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PubMed1984

The realities of policymaking. Can nurses have an impact?

Nurse executives have the access and organizational support to effectively influence national health policymakers. The author shows how nurses who wish to formulate and change policy should be prepared to forge alliances, do their homework, and bring their case before the public. By analyzing real-life situations in Australia and Michigan, she shows how policymaking actually works, and offers step-by-step guidelines for nurses who wish to assume a leadership role.

Administrative Personnel↗
PubMedDate not supplied

The Appalachian Rural Health Project in Chautauqua County, N.Y., 1973-78.

The Appalachian Regional Commission awarded a 5-year grant to the Chautauqua County Department of Health to establish primary health care services to medically underserved rural areas of the county. Four clinics were opened at various stages as the project grew.What began as an open system multidisciplinary approach to the delivery of primary health care changed abruptly to a closed system in March 1976, when the county medical society members voiced a strong objection to the rural health project. Among other assertions, the medical society claimed that the clinics of the project were "too costly and unnecessary as they now exist." Equally strong voices of community people demanded that the project be allowed to operate. An unprecedented public hearing was held and, as a result, a compromise plan was developed that permitted the medical services of the clinics to be continued, but most of the multidisciplinary components devoted to social development were eventually dropped.By September 30, 1978, when the project grant ended, three of the four clinics had been taken over on a private basis by physicians who had previously been assigned to the clinics and supported by the project.The effects of grassroots support and power of the people in a community in determining their health rights and needs were demonstrated and documented in this pioneer program. It is anticipated that the Chautauqua County experience may be a helpful model in planning other projects that attempt to institute change in the health care delivery system in underserved rural areas.

Appalachian Region↗
PubMedDate not supplied

The Federally Supported Health Centers Assistance Act of 1992: an experiment in malpractice coverage.

Based on a claims experience that was extremely low and malpractice insurance rates that remained at "commercial" rates, the Congress concluded in 1992 that coverage of malpractice actions against these grantees and their health care practitioners would be more cost-effective under the Federal Tort Claims Act. This, in turn, would allow the grantees to apply the savings to providing health services to their beneficiaries. The lawmakers thereupon enacted a 3-year experiment in coverage of malpractice actions involving certain Public Health Service grantees. This article describes the background, structure, and administration of this statutory experiment.

Community Health Centers↗
PubMedDate not supplied

Geriatric day hospitals: a golden opportunity for therapists.

The geriatric day care or day hospital program is an exciting new movement designed to aid the impaired elderly in the community. Federal legislation has made public financing of these programs possible under Title 18 and Title 19 of the Social Security Act. The potential for funding as a demonstration grant exists in a variety of Federal agencies. In spite of these funding possibilities, occupational therapists seem only marginally involved in the development of day care services for adults. Therapists must become more knowledgeable about health and social planning for the geriatric population and must become more assertive in seeking funding for new programs. Opportunities to play a role in these programs are available, and occupational therapists should become more alert to them and become leaders in developing new programs.

Aged↗