By Debra Wood, RN, contributor
October 17, 2013 - With a high degree of national attention focused on the Affordable Care Act (ACA) and the October 1, 2013, opening of the health insurance marketplaces, many nurses are fielding questions from patients and volunteering to educate the general public.
“Nurses have a huge role in helping to implement the Affordable Care Act,” said Wisconsin Nurses Association incoming president Lea Acord, PhD, RN, who chairs the association’s ACA enrollment task force.
Forty-five members signed up to serve on that task force. Nurses, members of the task force and others, are volunteering at each of the 11 regional enrollment networks. Nurses also can sign up to volunteer at the association’s annual conference.
Just days before the exchanges opened, a Kaiser Health Tracking Poll found that 51 percent of the public and 67 percent of the uninsured do not know how the law will affect them and their families. They want to know more about costs, which they can find once they access a health exchange, and basic information about the law and how it works. Additionally, only 15 percent of the public and 12 percent of the uninsured knew the exchanges opened in October.
“Some nurses do not understand the act either, so that’s why we feel a strong responsibility to help nurses,” Acord said.
WNA is educating its nurses about what they need to know about the act and providing accurate information to share with patients. A frequently asked questions (FAQ) section on the association’s website will answer queries for nurses about the ACA, and will debut this week. Other WNA task force subcommittees are working on educating consumers and determining how nurses can work with fellow health professionals.
The Washington State Nurses Association has developed a webinar about health care reform, the health exchanges in general and the Washington exchange and what nurses need to know for their practice, how to respond to patients’ questions or how to sign up themselves. Members also could learn about the ACA and exchanges during the WSNA’s leadership conference.
“The Washington exchange has been very successful,” said Sofia Aragon, JD, RN, senior governmental affairs advisor at WSNA, who served on a technical advisory committee that developed the training program used by enrollment assistance navigators. She reported that, in the first two weeks, 25,000 people have obtained coverage and 37,000 people have completed applications now pending. The state has made the information available in more than 150 languages.
“They are maximizing ways to make it easy and quick for folks,” Aragon said.
Patty Hayes, MN, RN, director of the community health services division of Public Health - Seattle and King County, one of 10 organizations chosen by the Washington Health Benefit Exchange to help residents enroll in a qualified health plan, has been heading up efforts to develop networks, training materials and an outreach plan tailored to the needs of that community. Working with 23 highly skilled organizations has allowed the department to streamline the enrollment process.
“We’re excited to have public health step up,” Hayes said. “Public health and the role nurses play in public health and how we see things on a community level is ideal for making this successful.”
Deb Fischer-Clemens, MHA, BSN, RN, a member of the South Dakota Nurses Association (SDNA) Government Relations Committee, has been presenting information to members of that association at chapter meetings throughout the state. She also wrote a question and answer article for the SDNA newsletter.
The Visiting Nurse Service of Iowa applied for a navigator grant and received $257,000 to pay the salaries, benefits and travel expenses of navigators working in the field to help people sign up at the federal marketplace, Healthcare.gov.
“It was a good fit for our organization,” said Linda Clauson, business development and communication director for VNS of Iowa in Des Moines, which serves 56,000 annually. Serving “vulnerable populations cued us into how important it is to have health care coverage.”
Clauson explained that VNS of Iowa has the internal resources to help a wide range of people understand their coverage options and sign up for a policy.
The Public Health Management Corp. (PHMC), a nonprofit public health institute in Philadelphia operating five nurse-managed federally qualified health centers, has been hosting events to assist those navigating the health insurance marketplace. In addition to a town hall-style event with marketplace experts, each day, one of the five centers conducts a health insurance information session, and at all times, certified application counselors are available to answer questions and help people enroll. PHMC counselors have experienced difficulties with the federal website and have resorted to using the toll-free telephone number or paper forms to help nearly 200 people enroll in the first two weeks.
The application counselors have educated staff members about the application process and provided answers to the most commonly asked questions. When the nurses meet with uninsured patients, they immediately refer them to an onsite application counselor at the health center to ensure that the patient receives insurance application assistance.
“Our goal is to have everyone we see insured,” explained Amanda Kimmel, social services manager at PHMC. “Across all five of our centers, we are working hard to disseminate information to the general public.”
Earlier this year, Diana Mason, PhD, C, FAAN, RN, a professor of nursing at Hunter-Bellevue School of Nursing in New York, wrote at the Future of Nursing: Campaign for Action website, that nurses should seize the opportunity to lead outreach efforts about the exchanges, saying “informing the public about the health exchanges can improve access to health care in our communities.”
Mason recommended nurses ensure their places of employment have accurate information, offer to hold community educational events or to talk on media broadcasts or to reporters about their state’s plans and how to enroll. Also, she suggested asking individual patients what they know and then directing them to the health exchanges.
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