Public Health Preparedness
You have just been hired as a new Vice President of quality and safety for a full-service 600-bed government healthcare organization.  Within your first month on the job, the national security threat level has been raised to Imminent, which means there is a credible, specific, and impending terrorist threat against the U. S., and your facility may be directly impacted. The Chief Executive Officer has requested an immediate six-page report of your proposal for handling such a situation.

Note: You may create and/or make all necessary assumptions needed for the completion of this assignment.

Write a 6-page paper in which you:

1. Examine the existing procedures related to at least four (4) of the ten (10) essential public health services. Focus on the principal effects that these procedures will have on your hospital during the emergency.  See below the table listing 10 Essential public health services.
2. Specify the importance of continuing to evaluate patients, as stipulated by the Emergency Medical Treatment and Active Labor Act (EMTALA), during the emergency.  See below table the EMTALA.
3. Detail three (3) measures that you would use in order to maintain the electronic medical record system during the emergency.
4. Defend your position on the decision to accept health insurance during the emergency as a potential source of income for the facility. Provide support with (4) examples that illustrate your position.
5. Analyze the extent to which this emergency might affect the quality of care provided to the patients and the unimpeded operation of the organization.
6. Insert citations where appropriate within the paper. You may repeat the citations/references throughout the paper, but that will count as one reference.  Ex. The ABC of… can be used more than once as a citation, but only counts as one reference.  Use (4) quality references with reference page. Include all necessary language, e.g., author, date, title, URL where applicable.  Wikipedia does not qualify as academic resources. Times Roman 12. Double space. One-inch margins. Include cover page with placeholder, e.g. assignment, name of student, name of professor and date.  Number pages on middle bottom and no numbers for cover page.

 

 

 

 

 

 

 

 

From text:

10 Essential public health services

 

From text:

EMTALA resource

Rights Under Healthcare and Health Financing Laws

We begin this discussion of rights-creating health laws with the Examination and Treatment for Emergency Medical Conditions and Women in Labor Act (also referred to as EMTALA, which is the acronym for the law’s original name—the Emergency Medical Treatment and Active Labor Act—or, for reasons soon to become clear, the “patient antidumping statute”). We then briefly discuss the federal Medicaid program in a rights-creating context and wrap up this section with a brief discussion of the ACA.

Rights Under Healthcare Laws: Examination and Treatment for Emergency Medical Conditions and Women in Labor Act

Because EMTALA represents the only truly universal legal right to health care in this country—the right to access emergency hospital services—it is often described as one of the building blocks of health rights. EMTALA was enacted by Congress in 1986 to prevent the practice of “patient dumping”—that is, the turning away of poor or uninsured persons in need of hospital care. Patient dumping was a common strategy among private hospitals aiming to shield themselves from the potentially uncompensated costs associated with treating poor and/or uninsured patients. By refusing to treat these individuals and instead “dumping” them on public hospitals, private institutions were effectively limiting their patients to those whose treatment costs would likely be covered out-of-pocket or by insurers. Note that the no-duty principle made this type of strategy possible.

EMTALA was a conscious effort on the part of elected federal officials to chip away at the no-duty principle: by creating legally enforceable rights to emergency hospital care for all individuals regardless of their income or health insurance status, Congress created a corresponding legal duty of care on the part of hospitals. At its core, EMTALA includes two related duties, which technically attach only to hospitals that participate in the Medicare program (but then again, nearly every hospital in the country participates). The first duty requires covered hospitals to provide an “appropriate” screening examination to all individuals who present at a hospital’s emergency department seeking care for an “emergency medical condition.” Under the law, an appropriate medical screening is one that is nondiscriminatory and that adheres to a hospital’s established emergency care guidelines. EMTALA defines an emergency medical condition as a

medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in (i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy, (ii) serious impairment to bodily functions, or (iii) serious dysfunction of any bodily organ or part; or with respect to a pregnant woman who is having contractions, that there is inadequate time to effect a safe transfer to another hospital before delivery, or that transfer may pose a threat to the health or safety of the woman or the unborn child.20

The second key duty required of hospitals under EMTALA is to either stabilize any condition that meets the above definition or, in the case of a hospital without the capability to treat the emergency condition, undertake to transfer the patient to another facility in a medically appropriate fashion. A proper transfer is effectuated when, among other things, the transferring hospital minimizes the risks to the patient’s health by providing as much treatment as is within its capability, when a receiving medical facility has agreed to accept the transferred patient, and when the transferring hospital provides the receiving facility all relevant medical records.

The legal rights established under EMTALA are accompanied by heavy penalties for their violation. The federal government, individual patients, and “dumped on” hospitals can all initiate actions against a hospital alleged to have violated EMTALA, and the federal government can also file a claim for civil money penalties against individual physicians who negligently violate an EMTALA requirement.