Federal Emergency Management Agency Financial Planning Free Sample

Obstacles to Strategic Financial and Fiscal Planning

The governmental policies are intended not only for the implementation of long-term initiatives but also for the mitigation of consequences of disasters. In the United States, there is a special entity engaged with these issues known as Federal Emergency Management Agency (FEMA), and it assists states in the management of emergencies (“About us,” 2020). This paper aims to provide a brief description of FEMA, discuss the internal and external factors affecting its activity, and demonstrate the way they impede the development of strategic financial plans. It also offers suggestions on how to overcome the specified obstacles.

Brief Description of the Federal Emergency Management Agency

The governmental organization under consideration, the Federal Emergency Management Agency, is involved in the process of bringing awareness to American citizens regarding the need for preparedness for any disasters. It was created in 1979 under the administration of President Carter as a response to the devastating catastrophes in the past since they demonstrated the incapability of the country to handle them efficiently (“About us,” 2020). At present, FEMA helps people before, during, and after disasters and emphasizes the role of emergency planning in all the country’s regions for the elimination of the accompanying risks (“About us,” 2020). In this way, they serve as a link between the government and the states in homeland safety matters.

Internal and External Factors

There are several internal and external factors affecting the activity of FEMA. The former include workforce management, response, and disaster resilience (U.S. Government Accountability Office, 2018). In other words, the outcomes of their operations correlate with the adequate training of staff, identification of previous challenges and their elimination, and the suitable strategy for improving the overall efficiency.

The latter, in turn, are related to the effectiveness of emergency management partnerships and the availability of resources for their operations (“External factors,” 2016). The need for coordination of their actions with other entities is defined by the responsibility of the government and the states for the consequences of disasters. In this way, it does not solve the problems but facilitates the process of finding the appropriate solutions. As for the resources, the agency is significantly dependent on the Administration and Congress since they make the ultimate decisions regarding the distribution of funds.

How These Factors Impede the Development of Strategic Financial Plans

The mentioned factors can impede the development of FEMA initiatives since the organization depends on external funding and information. Therefore, a strategic financial plan can be successful only in the case if they manage to cooperate with all the entities involved in the process since they do not have their funds (Federal Emergency Management Agency, 2018). Moreover, it is vital to ensure the well-coordinated operation of its offices (Federal Emergency Management Agency, 2016). Otherwise, the incapability of FEMA to address the specified needs might result in their failure in disaster management.

How to Overcome the Obstacles

To overcome the obstacles stemming from the internal and external factors affecting the work of FEMA, it is critical to optimize its operations. For this, they should focus on three aspects: federal support, state management, and internal functioning (Goss, 2018). Hence, they should ensure financing by the government, the correspondence of states’ actions to the overall strategic plan, and the competency of their personnel.

Conclusion

To summarize, the initiatives of FEMA are intended to mitigate the consequences of various disasters throughout the country. However, their effectiveness depends on internal and external factors connected to outside support and their domestic activities. They might adversely affect the outcomes of FEMA management of emergencies. Therefore, the coordination of work of all involved entities as well as the proper training of staff is needed.

References

About us. (2020). FEMA. Web.

External factors. (2016). FEMA. Web.

Federal Emergency Management Agency. (2016). Federal Emergency Management Agency publication 1. Web.

Federal Emergency Management Agency. (2018). 2018-2022 FEMA strategic. Web.

Goss, K. C. (2018). FEMA challenges & responses, 2017-2018. Domestic Preparedness.

U.S. Government Accountability Office. (2018). Emergency management: FEMA has made progress, but challenges and future risks highlight imperative for further improvements

Creating A Nurse Utilization Management Program

Introduction

Many healthcare organizations experience either overutilization or underutilization of their resources. These challenges create further problems with costs. In this particular scenario, the organization under consideration is experiencing underutilization of its resources hence the organization incurs high costs. The paper proposes a new service called Managed Care. The focus of Managed Care is to manage patients in the Veterans Affairs (VA) while utilizing care within VA hospitals rather than using community hospitals where the cost is significantly higher than VA hospitals. This paper addresses how to control costs using a change model to move patients back into the VA system. The change model is in the form of a nurse utilization program.

The Need for the Proposed Change

The change being proposed in the organization is a result of the need to optimize the resources in the organization. At the moment, the organizational resources are underutilized because many patients use the community hospitals instead of the VA healthcare system.

Organizational Barriers to the Proposed Change

Disagreement on the need for transparency

Many clinical and administrative leaders are unsure of the need for scrutiny of the use of resources. Clinical leaders believe that this is their purview and that their autonomy should not be disturbed. They are unconvinced of the value of reviewing the use of resources during clinical transactions. However, administrative clinical and managerial leaders understand the potential benefits of the retrospective, concurrent and prospective examination of resource use (American College of Medical Quality, 2005).

Fear of creeping bureaucracy

Many clinical professionals, as opposed to administrative leaders, are certain that utilization review is an expansion of the administrative bureaucracy. Regardless of the potential clinical benefits, clinicians believe that they and their staff will waste clinical hours in nonproductive administrative bookkeeping and data manipulation (American College of Medical Quality, 2005).

Unfocused attention

Administrative and clinical leaders attempt to evaluate every aspect of clinical operations. Although this evaluation is a desirable goal, successful utilization management programs must focus their efforts on specific targets of opportunity: those procedures or service units that seem to be highly variable in their use of resources and are considered high-volume or high-risk services provided by the organization.

Inadequate resources

Some utilization management programs develop as pilot experiments. Such programs are often structured on a lean resource base and therefore are inadequately funded. Together with ambitious leadership that intends to review all services, this shortage of resources hampers the efforts of utilization management employees. Without sufficient resources, staff will be unable to document contributions to the organization and to the management of patient care within the expected period of time (American College of Medical Quality, 2005).

Poor team membership

Utilization management programs have been managed by physicians and nurses. Early efforts did not recognize that strong utilization management programs were interdisciplinary in nature and required a mix of medical service disciplines and administrative department representatives. Although the design of the team members appears to be a simple task, the participation of various stakeholders becomes a challenge in terms of team characteristics. A balanced group should be composed of junior and senior leaders who possess organizational advocacy and authority.

Individual Barriers to the Proposed Change

Job security

The creation and implementation of a utilization management program creation of a specific department within the organization to oversee the process. This may require the organization to move the personnel from other departments to the newly created department. This may create anxiety within the affected employees and more so if they will assume new job titles roles and responsibilities. As a result, some of the employees may be resistant to the proposed change (Rossi, 2003).

Communication barriers

The creation and implementation of a utilization management program require successful communication between the utilization management committee and the various stakeholders, both internal and external. Specifically, the committee needs to communicate with the stakeholders about the resource utilization progress, and the impact of the program on the employees and management. Communication should also be done to recognize and reward group and individual efforts (Rossi, 2003).

Factors Influencing the Proposed Change

There are several factors that will affect the implementation of the proposed plan. These factors include third-party payer review and coordination, discharge planning monitoring, overutilization and underutilization surveillance, identification of quality of care and liability problems, financial issues, and physician and staff education. Third-party payer review and coordination involve a review of the medical record during a patient’s hospitalization to facilitate appropriate reimbursement. Coordination may also include facilitating referrals, for instance, to home health, rehabilitation, or long-term care for aftercare with the selected agencies of the third party.

The discharge planning and monitoring component facilitates appropriate, timely, and effective discharge planning. Discharge planning may actually be performed by nurses, social workers, case managers, or discharge planners (American College of Medical Quality, 2005).

Utilization management professionals review cases for appropriate use of resources using criteria sets, clinical pathways, or practice guidelines. Surveillance facilitates the identification or underutilization or overutilization of resources. During the course of the review, quality of care and risk/liability issues can be identified. Reporting of these issues to quality and risk management allows for timely corrective action. It is an integral part of an effective utilization program to obtain concurrent financial as well as clinical data on all cases. These data can educate providers about the cost of treating patients as well as provide the administration with information regarding case mix, cost, length of stay, complications, and mortality. A goal of every effective UM program is the education of physicians and staff in managing resources (Rossi, 2003).

Factors Influencing Organizational Readiness for the Proposed Change

Availability of resources

The organization can only be ready for the proposed change if it has adequate resources both human and physical resources to support the process. Without the resources, the organization will find it difficult to implement the utilization management program (Spector, 2010).

Education of the organization’s personnel

The organization can also only be ready for the creation and implementation of the utilization management program if the employees are educated and trained on the proposed change. Education and training create awareness among the employees

The Theoretical Model that Relates to the Proposed Change

The theoretical model that relates to the utilization management program is quality improvement. Quality improvement is a process that entails changing the manner in which things are run in an organization so as to improve the quality of the services offered while minimizing the costs at the same time. Utilization management will ensure the achievement of these two goals by minimizing the wastage of resources while ensuring that the patients receive adequate care.

Internal Resources Available to Support the Change Initiative

Human resource

The organization requires a committed human resource to support the utilization management program. The employees need to work collaboratively towards the accomplishment and success of the program (Borkowski, 2005).

Financial resources

The organization needs substantial financial resources to oversee the creation and implementation of the utilization management program. The financial resources will be used in the purchase of material resources and the reimbursement of the human personnel.

Information technology

The creation and implementation of the utilization management requires huge data of the clients as well as providers. This huge database can only be effectively and successfully managed through advanced information technology systems.

External Resources Available to Support the Change Initiative

Consultants

The organization will require external resources in the form of experts or consultants. The consultants will provide the organization with the knowledge and skills required to create and implement the utilization management program effectively. The consultants will come in handy in situations where the organization lacks certain skills and knowledge.

Conclusion

The paper proposes a change initiative in the form of a nurse utilization management program. The program aims at increasing the utilization of the organization’s resources and avoiding wastage. Nevertheless, various factors determine the success of the program’s creation and implementation. It is thus the management’s responsibility to ensure that these factors are dealt with to ensure the smooth running of the change process.

References

American College of Medical Quality. (2005). Core curriculum for medical quality management. Sudbury, MA: Jones & Bartlett.

Borkowski, N. (2005). Organizational behavior in health care. Sudbury, MA: Jones and Bartlett Publishers.

Rossi, P. (2003). Case management in healthcare. New York: Elsevier Health Sciences.

Spector, B. (2010). Implementing Organizational Change: Theory into Practice (2nd ed.). Upper Saddle River: NJ: Pearson Prentice Hall.

The Law On Hazardous Waste Management System

Comment

The law on hazardous waste management systems was published in the Federal Register on July 24, 2012. Besides, it was majorly designed to make some vital changes to the hazardous waste identification rules. These unsafe rules were put in place by the Resource Conservation and Recovery Act (RCRA). According to various reports from the environmental management section, the United States energy department should be held responsible for the mixed wastes. Therefore, the wastes should be treated in regard to the standards set by the environmental protection agency. Handling these dangerous wastes require numerous procedures that destroy its constituents to the environment. Additionally, handling the treated wastes pose some threats to the human health and the community at large. To show some responsibility, department of energy should work hand In hand with the environmental protection agencies. Consequently, vital alternatives for mixed waste management should be put in place to reduce the harmful effects associated with it.

However, garbage treated by immobilization technologies should not be included in the hazardous waste regulations since they hardly pose considerable threats to the environment, human health, and the community at large (Nunno, 1990). In addition, mixed waste should be treated by extraction technologies. Thus, immobilization will not go against the RCRA. The remnants should also be disinfected using suitable immobilization technology and radioactive waste disposal equipments. This will eventually lead to the protection of the environment, human health, and the whole society. Evidently, this is critical in the context of waste management.

Issues raised in the proposed rule

There are numerous issues raised in the proposed rule. First, the environmental protection agency should give permission to the United States’ energy department to make some vital changes to Idaho’s dangerous waste management plan. The essential changes should include the most current edition of the dangerous waste management regulations. Besides, the environmental protection agency is suggesting the restructure of the dangerous waste management program. This will be achieved by modifying subpart N of 40 CFR section 272, which at present, includes Idaho’s approved hazardous waste program (Nunno, 1990). The issue of making some important changes to check on the areas where the debris would be disposed, and also improve the numerical treatment standards, has been widely discussed. Additionally, some of the unsafe rules put in place by the RCRA should be excluded and amendments carried out thereafter. Immobilization method of waste treatment should not be included in the harmful waste guidelines since treated wastes do not pose serious dangers to human health or the environment.

The issue of excluding some of the hazardous waste management rules has been supported by the proposed use of suitable immobilization technology for disinfection. Besides, disposing off the wastes by using radioactive methods has proved to be less harmful to the environment and human health. Thus, it is crucial to embrace such techniques.

Opinion regarding the rule

The rule is completely viable and should be adopted since the treated and well-disposed garbage has proved to be less dangerous to the environment and the society at large. Besides, treated wastes are not toxic; thus, will not cause harm to the human health and the environment. Wastes destructed by radioactive method are hardly harmful to the human life. Conclusively, this proposed rule should be adopted since it has minimal or no risks. This is a critical provision in the context of waste management and environmental protection.

Reference

Nunno, T. (1990). International technologies for hazardous waste site cleanup. Park Ridge, NJ: Noyes Data Corp.

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