IHP610 Final ProjectIssue Prompt Option
#2: ImmunizationsThe Health Law and Policy Issue:The State of Evergreen adopted comprehensive immunization legislation 60years ago. The legislation addresses compulsory immunization requirements for children attending public school and for healthcare workers.
The language mandating compulsory immunizations for children makes available two exemptions: one for firmly held religious beliefs and the other for medical safety reasons.The only exemption available for healthcare workers is the exemption for medical safety reasons.The legislation has remained largely intact and without modification since it was passed.
Three majorcounties in the State of Evergreen—Cedar, Fir, and Pine—experienced large whooping cough outbreaks during the past year.Two children and one adult died in the outbreaks.It is unclear whether any of thethree had been vaccinated against whooping cough.In the past 10years, Pine County experienced a measles outbreak and several particularly bad flu seasons.
Cedar County and Fir County experienced occasional measles outbreaks.In response tothe outbreaks, the Evergreen Legislature is considering legislation to remove the exemption for firmly held religious beliefs.If the legislation passes, public schools will continue to be responsible for enforcing the immunization requirements.
The Tourism Bureau in Evergreen looked at statistics for the last 10years and concluded that tourism to the state was negatively impacted by the outbreaks.As a result, the business community largely supports the proposed legislation.
Elected representatives from Cedar County and Fir County oppose the bill.Several large congregations in those counties oppose vaccinations on religious grounds.Representatives from Cedar and Fir Counties have sponsoreda bill to add a third exemption to the existing immunization legislation.
That provision would allow parents to exempt their children from vaccination if they have a “personal objection” to the vaccine or vaccines. School nurses in all three counties are concerned about public backlash if the religious exemption is removed from the law.
School administrators are worried that they will not have the funds and staff power to enforce the more restrictive immunization requirements.Funding is lean as it is.The state association of school administrators has argued in the past that it is difficult to enforce the immunization requirements.
It is hard to ban a child from school if he or she isnotsick.The primary care association in Evergreen was asked to provide comment on the proposed legislation.
While the association refused to comment on the legislation, the association offered the following statements for consideration:
It is expensive to purchase and maintain a supply of vaccines in a primary care office.
Many primary care offices (including pediatric practices) are choosing not to administer vaccinations.
The practices send their patients to public health departments for vaccinations.
Public health departments do not know when a patient has been referred for vaccinations.There is no regional health information exchange or shared electronic medical record system.
Public health departments in Evergreen cannot bill commercial insurance plans for administration of vaccines.
You are a policy aide employed by the State of Evergreen.Your supervisor—the governor’s special advisor on health—has asked you to review the proposed legislation, consider all relevant perspectives and facts, and draft a policy memorandum.
Specifically, your memorandum must make a recommendation regarding whether the governor should support the legislation, oppose the legislation (and veto it if passed), or take some other action.Be sure your policy memorandum addressesboth pieces of legislation discussed above.
A.Describe the importance of the issue to the healthcare organization.
B.Identify the key organizational stakeholders involved in the issue.
Review the facts and consider whether any stakeholders are involved in the issue who may not be immediately apparent upon casual observation.
C.Explain how key stakeholders played a role in shaping the health law and policy issue identified in the scenario.
D.Identify potential legal risks and malpractice issues that apply. Be sure to provide evidence or examples to supportyour response.
E.Identify potential value conflicts among key stakeholders. Be sure to provide evidence or examples to support your response.
