Free Texas House Bill 1885 Essay Sample

Executive summary

Texas experiences the highest growth rate in United States of America (USA), which leads to increasing health care needs. The federal government through the federal health sector fails to provide health care needs for the rapidly increasing population because of the application of state laws and policies. The state law restricts Nurse Practitioners from practicing to the full potential of their profession capabilities. NPs are calling upon the federal state to implement the House Bill 1885 that allows them opportunity to practice to the full potential of a physician. The policy has social, environmental, ethical, and political significance to the state. The paper recommends that NPs form a political toolkit to help move the motion in senate and achieve their policy goal and objectives.
1.0 Problem identification
The growing health care needs in Texas go beyond the capability of the government even with the presence of federal health care reforms. The law prohibits Advanced Practice Registered Nurses (APRNs), including Nurse Practitioners (NPs) from performing duties according to their educational and clinical abilities. NPs must get authority from a physician before engaging in the practice of advanced nursing, which limits health care delivery process. Presence of such regulations complicates the practice of nursing and denies patients access to much needed care. Additionally, the problem creates geographical disparities, and increased cost of health care in Texas (Rodriguez & Burton, n.d). In order to deal with the rapidly growth and aging population Texas should implement changes in the health care workforce towards the present statutory requirements related to Advanced Nurse Practitioners. According to Mason, Leavit & Chafee (2012), health care reforms not only help in increasing access to health care and reduce health care cost but also help increase the quality of care by influencing the physician practice. The paper proposes full implementation of House Bill 1885 because it allows full practice authority of NPs.
1.1 Background

Denying NPs full practice authority contributes to social, economical, ethical and political issues and problems.

1.1.1 Social
Texas population keeps increasing each year and these people have different health care needs that require the attention of available health care givers. Most health problems are experienced in rural areas, where the government only allows physicians to diagnose and offer treatments. Most NPs are situated in community health care centers and they should be allowed a chance to safe lives of people in the society. The society suffers the most because quality health care is delivered to individuals with high income. Implementation of Texas House Bill 1885 will allow the society access to major health care services by covering the whole state especially rural areas and marginalized places.
1.1.2 Economical
Implementation of the proposed legislature will have a major economic effect in the state of Texas. The present Texas state law leads to increased cost of health care that has significant economic implications. The cost of Medicaid program and other health care insurances keeps increasing above federal requirements creating high financial burdens on citizens. Additionally, lack of quality health among people reduces productivity which has a negative effect towards the economy. The House Bill 1885 eliminates unnecessary and costly activities of individual physicians because patients will deal directly with NPs (Texas Nurse Practitioners, 2015). Allowing the society to access health care providers more easily is likely to decrease the cost of hospitalization. Implementation of the bill will reduce the cost of health care and reduce economic burdens brought about by poor access to health care services.
1.1.3 Ethical
Texas House Bill 1885 contains the highest ethical standards for NPs. All health care practitioners must be aware of different ethical principles needed at various qualifications, but the Texas state law denies such opportunities. Nurses irrespective of their position or qualifications play a major role in the future of health care. APRNs are mostly involved in primary care and provide preventive care to the public. Denying NPs the right to access a patient without the approval of the physician lowers their ethical standards. Implementation of House Bill 1885 would be the most ethical thing that Texas federal state can do to NPs.
1.1.4 Political/legal
The issue of APRNs in Texas being denied from practicing to full extent of their education and qualifications has brought major political divides within the federal government. Some leaders think the NPs should be allowed to practice according to their education and qualifications while others maintain they should work under physicians. Additionally, law makers play essential role in passing the above law into practice in order to save the rapidly growing population in Texas. It is the role of the Supreme Court to shape and pass legislations relating to health care. The judiciary has the power to execute such regulations and provide the way forward for the federal health care sector.
1.2 Stakeholders
Full implementation of the above legislative requires support from different groups and individuals. The major stakeholders for this program include the Texas Nurse Practitioners, Texas federal state health officials, Texas federal government officials working in the judiciary and other legal offices, Texas health care sector, the public, and the civil society group. The following stakeholders will play part in ensuring the government implements the House Bill 1885.
1.3 Issue Statement
The state has the duty of implementing every cost-effective and safe measure with the goal of increasing access of care in order to create an opportunity for the aging and growing population. A letter written by Julie and Priscilla claimed that Texas Nurse Practitioners were petitioning the government to advocate passage of the bill (Triggs, 2015). The federal state’s failure to put into action House Bill 1885 will result into the following issues within the next two years:

The gap demand of care and supply for care will expand

Texas nurse will leave the workforce as NPs and migrate to states with modernized licensure laws.
More time wasted in waiting areas especially in rural places where each health care facility has a single physician, or more than two health care facilities share a single doctor.

Increasing number of Medicaid patients with greater challenges of accessing cost-effective care and in a timely manner.

2.0 Interviews conducted
2.1 Focus
The main goal of conducting interviews was to gain views of NPs and the public on the issue. To NPs, the interview focused on what they thought about the House Bill 1885, should it be implemented or not? What benefits will the bill have to NPs? When should it be implemented? Interviews with NPs also sought to compare their skills and qualifications with those of physicians. To the society, the interview focused on the main challenges faced in terms of time, cost, and general quality of care with the current state law. Will the implementation of the House Bill 1885 have a positive or negative effect on patients? Do they feel satisfied when served by NPs?
2.2 Content analysis
The content of the interview was taken to all stakeholders for analysis. Only useful information was needed to ensure validity of the content. Additionally, a pilot test was undertaken using a small sample of respondents to test the reliability of interview questions.
2.3 Process analysis
The interview process was conducted by a team of experts who moved from hospital to hospital and from one homestead to the other interviewing respondents. Before the interviews began, all respondents were expected to sign an informed consent to show willingness to participate in the process. All interviewees were expected to answer questions in private or with the assistance of the research team member. Each interviewee spent 10 to 15 minutes to answer questions. All answered interview booklets were sealed and placed in a tamper proof envelope awaiting analysis. The whole process took one month.
2.4 Results/ Recommendations
The outcome from respondents showed that 98 percent of NPs to practice to the full extent of their clinical abilities and education. Most respondents claimed that the government restricts them from exercising their duties and limits a lot of potential within qualified NPs. 80 percent of the public who took part in the interview wanted the House Bill 1885 implemented. People claimed they waste more time in hospitals and dispensaries waiting for physicians whereas there are many NPs within the facility.
The research team recommended that the project stakeholders push the state government into passing the House Bill 1885 with immediate effect. Additionally, the team called upon doctors and physicians to allow NPs chance to practice and deliver health care because they have similar qualifications. According to
2.5 Planned follow up
Every stakeholder was given a duty to ensure follow up of the implementation of proposed health care laws. The state health officials were to make follow up on the federal state government into implementation of new laws. The government was asked to pass the law and gazette it in order for it to take action. Additionally, the NPs and physicians were asked to cooperate and ensure delivery of quality care to patients. Finally, the public was asked to always demand services from NPs should the government agree to pass the bill into law.
3.0 Policy goals, objectives, alternatives
3.1 Goal(s)
The main goal of implementing the following policy is to increase health care delivery and solve complex health problems experienced by the rapidly growing population in Texas.
3.2 Objectives

The policy aims at meeting the following objectives:

3.3 Alternatives
Implementation of the policy will also ensure NPs will ensure the state employs more NPs to take care of the growing population. The salaries for practicing NPs will also be reviewed because they will have additional duties if the law is passed by the federal government.
4.0 Evaluation of alternatives
4.1 Evaluation criteria
The research team will conduct surveys to the target groups, the NPs and the federal government to investigate the impact of implementing the policy. NPs will be asked if they would like to work as physicians and have their salaries reviewed. Additionally, political groups and leaders will be interviewed to give their views on the matter.
4.2 Analysis of alternatives
Each alternative will be analyzed separately to determine its impact. Information collected from the target group will be analyzed in a scale of 10. If the score is 7 and above, then the alternatives will be considered but a score below 7 leads to ignoring the alternatives.
4.3 Comparison of alternatives
Comparison will be made with the already stated goal and objectives. Respondents will be interviewed on the basis of policy goals and objectives. Every alternative should provide a good relationship with the policy goal or objectives for it to be considered and evaluated.
5.0 Recommendations
Texas is ranked in the 42nd position in terms of physicians per 100,000 people and 47 in the ratio of primary care physicians. Texas experienced high number of hospital visits in USA calling for a quick intervention to safe the rapidly growing population. In order to ensure full implementation of the policy, NPs should try the following recommendations. Firstly, they should develop political toolkit. Policy making and politics are functions of all health care stakeholders, both internal and external environments. Practitioners play a significant role in influencing the outcome of a policy with support from the federal government, the public, and politicians (Nickitas, Middaugh, & Aries, 2011). The political toolkit will enable politicians debate the matter in senate and pass it into law. If the federal government delays implementation of the policy, NPs should engage in peaceful demonstrations along the streets of Texas to express their grievances and show the importance of passing the policy. The public will also be requested to take part in demonstrations.
6.0 Summary
Texas has experiences a rapidly growing population that require complex health care needs but the presence of frequent health care crisis and limited resources interferes with delivery of quality care. There should be a state regulatory system allowing patients full and direct access to all services NPs are trained to provide in order to cope with the current and future health demands in Texas (Eastin, 2015). The goal of the policy is to promote health care delivery to the people of Texas. The main objective of the policy is to allow NPs practice as normal physicians in order to ensure every individual receives quality care at the right time and at affordable cost.

References

Eastin, E. (March 04, 2015). Texas lawmakers file bill to improve access to primary care in
Texas. Retrieved March 17, 2015 from http://www.texasnp.org/news/219865/Texas-Lawmakers-File-Bills-to-Improve-Access-to-Primary-Care-in-Texas.htm
Mason, D. J., Leavitt, J. K., &Chafee, M. (Eds.). (2012). Policy and politics in nursing and
health care 6th ed. St. Louis, MO: W.B. Saunders Elsevier
Nickitas, D. M., Middaugh, D. J., & Aries, N. (2011). Policy and politics for nurses and other
health professions: Advocacy and action. Sudbury, Mass: Jones and Bartlett Publishers.
Rodriguez & Burton. (n.d). Nurse Practitioner full practice authority bill HB 1885. Retrieved
Texas Nurse Practitioners. (2015). I chose NPs. Retrieved March 18, 2015 from
http://www.texasnp.org/?page=ichoosenps
Triggs, N. (2015). Texas Legislature 2015. Retrieved March 19, 2015 from
https://houstonnapnap.enpnetwork.com/nurse-practitioner-news/73411-texas-legislature- 2015