Measles Outbreak in Minnesota Spreads to 65 Cases

Managerial Report for Supervising Manager: Input Date Here
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Manager’s Name and Role:
Healthcare Setting:
Managerial Issue:
Impact & Details:
Severity & Details:
Scope & Details:
Two Healthcare Setting Issues:
1. First Healthcare-Related Issue with Characteristics Defined:
2. Second Healthcare-Related Issue with Characteristics
Defined:
Managerial Role Perspective Details:
Managerial Report for Supervising Manager: Input Date Here
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Two Policies, Laws, or Regulations with Responsible Parties
Information:

1. First Policy, Law, or Regulation Information:
1a.: Responsible Party, Regulatory Agency, or Regulatory Body
Information:
2. Second Policy, Law, or Regulation Information:
2a.: Responsible Party, Regulatory Agency, or Regulatory Body
Information:
Situation Management- Two Specific Tasks or Steps to Address
the Issues:
1. Details: First Task or Step to Address the Issues:
2. Details: Second Task of Step to Address the Issues:
Two Stakeholders Defined with Details:
1. First Stakeholder, Role Support, and Stakeholder Importance:
2. Second Stakeholder, Role Support, and Stakeholder
Importance:
TEST Instructions:
Your task is to complete all assigned questions to the best of
your ability. Best of luck!
1. What are the four different types of market structures?
2. In two or more sentences provide at least 3 or more
characteristics that separate a perfectly competitive market
structure from a monopolistic market structure?

3. Which type of market structure has differentiated goods and
services?
4. Identify at least one market structure that is predominant in
the United States?
5. At what point do all four market structures maximize profits?
6. In one to two sentences explain, how a monopolistic market
structure determines its optimal price and quantity?
7. Which type of market structure faces a perfectly elastic
demand curve?
8. In two or more sentences, explain the difference between
consumer surplus and producer surplus?
9. Given the graph below explain which triangle color
represents consumer surplus and which triangle color represents
producer surplus.
Values to construct the graph above are given in the table
below:
Price
Quantity Supplied
Quantity Demanded
30
30
0
28
25
5
26
20
10
24
15
15
22
10
20

20
5
25
18
0
30
10. Given the graph below, in one to two sentences, state
whether consumer surplus will increase or decrease and state
whether producer surplus will increase or decrease, if the price
was increased from $24.00 to $28.00.
Rubric
Able to state and articulate what market supply and demand are
as well as able to state market equilibrium and ability to state
and explain market shortages and market surpluses. Also, able
to give examples and articulate market supply and demand are
as well as able to state market equilibrium and ability to state
and explain market shortages and market surpluses
Four types of market structures include: NOTE/COURSE
MATERIALS
· Perfectly competitive market structures; Perfectly competitive
market structures possess the following characteristics:
homogeneous goods and services, many buyers and sellers,
similar vendors, price-takers, little to no barriers to entry, and a
perfectly elastic demand curve.
· Monopolistic competitive market structures; Monopolistic
competitive market structures possess the following
characteristics: Differentiated goods, downward sloping demand
curve, and little barriers to entry
· Oligopolistic market structures; Oligopolistic market
structures possess the following characteristics: High barriers to
entry, a few competitors in the market, similar goods and
services, kinked demand curved, and heavily influence prices.
· Monopolistic market structures; Monopolistic market

structures possess the following characteristics: High barriers to
entry, only provider or producers of goods and services, price-
maker, and downward sloping demand curve.
Monopolists in theory set their prices at the price in which
profits are maximized and then price is read from the demand
curve.
All four market structures maximize profits at the point in
which marginal cost (MC) = marginal revenue (MR).
Two predominate market structures in the United States are
monopolistic competitive market structures and oligopolistic
market structures.
Below is a graph that represents both consumer and producer
surpluses. The orange (red) triangle is represents consumer
surplus and the blue triangle represents consumer surplus.
Values to construct the graph above are given in the table
below:
Price
Quantity Supplied
Quantity Demanded
35
30
0
30
25
5
25
20
10
20
15
15
15
10
20
10

5
25
5
0
30
Given the graph below, in one to two sentences, state whether
consumer surplus will increase or decrease and state whether
producer surplus will increase or decrease, if the price was
decreased from $20.00 to $15.00.
Consumer surplus will increase and producer surplus will
decrease. Consumer surplus is represented by the area above the
equilibrium price and below the demand curve. Producer surplus
is represented by the area below the equilibrium price and
above the supply curve.
Morbidity and Mortality Weekly Report
Weekly / Vol. 66 / No. 27 July 14, 2017
INSIDE
718 Mortality from Amyotrophic Lateral Sclerosis and
Parkinson’s Disease Among Different Occupation
Groups — United States, 1985–2011
723 Racial and Geographic Differences in Breastfeeding —
United States, 2011–2015
728 Pneumococcal Vaccination Among Medicare
Beneficiaries Occurring After the Advisory
Committee on Immunization Practices
Recommendation for Routine Use Of 13-Valent

Pneumococcal Conjugate Vaccine and 23-Valent
Pneumococcal Polysaccharide Vaccine for Adults
Aged ≥65 Years
734 High Risk for Invasive Meningococcal Disease
Among Patients Receiving Eculizumab (Soliris)
Despite Receipt of Meningococcal Vaccine
738 Announcement
739 QuickStats
Continuing Education examination available at
https://www.cdc.gov/mmwr/cme/conted_info.html#weekly.
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Measles Outbreak — Minnesota April–May 2017
Victoria Hall, DVM1,2; Emily Banerjee, MPH2; Cynthia
Kenyon, MPH2; Anna Strain, PhD2; Jayne Griffith, MPH2;
Kathryn Como-Sabetti, MPH2;
Jennifer Heath, DNP2; Lynn Bahta2; Karen Martin, MPH2;
Melissa McMahon, MPH2; Dave Johnson, MPH3; Margaret
Roddy, MPH2;
Denise Dunn, MPH2; Kristen Ehresmann, MPH2
On April 10, 2017, the Minnesota Department of Health
(MDH) was notified about a suspected measles case. The patient
was a hospitalized child aged 25 months who was evaluated for
fever
and rash, with onset on April 8. The child had no history of
receipt
of measles-mumps-rubella (MMR) vaccine and no travel history
or
known exposure to measles. On April 11, MDH received a

report
of a second hospitalized, unvaccinated child, aged 34 months,
with
an acute febrile rash illness with onset on April 10. The second
patient’s sibling, aged 19 months, who had also not received
MMR
vaccine, had similar symptoms, with rash onset on March 30.
Real-
time reverse transcription–polymerase chain reaction (rRT-
PCR)
testing of nasopharyngeal swab or throat specimens performed
at
MDH confirmed measles in the first two patients on April 11,
and
in the third patient on April 13; subsequent genotyping
identified
genotype B3 virus in all three patients, who attended the same
child
care center. MDH instituted outbreak investigation and response
activities in collaboration with local health departments, health
care facilities, child care facilities, and schools in affected
settings.
Because the outbreak occurred in a community with low MMR
vaccination coverage, measles spread rapidly, resulting in
thousands
of exposures in child care centers, schools, and health care
facilities.
By May 31, 2017, a total of 65 confirmed measles cases had
been
reported to MDH (Figure 1); transmission is ongoing.
Investigation and Results
After receiving notification of the first case on April 10, MDH
and the Hennepin County Human Services and Public Health
Department began an investigation. The Council of State and

Territorial Epidemiologists and CDC case definition* was used
* An acute illness in a Minnesota resident during January 1,
2017–May 12, 2017,
characterized by generalized, maculopapular rash lasting ≥3
days with a temperature
≥101°F (≥38.3°C) and cough, coryza, or conjunctivitis. A
confirmed case is an acute
febrile rash illness with isolation of measles virus from a
clinical specimen; or
detection of measles-virus specific nucleic acid from a clinical
specimen using
polymerase chain reaction; or immunoglobulin G
seroconversion or a significant
rise in measles immunoglobulin G antibody using an evaluated
and validated
method; or a positive serologic test for measles immunoglobulin
M antibody; or
direct epidemiologic linkage to a case confirmed by one of
these methods.
to identify confirmed cases of measles in Minnesota (1). A
health
alert was issued April 12, which notified health care providers
of the two measles cases in Hennepin County and provided
recommendations concerning laboratory testing for measles
and strategies to minimize transmission in health care settings.
Emphasis was placed on recommendations for all children
aged ≥12 months to receive a first dose of MMR. Providers
identified patients with suspected measles based on clinical
findings and reported suspected cases to MDH. Testing with
rRT-PCR was performed at MDH on nasopharyngeal or throat
swabs and urine specimens. Among persons testing positive by
rRT-PCR who had received vaccine ≤21 days before the test,
genotyping was performed to distinguish wild-type measles
virus

https://www.cdc.gov/mmwr/cme/conted_info.html#weekly
714 MMWR / July 14, 2017 / Vol. 66 / No. 27 US Department
of Health and Human Services/Centers for Disease Control and
Prevention
The MMWR series of publications is published by the Center
for Surveillance, Epidemiology, and Laboratory Services,
Centers for Disease Control and Prevention (CDC),
U.S. Department of Health and Human Services, Atlanta, GA
30329-4027.
Suggested citation: [Author names; first three, then et al., if
more than six.] [Report title]. MMWR Morb Mortal Wkly Rep
2017;66:[inclusive page numbers].
Centers for Disease Control and Prevention
Brenda Fitzgerald, MD, Director
William R. Mac Kenzie, MD, Acting Associate Director for
Science
Joanne Cono, MD, ScM, Director, Office of Science Quality
Chesley L. Richards, MD, MPH, Deputy Director for Public
Health Scientific Services
Michael F. Iademarco, MD, MPH, Director, Center for
Surveillance, Epidemiology, and Laboratory Services
MMWR Editorial and Production Staff (Weekly)
Sonja A. Rasmussen, MD, MS, Editor-in-Chief
Charlotte K. Kent, PhD, MPH, Executive Editor
Jacqueline Gindler, MD, Editor

Teresa F. Rutledge, Managing Editor
Douglas W. Weatherwax, Lead Technical Writer-Editor
Soumya Dunworth, PhD, Kristy Gerdes, MPH, Teresa M. Hood,
MS,
Technical Writer-Editors
Martha F. Boyd, Lead Visual Information Specialist
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Timothy F. Jones, MD, Chairman
Matthew L. Boulton, MD, MPH
Virginia A. Caine, MD
Katherine Lyon Daniel, PhD
Jonathan E. Fielding, MD, MPH, MBA
David W. Fleming, MD
William E. Halperin, MD, DrPH, MPH
King K. Holmes, MD, PhD
Robin Ikeda, MD, MPH
Rima F. Khabbaz, MD
Phyllis Meadows, PhD, MSN, RN

Jewel Mullen, MD, MPH, MPA
Jeff Niederdeppe, PhD
Patricia Quinlisk, MD, MPH
Patrick L. Remington, MD, MPH
Carlos Roig, MS, MA
William L. Roper, MD, MPH
William Schaffner, MD
FIGURE 1. Number of measles cases (N = 65) by date of rash
onset — Minnesota, March 30–May 27, 2017
0
1
2
3
4
5
6
N
o
. o
f
ca
se

s
Date of rash onset
30 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 1 3 5 7 9 11 13 15
17 19 21 23 25 26
Mar Apr May
(genotype B3 virus) from the vaccine virus (genotype A virus).
Patients (or their parents or guardians) with confirmed measles
were interviewed by local public health officials to confirm
symp-
toms, onset date, and exposure history for the 21 days before
rash onset and identify contacts during their infectious period
(4 days before through 4 days after rash onset). Contacts were
defined as persons who had any contact with patients during
their infectious period.
Among the 65 confirmed cases, the median patient age was
21 months (range = 3 months–49 years). Patients were residents
of Hennepin, Ramsey, LeSueur, and Crow Wing counties.
During April 10–May 31, confirmed measles patients were iden-
tified in five schools, 12 child care centers, three health care
facili-
ties, and numerous households; an estimated 8,250 persons were
potentially exposed to measles in these settings. Rash onset
dates
ranged from March 30–May 27, 2017. Sixty-two (95%) cases
were identified in unvaccinated persons, including 50 (77%) in
children aged ≥12 months (i.e., age-eligible for MMR vaccina-
tion). U.S.-born children of Somali descent (Somali children)
accounted for 55 (85%) of the cases. Among the three patients

MMWR / July 14, 2017 / Vol. 66 / No. 27 715US Department of
Health and Human Services/Centers for Disease Control and
Prevention
with a history of measles vaccination, all had received 2 MMR
doses before illness onset. As of May 31, 20 (31%) patients had
been hospitalized, primarily for treatment of dehydration or
pneumonia; no deaths had been reported.
Public Health Response
Rosters and attendance records were obtained from child
care centers and schools where persons might have been
exposed to measles, and the vaccination status of each
attendee was verified through the Minnesota Immunization
Information Connection, a system that stores electronic
immunization records (http://www.health.state.mn.us/
miic). Health care facilities similarly identified contacts
who were exposed to measles patients and followed up with
susceptible (i.e., unvaccinated, pregnant, or immunocom-
promised) exposed persons. In accordance with the Advisory
Committee on Immunization Practices 2013 guidelines (2),
postexposure prophylaxis (PEP) with MMR or immune
globulin was recommended for susceptible, exposed persons.
Persons who received PEP with MMR within 72 hours of
exposure or with immune globulin within 6 days of exposure
were placed on a 21-day self-monitoring symptom watch for
development of fever or rash, but could continue attending
child care and school. Susceptible exposed persons who
did not receive PEP according to recommendations were
excluded from child care centers or school, and MDH rec-
ommended that they avoid public gatherings for 21 days,
including having visitors who were susceptible to measles

virus. By May 31, at least 154 persons had received PEP
(26 MMR doses and 128 courses of immune globulin),
and 586 susceptible exposed persons who did not receive
recommended PEP were excluded from child care centers or
school and advised to receive MMR vaccination to protect
against future measles illness.
On April 18, as the outbreak continued, MDH recom-
mended an accelerated MMR schedule; to provide additional
protection, a second dose of MMR vaccine was recommended
for children who had received a first dose >28 days previ-
ously.† These recommendations were initially for all children
living in Hennepin County and for all Minnesota Somali
children regardless of county of residence, because MMR
coverage rates among Somali children in Hennepin County
have declined since 2007. In 2014, coverage with the first
dose of MMR among Somali children in Hennepin County
was 35.6% (Figure 2). In response to the rapid increase in the
† The Advisory Committee on Immunization Practices (ACIP)
recommends
MMR vaccine for prevention of measles, mumps, and rubella
for persons aged
≥12 months. ACIP recommends 2 doses of MMR vaccine
routinely for children,
with the first dose administered at age 12 through 15 months
and the second
dose administered at age 4 through 6 years before school entry.
https://www.
cdc.gov/mmwr/preview/mmwrhtml/rr6204a1.htm.
number of reported cases, on May 4, 2017, MDH recom-
mended an accelerated vaccination schedule for all children
aged ≥12 months residing in all counties where a measles case
had been reported during the previous 42 days; MDH further
recommended that health care providers throughout the state

consider using an accelerated schedule.
Previously established culturally appropriate community out-
reach approaches (e.g., working with community and spiritual
leaders, interpreters, health care providers, and community
members) (3) were intensified during the outbreak. Using exist-
ing partnerships, state and local public health officials worked
with MDH Somali public health advisors, Somali medical pro-
fessionals, faith leaders, elected officials, and other community
leaders to disseminate educational materials, attend community
events, and create opportunities for open dialogue and educa-
tion about measles and concerns about MMR vaccine. Child
care centers and schools were provided talking points and
informational sheets on measles and MMR vaccine, and posters
with key messages were distributed in mosques and shopping
malls popular with the Somali community. Community out-
reach focused on oral communication, which is preferred by
this community, including radio and television messaging and
telephone call-in lines that permit approximately 500 persons
at a time to listen to a health professional.
Outreach to encourage vaccination was increased during the
out-
break. By the second week of May, the average number of MMR
vaccine doses administered per week in Minnesota had
increased
from 2,700 doses before the outbreak to 9,964, as reported by
the
Minnesota Immunization Information Connection.
Discussion
Minnesota law requires that children aged ≥2 months be
vaccinated against certain diseases or file a medical or consci-
entious exemption to enroll in school, child care, or school-
based early childhood programs. Before 2008, first-dose MMR

vaccination coverage among Minnesota-born Somali children
aged 2 years in Hennepin County exceeded 90%. However,
MMR vaccination coverage rates declined among Minnesota’s
Somali-American community members starting with the 2008
birth-year cohort. The decline in vaccination coverage was in
response to concerns about autism, the perceived increased
rates of autism in the Somali-American community, and the
misunderstanding that autism was related to MMR vaccine
(3,4). Studies have consistently documented that there is not
a relationship between vaccines and autism (5,6). The low
vaccination rate resulted in a community highly susceptible to
measles. Parental concerns were addressed by building trust
with
the community and identifying effective, culturally appropriate
ways to address questions, concerns, and misinformation about
MMR vaccine. In 2011, a smaller measles outbreak began in
http://www.health.state.mn.us/miic
http://www.health.state.mn.us/miic
https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6204a1.htm
https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6204a1.htm
716 MMWR / July 14, 2017 / Vol. 66 / No. 27 US Department
of Health and Human Services/Centers for Disease Control and
Prevention
FIGURE 2. Percentage of children receiving measles-mumps-
rubella vaccine at age 24 months among children of Somali and
non-Somali
descent, by birth year — Hennepin County, Minnesota, 2004–
2014
0

10
20
30
40
50
60
70
80
90
100
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Pe
rc
en
ta
ge
v
ac
ci
na

te
d
Birth year
Somali
Non-Somali
Source: Minnesota Immunization Information Connection,
Minnesota Department of Health.
Summary
What is already known about this topic?
Measles was declared eliminated from the United States in 2000
but continues to circulate in many regions of the world and can
be imported into the United States by travelers. Measles vaccine
is highly effective, with 1 dose being 93% effective and 2 doses
being 97% effective at preventing measles.
What is added by this report?
In a community with previously high vaccination coverage,
concerns about autism, the perceived increased rates of autism
in the Somali-American community, and the misunderstanding
that autism was related to the measles-mumps-rubella (MMR)
vaccine resulted in a decline in MMR vaccination coverage to a
level low enough to sustain widespread measles transmission in
the Somali-American community following introduction of the
virus. Studies have consistently documented that there is not a
relationship between vaccines and autism.
What are the implications for public health practice?

This outbreak demonstrates the challenge of combating
misinformation about MMR vaccine and the importance of
creating long-term, trusted relationships with communities to
disseminate scientific information in a culturally appropriate
and effective manner.
the Somali community in Hennepin County and resulted in 21
cases, including eight cases in persons of Somali descent (4,7).
At that time, the 1-dose MMR vaccination coverage rate among
Somali children aged 2 years in Hennepin County was 54%. The
source of the 2011 outbreak was a Somali child aged 30 months
who acquired measles while visiting Kenya (7). However, the
source of the current outbreak is unknown, which suggests that
additional cases have likely occurred that did not come to the
attention of health care providers or public health departments.
Although indigenous measles transmission has been elimi-
nated in the United States, the virus continues to circulate
widely in many regions of the world, including Africa,
Europe, and parts of Asia, and is often introduced into the
United States by international travelers (8). High measles
vaccination coverage rates across subpopulations within com-
munities are necessary to prevent the spread of measles. The
current Minnesota measles outbreak, with 31% (20 of 65) of
cases requiring hospitalization, demonstrates the importance
of addressing low vaccination coverage rates to ensure that
children are adequately protected from a potentially serious
vaccine-preventable disease (3).
Acknowledgments
Andrew Murray, Carol Hooker, Erica Bagstad, Hennepin County
Human Services and Public Health Department; Ruth Lynfield,
Malini DeSilva, Richard Danila, Danushka Wanduragala, Kirk
Smith, Ben Christianson, Ellen Laine, Hannah Friedlander, Sean

Buuck, Austin Bell, Carmen Bernu, Erica Bye, Corinne
Holtzman,
Katherine Schleiss, Victor Cruz, Megan Sukalski, Dave Boxrud,
Brian Nefzger, Victoria Lappi, Katie Harry, Net Bekele, Jacob
Garfin,
Gongping Liu, Ruth Rutledge, Lisa Levoir, Barbara Miller,
Fatuma
Sharif-Mohamed, Asli Ashkir, Hinda Omar, Minnesota
Department
of Health; Kris Bisgard, Stacy Holzbauer, Raj Mody, Paul
Gastañaduy,
Paul Rota, Rebecca McNall, Adam Wharton, CDC.
MMWR / July 14, 2017 / Vol. 66 / No. 27 717US Department of
Health and Human Services/Centers for Disease Control and
Prevention
Conflict of Interest
No conflicts of interest were reported.
1Epidemic Intelligence Service, CDC; 2Minnesota Department
of Health;
3Hennepin County Human Services and Public Health
Department,
Minneapolis, Minnesota.
Corresponding author: Victoria Hall, [email protected], 651-
201-5193.
References
1. Council of State and Territorial Epidemiologists. Public

health reporting
and national notification for measles. Atlanta, GA: Council of
State and
Territorial Epidemiologists; 2012.
http://c.ymcdn.com/sites/www.cste.
org/resource/resmgr/ps/12-id-07final.pdf
2. McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS.
Prevention of measles,
rubella, congenital rubella syndrome, and mumps, 2013:
summary
recommendations of the Advisory Committee on Immunization
Practices
(ACIP). MMWR Recomm Rep 2013;62(No. RR-4).
3. Bahta L, Ashkir A. Addressing MMR vaccine resistance in
Minnesota’s
Somali community. Minn Med 2015;98:33–6.
4. Gahr P, DeVries AS, Wallace G, et al. An outbreak of
measles in an
undervaccinated community. Pediatrics 2014;134:e220–8.
https://doi.
org/10.1542/peds.2013-4260
5. Jain A, Marshall J, Buikema A, Bancroft T, Kelly JP,
Newschaffer CJ.
Autism occurrence by MMR vaccine status among US children
with older
siblings with and without autism. JAMA 2015;313:1534–40.
https://doi.
org/10.1001/jama.2015.3077
6. Madsen KM, Hviid A, Vestergaard M, et al. A population-
based study

of measles, mumps, and rubella vaccination and autism. N Engl
J Med
2002;347:1477–82. https://doi.org/10.1056/NEJMoa021134
7. CDC. Notes from the field: measles outbreak—Hennepin
County,
Minnesota, February–March 2011. MMWR Morb Mortal Wkly
Rep
2011;60:421.
8. Orenstein WA, Papania MJ, Wharton ME. Measles
elimination in
the United States. J Infect Dis 2004;189(Suppl 1):S1–3.
https://doi.
org/10.1086/377693
mailto:[email protected]
http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/ps/12-
id-07final.pdf
http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/ps/12-
id-07final.pdf
https://doi.org/10.1542/peds.2013-4260
https://doi.org/10.1542/peds.2013-4260
https://doi.org/10.1001/jama.2015.3077
https://doi.org/10.1001/jama.2015.3077
https://doi.org/10.1056/NEJMoa021134
https://doi.org/10.1086/377693
https://doi.org/10.1086/377693Measles Outbreak — Minnesota
April–May 2017
Instructions: Complete a Managerial Report based upon the case
and your selected role. The healthcare setting in the report will
be based upon the course's selected case study and the role will
be based upon your selected role for the course. An
example Managerial Report Template has been provided for

your reference, ensure each section is completed with sufficient
details. Student are welcome to customize their report, but all
aspects of the report must be completed with the appropriate
amount of details for each section. Please provide a separate
APA cover page and APA reference page with the managerial
report that includes at least two credible sources. (Refer to the
Announcement Page for the case or the Week 1 Content.)
Managerial Report Template PDFManagerial Report Template
Word Document (Student may elect to use the Word document,
if desired. Please appropriately adjust the spacing and
formatting, when entering your information into the report.)
The managerial report should include the following items:
1. Managerial Issue Defined: Identification of one managerial
issue with the information on the severity, impact, and scope.
Ensure the report includes the appropriate amount of details for
each element of the managerial issue, impact, severity, and
scope. Note:
Impact: An effect one event makes on the other. For example,
the impact would be the restriction to the health services
accessibility for all area residents served by the hospital due to
the impacted transportation and infrastructure systems. Another
impact point could have been the lowered capacity of the
hospital to offer health care services to all served area residents
(in-patient and out in the community) due to the power failure.
Severity: The fact or condition of being severe. Talking about
the severity you needed to concentrate on the wider community.
For example, a snowstorm affected a half of the served area
living in widespread geographic allocation. The power failure
and infrastructure issues would generate public health issues in
the community. That should serve as an argument that this is a
severe situation for the only health service organized institution
in the area which duty is to prevent and mitigate public health
issues along with offering routine services.
Scope: The opportunity or possibility to do or deal with
something. Power failure and the infrastructure system failure
in the community restrict the scope of hospital influence

(opportunity and possibility) on the natural disaster and
associated health issues developing in the community.
2. Identify 2 Healthcare Case Study Issues: Discuss at least two
healthcare-related characteristics of the case.
3. Role Perspective: Offer insight to the situation through the
lens of your role.
4. Identify a Minimum of 2 Policies, Laws, and/or Regulations
with Responsible Parties Information: Describe the two
policies, laws, or regulations and include a discussion on the
responsible parties such as the government agency or regulatory
body.
5. Explain Your Role for Managing the Situation: Offer at least
two specific tasks or steps that you can conduct to appropriately
address the issues.
6. Identify at Least 2 Stakeholders: Provide a response that
includes two stakeholders that your role will work with to
address the issues, explain the relationship of the stakeholder to
your role, and why this relationship is important.
7. Provide at least 2 credible sources with corresponding in-text
citations.
Full sentences with proper grammar, articulation, and
punctuation are required throughout the report. Provide the in-
text citations throughout the report for the supervising
manager's reference.
Example of Responses for a HIPAA & Compliance Director for
a Case Study Involving an Urgent Care Setting:(Please note that
these examples may not be used in your submission and the
responses are not reflective of a managerial report format.)
· High severity issue: Potential for patient safety violations,
Protected Health Information (PHI) violations, and Health
Insurance Portability and Accountability Act (HIPAA)
violations. (Note: Offer supporting details on the severity
level.)
· Impact-HIPAA violations, PHI exposed, patients’ information
at risk, and patient safety at risk. (Note: Offer supporting
details on the impact.) Scope-Operational, Clinical, &

Legal. (Note: Offer supporting details on the scope.)
· Urgent Care Case Study: 2 Issues- Patient tracking issues and
staff unaware of patients’ locations including the collection of
blood and urine. (Note: Offer supporting details regarding the
two issues for the assigned course's case study, clearly stating
the issues as each one relates to the role and healthcare setting.)
· Role Perspective- Compliance & HIPAA Director: Address the
identified issues to minimize the risks, ensuring all aspects of
compliance are clearly defined, while following all regulatory
elements, rules, and laws. (Note: Describe your role as this
leader related to the response provided.)
· 2 Policies/Laws with Regulatory Parties- Apply HIPAA
regulations to the issues and revise the organization’s PHI
policy. Students do not need to identify specific regulatory
definitions but need to demonstrate an understanding of HIPAA
regulations and PHI policies for this example. The regulatory
parties that may be involved with these laws include the Centers
for Medicare and Medicaid (CMS) including CMS surveyors,
the Joint Commission, or the Department of Health and Human
Services’ Office for Civil Rights (OCR) related to HIPAA
enforcement. (Note: Students must include the regulatory body
for the selected policies, laws, or regulations that will be
presented in the managerial report.)
· 2 Collaborative Stakeholders: Under this scenario, two
collaborative stakeholders could be the facility manager and the
risk manager. (Note: Discuss how, and why, these two
stakeholders were selected, offer a discussion on their roles
associated to your role, and provide information to the
importance of their role.

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