SUPPORT For Patients And Communities Act Free Sample

Introduction

Overdose deaths from drugs have been the leading cause of death among Americans during the past two decades, surpassing deaths from any other reason. Because it is such a crisis for public health, federal, state and local officials have come up with plans to cut fatality rates and eliminate the factors that contribute to the outbreak. Both the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Congress recently enacted Acts to cut down on overdose deaths and provide addicts with access to treatment. The 2018 Interdict Act was signed into law by the Trump administration to provide law enforcement with the tools necessary to combat the trafficking and sale of illicit and synthetic opioids, both of which contribute to rising rates of opioid overdose across numerous states. These rules have not been very effective in lowering death rates or deterring the use of illegal substances. Therefore, it is necessary to conduct a comprehensive review of the effects that the SUPPORT for Patients and Communities Act has had on the prevention of opioid addiction, the treatment of opioid dependence, and clinical practice in order to identify the Act’s strengths and limitations and propose changes to the policy.

Analysis and Evaluation of the SUPPORT Act

The purpose of the SUPPORT for Patients and Communities Act is to streamline the process by which agencies work together to combat the opioid crisis in the United States and to lessen the number of barriers that patients with substance use disorders face while seeking treatment. In addition, President Trump signed this policy because it addresses some factors that predispose youth, ex-convicts, juveniles as well as the homeless to opioid consumption and usage (Davis, 2019). According to Felix, Sharfstein, and Olsen (2020), this policy prioritizes compensating SUD patients in the Children’s Health Insurance Program (CHIP) at the same rate as beneficiaries with other physical conditions and providing temporary health insurance coverage for ineligible adults receiving treatment for institutional mental diseases. As a result, the SUPPORT Act seeks to better opioid addiction treatment for persons at risk, who constitute the majority of addicts.

The critical evaluation of the SUPPORT Act’s goals revealed that the policy would likely lead to a rise in the number of healthcare facilities that offer MAT for opioid addiction, reducing access gaps. In addition, the vision of the policy expanded the pool of available MAT professionals and the number of people they could help. The SUPPORT Act also provides credit incentives to hospitals as well as treatment institutions in high-risk parts of the country, and it mandates the federal government to expand funding for MAT training programs for specialist nursing practitioners to reduce the availability gap in MAT for SUD patients. The study of the SUPPORT Act’s goals indicated that it was also created to enhance the regulatory environment by introducing a technologically based medicine ordering system. For instance, during the SUPPORT period in pain treatment, strict regulations on the timely delivery of prescriptions and other drug orders were waived for specific groups of patients. This public health strategy was enacted for similar reasons, specifically, to increase collaboration and coordination between government agencies in order to cut down on the distribution of illegal opioids in both urban and rural regions with a disproportionate number of overdose deaths.

Despite the SUPPORT Act’s goal of improving access to MAT therapy while simultaneously meeting patients’ social and emotional needs and protecting vulnerable populations from the hazards of this SUD, research has revealed that its impacts have been negligible. Furthermore, the difficulty of state and federal authorities to authorize funding for loan payback schemes for SUD treatment is another shortcoming of SUD implementation in the last two years, as evidenced by the findings of several studies on the achievement of policy objectives (Shapiro, Villarroel, and George 2019). In addition, despite the Act authorizing Medicaid financing for MATs and other psychiatric treatments for opioid use disorders, the lack of a clearly defined framework limits the potential ramifications of this policy. Due to the limits revealed during the critical analysis of this public health initiative, the projected advantages are unlikely to materialize.

Application into Clinical Practice

Meanwhile, the implementation of the SUPPORT Act in clinical practice is an important area to research to discover how it links to the public health goals of state and federal governments in relation to the opioid use disorder issue and its consequences. Clinical professionals who have not obtained MAT training, such as nurses, PAs as well as grad-level doctors, are needed to participate in the waiver training in order to earn a license to deliver treatments and drugs for opioid use disorders. This policy guarantees that those seeking treatment for opioid use disorders in Medicare-certified institutions can access the full spectrum of treatments available via these programs. The policy not only limits the capacity of disadvantaged populations to access drugs by setting treatment processes, but it also supervises physicians’ and pharmacists’ prescription practices. As a result of the passage of this legislation, clinical practitioners could provide services to disadvantaged populations, establish Medicare reimbursement mechanisms, and provide patients with access to high-quality therapy.

The policy’s greater use of evidence-based practice approaches in treating individuals with opioid use disorder was also revealed in a critical study of its consequences for healthcare professionals. Clinics seeking payment from the Centers for Medicare & Medicaid Services (CMS) for providing bundled Medicare care to these patients must use the services of mental and behavioral health professionals to implement the proven treatment plans (Shapiro et al., 2019). Another consequence of the SUPPORT Act for healthcare providers is the legalization of the policy provisions for the funding of telehealth as well as telemedicine for rural patients with opioid use disorder. In order to provide the appropriate level of care to patients and earn payments from Medicare and other treatment programs, healthcare institutions must engage in the use of evidence-based practice approaches, as mandated by several aspects of this public health policy.

Recommendations to Improve Policy Impacts

Patients suffering from opioid use disorder and members of groups at risk for opioid misuse and abuse will have fewer obstacles to obtaining effective treatment, according to the SUPPORT Act, a piece of public health legislation that aims to improve access to medication-assisted treatment. However, the rising toll from the opioid overdose and addiction crisis indicates that the overarching strategy needs some tweaking to be more effective and efficient. The federal government should seriously consider revising the SUPPORT Act by including a framework to track the results of the many initiatives launched due to the policy and to set up an interdepartmental group to deal with these problems. Reviewing this policy also includes gathering information on how well current evidence-based care procedures for medication-assisted treatment (MAT) are doing at reducing the tragically high mortality rates associated with opioid use disorder. One part of the strategy seeks to promote the development of novel psychosocial and pharmacological approaches to managing advanced illness and pain (Thakur, Frey, & Chewning, 2019). Thus, it is suggested that the SUPPORT Act be revised to add measures that increase its implementation effects on the negative repercussions of the disease on patients.

It is also recommended that medical schools reevaluate and harmonize their curricula to prepare the next generation of healthcare professionals better to help address the opioid problem in the United States. Particularly, strengthening the medical and nursing training programs would boost doctors’ and nurses’ faith in MATs’ ability to alleviate patients’ suffering. In addition, Davis (2019) argues that a uniform curriculum for administering MAT would save time in the classroom and increase the number of doctors available to treat patients with opioid use disorder. Lastly, the critical analysis of the SUPPORT Act suggests that more clinical professionals, such as nurses, should be involved in the decision-making processes that lead to laws like this one, which would allow the FDA to make naloxone available over-the-counter to treat opioid and painkiller addiction.

Conclusion

Opioid use disorder has become a severe public health problem for federal as well as state governments all over the United States because it hurts people, communities, and families in terrible ways. Legislative efforts to deal with the opioid crisis have not successfully reduced addiction and use among high-risk groups. This is mainly due to the shame that comes with getting help. With the SUPPORT Act, which was passed in 2018, stakeholders were able to make it easier for patients to get treatment and keep vulnerable groups from developing opioid use disorders. According to the results of a critical review and assessment, putting this public health strategy into action should improve access to care that is based on evidence, increase the number of healthcare providers, reduce healthcare inequities, and, in the end, lower the death rates that are linked to opioid use disorders. Because of this, the research’s ideas made the strategy’s positive effects on the US opioid crisis even better.

References

Davis, C. S. (2019). The SUPPORT for Patients and Communities Act—What will it mean for the opioid-overdose crisis? New England Journal of Medicine380(1), 3–5.

Felix, C., Sharfstein, J. M., & Olsen, Y. (2020). Help Is on the Way: Medicare Coverage of Opioid Treatment Programs. Journal of the American Geriatrics Society68(3), 637-640.

Hedberg, K., Bui, L. T., Livingston, C., Shields, L. M., & Van Otterloo, J. (2019). Integrating public health and health care strategies to address the opioid epidemic: the Oregon Health Authority’s opioid initiative. Journal of Public Health Management and Practice25(3), 214-220.

Sandoe, E., Fry, C. E., & Frank, R. G. (2018). Policy levers that states can use to improve opioid addiction treatment and address the opioid epidemic. Health Affairs Blog. Retrieved from https://www.healthaffairs.org/do/10.1377/hblog20180927.51221/full/

Shapiro, A., Villarroel, L. R., & George, P. (2019). A call to maximize the impact of the SUPPORT for Patients and Communities Act through standard inclusion of opioid use disorder treatment curricula in medical schools. Advances in Medical Education and Practice10, 581.

Thakur, T., Frey, M., & Chewning, B. (2019). Pharmacist services in the opioid crisis: current practices and scope in the United States. Pharmacy7(2), 60.

Cyber Related Issue Sample Essay

Introduction

The selected cyber-related issue to be investigated is functional safety in physical cyberspace. Gu et al. describe functional safety as a part of the general safety associated with the equipment under control (EUC) and its control system, whose proper functionality depends on safety-related systems (Gu et al. 2020, 1). Functional safety is an aspect that puts the security of cyber-physical systems (CPSs) in the spotlight. CPSs are new systems that integrate computational and physical abilities to allow interaction with humans through new methods (Mo et al. 2014, 8). CPS senses the physical environment and performs feedback operations using computers, communication, and control systems. The aim is to achieve interaction between the physical and cyber worlds. However, this kind of integration poses security and safety challenges due to the vast difference between the two worlds.

Lack of information security and functional safety in the CPS causes confidential information to leak, causing a devastating impact on the physical and cyber worlds (Alam and Saddik 2017, 2050). The problem of function safety exposes the CPS to many security attacks. Functional safety is a cyberspace issue requiring closer examination to identify the security challenges it exposes to CPS. Existing cyber security solutions to address safety and security problems have been unsuccessful. Future research in functional safety will provide a lasting solution to help mitigate the problems posed in cyberspace. Investigating the issue will enable the researcher to explain the best solutions for tackling associated security problems where new methods can be used to defend the CPS from failures and attacks. The paper examines functional safety as a cyber–related issue in cyberspace, clearly stating the problem and explaining why it is an issue, and showing how further research and solution will help mitigate the effects. Solutions to the problem of functional safety will be provided, and an optimal solution will be recommended.

The Problem, its Importance, and the Need for Future Research

Functional safety is a fundamental part of the cyber-space system. It is an issue due to the security problems and associated cyber-attacks it exposes to cyberspace. CPS, cyber security, and functional safety are intertwined, which evolves into a generalized functional safety and security problem (Gu et al. 2020, 1). Ambiguity in applying various technologies, including intelligent, digital, and networking, has led to broken functional safety extensions. System failures and function errors due to random mechanical, physical, and electronic catastrophes break the reliability of functional safety in CPS (Gu et al. 2020, 2). Increased software and central processing unit (CPU) usage have improved conventional functional safety but present cybersecurity issues. That has been evident with unknown cyber-attacks targeting the CPS backdoors and design vulnerabilities, thus subverting operational safety practices and methods (Wu 2019, 371).

Functional safety problem causes fusion effects with cyber security, but the existing solutions to the problem are chaotic to sort out. The problem is uncertain and destructive, where information leakage can cause colossal damage (Gu et al. 2020, 4). Functional safety issue causes superimposed effects of growing problems that outrun human problem-solving capabilities. These effects make the nature of functional safety problems inherent and inevitable. Thus, thoroughly addressing vulnerabilities in cyberspace has been challenging due to the complexity and completeness of human technology development and cognitive level. Institutions and nations have not achieved a self-sustainable technology chain in the globalization era to address the CPS backdoor problem through management engineering (Wu 2022, 156). Furthermore, in complex systems, humans’ scientific and technological abilities do not support scrutiny of software and hardware code vulnerabilities. That remains a technological challenge without a solution even in the foreseeable future.

Functional safety problem in the CPS is an essential issue for examination since previously proposed solutions have not addressed the issue. Cyber security and conventionally dependability technologies have been unable to solve subversive challenges (Gu et al. 2020, 1). They cannot provide security assurance in a quantifiable and verifiable way of responding to cyber-attacks from hardware and software containing harmful security problems. The CPS functional safety facilities and devices have become a scary ghost to the cyber-space. Sliwiski et al. provided a new method that integrates both safety and security industrial control system evaluation using a process and procedure safety and security management. It is a safe-security approach that ensures data integrity and non-rejection only.

Zhou recommended using information security in the industrial Ethernet security protocol stack based on Cortex-A8 (Chun-Jie, Zhou 2013, n.page). The results show that the approach only achieved device authentication, information encryption, and access control measures to solve shared security issues. A cyclic redundancy check only feature detected data integrity errors. The study did not adopt any suitable method of identifying functional safety problems. The study by Ding et al. used an extension approach to quantify the residual error rate for functional safety communication (Ding et al. 2016, 488). The above studies examined solutions to functional safety problems at the risk analysis level and security evaluation. They have not provided a comprehensive analysis or systematic security information on identifying and protecting ideas to solve functional safety problems in cyberspace.

Wu noted that the current cyber security development paradigm does not provide a lasting solution to safety and security problems (Wu 2022, 4). The solution paradigms are based on awareness of the situation and detection analysis. That makes functional safety problem remains stuck as an unsolvable dilemma. Knowing the attacker before and their precise characteristics are not enough ground to base a lasting solution for safety and security problems in cyberspace. According to Jajodia, an ultimate solution to a functional safety problem in cyberspace requires applying a “patch-like” defense mechanism based on threat awareness (Cai et al. 2016, 1123). The move-target defense (MTD) mechanism can reduce attack attempt effectiveness. However, it can still expose the network to security threats since the host execution system and dynamic scheduling step cannot exclude being short-circuited or bypassed by high-risk vulnerabilities.

Dynamism and diversity of the methods cannot achieve changes in the software and hardware vulnerabilities’ logical nature. Preventing internal and external card attacks becomes challenging (Wu 2022, 5). Furthermore, increased transformations of instructions, data, networks, and addresses cause their damage significantly. Further research of the issue and examining the solutions will assist with mitigating the effects of functional safety issues in cyberspace. A holistic method to achieve security goals in cyberspace is needed. Such an approach will recognize the complementary nature of the safety and security outcomes, then highlight problems and possible solutions to the function safety problem of cyber security.

Solutions

Practical solutions to a functional safety problem in cyberspace must address over 51% of common vulnerabilities or backdoor hardware and software problems. The architecture of the proposed methods should guarantee that the common endogenous security problems of the host do not short-circuit the functionality of distributed authentication nodes. A practical solution will have a robust mechanism to counteract disruptions caused by cyber-attacks and the nature of ingestion in cyberspace.

Wu (2022, p.7) proposed the dynamic heterogeneity redundancy (DHR) architecture and coding channel theory (CCT). This approach uses the cyberspace endogenous security paradigm to handle accidental failures and network attacks that are uncertain in an integrated manner. The generalized robust control method of DHR and CCT can solve the entire functional safety problem quantitative design under probability. DHR creates a new way of solving cyberspace’s collective endogenous security problems (Wu 2022, 8). The advantage is that DHR deals with random failures in the structure and guarantees the quantification and verification functionality of the generalized functional safety. However, one disadvantage of the DHR is that the reliability and trustworthiness of this functionality may not be assured when other factors, such as certificate theft, password cracking, and high-risk vulnerabilities to the interaction control, are present. DHR still requires encryption authentication technology support to fight the brutal force attacks at the front door.

Zakoldaev et al. (2020, p.1) proposed using a cluster and matric scheme as the typical structure for cyber and physical production to ensure functional safety in the company. The method engages reserve cyber and physical systems as part of the automatic technological line when the primary equipment elements have failed. CPS specifications help detect failures in time, thus creating equivalent technological lines reliability (Zakoldaev et al. 2020, 4). However, this approach has the disadvantage of depending on the level of functional safety within the smart factory since it may not be applicable at some levels.

The recommended optimal solution for CPS’s functional safety problem is applying functional safety and information security protection methods based on blockchain technology proposed by Gu et al. 2020. In this method, a distributed architecture of CPS is designed on the blockchain structure corresponding to each level. It has helped detect massive defects and risks in the CPS using physical equipment and communication protocols. At each architecture level, the blockchain structure applies a given technology to detect network risks to ensure complete fault diagnosis and protection against risk. Combining the calculation and determination and the encryption method reduces the authentication process complexity.

Conclusion

The functional safety problem is an issue in cyberspace that requires further examination. Ambiguity in applying different technologies to solve the problem has created anxiety around the issue. System failures and function errors make functional safety in CPS unreliable. Increased cyber-attacks at the CPS backdoors and design vulnerabilities have subverted the operational safety practices and efforts to address the problem using various methods. Previous solutions have not effectively addressed security attacks due to the functional safety problem in the CPS. Addressing the issue ultimately requires implementing an approach whose safety and protection mechanisms are applicable at different levels. Blockchain technology provides those capabilities and significantly reduces security risks in the CPS.

References

Alam, Kazi Masudul, and Abdulmotaleb El Saddik. 2017. “C2PS: A Digital Twin Architecture Reference Model for the Cloud-Based Cyber-Physical Systems.” IEEE Access 5, 2050–62. https://doi.org/10.1109/access.2017.2657006.

Cai, Gui-lin, Bao-sheng Wang, Wei Hu, and Tian-zuo Wang.  2016. “Moving Target Defense: State of the Art and Characteristics.” Frontiers of Information Technology & Electronic Engineering 17, no. 11, 1122–53. https://doi.org/10.1631/fitee.1601321.

Chun-Jie, Zhou. 2013. “Development of industrial ethernet security protocol stack based on Cortex-A8.” Computer Engineering and Design.

Ding, Long, Hong Wang, Aidong Xu, and Shixing Li. 2016. “New Considerations for SIL Verification of Functional Safety Fieldbus Communication.” Journal of Loss Prevention in the Process Industries 43, 488–502. https://doi.org/10.1016/j.jlp.2016.07.013.

Gu, Ai, Zhenyu Yin, Chuanyu Cui, and Yue Li. 2020. “Integrated Functional Safety and Security Diagnosis Mechanism of CPS Based on Blockchain.” IEEE Access 8, 15241–15255.

Śliwiński, M., E. Piesik, and J. Piesik. 2018. “Integrated Functional Safety and Cyber Security Analysis.” IFAC-PapersOnLine 51, no. 24, 1263–70. https://doi.org/10.1016/j.ifacol.2018.09.572.

Mo, Haining, Neeti Sharad Wagle, and Michael Zuba. 2014. “Cyber-Physical Systems.” XRDS: Crossroads, The ACM Magazine for Students 20, no. 3, 8–9. https://doi.org/10.1145/2590778.

Wu, Jiangxing. 2019. “The Principle of Cyberspace Mimic Defense.” Wireless Networks, 371–493. https://doi.org/10.1007/978-3-030-29844-9_9.

Wu, Jiangxing. 2022. “Development Paradigms of Cyberspace Endogenous Safety and Security.” Science China Information Sciences 65, no. 5, https://doi.org/10.1007/s11432-021-3379-2.

Wu, JiangXing. 2022. “Problems and Solutions Regarding Generalized Functional Safety in Cyberspace.” Security and Safety 1, 022001. https://doi.org/10.1051/sands/2022001.

Supreme Court Reforms Essay Sample For College

I was shocked by the reversal of the 1973 Roe v. Wade case in 2022 by a conservative-led Supreme Court. This monumental Supreme Court decision served as a wake-up call for most Americans who seemed to have finally realized the significant impact that potential Supreme Court decisions can have on their lives (Tanne, 2022). Thousands (myself included) came out in large numbers to protest against this decision and calling for Supreme Court reforms on numerous fronts. Considering the significant impact that potential Supreme Court decisions have on the day-to-day lives of Americans, there is need to make it more answerable to the people. Hence, the need for the following reforms to the selection of members of the bench of the US Supreme Court.

First, I would introduce an eight-year term limit and institute certain qualifications such as age, education and profession to depoliticize the US Supreme Court. As it stands now, justices appointed to the Supreme Court serve for life, in addition, the US constitution does not stipulate any specific qualifications required for appointment to the bench. These loopholes give the party in power the latitude to play political games that in most instances are not in the interest of the American people (Glick, 2023). The justification for allowing appointed justices to serve for life on the bench is mainly to enhance judiciary independence and protect justices from partisan political pressures. However, according to Glick, this provision is fundamentally undemocratic and undermines accountability as it does not reflect the reality of electoral outcomes and encourages judicial arrogance since there no provision for direct judicial accountability. Thus, introducing an eight-year time limit would not only underline the realities of electoral outcomes but also provide a window for judicial accountability.

In addition, I would introduce the following requirements for qualification for a seat at the Supreme Court. First, set the age for retirement at 60 years to keep up with generational needs. This provision may also stop appointing-authorities’ practice of appointing younger judges to the Supreme Court as a means of their parties’ dominating the Supreme court bench for long. Secondly, I would require that a potential appointee to the bench be a practicing judge with not less than 25-years of experience at a lower court. This provision is likely to give insight to the senate about the potential judge’s judicial history during the approval process. In my opinion, just like other professions such as medicine require certain educational backgrounds and working experience, appointment to the US Supreme Court (the highest court in the land) should be based on merit.

However, it must be noted that a merit based appointment procedure for members of the US Supreme Court is more likely to disadvantage minority groups. According to Thorp (2022), poverty, historical injustices among other social problems have historically disenfranchised minority groups from attaining the highest qualifications in their fields to the extent that using a merit-based criterion for filling up appointive positions can potentially disadvantage members of these groups. In such cases, affirmative action in selection can be applied to enable minority groups who are disadvantaged by the above mentioned reforms to benefit. In any case, the merit principle can also be applied to the affirmative action provision by introducing the concept of suitably qualified persons from the designated groups (Thorp, 2022).

Also, as a means of ensuring equal representation of all Americans at the Supreme Court bench and depoliticizing the bench, I propose that Congress increase the number of Supreme Court seats to fifteen and automatically designate five seats to the liberals, five seats to the conservatives and five seats to the moderates. As it currently stands, the US judicial system allows for an en banc bench consisting of fifteen justices in cases of significant decisions to be made (Larsen & Devins, 2022), thus, it is not far-fetched to allow a Supreme Court bench constituted of fifteen justices. In addition, dictating the partisan composition of the bench to be divided equally among the liberals, conservatives and moderates is acceptance of the US partisan political realities. In every issue in the US, public opinion is often divided in terms of the liberals, conservatives and moderates. This then justifies the need for all these voices to be given equal voting rights at the highest court in the land.

Opponents of the above proposal to increase the constitution of the Supreme Court bench to fifteen from the current nine argue that this phenomenon known commonly as ‘court packing’ undermines judicial autonomy and tramples on democratic norms (Larsen & Devins, 2022). However, it is inarguable that the US populous is a multi-cultural society; hence the need to fill the bench with members from diverse backgrounds to accommodate this cultural reality. Considering the en banc bench precedence set by the federal court of Appeals in the US, a Supreme Court bench constituted of fifteen individuals is a fair number. Besides, designating the composition of the bench in the above mentioned ratio assuades the fears of the Supreme Court being used to fight political battles by the appointing authority. In addition, increasing the number of Supreme Court justices to fifteen is more likely to help in addressing the perennial problem of excessive workload (Glick, 2023); thus serving the principal interest of the search for justice.

In a nutshell, if the above proposals is implemented, the US Supreme Court can be more answerable to the people. In this way, helping advance the interest of justice and democracy in the US.

References

Glick, D. (2023). Is the Supreme Court’s Legitimacy Vulnerable to Intense Appointment Politics? Democrats’ Changed Views Around Justice Ginsburg’s Death. Journal of Law and Courts, 1-12.

Larsen, A. O., & Devins, N. (2022). Circuit personalities. Va. L. Rev.108, 1315.

Rosenberg, G. N. (2022). The Triumph of Politics: The Republican Party’s Takeover of the US Supreme Court. National Law School Journal16(1), 7.

Tanne, J. H. (2022). US Supreme Court ends constitutional right to abortion. bmj377.

Thorp, H. H. (2022). Science needs affirmative action. Science375(6580), 473-473.

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