Advocacy plays an essential role in developing effective health care systems because it involves citizens in the decision-making process. The aspect enables individuals to hold the government and other responsible parties accountable for policies that directly affect their health lives (Kelly, Barksdale, & Gitelson, 2011). The policies implemented with a broad input aid provision of better healthcare services. People tend to require health care for various reasons throughout their lifespan. The war veterans are amongst the few groups who mostly require these vital services regularly. However, veterans seem to face different challenges in regards to the healthcare system. To curb these problems, advocates detect the gaps in the system and work to address them through various strategies (Conard & Armstrong, 2016). The advocacy involves participating in dialogues regarding problematic policies, devising best solutions, supporting the solutions legally, and ensuring responsible parties implement them. To address the topic in detail, I conducted several interviews with advocates that are working to ensure veterans in Barnes County receive quality mental health care services.
My first interview was scheduled for one hour with the North Dakota U.S senator Jocelyn Conrad. Senator Conrad is currently serving as a member of the Senate Committee on Appropriations, the Subcommittee on Veterans Affairs, Military Construction, and Related Agencies. Unfortunately, before the meeting, I received a message from the senator’s aid notifying me that she would not be available due to unavoidable circumstances. However, Senator Jocelyn assured me of her support if the agenda of improving the health care system of North Dakota’s veterans are presented to the U.S senate.
My next interview was with the state senator of North Dakota Ron Bowman. The senator was elected in 2012 to represent District 24, which includes the entire Barnes County and some parts of Cass and Ransom counties. Currently, Senator Ron is a member of the Government and Veterans Affairs committee, and the chair of the Transportation Committee. The interview took 25 minutes, during which we discussed various issues with the senator. First, we discussed the process through which Senator Bowman determines his legislative agenda. According to the senator, the constituents he represents, play a major role in his decision-making process. The citizens send their opinions via mail while lobbyists make appointments to argue about different strategies. The senator, however, stated that he often goes on fact-finding missions to gather the information that helps him determine what should be on the Assembly’s mind. Senator Ron also confirmed using reliable information from news sources to determine legislative agendas.
My next question to the senator was regarding the role his constituents play in establishing legislative agendas. Senator Bowman was delighted by the question; he explained that constituents play a key part in the process. Senator Ron said that residents inform him about issues that he does not know about and their impact on the North Dakota region. He continued, “Other times they help me to put a face on the issue, which makes it easier to make the rest of the Assembly understand why we need to act.” In addition, the senator said that citizens inform him whenever there are better solutions.
Addressing the issue of health care, I was curious to know how the matter is included in the Senator’s legislative agenda using an example of recent activity and its outcome. The senator confirmed being a co-signer on a bill enforcing the retired civil servants cover telehealth options similar to people in service. The bill passed, and his next objective is extending it to cover all individuals. However, Senator Bowman regarded telehealth funding as not part of his responsibility but instead that of his colleagues who ought to charge for the services.
My third interviewee was the mayor of Valley City, known as Floyd Knutson. The mayor was available for more than an hour hence making plenty of time to discuss various issues concerning the citizens of Valley City. The mayor started the interview by appreciating his constituents for allowing him to represent them for the past 16 years. When asked how his administration determines legislative agendas, Mayor Knutson stated that they just did what they needed to do. When I questioned the role of Valley City citizens in establishing administrative agendas, the mayor insisted that his administration does not often involve itself with such matters. Instead, Mayor Floyd explained that they concentrated more on domestic affairs. About the issue of the legislative marketing agenda, Knutson stated that he does not need to market personally since the constituents approach him regularly.
Concerning the issue of telehealth initiatives in Valley city’s legislative agenda, I asked the Mayor to describe one current or recent issue included in the agenda and its respective outcome. Mayor Knutson stated that they had discussed shallowly about Medicaid cuts in reimbursements for nursing homes during the previous commissioners meeting. He added that the idea came from an individual who is a member of the North Dakota Long Term Care Association. However, he could not recall the specific name at that moment when I inquired whether the mayor had included funding for telehealth initiatives in the current legislative agenda. The mayor explained that the hospital had been pushing the agenda; they were talking to Ned at the Health Department regarding the issue. Mayor Floyd insisted that he was not directly involved with the issue; he, however, wished good luck to individuals addressing the matter.
I also interacted with Joseph Turner, who serves as the office director of Barnes County Veterans Service. The director represents the veterans of Barnes County and their beneficiaries. Director Turner stated that he prioritizes the veteran’s needs while shaping legislative agendas. However, the director clarified that he works by influencing the state Service Officer; the officer is responsible for pushing the agendas to the VA, and sometimes the legislature (McMillan et al., 2017). Regarding the role constituents play in establishing legislative these agendas, the director explained that individuals experiencing problems often approach him. Such people present their grievances; the director advocates for their solutions; the efforts bear success at times, and sometimes they do not.
The next question posed to the director was concerning recent health care issues included in the legislative agenda. Director Turner confirmed to having tried to get the VA to work on developing a telehealth clinic in the area. However, their efforts had not yielded results yet. The director continued to explain the issue of funding; he emphasized that no funding could be accomplished from his current position. The major contribution director Joseph could offer is informing the state Service Officer of the progress of Veterans in Barnes County. The office director confirmed that there are a majority of veterans in the regions struggling with PTSD, overmedication, and self-isolation, whereas they cannot access health care services (Kinsinger, Van Riper, & Straits-Troster, 2009).
Another veteran affair advocate I engaged with was Ken Starzynski, who is the commander of the North Dakota Veterans of Foreign War (VFW). The commander officially represents all members of VFW posts in the region. However, Ken stated that personally he feels responsible for every constituent who is a veteran and living in North Dakota. When I inquired about the process his organization uses to determine the legislative agenda, the commander said that they pay attention to issues happening on the national scale and apply them to those emerging within the state. For marketing strategies, the commander stated that there is a website with a blog used for that purpose.
The next question addressed to Commander Ken was regarding the approach he applies to influence legislators on specific matters. The commander informed that there are Senators and Representatives who are members of the organization. Such individuals are his first targets when gathering support for a particular course of action. In addition, the commander also approaches legislators who represent districts with a high number of veterans for support.
We also had a discussion with the commander concerning a recent health care issue included in his legislative agenda. The commander stated that homelessness was one of their biggest challenge in regard to veterans’ health care. The reason for this problem is that veterans tend to have a hard time accessing health care services if they are homeless. The commander insisted that responsible parties should reach out to get veterans in such circumstances and give them the care they need. Commander Starzynski confirmed that one of his predecessors in the office had donated to the Fargo VA Health Care System recently and used the press to raise awareness about homelessness and health care for veterans. However, the commander said that they had not funded any telehealth initiatives in their legislative agenda.
The interviewed individuals play key roles in advocating for the health care service provision for war veterans in Barnes County. The interviews covered various topics in regards to veterans’ telehealth agendas in the county. The addressed issues include legislative decision-making process, strategies to influence legislative processes, and their specific input towards these processes. Considering the information gathered from the interviews, it is evident that less than half of veterans receive the required health care services due to certain reasons. However, nurses play a significant role in the health delivery system since they are the first to offer these services (McMillan et al., 2017). It is important that nurses work together with these advocates to enhance the healthcare provision for vets in Barnes County.
Conard, P. L., & Armstrong, M. L. (2016, October). Advocating for deployed women veterans' health differences, difficulties, and disparities. In Nursing forum (Vol. 51, No. 4, pp. 225-232). https://onlinelibrary.wiley.com/doi/abs/10.1111/nuf.12143
Kelly, D. C., Barksdale, S. H., & Gitelson, D. (Eds.). (2011). Treating young veterans: Promoting resilience through practice and advocacy. Springer Publishing Company.
Kinsinger, L. S., Van Riper, J., & Straits-Troster, K. (2009). Advocacy for veterans within the veterans health administration. North Carolina medical journal, 70, 159-162. http://nciom.org/wp-content/uploads/2017/07/PatientAdvocacy_CompleteIssue.pdf#page=73
McMillan, L. R., Crumbley, D., Freeman, J., Rhodes, M., Kane, M., & Napper, J. (2017). Caring for the Veteran, military and family member nursing competencies: Strategies for integrating content into nursing school curricula. Journal of professional nursing, 33(5), 378-386. https://www.sciencedirect.com/science/article/pii/S8755722316300904
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