SKW5002 Week 6 Assignment Policy Analysis

SKW5002 Week 6 Assignment Policy Analysis

Student Name

Capella University

SKW5002

Professor Name

Submission Date

Policy Analysis

The VA MISSION Act of 2018 has been developed to directly resolve the systemic problems that plagued the care delivery to veterans since, at least, the VA wait-time scandal of 2014, where veterans were harmed and in some cases died as they awaited receiving care. The political interest and media backlash led to the adoption of the Veterans Choice Act of 2014, which only partially allowed access to community-based care, which was criticized for being sectioned, bureaucratic, and underfunded (Oh et al., 2022). The policymakers saw the necessity of a more cohesive, efficient, and equitable system that can mitigate the healthcare disparities experienced by the veterans, especially in rural, minority, and marginalised populations, by eliminating structural barriers to proper and prompt healthcare.

Bipartisan support and powerful advocacy of such veteran service organisations as the American Legion and Iraq and Afghanistan Veterans of America (IAVA) affected the legislation. These organizations demanded massive reforms that would enhance access and enhance coordination of care, and also enhance the infrastructure of the V.A. This has led to the development of the VA MISSION Act. It included the existing community care initiatives, the improvement of telehealth services, and the increase in caregiver services, not to mention the financial support of the workforce recruitment and training (Rasmussen & Farmer, 2023). Its passage shifted to a false-public system of offering veterans healthcare that will enhance choice and flexibility.

Historical Background Leading to the Policy

The VA MISSION Act has a long history of decades of insufficient funding and bureaucratic malfunction within the VA healthcare system, and increasing discontent among veterans with the VA healthcare system (Rasmussen & Farmer, 2023). Before the scandal of 2014, long wait times, geographic inaccessibility, and lack of access to specialised mental health services among veterans were already long-standing problems. The results of the investigations were the discovery of tinkered wait-time records, systemic understaffing, as well as excessive lack of supervision, and that was sufficient enough to necessitate legislation right away. The Veterans Choice Act of 2014 was an effort to address such issues, but it was soon evident that the program was underfunded, and providers were not keen to join the program since the program was not well-coordinated.

It is also after this period that mental health crisis awareness among veterans increased, including rising cases of Post-Traumatic Stress Disorder, depression, substance use disorder, and suicide (Ramchand, 2022). Even bigger inequalities were demonstrated in rural veterans, racial and ethnic minorities, and veterans belonging to the LGBTQ + population because of their geographic remoteness, cultural stigma, and deficit of culturally competent care. Put together, these social and healthcare challenges are a compelling case that a more comprehensive policy should be adopted, and that was achieved with the development and further adoption of the VA MISSION Act in 2018 as a means to streamline accessibility, improve equity, and eliminate systemic gaps.

Goals of the Policy and How They Are Intended to Be Met

The VA MISSION Act was supposed to have four main purposes, which are improving access to high-quality and timely care to the veterans, enhancing the care coordination between the VA and the community care providers, modernising the VA facilities and infrastructure, and supporting the caregivers of severely injured veterans. In order to pursue these objectives, the Act established the Veterans Community Care Program (VCCP) that consolidated various programs, some of them overlapping, and combined them into one system (Mengeling et al., 2021). With this new system, Community Care Network (CCN) was formed that linked veterans to vetted providers in the private sector in the event that the VA services were not available within certain time or distance constraints.

Another significant component that was to be extended is telehealth, since it was projected to reduce geographic obstacles, primarily to the rural and homebound veterans. The policy also advanced the enhancement of programs that support caregivers, which provided funding to the caregivers in the form of financial stipends, training, and accessibility to healthcare for the family caregivers (Miller et al., 2022). The money was also utilized in the solicitation and maintenance of health care employees, the rebuilding of VA centers, and researching how to increase the technological infrastructure to facilitate the smooth delivery of care. All these were to make sure that all the eligible veterans, regardless of where he/she is and what he/she is, can have practical, timely, and fair care.

Effectiveness of the Policy concerning the Target Population

The VA MISSION Act has delivered measurable positive changes to the target population, particularly in enhancing access to care for veterans in underserved rural areas. The data provided by RAND and VA show that in most regions, the estimated wait time to schedule a community care appointment has decreased, whereas the tele-mental health visits have increased between 2020 and 2022 (Farmer, 2022). These gains have proved to be beneficial to the veterans who have mobility issues, veterans who live too far to visit the VA facilities, and veterans who require specialised services that cannot easily be provided by the VA system.

The success of the policy has, however, not been uniform. The number of people who can now access it has improved, but the gap between those veterans who do not have access to a reliable internet connection, or are served by providers who are not present in the area, or are simply uninformed about the military culture and the military trauma-informed care remains. The VA and non-VA providers have not synchronized well, and medical records transfer and follow-up care have been deferred. Based on this, the Act has shifted to greater equity within the system, but has not removed the barriers to marginalised groups of veterans.

Impact on Social Justice and Social Functioning

The VA MISSION Act has the potential to help the target population improve their social functioning through the support of stronger autonomy and dignity in control and healthcare choices. The veterans are not required to stay within the walls of their nearest VA center, but they can receive the care they require in their localities. This saves on travelling expenses as well, limits the interference of daily activities, and could enhance adherence to therapy. The support network of the veteran is further enhanced by the fact that the caregiver support services are also available, which is necessary for recovery and introduction into civilian life.

The Act is socially fair in a way that it is a social justice initiative to focus on the historically underserved population based upon central values of fairness and equity. The rural veterans, racial and ethnic minorities, or those veterans who belong to the lesbian, gay, bisexual, queer, and transgender community have greater chances to receive care that can address their needs (Singh et al., 2024). However, without the community providers also having their training in cultural competence, there will always be the possibility of the existence of such groups facing an inequality in the quality and responsiveness of care, which will not favour the objectives of social justice in the policy.

Alignment with Social Values of the Target Population

The principles of the veteran community are touched on in the Veterans of America MISSION Act, and they consist of respect, timely support, and acknowledgment of the sacrifice in service. The ideal in the provision of the best healthcare to the veterans as a national responsibility is respected by ensuring that the care is more accessible to the veterans (Kintzle et al. 2024). Independence and self-determination are very important to the veterans, and the policy emphasizing patient choice in the care environment supports such principles.

In the meantime, the policy is to cover the remaining concerns regarding the quality of the non-VA care. The lack of said knowledge in certain care settings within the community can be a source of distrust in the case of veterans who value the cultural understanding of the providers so much. This is to guarantee that the policy is completely compliant with the social values and expectations of the targeted population, as the care must be premised on the lived experience of the veterans.

Adherence to Best Practice Ethics and Standards

The VA MISSION Act adheres to some of the best practice ethics, including justice (levelling access), beneficence (timely and effective care), and autonomy (increasing choice). There is the utilization of evidence-based telehealth and community partnerships, which is an indication of commitment to innovation and efficiency. The ethical responsiveness to the needs of the veteran community is also exhibited by the fact that the stakeholders are engaged in the process of policy development.

Nevertheless, the deficits in the best practice standards are not yet present. One potential transgression of nonmaleficence principles is the absence of some generic training of cultural competence of community providers, because culturally uninformed care can not be harmful, but rather can be harmful. Besides, the lack of interoperability between VA and the system of community providers compromises continuity of care, which equally fails to address the ethical principle of offering safety to patients through the coordination of services.

Feasibility of the Policy

The VA MISSION Act is quite viable politically, and it has been passed by both sides without receiving any opposition, and continues to enjoy the backing of large organisations of the veteran service. Its tilt towards the development of choice, exploitation of the capacity of the private sector, rings in with a larger dose of political priorities, which lean towards a public-private coalition in the provision of healthcare. The political will to turn back the program is not great despite the fact that funds have been argued to be too many.

The policy is more difficult economically. Community care expenditure has grown enormously since its implementation, and this has cast uncertainty on its sustainability. At the administrative level, the VA has been forced to invest in IT infrastructure, staff, and provider networks to sustain the augmented system. These investments have made operations more viable, but since the workforce is short and the administrative aspect of the work complicated, this is a challenge that may hinder full and effective implementation.

Policy Constraints

The original limits included distance or wait time limits, which were eligibility limits, and limited access to some veterans, even when necessary. Even though the community care authorisation process is not as complicated as the Veterans Choice Act, it can cause delays. The modernisation of the infrastructure and the establishment of a larger workforce were also hindered by the financial constraints.

Since its enactment, new limits have been reached. The Covid-19 pandemic has led to a scaling up of telehealth overall and the digital literacy and internet access disparity in veterans, particularly the older ones, and in communities with many veterans (LeBeau et al., 2023). Inflation and rising healthcare costs have continued to put strain on the budget of the program, and legal disputes in the area of reimbursement of providers have stalled the growth of the network in other regions. In others, they have made more available to the tech-savvy veterans and less of it to the veterans who have not been resourceful in utilizing the digital care systems.

Related Sample for this class: SKW5002 Week 5 Assignment