and IT specialist. | ||
| How will the data be analyzed? | The data will be analyzed following review of the self-reported forms that identify common triggers and patterns. | ||
| What do you consider a good outcome? What would be a poor outcome? | A good outcome will be at least 3 triggers of PTSD identified by every participant. A poor outcome is failure to identify any based on the given timeframe. | ||
| Goal #1: Reduce PTSD symptoms | ||
| Objective #1: Implement mindfulness practices for 10 minutes daily as self-reported in a journal for 90 days, missing no more than 10 days in that timeframe. | ||
| AUDIENCE: Who do you want to change (audience)? | Veterans who experience PTSD | |
| DEPENDENT VARIABLE: What are you trying to change? | PTSD | |
| MEASUREMENT TOOL: How are you measuring the change? What is your measurement tool? Be specific. | PTSD checklist for DSM-5 (PCL-5) | |
| AMOUNT OF CHANGE: How much change are you expecting? | Reduce symptom severity by at least 5 points | |
| DIRECTION OF CHANGE: What is the direction of the expected change? Increase, decrease or maintain? | Decrease | |
| TIMEFRAME: By when do you expect the change to occur? | 90 days | |
| Objective #2: Clients will reduce their PTSD symptoms as measured by a score reduction of at least 10 points on the PTSD checklist for DSM-5 (PCL-5) within 8 months, ensuring at least 95% of sessions are attended. | ||
| AUDIENCE: Who do you want to change (audience)? | Veterans who experience PTSD | |
| DEPENDENT VARIABLE: What are you trying to change? | PTSD | |
| MEASUREMENT TOOL: How are you measuring the change? What is your measurement tool? Be specific. | PTSD checklist for DSM-5 (PCL-5) | |
| AMOUNT OF CHANGE: How much change are you expecting? | Reduce symptom severity by at least 10 points | |
| DIRECTION OF CHANGE: What is the direction of the expected change? Increase, decrease or maintain? | Decrease | |
| TIMEFRAME: By when do you expect the change to occur? | 8 months | |
| Objective #3: Clients will reduce their PTSD symptoms as measured by a score reduction of at least 15 points on the PTSD checklist for DSM-5 (PCL-5) within 12 months, ensuring at least 95% of sessions are attended. | ||
| AUDIENCE: Who do you want to change (audience)? | Veterans who experience PTSD | |
| DEPENDENT VARIABLE: What are you trying to change? | PTSD | |
| MEASUREMENT TOOL: How are you measuring the change? What is your measurement tool? Be specific. | PTSD checklist for DSM-5 (PCL-5) | |
| AMOUNT OF CHANGE: How much change are you expecting? | Reduce PTSD symptoms by at least 15 points | |
| DIRECTION OF CHANGE: What is the direction of the expected change? Increase, decrease or maintain? | decrease | |
| TIMEFRAME: By when do you expect the change to occur? | 12 months | |
| Goal #2: Increase Veteran’s coping strategies | ||
| Objective #1: Clients will improve their ability to cope with PTSD symptoms as measured by an increase of at least 7 points using the IES-R self-report measurement scale within 4 months. | ||
| AUDIENCE: Who do you want to change (audience)? | Veterans who experience PTSD | |
| DEPENDENT VARIABLE: What are you trying to change? | PTSD | |
| MEASUREMENT TOOL: How are you measuring the change? What is your measurement tool? Be specific. | IES-R is a self-report measure | |
| AMOUNT OF CHANGE: How much change are you expecting? | Improve client’s ability by at least 5 points | |
| DIRECTION OF CHANGE: What is the direction of the expected change? Increase, decrease or maintain? | increase | |
| TIMEFRAME: By when do you expect the change to occur? | 4 months | |
| Objective #2: Objective #1: Clients will improve their ability to cope with PTSD symptoms as measured by an increase of at least 10 points using the IES-R self-report measurement scale within 8 months, ensuring at least 95% of sessions are attended. | ||
| AUDIENCE: Who do you want to change (audience)? | Veterans who experience emotional management | |
| DEPENDENT VARIABLE: What are you trying to change? | PTSD | |
| MEASUREMENT TOOL: How are you measuring the change? What is your measurement tool? Be specific. | IES-R is a self-report measure | |
| AMOUNT OF CHANGE: How much change are you expecting? | Improve the client’s ability by at least 10 points | |
| DIRECTION OF CHANGE: What is the direction of the expected change? Increase, decrease or maintain? | increase | |
| TIMEFRAME: By when do you expect the change to occur? | 8 months | |
| Objective #3: Clients will identify (self-report) at least 3 PTSD triggers within 3 weeks. | ||
| AUDIENCE: Who do you want to change (audience)? | Veterans who experience emotional management | |
| DEPENDENT VARIABLE: What are you trying to change? | PTSD | |
| MEASUREMENT TOOL: How are you measuring the change? What is your measurement tool? Be specific. | Self-reported data | |
| AMOUNT OF CHANGE: How much change are you expecting? | Identifying 3 or more | |
| DIRECTION OF CHANGE: What is the direction of the expected change? Increase, decrease or maintain? | Just identifying | |
| TIMEFRAME: By when do you expect the change to occur? | 12 months | |
CAT II
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CAT II
The Coronavirus Aid, Relief, and Economic Security (CARES) Act is a federal law enacted in March 2020 to mitigate the economic and health impacts of the COVID-19 pandemic. The Act allocated over $2 trillion to individuals, businesses, healthcare providers, state and local governments, and other sectors affected by the outbreak (Office of Inspector General, 2021). The major provisions included financial assistance in the form of stimulus checks, expanded unemployment benefits, and forgivable loans to small businesses to retain employees. The Act also allowed funding for hospitals and healthcare providers to address the surge in COVID-19 cases and to ensure they had the necessary resources to combat the virus. Thus, the CARES ACT aimed to ease the impacts of COVID-19.
The purpose of the Act was to provide financial relief and support to individuals, businesses, the healthcare industry, and the economy at large. Direct payments and enhanced unemployment benefits to individuals aimed to alleviate their financial burdens caused by job losses and reduced income. Consequently, small enterprises profited from funding that was designed to maintain employment levels and prevent widespread layoffs (Office of Inspector General, 2021). The healthcare industry also received federal funding aimed to enhance its capacity to handle the unprecedented number of COVID-19 cases and ensure that hospitals could maintain operations despite the strains on their resources. Lastly, the Act aimed to stabilize the broader economy by injecting liquidity and confidence. Thus, the CARES Act could enhance public well-being by supporting individuals and organizations affected by the pandemic.
While the CARES Act provided critical and timely support, disbursement efficiency and equality in allocation could have been improved to increase its impact. One significant issue was the speed and efficiency of the distribution of funds, as small businesses reported difficulties accessing PPP loans due to the high demand and limited initial funds (Pandemic Oversight, 2021). The government should have implemented a streamlined application process and perhaps a tiered funding approach to prioritize vulnerable businesses. Moreover, there were disparities in the allocation of healthcare resources, with some regions experiencing shortages while others had surpluses. The government should have developed a dynamic distribution system based on real-time data to ensure that healthcare resources are allocated where they are most needed. These improvements would have increased the CARES Act’s effectiveness.
References
Office of Inspector General. (2021, January 15). CARES Act. https://oig.treasury.gov/cares-act
Pandemic Oversight. (2021). Update: Top challenges in pandemic relief and response. In Pandemic Oversight. https://www.pandemicoversight.gov/media/file/update-top-challenges-pandemic-relief-and-response
Video Script (complete form)
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Video Script (complete form)
Agency:
The U.S. Senate has a Special Committee on Aging that addresses issues affecting older persons.
It is the mandate of this committee to initiate and popularize policies targeting to enhance the quality of life and safety for the elderly.
The committee works on legislation dealing with the prevention of elder abuse and neglect. Moreover, the committee ensures that the needs of the aging population are catered for by coming up with effective programs and policies.
Problem:
Among the high-profile issues that have copiously impacted veterans enough to drive them to critical and dangerous mental health problems are PTSD, poor well-being, and reduced quality of life.
The PTSD syndrome cripples veterans with the harshest symptoms of anxiety, flashbacks, and depression, which give devastating effects on the ability to readjust to civilian life.
Added to this is the stigma associated with mental health and a lack of access to effective treatment that may increase the problem beyond control, leaving many veterans without adequate support to manage their symptoms.
Program:
The PTSD program offers a multifaceted treatment approach at the Veterans Health and Wellness Center.
It involves daily mindfulness practices, professional counseling sessions, and personal coping strategies.
The licensed psychologists and professional counselors will help the veteran through programmed activities that have shown to make the symptoms of PTSD more manageable and help one better cope with them.
. The program advocates regular practice and joint participation, ensuring consistency in the support or resources that veterans garner.
Outcome Indicators:
The success of the PTSD management program is measured concerning several vital indicators, which include a decrease in symptoms of PTSD as assessed by the PCL-5, with a target reduction of at least 10 points within eight months.
Improvement in coping skills is assessed by an increase of more than 7 points on the IES-R self-report measurement scale within four months.
Participants are expected to have done the recommended regular mindfulness practice and, therefore, have done it for at least 80 days out of a total of 90.
Veterans should be able to understand and identify their triggers of PTSD and report these triggers within three weeks from the beginning of the program.
How You Know the Program Works:
The success of the program can be assessed through significant improvements in mental health and coping abilities for veterans participating in the program, measured by a severe decline in symptoms of PTSD classified as a ten or more point decrease on the PCL-5 score.
Furthermore, veterans showed better coping, a 7-point or more increase on the IES-R, and consistently involved themselves in practicing mindfulness skills.
The successful identification of the triggers of PTSD by veterans further proves the effectiveness of the program.
Improvement in such parameters thus signals that the program is successful in helping veterans deal with their PTSD symptoms and improving life quality.
The Costs of Living
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June 20, 2024
The Costs of Living
Based on Zillow, the average monthly rent for a three-person family (an adult female, a nine-year-old girl, and a seven-year-old boy) near Barry University, located on Northeast 2nd Avenue, Miami Shores, Florida, is $3,225 (based on four properties going for $2,700, $2,800, $3,500, and $3,900) (Zillow, 2024). This is the rate for a three-bedroom apartment with only one bathroom. Apartments with more bathrooms have higher prices.
The additional money a three-person family needs on top of the average monthly SNAP benefit of $239 to cover the cost of food for an entire month is roughly $537. If we assume the family is taking a nutritious meal, they would need the following food items: milk $9, fruits $19, eggs $7, bread $7, yogurt $11, granola $11, rice $9, chicken $22, salmon $17, ground beef $11, turkey $14, vegetables $15, beans $10, tomatoes $5, cheese $12, quinoa $9, and tofu $6. The weekly total is $194. The monthly food cost is approximately $776 (194 × 4). The average monthly SNAP benefit is $239, lower than the approximate monthly food cost. The additional money the family needs each month is $776 – $239 = $537.
The monthly expenses for a three-person family maintaining a car, paying for apartment utilities, and covering other incidentals is roughly $750. The average cost for maintaining a car, including gas, oil changes, and auto insurance, is approximately $500. The average cost of apartment utilities, including electricity, gas, and water, is around $150 per month (minus rent which I roughly $3,200). Other incidentals such as personal care items can add up to about $100 per month. Without including rent and food items, the family would need approximately $750.
The estimated monthly cost of an afterschool care program near Barry University is $130
As per the Labor Law Center, the minimum wage in Florida since September 30, 2023 is $12.00 (Labor Law Center, 2024). Assuming no holidays (52 weeks worked), the annual pay is $12 × 40 × 52 = $24,960.
The minimum income does not cover the housing rent, additional dollars for food, and other expenses. As per the Family Budget Calculator, the annual expenses for a single adult and two children in Miami-Dade County is $96,246 (which is $8,020 per month). This covers housing, food, child care, transportation, health care, other necessities, and taxes.
Based on the findings, the minimum wage should be at least $25, which translates to $,4000 per month ($25 × 40 hours × 4 weeks). The total monthly expenses assuming the family lives in the three bedroom house $4,772: rent ($3,225), additional dollar for food ($537), cost for maintaining a car and paying for utilities ($750), and child care for two children (2 × 130). While $25 per hour may not fully cover all the expenses (there is a deficit of $772), the deficit can easily be bridged with overtime work.
References
Labor Law Center. (2024). Florida labor law updates. https://www.laborlawcenter.com/labor-law-poster-update-products/labor-law-poster-compliance-update-check-florida
Zillow. (2024). Apartments For Rent—0 Rentals. Zillow. https://www.zillow.com/homes/Barry-University,-Address%3A-11300-NE-2nd-Ave.,-Miami-Shores,-FL-33168_rb/
Guiding Theory and Model Assignment
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Guiding Theory and Model Assignment
Based on the agency review and best practice proposal, it is vital to identify a theoretical framework ideal for implementing best practices that can help improve the quality of care and clinical outcomes for veterans. Miami VA Health Systems is an agency whose goal is to serve the veterans who have also contributed significantly to the safety of the citizens. The services that it offers are varied, ranging from prosthetic treatments, addressing spinal cord injuries and complications, HIV/AIDS management, and geriatric research and education for the sake of improving clinical outcomes and making the population report improved health and minimal cases of comorbidities. The paper aims to define the population, detail a theory explaining the targeted problem, and discuss the best practices for change.
Statement of the Population and Problem Targeted for Change
Many veterans report undermined health because of a lack of access to healthcare services. The contributing factor to the challenge is the lack of adequate transportation systems that can make them reach healthcare centers in time. The problem arises because of various constraints, such as limited access to public transportation, long geographical distances, financial limitations, and poor health. These factors are some of the disparities contributing to undermined patient safety and inadequate delivery of healthcare services (Hahn et al. (2023). The problem is significant, considering that veterans in Florida experience the challenge. They must travel to Miami-Dade County institutions for healthcare services. Public transport is insufficient, and most cannot afford private transportation. The aftermath of the challenge is reduced health outcomes that result in missed appointments, delays in medical care, and poor management of chronic conditions. Consequently, most have reduced clinical outcomes indicated by a high prevalence of poor mental health, diabetes, cardiovascular complications, exacerbated handicap conditions, chronic pain, and sleep disorders. Hence, it is significant to identify the best modalities to solve the challenge and enhance the population’s wellness.
Theory Explaining the Problem
The theoretical framework to address the challenge should focus on managing the susceptible population efficiently by adopting structures and modalities to improve infrastructure and healthcare systems, enhancing adequate interactions between patients and care providers. Total quality management (TQM) is a formal theoretical model that can help describe the problem and offer a rationale for the best approaches to help care practitioners streamline care for patients. Alzoubi et al. (2019) observe that TQM is an effective model that enriches systems for both organizations and employees to ensure that they identify innovative ways of managing challenges that undermine care delivery. The approach works by identifying the intricate causes of healthcare challenges and the combination of good predictors that can help solve them to optimize care. The theory is a holistic approach that relies on the input of various departments and collaborative approaches to standardize operations. The authors indicate that the uniqueness of the theory is its focus on clinicians analyzing processes keenly and adopting patient-centeredness as the primary determinant of the modalities for health promotion. The multidisciplinary approaches that arise from the employment of the model go beyond departmental and conventional lines, utilizing rational and data-based process analysis for change.
The theory is ideal for the population and the problem because of its nature and theoretical background. The gaps in healthcare that led to the development of the theory include lack of quality improvement initiatives in hospitals, poor leadership and management of healthcare organizations, lack of adequate information systems to enhance quality care, ignorance of practical quality terms by healthcare practitioners, insufficiency of organizational resources, and lack of accountability. TQM typically concerns itself with people and processes that focus on patient satisfaction and improving organizational performance through content and delivery quality (Aggarwal et al., 2019). Hence, the model helps describe the problem and determine the best intervention approaches by streamlining organizational culture, empowering clinicians to improve the care delivery process, developing an interdisciplinary approach that goes beyond the conventional modalities, and initiating a data-based cooperative strategy for problem analysis of change.
Explanation of the Best Practices for Change
The best strategies for initiating change that can help minimize the challenge of transportation require a multidisciplinary approach that entails a change of organizational culture and adoption of the Plan-Do-Study-Act method to streamline the operations of Miami VA Health Systems and its affiliated institutions. Aggarwal et al. (2019) describe the process for quality improvement by discussing the practical steps. The first strategy is the analysis of the plan’s effectiveness to the healthcare organization, patients, and healthcare personnel in enhancing institutional development, patient safety, and effective risk management. The subsequent steps entail identifying processes for quality, engaging an organizational assessment, conducting a gap analysis and quality assurance procedures, and determining the modalities for quality control and evaluation of methods. If the organization is educated on the steps above, it can effectively support a program for change to enhance the adoption of telehealth services to improve the quality of care. The Plan-Do-Study-Act method makes the participants move the plan from the pre-contemplation to the maintenance stages. Knudsen et al. (2019) state that the approach is practical in healthcare because it allows organizations to start small while adopting organizational change to minimize risks and costs. Challenges are curtailed before they get complicated. The “Plan” step will entail the identification of the population, their needs, organizational resources, and the timeline. The“Do” phase will involve executing the plan using the available resources to determine the best technologies and organizational input necessary for adopting telemedicine. The “Study” level will entail evaluating the process to ascertain if it is worthwhile to bring about the desired change. The “Act” stage will involve a reflection on the plan and outcomes and whether they help improve the clinical outcomes of patients by minimizing pain, reducing comorbidities, and curtailing the high prevalence of chronic conditions and poor mental health by the veterans. The practices above are unique and will help the healthcare organization adopt the best modalities for improving quality care and patient outcomes.
Conclusion
Miami VA Health Systems should adopt a multidisciplinary approach that entails altering the organizational culture and adopting the Plan-Do-Study approach to solve the challenge of poor access to healthcare services. The strategies are guided by the total quality management (TQM) model. The theoretical inclination focuses on quality improvement procedures that focus on quality care delivery, analysis of organizational performance, and patient satisfaction. The model can help streamline the organizational culture and promote the utilization of organizational resources well to enhance patient outcomes and the quality of healthcare services. Best practices to implement telehealth in the institution should focus on a multidisciplinary approach to change the organizational culture by utilizing resources sustainably to ensure patients and clinicians can interact well in real-time. However, the Plan-Do-Study-Act method is required to ensure that the participants stick to the plan meticulously while utilizing resources cost-effectively and managing risks strategically. With the approaches above, the organization can effectively adopt telehealth to improve veterans’ quality of care and clinical outcomes.
References
Aggarwal, A., Aeran, H., & Rathee, M. (2019). Quality management in healthcare: The pivotal desideratum. Journal of Oral Biology and Craniofacial Research, 9(2), 180-182. https://doi.org/10.1016%2Fj.jobcr.2018.06.006.
Alzoubi, M. M., Hayati, K. S., Rosliza, A. M., Ahmad, A. A., & Al-Hamdan, Z. M. (2019). Total quality management in the health-care context: integrating the literature and directing future research. Risk Management and Healthcare Policy, 167-177. https://doi.org/10.2147%2FRMHP.S197038.
Hahn, Z., Hotchkiss, J., Atwood, C., Smith, C., Totten, A., Boudreau, E., Folmer, R., Chilakamarri, P., Whooley, M., & Sarmiento, K. (2023). Travel burden as a measure of health care access and the impact of telehealth within the veterans’ health administration. Journal of General Internal Medicine, 38(3), 805–813. https://doi.org/10.1007/s11606-023-08125-3.
Knudsen, S. V., Laursen, H. V. B., Johnsen, S. P., Bartels, P. D., Ehlers, L. H., & Mainz, J. (2019). Can quality improvement improve the quality of care? A systematic review of reported effects and methodological rigor in plan-do-study-act projects. BMC Health Services Research, 19, 1-10. https://doi.org/10.1186/s12913-019-4482-6.
Agency Review and Best Practice Paper
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Agency Review and Best Practice Paper
Agency Overview: Miami VA Health Systems
The field placement agency is Miami VA Health Systems, which provides comprehensive health care services to veterans in Miami, Florida. Managed under the U.S. Department of Veterans Affairs, Miami VA is dedicated to delivering high-quality medical care to veterans, conducting essential medical research, and training America’s future health providers (Veterans Affairs, 2024). Miami VA provides health care services at nine locations in South Florida (Veterans Affairs, 2024). The mission of the Miami VA Health Systems is to “serve the veteran who served us” (Veterans Affairs, 2024). This vision statement recognizes the importance of veterans in society and highlights the dedication of the organization to serving them as well. The vision statement stresses the need to strive to be the benchmark of excellence and value in the industry through the provision of quality services that are evidence-based and patient-centered (Veterans Affairs, 2024).
VA Miami health care is a center of excellence for various services offered through its prosthetic treatment, spinal cord injury rehabilitative, AIDS/HIV and geriatric research, education, and clinical centers (Veterans Affairs, 2024). Regarding research, Miami VA Health Systems conducts research to discover knowledge and advance health care at its Bruce W. Carter VA Medical Center (Veterans Affairs, 2024). The goal of this research function is to use research to enhance health care and health for everyone. The Bruce W. Carter VA Medical Center is also a teaching hospital that offers a wide range of services as well as education and research (Veterans Affairs, 2024). The Miami VA Health Systems serves military veterans of all ages and backgrounds by offering specialized care to address their unique health needs.
Problem Statement
Transportation is a critical issue for many veterans in accessing health care services. Many veterans face difficulties reaching health facilities due to limited access to public transportation, geographic distance, and financial constraints. Hahn et al. (2023) conducted a study in which they established that, from 2017 to 2021, veterans traveled an excess of 14.1 million miles. In this study, excess distance referred to the difference between where an individual received care and the nearest facility offering the service needed (Hahn et al., 2023). Similarly, in Florida, veterans experience transportation-related barriers. According to the Florida Department of Veterans’ Affairs (2024), Florida has the third biggest veteran population (1,430,000) in the country, behind California and Texas. Because of this large population, transporting veterans to health facilities can be challenging.
The transportation issue could be attributed to geography, public transportation limitations, and financial constraints. Geographic distance is a particularly challenging problem as many veterans live far from the health care facilities in Miami-Dade County. The public transportation infrastructure in place is also insufficient, which makes it problematic for veterans to travel to appointments. When it comes to finances, some veterans cannot afford private transportation. Without reliable transportation, veterans often miss appointments, leading to delayed care, unmanaged chronic conditions, and overall poorer health outcomes. Addressing this problem would lead to more consistent health care access and better health for veterans.
Best Practices
Various best practices could be implemented to address veterans’ transportation issues and limit transportation for non-eligible veterans. One of them is the adoption of telehealth services, which would allow veterans to consult health care providers remotely via secure video or phone calls. Telehealth reduces the need for in-person visits for routine check-ups and follow-ups (Hahn et al., 2023). In addition to ensuring timely health care interactions, telehealth improves accessibility and convenience. At the same time, telehealth aligns with the Miami VA’s vision by leveraging technology to enhance health care access.
The second option entails strengthening veteran transportation services. Miami VA Health Systems provides shuttles, buses, and wheelchair-accessible transport to patients (Veterans Affairs, 2024). The U.S. Department of Veterans Affairs has also partnered with providers to offer transportation services to veterans. However, these services are limited in terms of reach and capacity. In most cases, veterans who are discharged can only ride a van if space is available. Therefore, enhancing this transportation service can ensure that veterans have reliable means to reach health care appointments and get back home. Additionally, non-eligible veterans would be covered. However, this option is associated with high operational costs and logistical challenges in managing the service.
Out of these two options, the recommended best practice is the utilization of telehealth services. Enhancing telehealth services is less costly as compared to providing dedicated transportation services. Rather than having to travel to a health facility, patients can receive care services from their homes and workplaces. Telehealth also reduces the strain on physical transportation resources and allows for efficient use of health care providers’ time. Studies have shown that telehealth increases health care access among veterans, improving health outcomes by facilitating timely medical consultations and continuous care (Hahn et al., 2023). For example, Hahn et al. (2023) demonstrated that about 11 million miles of veteran travel were avoided due to the utilization of telehealth between 2017 and 2021. The usage of telehealth would also allow non-eligible veterans to access health care services without having to look for alternative means of transportation. Overall, by strengthening telehealth, the agency can enhance health care accessibility and outcomes for its veteran population.
References
Florida Department of Veterans’ Affairs. (2024). Fast facts. https://www.floridavets.org/our-veterans/profilefast-facts/
Hahn, Z., Hotchkiss, J., Atwood, C., Smith, C., Totten, A., Boudreau, E., Folmer, R., Chilakamarri, P., Whooley, M., & Sarmiento, K. (2023). Travel burden as a measure of health care access and the impact of telehealth within the veterans’ health administration. Journal of General Internal Medicine, 38(Suppl 3), 805–813. https://doi.org/10.1007/s11606-023-08125-3
Veterans Affairs. (2024). VA Miami health care. https://www.va.gov/miami-health-care/
