Agency Synopsis

Identify regulatory agencies that regulate health and the health care system within the US, create a table listing your 5 regulatory agencies and address the following:
Describe the agency, level of regulatory authority (local, state, federal), scope of regulatory authority, and role within the US healthcare system.
Address relevance of the organization or the organization’s authority to the APRN/DNP graduate.
Describe relevance to specialty area, area of practice, or setting of practice. For an example, mental health.

Full Answer Section

       
Oversees Medicare (health insurance for seniors and some disabled individuals) and Medicaid (health insurance for low-income individuals and families). Sets quality standards for healthcare providers participating in these programs. Administers reimbursement for mental health services provided to Medicare and Medicaid beneficiaries. Ensures qualified providers deliver these services. Requires APRNs/DNPs to meet specific educational and experience requirements to participate in Medicare and Medicaid programs. Sets billing codes and documentation standards for mental health services.
State Boards of Nursing State Regulates nursing practice within each state, including licensure, scope of practice, and continuing education requirements. Protects the public by ensuring qualified nurses provide care. Sets the specific requirements for APRNs/DNPs to practice in the state, including their scope of practice in mental health (e.g., medication prescribing, psychotherapy). Licensure is mandatory for APRNs/DNPs to practice in any state, and scope of practice defines the specific mental health services they can provide.
Substance Abuse and Mental Health Services Administration (SAMHSA) Federal Provides national leadership and funding for mental health and substance abuse prevention, treatment, and recovery services. Sets standards for these services. Leads national efforts in mental health, including developing best practices and funding mental health programs. Provides resources and guidelines for APRNs/DNPs working in mental health settings, including evidence-based treatment practices and reducing stigma. SAMHSA resources can inform treatment approaches and program development.
The Joint Commission (JCAHO) Private, Non-Profit Develops healthcare quality standards, conducts accreditation surveys, and certifies healthcare organizations. Promotes quality of care and patient safety through voluntary accreditation. Sets standards for mental health facilities, including hospitals, outpatient clinics, and residential treatment centers. May be relevant if the APRN/DNP practices in a JCAHO-accredited facility. Standards address patient rights, medication management, and safety.
drive_spreadsheetExport to Sheets Additional Notes:
  • Depending on the specific area of practice or setting (e.g., private practice vs. hospital), additional regulatory bodies may be relevant.
  • This table focuses on federal agencies and national organizations, but state-level agencies may also have specific regulations related to mental health practice.
  • It's crucial for APRNs/DNPs to stay up-to-date on the latest regulations and guidelines from these agencies to ensure they are practicing legally and ethically.
 

Sample Answer

     

Regulatory Agencies in US Healthcare: Mental Health Focus

The following table outlines five key regulatory agencies involved in the US healthcare system, with a specific focus on their relevance to an APRN/DNP practicing in mental health:

Agency Level Scope of Regulatory Authority Role in US Healthcare System Relevance to APRN/DNP (Mental Health)
Food and Drug Administration (FDA) Federal Regulates drugs, medical devices, food (including dietary supplements), cosmetics, tobacco products, and electronic radiation-emitting products. Ensures safety, effectiveness, and quality of these products. Sets standards for medications and devices used in mental health settings, including psychotropic drugs and electroconvulsive therapy (ECT) devices. APRNs/DNPs must prescribe medications approved by the FDA and follow protocols for using FDA-approved devices.