NURS 6050 Assignment: Legislation Grid and Testimony/Advocacy Statement SAMPLE

Sample Answer for NURS 6050 Assignment: Legislation Grid and Testimony/Advocacy Statement SAMPLE Included After Question

Maternal healthcare is one of the determinants of the quality, safety and efficiency of health in a state. The US is one of the most developed countries in the world. It is therefore expected to have the lowest maternal mortality and morbidity rates in the world. However, statistics show that the rates of maternal mortality and morbidity in the US are significantly high. Consequently, this paper explores a proposed policy that aims at reducing the current rates and trends in maternal mortality and morbidity in the USA.

A Sample Answer For the Assignment: NURS 6050 Assignment: Legislation Grid and Testimony/Advocacy Statement SAMPLE
Title: NURS 6050 Assignment: Legislation Grid and Testimony/Advocacy Statement SAMPLE

Legislation Grid Template

Maternal health is defined as a woman’s health and well-being before, during, and after pregnancy. It includes aspects of physical, emotional, mental, and social health. Maternal health also encompasses the absence of maternal morbidity, acute maternal morbidity, and maternal mortality (CMS, 2019). Rural women in the U.S have poorer maternal health outcomes than their urban counterparts, including higher pregnancy-related mortality (Simpson, 2020). This necessitates for laws to be enacted to improve maternal health outcomes in rural areas. This assignment will describe a proposed Bill that seeks to address the maternal health issue and advocate my position for the Bill.

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Health-related Bill Name	Rural MOMS Act
Bill Number	S. 1491
Description	The Rural MOMS Act is a bill to amend the Public Health Service Act to improve obstetric care in rural areas. The Bill expands initiatives to address maternal health in rural areas.
Federal or State?	Federal
Legislative Intent	The Rural MOMS Act was proposed to provide funding through FY2025 for the Health Resources and Services Administration (HRSA) to create rural obstetric networks (GovTrack.us, 2021). The rural obstetric networks must support collaboration to enhance birth outcomes and reduce maternal morbidity in rural areas. Besides, HRSA must reward demonstration grants to medical institutions and health professional training programs to support maternal health education and training in rural areas (GovTrack.us, 2021). The Bill also integrates maternal health services in various telehealth grant programs. It also reviews specific research and other Department of Health and Human Services activities related to maternal health (GovTrack.us, 2021). In addition, the Government Accountability Office must report on maternal health topics, such as health inequities and data issues. If the Rural MOMS Act is passed to law, the Secretary will be required to award grants or cooperative agreements to eligible entities to establish collaborative improvement and rural obstetric networks to improve maternal and infant health outcomes (GovTrack.us, 2021).
Proponents/ Opponents	Proponents: The Bill has eight Cosponsors: 4 Republicans, 3 Democrats, 1 Independent. Primary sponsor- Smith, Tina [D-MN] Original Cosponsor- Luján, Ben [D-NM] Original Cosponsor- Murkowski, Lisa [R-AK] Original Cosponsor- Ernst, Joni [R-IA] Original Cosponsor- Gillibrand, Kirsten [D-NY] Original Cosponsor- King, Angus [I-ME] Original Cosponsor- Stabenow, Debbie [D-MI] Joined May 25, 2021- Collins, Susan [R-ME] Joined May 12, 2021 – Capito, Shelley [R-WV]
	Opponents: None
Target Population	Women Infants
Status of the Bill (Is it in hearings or committees?)	The Bill was introduced in Senate on April 29, 2021, and is currently in the Committee stage. The Senate committee assigned to this bill, Health, Education, Labor, and Pensions Committee, sent it to the Senate as a whole for consideration on May 25, 2021 (GovTrack.us, 2021).
General Notes/Comments	The Bill will significantly help to reduce preventable maternal mortality and acute maternal morbidity by improving maternity care and access to care in rural areas, maternity care health professional target areas, and jurisdictions of Indian Tribes and Tribal organizations.

NURS 6050 Legislation Grid Template SAMPLE Part 2: Legislation Testimony/Advocacy Statement

An ideal maternal health system should have all women accessing comprehensive maternal care that encompasses behavioral, social, and economic supports. Besides, women should be involved with the health system before, during, and after pregnancy (Simpson, 2020). However, most women are not receiving care in an ideal system, with women in rural areas encountering challenges that make it difficult for them to access ideal maternal care or any care at all (Simpson, 2020). I support the Rural MOMS Act since it seeks to improve obstetric care for women living in rural areas. The Bill also broadens initiatives that aim to improve maternal health in rural areas. NURS 6050 Assignment: Legislation Grid and Testimony/Advocacy Statement

The lack of access to ideal maternal healthcare disproportionately impacts Black and Hispanic communities and women with low income since they mostly live in urban areas. Women in rural areas are less likely to access prenatal care (CMS, 2019). I would advocate for the Bill because there is a high need for quality maternal health programs in rural areas to address the barriers rural women encounter.

I would address the proponent of the Rural MOMS Act by enlightening them of the barriers that rural women face in accessing maternal care. These include social determinants of health such as low educational attainment, low household incomes, high uninsurance rates, poverty, and housing instability (Lee et al., 2020). For instance, housing insecurity poses maternal health risks such as low birth weight and preterm birth. Rural women also encounter challenges with transportation challenges, food insecurity, and a lack of educational and employment opportunities connected with poor mental health outcomes (Lee et al., 2020). Furthermore, I would inform the proponent that the Bill will provide funds to help eliminate challenges in rural areas such as the closure of rural hospitals and obstetric units, poor physical and mental health, lack of data on maternal health, and lack of care coordination. NURS 6050 Assignment: Legislation Grid and Testimony/Advocacy Statement

Conclusion

If the Rural MOMS Act Bill is passed, it will require the Secretary to provide funding through FY2025 for the HRSA to create rural obstetric networks.

The HRSA will be required to reward grants to medical schools and other professional training programs to support education and training on maternal health in rural areas. The Bill seeks to improve obstetric care in rural areas and expand initiatives to improve maternal health in rural areas. Maternal health initiatives in rural areas can help to increase access to high-quality healthcare services before, during, and after pregnancy and mental health and social support. I support the Bill since it will provide funds that will help address barriers faced by women in rural areas. The Bill will also improve maternity care, which will reduce preventable maternal mortality and acute maternal morbidity.

References

Centers for Medicare & Medicaid Services. (2019). Improving access to maternal health care in rural communities.

GovTrack.us. (2021). S. 1491 — 117th Congress: Rural MOMS Act. Retrieved from https://www.govtrack.us/congress/bills/117/s1491

Lee, H., Hirai, A. H., Lin, C. C. C., & Snyder, J. E. (2020). Determinants of rural-urban differences in health care provider visits among women of reproductive age in the United States. PloS one, 15(12), e0240700. https://doi.org/10.1371/journal.pone.0240700

Simpson, K. R. (2020). Ongoing crisis in lack of maternity services in rural America. MCN: The American Journal of Maternal/Child Nursing, 45(2), 132. https://doi.org/10.1097/NMC.0000000000000605 NURS 6050 Legislation Grid Template SAMPLE

Legislation Grid Template

Legislation Grid Template

Nurses experience events and situations that motivate them to assume the advocacy role in hopes of influencing policies, regulations, and laws related to healthcare and care provision. To do so, they have to enter into the less familiar political and policy making spheres to demonstrate their interests by evaluating proposed bills and their overall effects on the target health populations, the nursing profession and the healthcare industry at large. The purpose of this assignment is to review a selected health-related bill that has been proposed in Congress and complete the Legislation Grid Template to determine its intent, proponents and opponents, the target population and issue an advocacy statement or testimony.

Health-related Bill Name	Mobile Health Record Act of 2019
Bill Number	H.R.1390
Description	Mobile Health Record Act of 2019 was introduced in the house on February 27, 2019 and was sponsored by Susan Brook, the house representative from the fifth Congressional District in Indiana. The bill’s co-sponsors include Yvettte Clarke the New York representative of 9th Congressional District, Levine Mike from California, Schweikert David from Arizona and Gottheimer Josh from New Jersey. The proposal mandates the Centers of Medicare and Medicaid Services (CMS) to develop a program, which ensures Medicare enrollees link their data using reliable applications, services and research initiative. The bill also requires enrollees to access information using a mobile health record application of their choice and one that is approved by the CMS and meets the specified requirements. The CMS must make such information accessible to such applications as stipulated by the current Blue Button 2.0 program. The proposed legislation also mandates federal payments to states that opt to develop or purchase similar applications for the enrollees.
Federal or State?	Federal
Legislative Intent	The legislative intends to change the Social Security Act with the aim of offering benefits from part A or part B of the Medicare programs. These include individuals who enroll in state programs under Medicaid. The bill will empower the beneficiaries to access personal medical data that comprises of prescribed medicines, their diagnoses, providers and tests through the use of their selected mobile health records applications.
Proponents/ Opponents	Proponents: Proponents of the bill include the representatives introducing and supporting it, healthcare providers like nurses and physicians, software development companies and startups, and Centers for Medicare and Medicaid Services (CMS).
	Opponents: Opponents may include insurance companies that have always had the monopoly to offer consultancy services to the beneficiaries.
Target Population	Medicare and Medicaid Enrollees
Status of the bill (Is it in hearings or committees?)	The sponsor introduced the bill in Congress in 2019. The bill went to the respective Committee on Energy and Commerce. The bill is currently in the Committee of Ways and Means’ subcommittee on Health. Lastly, while the bill has received substantial amount of coverage, it is still new and at the committee stage.
General Notes/Comments	The need to expand access to health care, especially for older Americans and individuals with chronic conditions, is essential as the country continues to battle pandemics like the Coronavirus disease of 2020. The use of health information technology models like mobile health expands access, particularly to underserved and susceptible populations. Therefore, the bill seeks to enhance access to information and allow individuals to have effective management and involvement in their health decisions (Bouayad et al., 2017). By allowing Medicaid and Medicare beneficiaries to access personal health information through mobile applications, the bill expands care and individual autonomy to make decisions.

Part 2: Legislation Testimony/Advocacy Statement

Access to healthcare remains one of the fundamental goals of different administrations, particularly at this time when the country and the world are battling a resurgence in COVID-19 cases due to the Delta variant. The cost of healthcare continues to rise, particularly for those from low-income households and neighborhood and racial minorities. Initiating different interventions such as the introduction of Mobile Health Records Act of 2019 will ensure that these people can access healthcare at affordable cost. The bill focuses on improving access to care information at an individual level by using novel technology. In their study, Dameff et al. (2019) advance that the deployment of mobile health records platforms can enhance health delivery and outcomes. The authors emphasize the need to embrace health information technology models to enhance overall care delivery, particularly access to personal health records.

The main concern should be on whether the model through the provision of access to personal health information can improve care outcomes at the minimal cost while maintaining the quality of care service (Snezana et al., 2020). It is essential to know that the advent of electronic health records and expanded use of Internet platforms and smart technologies have led to seamless flow of critical clinical information among care organizations and providers (Harahap et al., 2021). Imperatively, if the same can be attained at a personal level, it will enhance patient involvement in decision making concerning their care plans and interventions.

The approach will also enhance individuals’ ability to make informed choices concerning the use of healthcare services. Opposition to this Act can only arise due to unproven status of such applications in improving access and quality of care (Niazkhani et al., 2020). Such positions can be addressed by looking at the success of models like the electronic health records, the use of telehealth and telemedicine, and even artificial intelligence in care provision and reducing the cost of healthcare.

Conclusion

The Mobile Health Records Act of 2019 is a mobile version of EHRs and should be passed and enacted into law to enhance access to care and reduce the overall costs. The use of such technologies will also enhance patients’ participation in their treatment plans and interventions and allow them to make better informed choices and decisions.

References

Bouayad, L., Ialynytchev, A., & Padmanabhan, B. (2017). Patient health record

systems scope and functionalities: Literature review and future directions. Journal of Medical Internet Research, 19(11), e388.

doi: 10.2196/jmir.8073.

Congress.GOV. (2021). H.R.1390 – Mobile Health Record Act of 2019.

https://www.congress.gov/bill/116th-congress/house-bill/1390/committees

Dameff, C., Clay, B., Longhurst, C. A. (2019). Personal Health Records: More

Promising in the Smartphone Era? JAMA, 321(4):339-340.

doi: 10.1001/jama.2018.20434.

Harahap, N. C., Handayani, P. W., & Hidayanto, A. N. (2021). Functionalities and

issues in the implementation of personal health records: Systematic review. Journal of medical Internet research, 23(7), e26236.

doi: 10.2196/26236

Niazkhani, Z., Toni, E., Cheshmekaboodi, M., Georgiou, A., & Pirnejad, H.

(2020). Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review. BMC medical informatics and decision making, 20(1), 1-36.

doi: 10.1186/s12911-020-01159-1

Snezana, S., Kilintzis, V., Jakimovski, B., Jolevski, I., Beredimas, N., Mourouzis,

A., … & Trajkovik, V. (2020, September). Cloud Based Personal Health Records Data Exchange in the Age of IoT: The Cross4all Project. In International Conference on ICT Innovations (pp. 28-41). Springer, Cham.

Maternal healthcare is one of the determinants of the quality, safety and efficiency of health in a state. The US is one of the most developed countries in the world. It is therefore expected to have the lowest maternal mortality and morbidity rates in the world. However, statistics show that the rates of maternal mortality and morbidity in the US are significantly high. Consequently, this paper explores a proposed policy that aims at reducing the current rates and trends in maternal mortality and morbidity in the USA.

Health-related Bill Name	Recognizing The Maternal Health Crisis In The United States And The Importance Of Reducing Mortality And Morbidity Among All Women And Honoring Mothers
Bill Number	H.Res.539
Description	Maternal mortality and morbidity is a critical issue affecting the United States of America. The statistics presented in the bill shows that despite being a developed nation, America has the highest rate of maternal mortality and morbidity. The statistics also show that the risk for maternal mortality and morbidity is significantly elevated among women from ethnic minority groups when compared to the American natives. Women also experience challenges in their maternal care such as mistreatment that degrade their self-identity and autonomy. Based on the above maternal health-related issues, the Recognizing The Maternal Health Crisis In The United States And The Importance Of Reducing Mortality And Morbidity Among All Women And Honoring Mothers Act was proposed for implementation. The act seeks to address the issue by focusing on a number of aspects related to maternal health. Firstly, it seeks to raise the awareness of the public about maternal morbidity, mortality and the existence of disparities in maternal health-related outcomes. The bill also seeks to encourage states, Federal Government, territories, local communications and healthcare organizations among other stakeholders to take interventions that reduce the risk and rate of adverse maternal health outcomes as well as improve maternal safety. The other aims of the act include addressing and eliminating disparities in maternal health outcomes, ensuring the provision of equitable and respectively maternal care, honoring mothers who have died due to pregnancy-related complications, and supporting the collection of data on maternal morbidity and mortality. It also supports the need for further investment efforts to enhance maternal health and health outcomes as well as eliminate disparities in maternal healthcare.
Federal or State?	Federal
Legislative Intent	The legislative intent of the act is to recognize the seriousness of maternal morbidity and mortality issues in the US. The act also seeks to raise the awareness of the public and other stakeholders on the need to prevent maternal morbidity and mortality. Further, the act aims at ensuring the disparities in outcomes of maternal health are eliminated. Lastly, it aims at ensuring that mothers and pregnant women receive respectful care that meets their health needs.
Proponents/ Opponents	Proponents: They include Reps. Underwood Lauren, Kelly Robin, Spanberger Abigail Davis, Wexton Jennifer, and Adams Alma.
	Opponents: none
Target Population	The primary beneficiaries of the proposed bill are pregnant women and mothers. It also includes women from ethnic minorities. The secondary target population includes healthcare providers, policymakers, and communities.
Status of the bill (Is it in hearings or committees?)	The bill has been referred to the House Committee on Energy and Commerce.
General Notes/Comments	The proposed bill is a crucial bill that should be adopted in the US. The need for the bill is attributed to the high rate of maternal mortality and morbidity rates in the USA. Its implementation would therefore support the provision of care that addresses the needs of pregnant women and mothers from diverse ethnic backgrounds.

Advocacy Statement

Maternal mortality and morbidity is a critical issue in the US despite it being a developed nation (Collier & Molina, 2019; Joseph et al., 2021). For example, statistics show that 60% of the maternal mortalities reported in the US are preventable. In addition, the risk of women of ethnic minority groups such as African American and American Indians dying from pregnancy related complications is three times that of the White women. Women also experience different forms of mistreatment, as they receive their needed maternal healthcare (Morton et al., 2019). Therefore, the proposed bill should be adopted in the USA to address the identified issues. The bill will increase the maternal health outcomes as well as the quality of care mothers and pregnant women receive (Congress.gov, 2021). Through the bill, the USA will rank among the world’s leading nations with lowest maternal mortality and morbidity rates. I will address the opponents in my position by presenting facts above the severity of the issue of maternal mortalities and morbidities in the US. I will also provide the socioeconomic implications of maternal mortalities and morbidities to the state. For example, I will explore the cost implications of the issue to the American economy and families.

Conclusion

The US currently has a high rate of maternal mortality and morbidity. Significant disparities exist in maternal health outcomes due to ethnicity of the mothers and pregnant women. The proposed bill is important in ensuring equity in maternal healthcare and adoption of best practices to reduce and prevent maternal mortalities and morbidities. Therefore, it should be implemented to promote public health.

References

Collier, A. Y., & Molina, R. L. (2019). Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. NeoReviews, 20(10), e561–e574. https://doi.org/10.1542/neo.20-10-e561

Morton, C. H., VanOtterloo, L. R., Seacrist, M. J., & Main, E. K. (2019). Translating Maternal Mortality Review Into Quality Improvement Opportunities in Response to Pregnancy-Related Deaths in California. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(3), 252–262. https://doi.org/10.1016/j.jogn.2019.03.003

Joseph, K. S., Boutin, A., Lisonkova, S., Muraca, G. M., Razaz, N., John, S., … & Schisterman, E. (2021). Maternal Mortality in the United States: Recent Trends, Current Status, and Future Considerations. Obstetrics and Gynecology, 137(5), 763. doi: 10.1097/AOG.0000000000004361

Congress.gov. (2021, July 19). Text – H.Res.539 – 117th Congress (2021-2022): Recognizing the maternal health crisis in the United States and the importance of reducing mortality and morbidity among all women, and honoring mothers. (2021/2022) [Legislation]. https://www.congress.gov/bill/117th-congress/house-resolution/539/text

A Sample Answer 2 For the Assignment: NURS 6050 Assignment: Legislation Grid and Testimony/Advocacy Statement SAMPLE
Title: NURS 6050 Assignment: Legislation Grid and Testimony/Advocacy Statement SAMPLE

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? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.

NURS 6050 Assignment: Legislation Grid and Testimony/Advocacy Statement SAMPLE

The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)

Be sure to add a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.

Part 1: Legislation Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. 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.

A legislator’s primary objective is representing the people’s fundamental rights and agitating for their holistic well-being. A cost-benefit analysis can help such leaders to make rational and improved decisions based on the perceived impacts on their constituents, such as when considering whether repeal or replace the Affordable Care Act. ACA’s primary objective is to make affordable health insurance available to more people. The American Health Care Act (AHCA) was one of the efforts made to repeal and replace the ACA by the Republican Party in 2017, which proposed a tax credit based on income and not age, and would have caused over 29 million Americans to lose health insurance coverage (Congress.gov, n.d.). Thus, a cost-benefit technique can help a legislator to evaluate the socioeconomic impacts of proposed changes to the policy or law (Milstead & Short, 2019). In essence, the decision to use a CBA technique depends on the personality of the legislator running for office, their perspectives on the healthcare system in general, and political affiliation.

For example, a legislator may feel that the money being used for ACA could be invested somewhere else that he considers “better” or reasonable based on the cost-benefit analysis. This perspective may impact or influence the legislator’s decision or idea to repeal or replace ACA (Béland et al., 2019). Another possible impact of this decision is that about 30 million people, including the legislator’s constituents, may lose their health insurance across the United States (Béland et al., 2019). Millions of Americans directly and indirectly employed under ACA may also lose their jobs. Therefore, legislators should rely on a comprehensive cost-benefit analysis to make the right, independent, and rational decisions concerning repealing or replacing ACA.

Furthermore, a cost-benefit analysis would help a legislator assess and understand the statistics of how many Americans benefit from ACA or will be affected by the proposed changes. Specifically, relevant statistics and data, including the number of people currently covered or employed under ACA, would help the candidate or legislator make a rational decision (Milstead & Short, 2019). The prospective candidate should listen to the voice of people concerning the Act and speak with action to help them get re-elected.

Elected officials should formulate good policies by constantly thinking about making meaningful societal changes based on voters’ views. Their decisions and positions on policy matters, such as the ACA, are typically influenced by what voters think, and the overriding interest is to get re-elected to the office (Milstead & Short, 2019). For instance, they should ask themselves whether repealing or replacing ACA is an astute action for the constituents in the long run. They should initiate independent and unbiased research to help them make effective decisions (Milstead & Short, 2019). For example, a survey of the constituents’ perspectives on repealing and replacing ACA can help the legislators when voting on the proposed changes. The legislator should ask specific questions before voting to repeal/replace ACA. First, the elected official should ask himself whether his constituents care about repealing/replacing ACA, if the legislation is a good policy for the Nation or make any sense to the majority, and whether it is press worthy.

In conclusion, influencing positive changes through policy decisions and formulation can positively impact citizens. Thus, legislators should conduct a cost-benefit analysis before supporting the ACA’s proposed amendments. They should also listen to the voters’ views before positioning or recommending national policies that are likely to convince the constituents to get them re-elected.

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Regardless of geographical location, race, culture, and other factors, all populations deserve quality, timely, and affordable health. Besides, health care providers and stakeholders should devise interventions for health promotion and the protection of vulnerable communities. Health care policies are instrumental in health promotion since they outline guidelines for benefitting patients, communities, and health care providers (Wolstenholme & McKelvie, 2019). As a result, Congress and other law-making bodies formulate health promotion bills to advance health in the United States. The purpose of this paper is to evaluate a recently-proposed health-related bill and an advocacy statement supporting its legislation

Part 1: Legislation Grid

Health-related Bill Name	End Tuberculosis Now Act of 2022
Bill Number	H.R. 8654 (Congress.gov, 2022).
Description	End Tuberculosis Now Act of 2022 underlines that the United States foreign assistance program has an obligation to end global tuberculosis (TB) pandemic through multifaceted interventions, including actions that support TB diagnosis and treatment among all adults and children and prevent new infections (Congress.gov, 2022; Kaiser Family Foundation, 2022). The bill also outlines the objectives and goals of TB-related policy, such as appropriate funding of comprehensive person-centered programs, capacity building among populations where the TB burden is high, and direct support to at-risk and impoverished populations.
Federal or State?	Federal
Legislative Intent	The bill’s intent is to prevent, cure, and treat tuberculosis globally. Besides, the bill ensures that at-risk populations are identified and get appropriate support.
Proponents/ Opponents	Proponents: Representative Ami Bera (Congress.gov, 2022).
	Opponents: no opponent has been noted
Target Population	All adults and children with all forms of Tuberculosis and at-risk populations in the United States (Congress.gov, 2022; Kaiser Family Foundation, 2022).
Status of the bill (Is it in hearings or committees?)	The bill is in the committees stage (House- Foreign Affairs)
General Notes/Comments	The bill focuses on a critical population health matter that deserves maximum attention from individuals, communities, health care providers, and governments. Generally, optimal health outcomes can only be achieved by protecting populations from infections, supporting health promotion programs, and identifying vulnerable populations. Since the bill will be instrumental in ending the TB pandemic and reducing health care costs, quick implementation is crucial. The federal government should also ensure that the United States foreign assistance program has adequate funding to achieve the health care goals outlined in the bill.

Part 2: Legislative Testimony/Advocacy Statement

Healthy populations are critical for a nation’s productivity and progressive economic well-being. The End Tuberculosis Now Act of 2022 will be instrumental to people’s health and well-being and should be quickly implemented. It will be crucial to health and well-being since it promotes preventive health, which helps to reduce deaths, disability, and health inequities (Franklin & Sleet, 2018). Besides, the bill applies a global approach to achieve internal health outcomes since it will advance measures for protecting Americans from foreign TB infections. Such an approach will further help the nation to achieve Healthy People 2030 goals.

TB rates vary with populations’ characteristics. Social determinants of income affect the legislation of the End Tuberculosis Now Act of 2022 since the variance in TB rates necessitates intervention programs specific to a population’s needs. Health research demonstrates a close link between TB and poverty since TB infections are high in low-income areas (Abou Jaoude et al., 2022). People living in low-income areas are likely to live in poorly ventilated and overcrowded conditions that are ideal for the spreading of TB bacteria. The rates of malnutrition and diseases such as HIV/AIDS are also high in low-income areas and increase TB resistance (Balinda et al., 2019). Such income-related outcomes necessitate adjustments in intervention measures since a universal approach cannot be used to promote health in populations with varying needs, vulnerabilities, and cultural practices.

Opponents should understand the implications of TB on populations, health care spending, and the progressive economic well-being of the nation. The best way to address them is through research and health statistics demonstrating the link between TB and adverse health outcomes. For instance, the Centers for Disease Control and Prevention (2020) reported that TB is the leading infectious disease in the world and claims approximately 1.5 million lives annually. As a result, multifaceted health promotion programs are vital. Abou Jaoude et al. (2022) stated that Stop TB Partnerships and health promotion programs have helped to reduce TB spending. Similar measures underlined in the End Tuberculosis Now Act of 2022 should be intensified to protect general and vulnerable populations.

Conclusion

Health care bills advance health through more funding, advocacy, and the protection of special populations, among other strategies. Implementing the End Tuberculosis Now Act of 2022 will be instrumental in attaining healthy and productive populations. As a result, quick implementation of the bill is essential and more support from legislators is needed as well. The government should also supplement such interventions with other health promotion programs, particularly in vulnerable communities where TB rates are high.

References

Abou Jaoude, G. J., Baena, I. G., Nguhiu, P., Siroka, A., Palmer, T., Goscé, L., … & Haghparast-Bidgoli, H. (2022). National tuberculosis spending efficiency and its associated factors in 121 low-income and middle-income countries, 2010–19: a data envelopment and stochastic frontier analysis. The Lancet Global Health, 10(5), e649-e660. https://doi.org/10.1016/S2214-109X(22)00085-7

Balinda, I. G., Sugrue, D. D., & Ivers, L. C. (2019). More than malnutrition: a review of the relationship between food insecurity and tuberculosis. Open forum infectious diseases, 6(4), ofz102. https://doi.org/10.1093/ofid/ofz102

Centers for Disease Control and Prevention. (2020). Tuberculosis. https://www.cdc.gov/globalhealth/newsroom/topics/tb/index.html

Congress.gov. (2022). H.R. 8654– End Tuberculosis Now Act of 2022. https://www.congress.gov/bill/117th-congress/house-bill/8654

Franklin, R. C., & Sleet, D. A. (2018). Injury prevention and health promotion: A global perspective. Health Promotion Journal of Australia: Official journal of Australian Association of Health Promotion Professionals, 29(2), 113–116. https://doi.org/10.1002/hpja.191

Kaiser Family Foundation. (2022). U.S. global health legislation tracker. https://www.kff.org/coronavirus-covid-19/fact-sheet/u-s-global-health-legislation-tracker/

Wolstenholme, E., & McKelvie, D. (2019).The dynamics of care: Understanding people flows in health and social care. Springer.

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Federal and State Legislation Part 1: Legislation Grid Based on the health-related bill you selected, complete the Legislation Grid Template. 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?		32 (32%) – 35 (35%) The response clearly and accurately summarizes in detail the legislative intent of the health-related bill. The response accurately identifies in detail the proponents and opponents of the health-related bill. The response accurately identifies in detail the populations targeted by the health-related bill. The response clearly and thoroughly describes in detail the current status of the health-related bill.	28 (28%) – 31 (31%) The response accurately summarizes the legislative intent of the health-related bill. The response accurately identifies the proponents and opponents of the health-related bill. The response accurately identifies the populations targeted by the health-related bill. The response accurately describes the current status of the health-related bill.	25 (25%) – 27 (27%) The response vaguely or inaccurately summarizes the legislative intent of the health-related bill. The response vaguely or inaccurately identifies the proponents and opponents of the health-related bill. The response vaguely or inaccurately identifies the populations targeted by the health-related bill. The response vaguely or inaccurately describes the current status of the health-related bill.	0 (0%) – 24 (24%) Summary of the legislative intent of the health-related bill is vague and inaccurate or is missing. Identification of the proponents and opponents of the health-related bill are vague and inaccurate or is missing. Identification of the populations targeted by the health-related bill is vague and inaccurate or is missing. The description of the current status of the health-related bill is vague and inaccurate or is missing.
Advocating for Legislation 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.		45 (45%) – 50 (50%) Testimony clearly and thoroughly provides statements that fully justifies a position for a health-related bill. Response provides a detailed, thorough, and logical explanation of how to address opponents to the position for the health-related bill and includes one or more clear and accurate supporting examples. A complete, detailed, and specific synthesis of two outside resources is provided. The response fully integrates at least 2 outside resources and 2-3 course specific resources that fully supports the responses provided.	40 (40%) – 44 (44%) Testimony clearly and accurately provides statements that somewhat justifies a position for a health-related bill. Response provides an accurate explanation of how to address opponents to the position for the health-related bill and may include at least one supporting example. An accurate synthesis of at least one outside resource is provided. The response integrates at least 1 outside resource and 2-3 course specific resources that may support the responses provided.	35 (35%) – 39 (39%) Testimony used to justify a position for a health-related bill is vague or inaccurate. Explanation of how to address the opponents to the position for the health-related bill is vague or inaccurate, lacks logic, and/or the supporting examples are vague or inaccurate. A vague or inaccurate synthesis of outside resources is provided. The response minimally integrates resources that may support the responses provided.	0 (0%) – 34 (34%) Testimony used to justify a position for a health-related bill is vague and inaccurate, incomplete, or is missing. Explanation of how to address the opponents to the position for the health-related bill is vague and inaccurate, or is missing. A vague and inaccurate synthesis of no outside resources is provided, or is missing. The response fails to integrate any resources to support the responses provided.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.		5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.	4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.	3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.	0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation		5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.	4 (4%) – 4 (4%) Contains a few (1-2) grammar, spelling, and punctuation errors.	3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors.	0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.		5 (5%) – 5 (5%) Uses correct APA format with no errors.	4 (4%) – 4 (4%) Contains a few (1-2) APA format errors.	3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) APA format errors.	0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors.
Total Points: 100

Legislation Grid 

Health-related Bill Name	H.R.5 – Equality Act
Bill Number	H.R.5
Description	The H.R.5 – Equality Act is a bill that was introduced in the House of Representatives on February 18, 2021. The purpose of this bill is to amend the Civil Rights Act of 1964 and other existing federal laws to prohibit discrimination based on sexual orientation and gender identity in various areas of life, such as employment, housing, education, and public accommodations (U.S. Congress, 2021). The bill aims to ensure that all individuals, regardless of their sexual orientation or gender identity, are protected from discrimination under federal law. The bill also includes provisions to protect religious freedom and exempts certain religious organizations from the non-discrimination requirements in certain circumstances (U.S. Congress, 2021).
Federal or State?	Federal
Legislative Intent	The legislative intent behind the H.R.5 – Equality Act is to extend federal protections against discrimination to individuals who are LGBTQ+ and ensure that they are afforded the same rights and opportunities as everyone else (Hussain, Rizvi, & Sheikh, 2022). The bill aims to provide explicit protections against discrimination based on sexual orientation and gender identity in various areas of life, such as employment, housing, education, and public accommodations, and close existing gaps in federal law that leave LGBTQ+ individuals vulnerable to discrimination (Hämäläinen, 2021). The bill also aims to provide clarity and consistency across federal law to ensure that individuals are not subject to different standards of protection based on where they live or work. Overall, the legislative intent behind the Equality Act is to promote equal treatment and dignity for all individuals, regardless of their sexual orientation or gender identity (U.S. Congress, 2021).
Proponents/ Opponents	Proponents: The bill argue that it is necessary to provide explicit federal protections against discrimination based on sexual orientation and gender identity (Hussain, Rizvi, & Sheikh, 2022). They argue that LGBTQ+ individuals face significant barriers to full and equal participation in society, including in areas such as employment, housing, and public accommodations. They also argue that existing federal laws do not go far enough in protecting these individuals from discrimination and that the Equality Act would fill in these gaps and ensure that all individuals are treated fairly and equally under the law.
	Opponents:  The bill argue that it could infringe on religious freedom and lead to conflicts with existing federal laws, particularly with respect to gender identity. They argue that the bill could require religious organizations to violate their beliefs by requiring them to hire or accommodate individuals whose beliefs or behaviors conflict with the organization’s religious tenets. They also argue that the bill could have unintended consequences, such as allowing biological males to compete in female sports, which could disadvantage biological females and threaten women’s rights.
Target Population	Individuals who are LGBTQ+ and who may face discrimination based on their sexual orientation or gender identity (Haik et al., 2022). The bill seeks to extend federal protections against discrimination in various areas of life, such as employment, housing, education, and public accommodations, to ensure that LGBTQ+ individuals are afforded the same rights and opportunities as everyone else (Hämäläinen, 2021). The bill also includes provisions to protect religious freedom and exempts certain religious organizations from the non-discrimination requirements in certain circumstances. The overall goal of the bill is to promote equal treatment and dignity for all individuals, regardless of their sexual orientation or gender identity (U.S. Congress, 2021).
Status of the bill (Is it in hearings or committees?)	As of March 18, 2023, the H.R.5 – Equality Act is listed as “Held at the desk” in the Senate. This means that the bill is not currently being considered by the Senate and is being held for further action. The bill was passed by the House of Representatives on February 25, 2021, and was received in the Senate and referred to the Committee on the Judiciary (U.S. Congress, 2021). However, the bill has not yet been reported out of committee or brought to the Senate floor for a vote. It is possible that the bill may be considered in the future, but its current status indicates that it is not actively being considered by the Senate at this time.
General Notes/Comments	The H.R.5 – Equality Act is a highly debated and contentious bill that has been the subject of significant discussion and controversy in both the House of Representatives and the Senate. The bill seeks to provide explicit protections against discrimination based on sexual orientation and gender identity in various areas of life, and it has been supported by LGBTQ+ advocates and civil rights groups as an important step towards ensuring equality for all individuals. However, opponents of the bill argue that it could infringe on religious freedom and have unintended consequences, and the bill has faced significant opposition from some conservative and religious groups. The bill’s status as of March 2023 is that it is held at the desk in the Senate, meaning that it is not currently being actively considered. However, the bill could be brought up for consideration at a later time, and its status may change. Regardless of the bill’s ultimate fate, it is clear that the issue of LGBTQ+ rights and discrimination will continue to be a significant topic of debate in the United States, and the outcome of this bill could have significant implications for the LGBTQ+ community and for the broader fight for civil rights and equality.

Part 2: Legislation Testimony/Advocacy Statement 

Introduction 

The H.R.5 – Equality Act is a bill that aims to prohibit discrimination on the basis of sex, gender identity, and sexual orientation in various areas, such as employment, housing, and public accommodations. The bill has received mixed reactions, with proponents arguing that it would offer essential protections to LGBTQ+ individuals, while opponents express concerns over potential implications for religious freedom. This testimony will advocate for the position in support of the bill, examining the impact of social determinants on LGBTQ+ individuals and emphasizing the need for explicit legal protections. 

Purpose Statement 

The purpose of this testimony is to urge lawmakers to support H.R.5 – Equality Act, which would provide essential protections against discrimination for LGBTQ+ individuals (Hussain, Rizvi, & Sheikh, 2022). By exploring the ways in which social determinants impact the health and well-being of LGBTQ+ people, we can understand the critical need for legal safeguards that protect against discrimination in various areas of life, including employment, housing, and public accommodations. Additionally, this testimony will address the concerns of opponents to the bill and suggest ways in which these concerns can be addressed without compromising the protections afforded to LGBTQ+ individuals. 

Advocacy Statement in Support of H.R.5 – Equality Act 

Good afternoon. My name is Wondeja Gibson, and I am here to speak in support of H.R.5 – Equality Act. As a Registered Nurse, I believe this bill is a crucial step towards ensuring equal rights and protections for all individuals, regardless of their sexual orientation or gender identity. 

The H.R.5 – Equality Act seeks to provide explicit protections against discrimination based on sexual orientation and gender identity in various areas of life, including employment, housing, education, and public accommodations (Crissman & Berger, 2019). These protections are vital, as members of the LGBTQ+ community have historically faced significant barriers and discrimination in many aspects of their lives. 

The social determinants of income, age, education, and gender can have a significant impact on the experiences of LGBTQ+ individuals and their access to equal rights and opportunities (Ogunbajo et al., 2019). For example, LGBTQ+ individuals are more likely to experience poverty and homelessness, which can limit their access to quality education, healthcare, and job opportunities (Haik et al., 2022). Additionally, LGBTQ+ individuals who are older or who have lower levels of education may be more vulnerable to discrimination and social exclusion (Hämäläinen, 2021). 

Opponents of this bill argue that it could infringe on religious freedom and have unintended consequences. However, I believe that the bill’s provisions provide adequate protections for religious freedom while also ensuring that LGBTQ+ individuals are afforded the same rights and opportunities as everyone else. For example, the bill includes exemptions for certain religious organizations in certain circumstances, and it does not require individuals or organizations to violate their sincerely held religious beliefs. 

Conclusion 

In conclusion, I strongly support the H.R.5 – Equality Act and urge lawmakers to pass this crucial piece of legislation. The bill’s protections against discrimination based on sexual orientation and gender identity are long overdue, and it is time to ensure that all individuals are afforded equal rights and opportunities, regardless of their sexual orientation or gender identity. 

References 

Crissman, H. P., & Berger, R. (2019). Sexual and gender minorities and social determinants of health: Variations in discrimination and health outcomes. Journal of Social Issues, 75(3), 635-656. https://doi.org/10.1111/josi.12325 

Haik, A. K., Greene, M. C., Bergman, B. G., Abry, A. W., & Kelly, J. F. (2022). Recovery among sexual minorities in the united states population: Prevalence, characteristics, quality of life and functioning compared with heterosexual majority. Drug and Alcohol Dependence, 232. https://doi.org/10.1016/j.drugalcdep.2022.109290 

Hämäläinen, N. (2021). Conflict and Moral Change: LGBTQ+ Rights Education, Religion and Renegotiation. Journal of Philosophy of Education, 55(4–5), 551–563. 

Hussain, Z., Rizvi, L. J., & Sheikh, H. (2022). The Equality Act (2010)-pre- and post-pandemic historic development on equality and discrimination issues for employers: review of literature. International Journal of Law and Management, 64(2), 168–183. https://doi.org/10.1108/IJLMA-03-2021-0067 

Ogunbajo, A., Kershaw, T. S., Kushwaha, S., & Boakye, F. (2019). Sexual and gender minority status and social determinants of HIV-related outcomes in the United States: A scoping review. AIDS and Behavior, 23(5), 1209-1227. https://doi.org/10.1007/s10461-019-02552-9 

U.S. Congress. (2021). H.R.5 – Equality Act. https://www.congress.gov/bill/117th-congress/house-bill/5