CALIFORNIA STATE UNIVERSITY, LONG BEACH



CALIFORNIA STATE UNIVERSITY, LONG BEACHCOLLEGE OF HEALTH AND HUMAN SERVICES - HEALTH CARE ADMINISTRATION DEPARTMENTCourse Syllabus: HCA 502 - The Health Care System – Fall 2013Instructor: Janice Frates, Ph.D.On Campus: Janice.Frates@csulb.edu 562/985-5394Office Hours: M, T 2:00-3:45 & by appointmentOffice Location: F0A-004Home: 949/515-0181 (fax) 949/515-0191 (OK to call 9 am – 9 pm 7 days/week)Teaching Assistant: John FayJohn.Fay@student.csulb.edu; (619) 339-2176Course Number: 2115Class Meets: T 4-6:45, E-TEC 105August 27 – December 17, 2013HCA Department Administrative Coordinator: Deby McGill, Deby.McGill@csulb.eduTel. 562/985-5694; fax 562/985-5886HCA Office Location: HHS2-118Course Description: Overview, developmental summary of the American health care system and its driving forces. Major elements of the healthcare system; today’s major health policy issues in a historical, economic and political context. Letter grade only (A-F). (Lecture)Course Outcomes, Competencies and Assessments: The Health Care Administration Department has adopted a competency-based curriculum, based on the American College of Health Care Executives (ACHE) Competencies Assessment Tool and the Healthcare Leadership Alliance (HLA) Competency Directory. As HCA 502 is one of the first courses that students majoring in Health Care Administration take, the emphasis is on acquiring competencies in HLA Domain 4, knowledge of the healthcare environment. Alignment of the expected outcomes and the ACHE and HLA competencies provides clear expectations and standards for students and instructors alike. Students will demonstrate a level of proficiency in each of the expected outcomes through the course assignments as indicated in the following table. Learning ObjectiveDomain CompetencyActivity (A1), Assignment (A2) or Assessment (A3)Describe the organization, administration and financing of the U.S. health care delivery system and the principal California health care programs and administering agencies4- Knowledge of the healthcare systemRole of non-clinical professionals in the healthcare systemOrganization and delivery of healthcare Funding and payment mechanisms of the hc systemThe interrelationships among access, quality, cost, resource allocation, accountability and communityGovernmental, regulatory, professional and accreditation agencies Educational funding for healthcare personnelNursing, physicians, and allied health professionals’ roles and practiceManaged care models, structures and environmentSocioeconomic environment in which the organization functionsA1-Class discussions & In-Class Exercises (ICEs)A3-Midterm, final examsName the major historical events that shaped the U.S. health care system4- Knowledge of the healthcare systemInteraction and integration among healthcare sectorsWorkforce issuesHealthcare technological research and advancementsA1-Class discussions & ICEsA3-Midterm, final examsArticulate the key elements of health policy formation and the policy making process4- Knowledge of the healthcare systemLegislative issues and advocacyThe patient perspectiveWorkforce issuesInteraction and integration among healthcare sectorsA1-Class discussions & ICEsA2-Health policy issue report and presentationAnalyze major contemporary U.S. health care policy issues.4- Knowledge of the healthcare systemLegislative issues and advocacyThe interrelationships among access, quality, cost, resource allocation, accountability and communityFunding & payment mechanisms of the hc systemA1-Class discussions & ICEsA2-Health policy issue report and presentationRequired texts (available for purchase and on 3-hour reserve in Library)Barton, P.L. (2010). Understanding the U.S. Health Services System (4th ed.). Chicago: Health Administration Press. Longest, B. B., Jr. (2010). Health policymaking in the United States (5th ed.). Chicago: Health Administration Press.Other required reading:Kaiser Family Foundation (2010). Summary of new health reform law. Retrieved from: . Highly recommended reference/reading:American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Washington, D.C.: Author. California HealthCare Foundation, California HealthLine. Free daily electronic newsletter. Available at: . Garrard, J. (2013). Health Sciences Literature Review Made Easy: The Matrix Method (4th ed.). Sudbury, MA: Jones & Bartlett.Course lecture notes will be available on BeachBoard. Lectures will include extemporaneous information in addition to that in notes.Other Requirements: You must have an Email address and Internet access to participate in this course and access materials through the BeachBoard online courseware system. For BeachBoard, MyCSULB, or other computer problems, contact the CSULB Help Desk: 562-985-4959, helpdesk@csulb.edu or visit the web site at helpdesk.csulb.edu. You may seek in-person help at AS-120. Student Assignments and GradingIn-Class Exercises; Class Preparation, Participation and Attendance: You are expected to have read the assigned readings and visited the web sites before the class session. On most days (check class schedule), there will be an In-Class Exercise (ICE). You will be assigned to a discussion group of 4-5 students. There will be a list of discussion questions regarding one or more articles posted for the week; your team will prepare and present a response to the question that matches your group number. Students unable to attend class may earn points by submitting a written response to their team by 4 p.m. the Monday before class, or to the instructor if the absence is unplanned and meets University criteria for an excused unplanned absence. Class attendance policy conforms to University policy: see: HYPERLINK "" students requiring special accommodations for class participation and/or exams, please advise instructor at start of course.Healthcare Reform Policy Issue Report and Presentation: The Patient Protection and Affordable Care Act of 2010, Public Law 111-148 and companion legislation PL-11-152, will have significant and far-reaching effects on the nation’s health care system. Your major assignment for this course is to select and study one aspect of the 2010 reform legislation and share your findings with your classmates. You will find articles in recent issues of scholarly health care journals in the bibliography, major urban/national newspapers (LA Times, NY Times, Washington Post, Wall Street Journal), the Internet (see policy and stakeholder web sites) and general interest magazines such as Time, Newsweek, U.S. News and World Report, Business Week, etc. Full text of the enacted legislation is available at: . Submit the paper in 3 stages:Issue outline and stakeholder interview protocol. Submit a fairly detailed outline of your selected health policy issue (see final health reform policy issue report below for format), a preliminary reference list (minimum 10 sources, in APA style). Stakeholder interview - Personal interview (in person, by telephone or via email) with a policy expert or professional in the field impacted by the issue or a leader in an advocacy organization. Submit a protocol with the questions you will ask. Describe the intent of each of your questions. By stating the intent you will be able to clarify or re-phrase the question if your source is unclear. Examples on BeachBoard. Annotated bibliography and stakeholder interview transcript summary. List (APA style) and summarize the literature you have reviewed for your healthcare reform policy topic (minimum 10 sources). For information on how to write an annotated bibliography, see: .. Summarize the responses to your stakeholder interview questions. Examples are posted on BeachBoard.c.Health reform policy issue report. MAXIMUM of 3,000 words (about 15 double-spaced pages – does not include executive summary or references), with a 1-page single spaced executive summary at the beginning. This report is designed to serve as a sample of your research, writing and analytical abilities and for inclusion in a professional learning portfolio (see portfolio guidelines on BeachBoard). Please follow APA 6th edition guidelines for in-text citations of printed and electronic references as well as for your reference list. Your final report should be a thorough but concise textual elaboration of your outline, with particular attention to:Introduction/archaeology of the problem. Provide brief background and contextual information on the issue. How did it arise? How did it become an issue on the public agenda? Stakeholder analysis. Here, your objective is to understand the positions of the various interest groups. What groups, industries and organizations supported/opposed this part of the legislation and why? Discuss how they are affected, and what they stand to gain or lose. In addition to investigating stakeholders' published materials, you may also personally contact representatives of key interest groups or request information from an elected official. If the reform policy you are analyzing is occurring at the national level, discuss the policy’s impact on California.Legislative summary and impact analysis. Summarize the key provisions of the legislation. Analyze the proposed legislation in a thoughtful, objective manner. What will change? What will it cost and how will it be funded? Implementation issues and time line. What are the challenges you or stakeholders note with respect to making the proposed legislation operational? When will the legislation become effective? What regulatory actions have occurred or will occur at the federal and state levels? What implementation actions have been taken? How are stakeholders seeking to influence the administrative regulations? Are there any legal challenges? Reflection and conclusion. Tips for writing a strong paper: Choose your topic and begin your research early in the term. A library information session is scheduled for the second week of class to help you learn about resources available through the library and its vast selection of data bases. Seek feedback on your work. Students will discuss and provide feedback to each other on their topics Week 3. The Writers’ Resource Lab () offers free individualized tutorials to guide students throughout the process of writing a paper. You may (and are encouraged to) submit a draft of your report for review and comments and a preliminary grade 2 weeks before the final paper is due. If you are satisfied with your preliminary grade, no need to resubmit.d.Oral presentation. Students will form groups based on their topics, and make 15-30 minute team presentations drawing from their individual health policy reports during the last two weeks of class (time allowed depends on the number of groups).Exams: There will be a mid-term and a final exam. Questions will be based on the textbook readings and lectures, and include information from guest speaker presentations, class discussions & In-Class Exercises. The mid-term will cover the first seven weeks of instruction; the final will be cumulative, with emphasis on post-midterm sessions. Students absent for scheduled presentations, mid-term or final exams must provide written third party documentation of unforeseen and unavoidable circumstances in order to be eligible to take a make-up exam. Disabled students who qualify for alternative testing arrangements, please advise the instructor and make arrangements well in advance of the exams. If you know you will be unable to attend a particular class, please provide advance notice to your group.Grade Weights and Policies. Assignments are due by 11:55 p.m. on the day class meets for the week. Submit via BeachBoard Drop Box– not hard copy. Late assignments will lose 10% of points for each day they are late. NO ASSIGNMENTS ACCEPTED AFTER THE LAST DAY OF CLASS.Course Assignments, Due Dates and Grade WeightsItemDue DatePoints% of GradeHealth reform policy issue (HRPI) outline, reference list, stakeholder interview protocolWeek 4153.75HRPI annotated bibliography & stakeholder transcriptWeek 7153.75HRPI reportWeek 1210025HRPI presentations (group)Weeks 13-144010In-class exercises/discussion (ICEs): 10@3 pointsOngoing307.5Midterm: Material assigned Weeks 1-7Week 810025Final: Cumulative, emphasis on material assigned Weeks 9-14Week 1510025Total =SUM(ABOVE) 400 =SUM(ABOVE) 100Final course grade weights are: 360+ = A; 320-359 = B; 280-319 = C; 240-279 = D; <240 = F5.Cheating And Plagiarism. Please be aware of and ensure that your behavior conforms to University Policy, as contained in the California State University, Long Beach Policy Statement 80-01: . Annotated bibliography and final HRPI reports will be screened for plagiarism using the “TurnItIn” software system. Turnitin is a plagiarism prevention service available in BeachBoard. Students submit papers electronically, and Turnitin compares the text of those papers to the text in millions of other documents on the Internet, in papers submitted by other students around the world, and in commercial databases of journal articles and periodicals. Turnitin highlights similarities between the text in a student's paper and the text in an existing document. Turnitin provides an annotated document showing both the student's paper and the original source.?The similarity index for your papers should be less than 30%. Although the University catalog does not cover this aspect of plagiarism, it is NOT acceptable to submit the same paper for two courses. If you want to write a paper on the same topic for two different courses, you must submit two different papers. If I discover that you have submitted the same paper for another course, you will receive an “F” for your paper in this course.6.Class Topic & Assignment Schedule: “B” = Barton; “L” = Longest; ICE articles in bibliography (marked *)Schedule may change depending upon availability of guest speakersWk #, DateTopicAssignments, ActivitiesDeliverable(s) 1 Aug 27Introductions, course overviewHow to write a research paper; APA styleICE: What you know and want to know about ACATurn in student info sheet 2 Sep 3Guest speaker Eileen Wakiji, MLS, CHHS librarian: Research resources & toolsICE: As assigned by librarianMeet in Spidell Room 201, Main Library 3 Sep 10Current key healthcare reform policy issues Health policy definition, form, process2010 healthcare reform legislationL Chapters 1, 2; PPACA summary (KFF); ICE: Morone, OberlanderHealth policy topic discussion 4 Sep 17Policy implementation, modification L Chapters 5, 6, 7; Health Reform GPS; ICE: Pear-HRPI outline, ref. list, stakeholder protocol due; discuss brief topic 5 Sep 24US hc system overview, organizationPractice mid-term (self-graded, no points)B Chapters 1, 2 , 4; ICEForm groups for HRPI presentations 6 Oct 1Health insuranceWomen in Health Administration, Health Insurance Reform Implementation. Leeanne Gassaway, VP, State Health, AHIPB Chapter 6, L Appendices 1 & 2ICEOFFSITE MEETING: Foley & Lardner Conference Room, 555 South Flower Street #3500,LA 90071 7 Oct 8Financing health servicesMidterm reviewB Chapter 7; ICEHPRI annotated bibliography & stakeholder transcript 8 Oct 15Midterm (material from weeks 1-7) 9 Oct 22Health Services Workforce, Primary CareB Chapters 8, 13; ICEHRPI progress discussion10 Oct 29Hospitals, Tertiary CareGuest speaker: Josh Luke, PhD, FACHEVP Post-Acute Care, Torrance Mem. Med CtrB Chapters 9, 16; ICEDraft HRPI report - optional/recommended11 Nov 5Long Term Care, Palliative CareB Chapters 15, 17; ICENov 12 NO CLASS – ENJOY THE BREAK12 Nov 19Special Populations – Mental HealthB Chapter 18; ICE13 Nov 26Biomedical Research, Quality of CareB Chapters 10, 20;ICEFinal HRPI report14 Dec 3 Student HRPI presentations15 Dec 10Student HRPI presentation nsAll assignments due16 Dec 17Final Exam (5-7 pm)Bibliography– updated June 2013Selected Health Administration & Policy Journals:American Journal of Managed CareAmerican Journal of Medical QualityAmerican Journal of Public HealthBusiness and HealthHarvard Business ReviewCambridge Quarterly of Healthcare EthicsHealth AffairsHealth Care Financing ReviewHealth PolicyHealth Services ResearchHealth Technology TrendsInquiryJournal of the American Medical Association J of Health Services Research & PolicyJournal of Health, Politics, Policy and LawMedical CareMedicine and HealthMilbank Memorial Fund QuarterlyNew England Journal of MedicineJ of Health Care for the Poor & UnderservedPublic Health ReportsJournal of Public Health PolicyJournal of Ambulatory Care ManagementSocial Science and MedicineJournal of Law, Medicine & EthicsMedical Care Research and ReviewPolicy Studies JournalModern HealthcareWebsites – by TopicTopicWeb SitesHealth policy (national) including health reform and ACAU.S. Congress & Federal Legislation: of Health and Human Services: : index.htmlMedicare: Office of Consumer Information and Insurance Oversight: ociio/index.htmlAcademy for Health Services Research & Health Policy: Health Reform GPS: Navigating Implementation: Kaiser Family Foundation: Commonwealth Fund: National Academy for State Health Policy: Accountable Care Organizations: Health policy (California)CA State Legislature: California HealthCare Foundation: Insure The Uninsured Project: Health Access: Public Policy Institute of CA: California Health Reform Implementation: Consumer Alliance: California Health Report: Information resources – generalNational Library of Medicine: nlm. Virtual reference style manuals: csulb.edu/library/eref/vref/style.htmlAPA electronic citations: apa-style-help.aspx.Health policy formation, agenda settingRobert Wood Johnson Foundation: The Urban Institute: ; Families USA: Center for Health Care Strategies: Center for Studying Health System Change: Policy implementation & modificationNational Academy for State Health Policy: UCLA Center for Health Policy Research: healthpolicy.ucla.eduCalifornia HealthCare Foundation: Kaiser Family Foundation: ; Rand Corporation: Mathematica Policy Research: The Commonwealth Fund: Health-Reform.aspxFinancing health servicesCenter for Medicare & Medicaid Services: Center on Budget & Policy Priorities: CA Legislative Analyst's Office: lao.Healthcare Financial Management Assn: Managed care, insurance & benefitsEmployee Benefits Research Institute: America’s Health Insurance Plans: CA Assn. Of Health Plans: CA Dept. of Managed Health Care: dmhc.CA Office of the Patient Advocate: opa.index.aspxNational Governors Association: National Association of Insurance Commissioners: Ambulatory health servicesAmerican Academy of Urgent Care Medicine: National Association for Ambulatory Care: Medical Group Management Association: Hospitals & health systemsAmerican Hospital Assn.: ; Association for Community Health Improvement: Long Term Care; Politics of Aging & DisabilityAmerican Association of Retired Persons: Disability Rights Education & Defense Fund: Mental healthNational Institute of Mental Health: nimh. Bazelon Center for MH Law: Medline Plus: nlm.medlineplus/mentalhealth.htmlPharmaceuticalsPharmaceutical Research & Manufacturers of America: American Society of Health-System Pharmacists: Public healthCenters for Disease Control & Prevention: American Public Health Association: Health professionalsAm. Medical Assn.: ama-; Am. Nurses Assn. Am. Academy of Physician Assistants: Am. Pharmaceutical Assn.: Quality of careInstitute of Medicine: iom.eduNational Committee for Quality Assurance: Joint Commission (accreditation): California Healthcare Foundation Quality Initiative: Robert Wood Johnson Foundation: National Quality Directory: Ethical issuesAlliance for Health Reform: Hastings Center: Books and ArticlesBrill, S. (2013). Bitter Pill. Time, 181(8), 16-55.Burke, S. (2011, June). The U.S. Congress and Health Policy. Retrieved from: . Blumenthal, D., and Collins, S. (2013, May 23). Implementing the Affordable Care Act’s Health Coverage Provisions. The Commonwealth Fund. Retrieved from: California HealthCare Foundation. (2012, August). Health Care Costs 101, 2011 Edition.. Retrieved from: Campbell, C.G. & Zinner, D.E. (2010). Disclosing industry relationships - toward an improved federal research policy. New England Journal of Medicine, 363, 604-606. DOI: 10.1056/NEJMp1006973Conover, C. (2013, March 4). 5 myths in Steven Brill’s opus on health costs-part 1. Forbes. Retrieved from: ; er, C. (2013, March 7). 5 myths in Steven Brill’s opus on health costs-part 2. Forbes. Retrieved from: Craig, R.L., Felix, H.C., Walker, J. F., & Phillips, M. M. (2010). Public health professionals as policy entrepreneurs: Arkansas’ childhood obesity experience. American Journal of Public Health, 100, 2047-2052. DOI: 10.2105/AJPH.2009.183939Dash, S., Monahan, C., & Lucia, K. (2013, June 19). Evolving Dynamics of Health Insurance Exchange Implementation.The Commonwealth Fund. Retrieved from: . Donabedian, A. (2003). An introduction to quality assurance in healthcare. Cary, NC: Oxford University Press.Gawande, A. (2009, 1 June). The cost conundrum: What a Texas town can teach us about health care. The New Yorker. Retrieved from: articles. Hollingsworth, J.M., Ye, Z., Strope, S.A., Krein, S.L., Hollenbeck, A.T., & Hollenbeck, B.K. (2010). Physician ownership of ambulatory surgery centers linked to higher volume of surgeries. Health Affairs, 29, 683-689. Hsu, R.Y., Kellerman, A.L., & Shen, Y. (2011). Factors associated with closures of emergency departments in the United States. Journal of the American Medical Association, 305, 1978-1985. Joynt, K.E., Orav, E.J., & Jha, A.K. (2011). Thirty-day readmission rates for Medicare beneficiaries by race and site of care. Journal of the American Medical Association, 305, 675-681. Kaye, H.S., Harrington, C. & LaPlante, M.P. (2010). Long-term care: Who gets it, who provides it, who pays and how much? Health Affairs, 29, 11-21. DOI: 10/13777/hlthaff.2009.0535. Long, P. & Gruber, J. (2011). Projecting the impact of the Affordable Care Act on California. Health Affairs, 30, 63-70. doi:10.1377/hlthaff.2010.0961Metzl, J.M. (2010). The protest psychosis: How schizophrenia became a black disease. Boston: Beacon Press.*Morone, J.A. Presidents and health reform: From Franklin D. Roosevelt to Barack Obama.Health Affairs, 29, 1096-1100. Neumann, P.J. (2005). Using cost-effectiveness analysis to improve health care: Opportunities and barriers. New York: Oxford University Press.*Oberlander, J. (2010). Long time coming: Why health reform finally passed. Health Affairs, 29, 1112-1116.*Pear, R. (2013, June 28). Contraceptives stay covered in health law. New York Times. Retrieved from: . Picard, A. (2008). The making of the American mouth: Dentists and public health in the twentieth century. Piscataway, NJ: Rutgers University Press. Saranson-Kahn, J. (2011, November). Primary care, everywhere: Connecting the dots across the emerging health landscape. Oakland, CA: California HealthCare Foundation. Retrieved from: . Starr, P (2011). Remedy and reaction: The peculiar American struggle over health care reform. New Haven: Yale University Press. Warnock, M. & MacDonald, E. (2008). Easeful death: Is there a case for assisted dying? New York: Oxford University Press. STUDENT INFORMATION SHEETHCA 502 – Fall 2013(TURN IN TO INSTRUCTOR – FIRST CLASS SESSION)Name_________________________________________________________________Name you prefer to use__________________________________________________Address_____________________________________________________________________________________________________________________________________Phone(s):______________________________________________________________Best time/place to reach you:______________________________________________E-mail address:__________________________________________________________Please describe briefly:a.Your educational background:b.Work experiencec.Future career (and education, if applicable) plans:d.Your reasons for taking this course, what you hope to learn from it:e.Languages you speak, read and write ................
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