es covered in the law. However, more changes can be expected to be forthcoming because certain provisions of the law, such as prospective payment plans, will not be enacted until next year (see: Fogel, 1998).
The organization for which this writer will provide a policy analysis of the issue is that of a Community Health Nursing Organization. According to Albrecht (1994), the primary objectives of the community health nurse are to provide the patient with quality care in the areas of assessment, planning, and treatment---and to do so in a manner that is cost efficient. Thus, the analysis that will be conducted will examine policy changes from the standpoint of whether they facilitate or obstruct these primary care objectives.
The just stated objectives appear to be basically compatible with the objective of all other key actors influencing the issue in that most of the other agencies, institutions, and organizations associated with the issue consider the need for quality services delivered within a cost-effectiveness framework. The primary difference between the definition provided by these other sources and by the organization for which the policy analysis is will be prepared is in the area of the definition of what constitutes home health care.
Medicare and other related legislation (e.g., Title XVIII of the Social Security Act, Title XIX of the Social Security Act, the Older Americans Act of 1965) tends to define home health care almost entirely in terms of the specific services that are provided by health care agencies and personnel. On the other hand, nursing definitions of home health care consider---in addition to the specific services provided--such related and supplementary matters as the coordination of said services, their therapeutic intent, and the overall treatment plan (Albrecht, 1994).
In terms of the analysis that will be presented, the issue is, therefore, going to have to use this broader, more co...