The Missions Act and Veteran Administration

The Missions Act and Veteran Administration

Health care delivery is a critical assignment in the life of a medical care provider. It requires functional structures, competencies, and morally sound individuals to handle such an immense task, failure to which dire consequences arise. Health care delivery requires the right infrastructure, personnel as well as supporting legislation. Different factors contribute to the proper delivery of efficient and high-quality medical services.

Social Equity

Social equity is defined as the act of fairness when delivering public services. Social equity is egalitarian since every person has the right to be accorded fair treatment just like any other person even though economically and in terms of personal traits, they are different.

The Mission Act has enhanced access to quality care in the VA medical centers. The quality of services has also improved and extended to the medically underserved areas. The implementation of the Mission Act has given the Veterans more options for medical services as to where they can receive treatment (Adams, Sayre & Saini, 2019). Furthermore, more care is available for the community outside the general VA healthcare system. The access has resulted in breaking the barriers of distance and waiting time while enjoying social cohesion as they receive treatment from fellow Veterans (Alford & O’flynn, 2012). Such access standards were an order from Congress to the VA (Gooden & Portillo, 2011). The Veterans Health Administration has enabled a million of them to access healthcare countrywide through its initiative to pay. The deployment of medical homes, which are patient-centered, improves on access as well as the quality (Jarvis, 2014). The promotion of care centered around the patient is critical in enhancing services as there is individualized attention. The patient who does not have to cover distances to receive care is relaxed and in a better position to highlight symptoms of a particular disease. The fatigue that most patients would undergo as they travel may compromise the information they are giving to medical personnel who may not get the exact symptoms of the disease affecting the patient. At times, whatever the patient had planned to share with the medical staff gets lost along the way as they proceed to seek treatment.

The decentralization of the VA gave more authority to officers who are at field offices. Field offices officers are the ones in direct contact with the Veterans. Therefore, they see and feel the needs of the Veterans and, therefore, respond appropriately (Riccucci, 2009). The empowering of the officers goes a long way in enhancing their capacities, which is critical when they are undertaking their assignments. Such a response goes a long way in improving the delivery of services as well as the quality. The results are a happy customer.

Frederickson (2015) observes that housing, which is a fundamental human right, is a significant contributor to health. The lack of housing can contribute immensely to the rising of diseases. The VA has handled this through the Opening Door initiative, which has seen the numbers of Veterans without homes decline. Through the Veterans Benefits Administration(VBA), a department of the VA, the Veterans are provided with disability compensation, life care as well as survivors’ benefits which supplement them incase they have to copay for treatment.

Decision making

Decision making, as a concept, has two main parts, which are decision formulation and its implementation. Decision formulation and implementation connect such that one cannot exist without the other. Decisions not taken on time and adequately defeat the objective of the organization. Decision-making refers to the sequence of activities that deal with several stages, including recognition of a problem, searching for information, the definition of alternatives, and finally, the selection of an actor drawn from one of two or more options that are in line with the hierarchical preferences.

War will most of the time, result in casualties. Some of the victims may need admission to a health facility. With the VA allowing for home-based care, the officers on the ground, in conjunction with the rating board, will make their conclusions. The patient may either be treated at a health facility or be attended from home. The increasing demands from the Veterans for health services such as nursing beds to be used at home, mental health care as well as injury rehabilitation has resulted in categorization of patients so that they are able to get better services. The decision to categorize Veterans into several groups such as priority groups or additional subgroups is informed by such factors as their income and assets or service-connected disabilities. Based on service-connected disabilities, it is a rule that Veterans with fifty percent or exceeding this service-connected disability will receive comprehensive care as well as medication at no cost. Veterans with lower qualifying factors and with an excess of a pre-defined income threshold will have to copay for care in relation to ailments not arising from service as well as the cost for medication. All these rules are laid down by a rating board operating from the regional office. For national guard and reservist personnel without service-related disabilities, do not qualify for VA health benefits ((Menzel, 2019). The knowledge of such rules by the employee is critical is their discharge of duties to ensure that the VA services are sustainable. Adam, Sayre, and Saini (2019) note that the effects of war, and therefore, the personnel to engage for war is not just limited to men. Women to play a significant role. Some of them have been enlisted in the army and therefore become casualties of war. Thus, the VA decided that it will also have a place for the women. Such a decision led to the Center for Women Veterans. The center has a range of activities to ensure that the needs of women Veterans are also taken care of. The key to the events is their receipt of health care and other healthcare-related benefits.

The Missions Act and Veteran Administration were as a result of consultations among stakeholders. Its execution still relays on close coordination with other stakeholders (Reynaers, 2014). Such stakeholders include the federal state, the local agencies, and organizations as well as non-governmental actors who are involved in Veteran women’s affairs. The development of the VA enhanced the operations of the health facilities and made decision making path rapid and effective. Veterans who need specialized treatment and cannot access the VA centers are aware of where to seek treatment. Service providers in the facility offering treatment will also have an easy time since their mandate is clear. The decision to serve such patients is clear and within the organization mandate.

Public Service Motivation

Fry and Raadschelders (2013) contend that public service motivation is an attribute of employment, whether, in the government or non-governmental organization, that explains why an individual has a desire to serve in public and links the individual’s personal actions to the overall public interest.

The Congress Amendment to S.2372 was to strengthen as well as improve the Veterans Affairs department’s healthcare system (Adams, Sayre & Saini, 2019). The system is to benefit the nation’s Veterans. In the amendment, there is consolidation of the VA’s multiple programs that deal with community care and authorities as well as providing further funding. The bill allowed for modernizing and realigning VA’s massive infrastructure in medicine and also expanded its family caregiver program so that it will serve more Veterans (Herzberg, 2017). The VA’s internal capacity to manage Veteran patients also became enhanced.

Outside the VA institution, the VA was to support caregivers deliver services through training and education, self-care courses, among other services. The time when the Veteran was injured is insignificant when offering assistance to such a Veteran. To ensure that the caregivers are motivated to carry out their assignments, they receive a monthly stipend, travel allowances, and mental health counseling alongside other benefits. Mental health counseling is critical for such caregivers so that they do not get overwhelmed as they carry out their services (Wright, Moynihan,& Pandey, 2012). The VA healthcare services are all over, at the national level as well as near the patients using mobile health clinics for serving rural areas and through telehealth, which can be achieved using a phone or a computer.

. Some of the veterans are ranked as the poorest in society and may not afford to have a decent life. The VA has in place some departments that work towards ensuring that Veterans live a fair life. The Veterans Health Administration(VHA) caters for the provision of healthcare in its diverse forms to the Veterans. The office of Research and Development ensures that better services are available at the VA health centers. The VBA provides that homelessness by the Veterans is insignificant while improving their own capacities to take care of their needs, which further promotes their wellbeing. The women are covered under the CVW so that their welfare is looked into.

. However, selflessness remains critical, and the strongest as public service is about serving the needs of others so that the society is a better place to live (Kim &Vandenabeele, 2010). While at times, the health personnel face challenging situations such a violent behavior of some patients, they are expected to treat them with compassion and selflessness (Jeon & Robertson, 2010). When confronted by issues that border on moral authority and values, the public officer needs to be firm. The motivation should be for a fair society so as to meet the needs of the citizenry. The Veterans Affairs resignation points to the values and ethics of a public officer who is motivated to do the right thing (Kim &Vandenabeele, 2010).

Accountability

Accountability, as well as transparency, are two essential aspects of government oversight that ensure that things are right. The two characteristics are part of the top core values that define the personality of a public officer or the organization. Thus, the features are critical to any government agency.

Accountability refers to the administrative responsibility through which public officers can have an answer to support their actions, morality as well as respond to legal demands.

Kettl (2016) notes that public officers draw their wages and benefits from taxes paid by the public. Taxpayers money pays the VA member of staff. Therefore, they have a mandate to meet the expectations of the people and remain accountable to them for the work they are doing on their behalf (Jarvis, 2014).

Denhardt and Denhardt (2015) conclude that executive officers are supposed to supervise those under them and to take responsibility for their actions.

Individuals opposed to the VA system had cited problems of delays in securing medical services by the Veterans. One of the retired doctors is on record having said that at least forty Veterans would die as a result of delays in getting care. The Veterans had died at the Phoenix, Arizona Health Administration facilities that were meant to take care of Veterans. Upon investigations into the delays by an Inspector General of the Veterans Affairs, the figures declined from forty to three. The three Veterans who would die would die while waiting to be served. It was not true that they had died because of delays (Ball, Grunic, & Birchall, 2014). It was irresponsible of such an officer who was holding a public office. In the least, the officer’s wrong information can result in a total shut down of the facility. Bovens, Schillemans, and Goodin (2014) concludes that a complete shut down would jeopardize people’s careers as well as their livelihoods. The demand for VA personnel to meet scheduling data had compromised their morals so that they could alter scheduling data. These immoral behaviors were to compensate for their laxity or poor performance. Following this revelation, the Veteran Affairs Secretary resigned from office because of such a great scandal. He could not tolerate working with leaders whose integrity was questionable. A moment for redefining accountability by public officers arose. Though his colleagues had failed the integrity test, his resignation was a new dawn where integrity will be an organizational lifestyle. It was a wakeup call to all the VA employees that they need to be accountable for their actions. Teamwork is key for good results within an organization. The secretary, not having looked at the reports, believed in his colleagues and the inaccurate reports, though he was the accounting officer. The statement by the secretary that he could not defend poor services by public officers and his eventual resignation was the highest form of accountability. The creation of an Office of Accountability and Whistleblower Protection by President Trump was a great boost to accountability by public officers. There was also an intent to abolish a 1960s conflict of interest rule which Veterans would bar VA doctors so that they do not teach at for-profit universities while taking advantage of the Veterans (Adams, Sayre & Saini, 2019). An electronic health record is to be set in place to modernize the appointment system, automation of the disability as well as the payment claims systems. The VA would be connected to the private healthcare providers together with private pharmacies.

Values

Values are those enduring beliefs that direct the choices that we make amid available means or ends. Several public service values are key to enhancing efficiency and effectiveness during the delivery of services in the public sector. Brewer, Leung, and Scott (2014) point out that ethical values such as honesty, accountability, and integrity are vital in maintaining organizational legitimacy in the eyes of stakeholders. Ethical values are not just limited to the public service but are an integral part of an officer’s lifestyle. Therefore, an officer who is rich in moral values outside the working environment will not struggle to maintain the same in the workplace.

Professional values are principles acquired as a result of training or experience so that an individual possesses some expertise. In the VA, most of the employees receive training on how to handle specific conditions beyond normal conditions. Such instructions include the latest evidence-based treatments for Post-Traumatic Stress Disorder (PTSD). VA has plans to bring on board researchers to allow for further transformation of the VA into a Learning Healthcare System. The system will enable the VA to address its leadership priorities. VA is also determined to become a High-reliability Care System to be able to offer care that is optimal and consistent within its different settings. The VA has established guidelines contained in the Opioid Safety Initiative, which are crucial during community care provision. Such initiatives must be known to the caregiver. Therefore, the training ensures efficiency and effectiveness in the treatment process.

Democratic values arising from fair governance are the primary tools used to encourage communities to trust government institutions. Such values include transparency and inclusiveness. There were a series of meetings and workshops that involved the veterans before the enactment of The Missions Act and Veteran Administration. However, a group for the Veterans of Foreign Wars (VFW) feels that their opinions did not count following some public presentations that were not factored by Congress. A large number of VFW use the VA for their health care needs. Therefore, when their opinions do not count, they feel that the quality of health care that they receive is compromised.

Human values such as inclusiveness and transparency may promote the common interest and receive acceptance within the context of our political tradition. The VA facilities ensure that the working environment of their staff is okay. Lift equipment has been installed to secure the nursing staff from debilitating and often career-ending back, shoulder, and neck injuries. The members of staff, a majority composed of other veterans, have revolutionalized the medical environment where they can show empathy and solidarity between the patients and themselves (Adams, Sayre & Saini, 2019). Such patients enjoy peace of mind while receiving treatment from such staff and accelerate their healing process. The resignation by the secretary of Veteran Affairs is a great testimony of how he values human life.

.

Ethics

Ethics are a means of guiding human conduct as they attempt to help men leave a good life through the application of moral principles. Ethics refers to the measurement of the extent of right or wrong, which are well based and prescribe what man should do, usually in terms of obligations, rights, fairness, specific virtues, or benefits to the society. Ethics consists of rightness and wrongness as well as propriety. Whatever thing is right is ethical, while that which is wrong is unethical.

Such codes are enforceable within the rules and regulations of the institutions that established them (Rissler & Shields, 2016). The VA currently is supposed to ensure that its care providers make use of evidence-based guidelines for the prescription. Equally, community health care providers should have appropriate access to the medical history of the patient (Cooper, 2019). In any democratic society, every public office holder is accountable to the people. The resignation by the Veterans Affairs secretary during the 2014 scandal within the Veterans Health Administration is a testament that any public officer should be answerable to their actions. Such actions should be for the betterment of human life. Lawton, Rayner, and Lasthuizen (2013) conclude that any actions devoid of such should result in the resignation of such an offer. The resignation by the Veterans Affairs secretary confirms that any public officer should be of high integrity.

Adams, Sayre, and Saini (2019) observe that the VA’s attention is to have veterans of war access to high-quality health care. All persons should be served with respect, courtesy. The employees at VA are receiving regular training to ensure that they are up to date with current legislation, strengthening of social equity since all persons should be treated with fairness, equality, justice, and there should be respect for individual differences, others’ rights, and freedoms. Treatment is not limited to discipline patients but also to those who can become combative at times (Arowolo, 2012). The caregivers have mastered how to manage such combatant patients so that they also receive medical care, which is their right. Such freedoms and rights include career advancement by the female gender (LaPierre & Zimmerman, 2012). Women Veterans are also receiving fair treatment like their male counterparts under the Center for Women Veterans, where they enjoy health care services, other benefits as well the presence of women Veterans programs. The center advocates for the recognition of women Veterans and the services they are offering in the military. Awareness is also raised where women Veterans should receive treatment with respect and dignity. The establishment of The VA has solved distance factor and waiting time by allowing patients to access health centers of their choice.

Moral heroism – this is the intentional and selfless upholding of moral value. According to Hackett and Wang (2012), the VA is exercising justice and compassion when they allow the choice of health care facilities for veterans who may be disadvantaged by distance or waiting time. Therefore, the engagement of Veteran health officers in the facility ensure that trust prevails between the caregiver and the patient (Jørgensen & Sørensen, 2012). When the Veteran Affairs secretary resigns because of a lack of integrity in the office that he serves, it goes beyond moral heroism to love and care for his own country and the citizenry. Many people holding such an office would have covered the moral shortcomings of the VA personnel.

In conclusion, health care delivery requires the utilization of both the hardware and software within the institution. While the physical infrastructure is critical, its value is inconsequential when the organizational personnel is lacking in some human values. The idea of health care delivery begins with decision-making by an individual. Then there is the acquisition of the right staff to carry out particular roles. Such personnel should understand the requirements of public service such as social equity, decision making, public service motivation, ethics, values, and virtues as well as accountability to deliver the best service to the client and help the organization in achieving the set objectives.