By Susan Plough, MSN, PHCNS-BC, CCM
Hello from the National Public Policy Committee! My name is Susi Plough, and I am the Chair of the Committee. The purpose of the PPC is to serve as a communication and educational resource for health policy issues related to the professional practice of case management. Our goals for the next 2 years are to develop, utilize and monitor the process by which regulatory and legislative issues pertaining to the practice of case management are analyzed and evaluated, to assist and support chapters in establishing their own public policy committees and in their local public policy efforts, and develop and promote strategies to affect legislation to include Hill Days and annual conference activities for CMSA.
What is your opinion of politics? Do you love it, do you like it, do you think it is a dirty word or do you wonder what does politics have to do with me? Most case managers find themselves in the “like” category but are not sure how it fits into their jobs. When most people hear the word politics, they immediately think about Democrats vs Republicans and all the issues that get high-profile media coverage. Politics is much more than what we see on TV or Podcasts. Politics is defined as activities that relate to influencing the actions and policies of a government. This definition goes beyond party lines and into the real reason we have the legislative process in this country.
Take healthcare for example. As Case Managers, we see healthcare in a very different light than other healthcare professionals. This is because we see a deeper side of the care that is provided. We not only see the illness that the patient presents with, but we also see the family and the social determinates of health that so often accompany a patient’s health issues. It is here that many case managers find their passion. Whether that is dealing with a specific determinate of health or the high cost of prescription drugs, healthcare illiteracy or issues around title protection for case managers, we all have that one thing that touches our heart and that we feel needs to be changed in our healthcare system.
We also know that healthcare moves because of legislation but we often forget that the changes in legislation start with someone having a passion about something and bringing that passion forward to legislators either by an opinion or by a story. As case managers, we solve hard problems every day and we learn something about the world that not everyone knows. Take for instance the diabetic patent that has been labeled as “non-compliant” by the nursing staff and physicians. We know by virtue of the work that we do, that the patent is NOT non-compliant, but is living on a fixed income and must decide about whether to buy that costly insulin or put food on the table for his spouse and 3 small children. Or what about the congestive heart failure patient that keeps being readmitted for fluid overload. We hear healthcare providers say, “Why does he continue to eat high sodium foods; we tell him not to and he just keeps doing it.” We know that he lives in a rural area that is a food desert and his only access to food is what he can purchase at the convenience store down the street because he does not have a reliable car that can get him to the nearest grocery 5 miles away. We also know that the patient that was in a catastrophic car accident and requires 24-hour care is much better suited for 1:1 care at home than in a facility where the nurse-patient ratio is so high that he will not get the care he requires, even though it seems like it would be more costly for that care to be given at home.
This is the side of patient care that case managers deal with every day. It is a side of the patient’s story that they share with us because they know that as case managers, we are compassionate and that we are advocates for a just society through our actions and our words. We all have a passion, and we all have stories. As case managers, we can advocate for our patients by communicating effectively with legislators and policymakers to persuade them to take action that they might not have taken without our influence.
For more information on how you can get involved visit the CMSA PPC webpage or email firstname.lastname@example.org
Susan has a diverse background in both Nursing and in Case Management. She has served as Executive Director of Medical Management with Physician Hospital Organizations as well as Director of Hospital Case Management for both large multi-hospital healthcare systems and smaller Case Management departments in the Midwest. She is a Board-Certified Clinical Nurse Specialist in Community Health as well as a Certified Case Manager. Currently, she is on the Faculty for Indiana University School of Nursing and does private geriatric case management for Senior 1 Care. Susan is Chairman of the National Public Policy Committee for CMSA and is a Board Member and Past President of the Central Indiana Chapter of CMSA. She has published nationally and has presented both locally and nationally on case management topics.