PPACA 1) Use your critical thinking skills to write a paper of 1,000–1,200 words that responds to the question, “Is the PPACA legislation an improvement or a liability to our health care delivery system?” Use examples to illustrate your points and include pros and cons of the changes. 2) Refer to the assigned readings to incorporate specific examples and details into your paper. 3) Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 4) This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment. Rubic Demonstrates thorough knowledge of the principles of health care reform in the PPACA legislation. Clearly develops a strong analysis of the pros and cons. Introduces appropriate examples. Supports main points with references, examples, and full explanations of how they apply. Thoughtfully analyzes, evaluates and describes major points of the criteria. Thesis and/or main claim are comprehensive. The essence of the paper is contained within the thesis. Thesis statement makes the purpose of the paper clear. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative Reading The Patient Protection and Affordable Care Act http://www.cms.gov/LegislativeUpdate/downloads/PPACA.pdf What Are Accountable Care Organizations? http://healthcare-economist.com/2010/01/26/what-are-accountable-care-organizations/ Creating Accountable Care Organizations http://www.nejm.org/doi/full/10.1056/NEJMp1009040]]>

In an emergency evacuation of patients, training plays an important role. Here is an incidence of emergency evacuation of Phillips County Regional Medical Center discussed by Vogt and Sorenson (1999): Shortly after 1:00 p.m. on Thursday, May 8, 1997, clouds of foul-smelling smoke began pouring from an herbicide and pesticide packaging plant in West Helena, Arkansas. An alert was sounded, employees evacuated, and the West Helena fire department was called. As three firefighters prepared to enter the plant, the chemical compounds exploded, collapsing a solid concrete block wall, and killing all three firefighters. As the odorous smoky cloud drifted away from the plant, authorities ordered residents in a 2-mile area downwind of the plant to evacuate and those in the 2- to 3-mile zone to shelter in . . . The findings indicate that 90% of those that were told to evacuate did so but only 27% of those told to shelter-in-place did so, with 68% opting to evacuate instead. The implications of these findings for emergency managers is that people will likely choose to evacuate when both warnings to evacuate and warnings to shelter are issued to residents in close proximity to each other (Abstract section, para. 1). The evacuation of the medical center was facilitated by efforts taken 6 months earlier to update the hospital’s evacuation plan and reconfirm support agreements for relocation sites and supplies. At that time of updating the plan, the entire staff had also participated in a mock drill. When the safety officer observed the buildings across the highway being evacuated and started questioning officials on the possibility of also being evacuated, evacuation plans familiar to staff were in place and had been practiced. When the Director of Nursing gave the “Code White” alert (the signal that an evacuation to an off-site facility would follow) staff was amply prepared to move patients (p. 11). Interviews with staff indicated that all patients that could be discharged were sent home with a physician’s nurse. Another four or five patients (the most seriously ill) were transferred to a hospital about a half hour away. The majority of the patients 11 (approximately 17) in the rehabilitation unit were transferred to a vacant wing of the Crestpark Nursing home accompanied by hospital support staff. Only one maternity patient evacuated to the Phillips College—Community College where the hospital staff had evacuated and opened emergency room services. The evacuation of patients began at 1:40 p.m. and all patients (except for two on ventilators and one being stabilized in the emergency room) were out 55 minutes later. The remaining three patients were evacuated 15 minutes later. A variety of vehicles transported patients—vans, school buses, ambulances, private cars, and mortuary services. As a precaution, National Guard personnel provided security at the evacuated hospital (pp. 11–12). On the basis of your understanding on the topic, answer the following questions regarding the incidence of emergency evacuation mentioned above:

• What does this study tell you about the lack of training for the community?
• Why is communication and education of the community important in saving lives?
• Was the community clear on what the procedures were? How?
• Why was the evacuation of the hospital so successful?
• How important are external relationships with other agencies to having an efficient evacuation plan?

• Support your responses with reasoning and examples.
• Cite any sources in APA format