Sample Essay on NURS6050 Agenda Comparison Grid and Fact Sheet

Posted: January 22nd, 2023

NURS 6050: Agenda Comparison Grid and Fact Sheet or Talking Points Brief Assignment

Study Notes: Writing Guide:
I will be discussing the topic of mental health and its role at the presidential level, discuss how different presidential administrations addressed it and what I would have done differently.
Identify the Population Health concern you selected: Mental Health
Describe the Population Health concern you selected: Mental health refers to a person’s emotional, psychological, and social well-being. It affects how we think, feel, and act. Mental health concerns can include a wide range of conditions, such as depression, anxiety, and post-traumatic stress disorder. Factors that can contribute to mental health concerns include stress, trauma, genetic predisposition, and social determinants of health.

Administration (President Name)
-Current Administration (President Joe Biden)
-Previous Administration 1 (President Donald Trump)
-Previous Administration 2 (President Barack Obama)
I will discuss the Obama, the Trump, and the Biden administrations. Mental Health According to the National Institute of Mental Health (n.d.), nearly one out of every five United States adults live with a mental illness. However, the average delay between the onset of symptoms in those experiencing a mental health illness and receiving treatment and/or counseling is 11 years (NAMI,2021). The issue of suicide and mental health began its climb up the political ladder in the mid-1990s when a small, lower-level group replicated the United Nation’s guidelines to encourage a national strategy addressing mental health (U.S. Dept. of Health and Human Services, Office of the Surgeon General, National Action Alliance for Suicide Prevention, 2012). This effort birthed two Congressional Resolutions that placed suicide a national problem and its prevention a national priority (U.S. Dept. of Health and Human Services, Office of the Surgeon General, National Action Alliance for Suicide Prevention, 2012). Since then, there has been an ebb inflow in the level of public attention or directed national reforms in mental health. Nonetheless, progress was never halted with new legislative achievements including acts providing grants to implement suicide prevention, suicide prevention programs for veterans, and the establishment of the National Suicide Prevention Line. In the following sections, I will evaluate the different presidential agencies’ strategies and progression in mental health reform, acts, and improvements.

The Obama Administration

The Obama administration demonstrated major leaps in many areas of healthcare reform. In 2010, President Obama placed the Affordable Care Act into action. This act required all small-group health plans starting January 2014 to cover ten essential health benefits in which mental health and addiction treatment were included (Norris, 2021). Although the act could not require large-group plans to cover the ten essential health benefits if they did provide mental health or addiction services the coverage rates had to be in parity with medical/surgical benefits (Norris, 2021). In December of 2016, the Obama administration signed the 21st Century Cures act into place. This Act not only supported major mental health and substance abuse treatment but also recruitment, training, and keeping the mental health workforce through grants for those who practiced psychiatry and/or addiction in underserved communities (Levin, 2017). The drive to form and implement these acts is sourced from a noted strong deficit in healthcare coverage or affordable healthcare. With the acknowledgment of the low percentage of healthcare coverage in the lower economic status, a lack of support for mental health providers, and the noticed under-recognized mental illness, lobbyists and healthcare reformers were eager to seek attention and seize the open window of a change in administration Just as John W. Kingdon (2001) describes in his stream analogy when a problem is recognized, a solution is recognized and the political environment is right, the three metaphorical streams are joined and conditions to successfully push proposals are made. Mental health activists successfully lobbied for their identified problems and when the Obama administration opened the ‘window’ they were able to set reform into place.

The Trump Administration

With another change in the political climate, the Trump administration had its own reforms in contrast to the Affordable Care Act. The Trump administration sought to repeal the ACA formerly put into place. This would retract the security that the ACA set of equal parity requirements in the small-group and Medicaid health coverage (Nuzum & Abrams, 2020). In doing this, access to mental health services became limited to a large percentage of the lower socioeconomic status population and the older population. Although the act was not completely repealed, changes were made so that those covered were affected and the requirements to have coverage were altered. This modification, however, came with demand and recognition of lobbyists during a time of ‘open window’ at the change of administration. The start of a pandemic sparked a different type of ‘change’ availability. In response, the Trump administration signed an order that had the potential to increase mental health services to those suffering from symptoms that were worsened by the global pandemic. This order spawned the Coronavirus Mental Health Working Group which collaborates with the public, stakeholders, and agencies to help people in crisis (Le, 2020). However, there was a noticed shortage of mental health providers which demanded action and recognition as well. In 2021 the Trump administration presented a 24% increase in the budget for behavioral health workforce programs (Nuzum & Abrams, 2020). President Trump also set an executive order laying the pandemic-related mental health needs as a national priority (Nuzum & Abrams, 2020). In this administration’s time frame, we can directly see the correlation between identified problems, proposed solutions, and the opportunities created by ‘open windows’ of different types (change in administration, the onset of pandemic setting).

The Biden Administration

Once again, in a very distinct political battle, the figurative window for policy change was opened again. The Biden administration quickly placed an executive order that opened a special enrollment time frame for citizens and reeled back Trump’s constraints on the ACA and Medicaid (NAMI, 2021). The demand for another healthcare reform inspired expansions of the ACA. This expansion was part of the American Rescue Plan Act (ARPA) which gave $10.7 million to expand pediatric mental health access (Department of Health and Human Services, 2021). The ARPA also gave $2.5 billion to the states to address the mental illness and addiction crisis in the nation, $20 million toward programs for mental health professionals and first responders, $20 million to carry out Youth Suicide Prevention Programs, $100 million for mental health education grants and much more (Le, 2021).

What Would I Do Differently?

In studying the different administrations and the reactions to political and social influence, I was both encouraged and slightly concerned about the lengthy and sometimes politically biased process reform has to go through to come to action. Although, I understand different platforms of perspectives on social, economic, and most recently pandemic change; the interruption of progress strikes me as anti-progressive. As a healthcare professional, my ideal strategy to keep a flow of progressing solutions would be to present my addressed problem/topic (mental health) that was appealing to multiple ‘open window’ scenarios. Keeping my mental health problem at the forefront and making sure my proposed solutions are sustainable through different political stances would be my strategy to keep it from faltering in progression through partisan changes. Federal Agenda and Healthcare IssuesHealthcare issues become political agenda priorities through a system of defining problems, finding solutions, promoting those solutions to policymakers, and through the mechanism of politics, those solutions become policies, laws, or regulations. (Laureate Education, 2018). The timing and readiness of policymakers are imperative to the effectiveness of the presentation of a proposed problem and solution. Any change in administration, social crisis, or pandemic can represent a change or opening in the federal agenda. When this change or opening occurs, lobbyists and representatives must be quick and ready to briefly yet effectively present. Just as DeMarco & Tufts (2014) describe, a policy brief is a condensed report containing information that can be understood quickly, provide findings and offer recommendations to those who may not be an expert in the proposed field. Therefore, healthcare issues become federal agenda priorities through identification, preparedness, and correct timing and opportunity of information provided, and in return, the federal agenda promotes healthcare issues by bringing awareness of the problem to those, not healthcare professionals and seeking a solution to implement by way of policy, laws or regulations.

References/study materials/coursework readings.

Bell, E., Christensen, J., Herd, P. and Moynihan, D., 2023. Health in citizen‐state interactions: How physical and mental health problems shape experiences of administrative burden and reduce take‐up. Public Administration Review, 83(2), pp.385-400.

Bose, M. and Fritz, P. eds., 2024. Evaluating the Obama Presidency: From Transformational Goals to Governing Realities (Vol. 1). Walter de Gruyter GmbH & Co KG.

Department of Health and Human Services. (2021, August 27). Biden-Harris Administration invests $10.7 million in American rescue plan funds to expand Pediatric Mental Health Care Access. HHS.gov. https://www.hhs.gov/about/news/2021/08/27/biden-harris-admin-invests-nearly-11-million-for-pediatric-mental-health-access.html

DeMarco, R., & Tufts, K. A. (2014). The mechanics of writing a policy brief. Nursing Outlook,62(3), 219-224. DOI: 10.1016/j.outlook.2014.04.002

Kenney, C. and Kropf, J., 2023. Biden Versus Trump: a Libertarian-Right Perspective.

Kingdon, J.W. (2001). A model of agenda-setting with the application. Law Review M.S.U.-D.C.L., 2(331)

Kwapong, Y.A., Boakye, E., Khan, S.S., Honigberg, M.C., Martin, S.S., Oyeka, C.P., Hays, A.G., Natarajan, P., Mamas, M.A., Blumenthal, R.S. and Blaha, M.J., 2023. Association of depression and poor mental health with cardiovascular disease and suboptimal cardiovascular health among young adults in the United States. Journal of the American Heart Association, 12(3), p.e028332.

Laureate Education (Producer). (2018). The Policy Process [Video file]. Baltimore, MD: Author.

Le, D. (2021, March 12). President Biden Signs American Rescue Plan Into Law. American Counseling Association. https://www.counseling.org/news/updates/2021/03/12/president-biden-signs-american-rescue-plan-into-law.

Le, D. (2020, October 6). Latest news from ACA. American Counseling Association. https://www.counseling.org/news/updates/2020/10/06/president-trump-issues-executive-order-on-behavioral-health.

Levin, A. (2016). Obama signs landmark legislation with major mental health provisions. Psychiatric News, 52(1), 1-1. https://doi.org/10.1176/appi.pn.2017.1a10

National Alliance on Mental Illness (2021) Mental health by the numbers. NAMI. https://www.nami.org/mhstats.National Alliance on Mental Illness. (2021, January 28).

NAMI Applauds President Biden’s Efforts to Strengthen Access to Quality, Affordable Health Care [Press release]. https://www.nami.org/Press-Media/Press-Releases/2021/NAMI-Applauds-President-Biden-s-Efforts-to-Quality-Affordable-Health-CareNational Institute of Mental Health (n.d.). Mental Illness.

National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/mental-illness.

Norris, L. (2021, March 30). How Obamacare improved mental health coverage. health insurance.org.https://www.healthinsurance.org/obamacare/how-obamacare-improved-mental-health-coverage/

Nuzum, R., & Abrams, M. (2020, October 14). Health care in the 2020 presidential election: Mental health and substance use disorders. Commonwealth Fund. https://www.commonwealthfund.org/blog/2020/health-care-2020-presidential-election-mental-health-and-substance-use-disorders.
Panagopoulos, C. and Weinschenk, A.C., 2023. Health and election outcomes: evidence from the 2020 us presidential election. Political Research Quarterly, 76(2), pp.712-724.
Semel, R., 2023. Malignant Narcissists and Divisive Fabricators: Psychological Characteristics of Two US Presidents in a Tensely Divided 21st Century America. EC Psychology and Psychiatry, 12, pp.01-17.

U.S. Dept. of Health and Human Services, Office of the Surgeon General, National Action Alliance for Suicide Prevention. (2012). 2012 National Strategy for Suicide Prevention: Goals and Objectives For Action: A Report of the U.S. surgeon general and of the National Action Alliance for Suicide Prevention.

Titelman, D., Abrams, M., & Gould, E. (2023). The Politics of Mental Health Policy in the United States: A Historical and Contemporary Analysis.

Ungar, L., Berry, J. W., & Weems, C. F. (2024). Addressing the Mental Health Needs of Vulnerable Populations: A Public Policy Analysis. Published in the Journal of Public healthcare essays Policy,

Torrey, E. F., & Fenton, K. (2024). The Future of Mental Health Policy in the United States: A Presidential Agenda
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Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief

It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember. This ongoing discourse reflects the complex and ever-evolving nature of healthcare policy in the United States. Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since. The longevity of this issue underscores its importance in American politics and society, shaping the nation’s approach to public health and welfare for over two centuries.

As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. Your unique perspective as a frontline worker can offer valuable insights into the practical implications of proposed changes. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news. Staying informed about current healthcare debates and policy trends is crucial for effectively advocating for your patients and profession in this dynamic landscape.

In this Assignment, you will analyze recent presidential healthcare agendas. This analysis will help you understand the priorities and approaches of different administrations. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy. This exercise will hone your ability to synthesize complex information and present it in a clear, concise manner for policymakers and other stakeholders.

To Prepare:

Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations.

Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.

Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.

Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.

The Assignment: (1-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet)

Part 1: Agenda Comparison Grid

Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. This systematic approach will help you identify patterns and shifts in healthcare priorities over time. Be sure to address the following:

Identify and provide a brief description of the population health concern you selected and the factors that contribute to it.

Describe the administrative agenda focus related to the issue you selected.

Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.

Explain how each of the presidential administrations approached the issue.

Part 2: Agenda Comparison Grid Analysis

Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:

Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?

How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?

Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?

At least 2 outside and 2-3 course resources are used.

Part 3: Narrative

Using the information recorded on the template in Parts 1 and 2, develop a 1-page narrative that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. This narrative should be concise yet compelling, highlighting the key points that would resonate with your audience. Be sure to address the following:

Summarize why this healthcare issue is important and should be included in the agenda for legislation.

Justify the role of the nurse in agenda setting for healthcare issues.

At least 3 resources are used.

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Assignment: Legislation Grid and Testimony/Advocacy Statement

As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? This sentiment often arises from firsthand experiences with the healthcare system’s strengths and weaknesses. Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice. This growing awareness is empowering nurses to become more active in shaping healthcare policy and practice.

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. These experiences provide valuable insights that can inform and improve healthcare policy. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy. This potential for positive change makes the challenge of policy advocacy well worth the effort for many nursing professionals.

To Prepare:

Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.

The Assignment: (1- page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. This structured approach will help you analyze the bill systematically and comprehensively. Be sure to address the following:

Determine the legislative intent of the bill you have reviewed.

Identify the proponents/opponents of the bill.

Identify the target populations addressed by the bill.

Where in the process is the bill currently? Is it in hearings or committees?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:

Advocate a position for the bill you selected and write testimony in support of your position.

Describe how you would address the opponent to your position. Be specific and provide examples.

At least 2 outside resources and 2-3 course specific resources are used.

This exercise will strengthen your ability to articulate your position effectively and anticipate counterarguments, crucial skills for successful healthcare advocacy.

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