Discussion 10 Defend Your Policy Recommendations

Final Submission: Policy Memorandum

Luz Rodriguez

Southern New Hampshire University

Final Submission: Policy Memorandum

I. Executive Summary

The scenario selected is that of the State of Evergreen. Following a series of outbreaks of diseases that can be prevented through immunization, a new piece of legislation has been proposed to make it mandatory for all public school-going children to be immunized. There are stakeholders who support the move and those who oppose it. The major issues that arise in this regard include the right to life, right to religion, and the need to kick start the local economy. From the analysis conducted, it is clear that whatever legislation is passed, it will not be fully supported by each stakeholder. Consequently, there is need to reach a compromise that will best suit all the parties involved. In this regard, the course of action that should be taken is to support the proposed legislation and ignore the counter-proposals. Specifically, the legislation that allows public school children from being exempted from immunization on religious grounds should be exempted. To ensure that the proposed legislation is implemented effectively, it will be crucial to reconcile the divergent needs and interests of the stakeholders. Individuals who do not wish to immunize their children because of religious issues should be given the alternative of taking their children to private schools. This may ensure that there is a leeway for these individuals to take their children to school without having their children being immunized.

II. Factual Overview: Immunization

Importance of Immunization to the Healthcare Organization

According to Pope (2019), a huge proportion of the existing health professionals and healthcare institutions recommend immunization. He notes that immunization aids in the protection of a person and those around him/her from infectious diseases. He adds that an immunization program is only successful if every individual cooperates in its participation. Largeron et al. (2015) state that for healthcare organizations, immunization is crucial in ensuring there are substantial savings in healthcare-related costs. This is because immunization prevents certain diseases in individuals and leads to fewer medical visits, hospitalizations, treatments, and diagnostic tests.

Key Organizational Stakeholders Involved

The primary stakeholders involved in this issue include healthcare workers and public-school children. They are the ones who will be directly impacted by a change in the current legislation. Second, there is the Evergreen Legislature, which is responsible for the formulation and passing of any new legislation. Third, there are nurses, who feel schools do not have adequate funds to enforce the new legislation. Fourth, there are religious leaders who may feel that the new legislation is infringing on the right to worship. Finally, there is the business community, which supports the proposed legislation since there is a general consensus that the outbreaks are affecting tourism and the overall economic landscape of the State of Evergreen.

How Stakeholders Played a Role in Shaping the Health Law and Policy

These stakeholders play a huge role in shaping the relevant legislation surrounding immunization. These stakeholders are divided into three. First, there are those who support the proposed legislation. This legislation calls for the repealing of the clause that allows public school children to be exempted from immunization on religious grounds. Their motivation is to lower the outbreaks of infectious diseases, which can be prevented through immunizations. Second, there are those who oppose the proposed legislation. Instead, these stakeholders want to ensure that people can refuse to be immunized on the reason of ‘personal objection.’ Finally, there are stakeholders who do not openly support or reject the two-contrasting legislation. This group is made up of healthcare organizations and practitioners. This group is instead worried about the inability to get adequate funds to support and sustain a comprehensive immunization program.

Potential Legal Risks and Malpractice Issues that Apply

Potential legal risk is that if the proposed legislation passes, it might infringe people's right to religion. For instance, if a person's religion does not allow immunization for its members, forcing his/her child to be immunized might push him/her to sue the state for infringing on his/her child's right to religion. Also, there is a risk of malpractice when carrying out immunization. If the first legislation is passed, there will be a higher number of individuals to immunize. If this number is significantly high, healthcare workers may be overwhelmed and prone to mistakes and malpractice.

Potential Value Conflicts among Key Stakeholders

There are two potential conflicts. First, there is the right to religion. If the proposed legislation is passed, then it causes conflict among the stakeholders since it will infringe the right to religion among some of them. Second, there is the right to life. If the alternative legislation is passed, then it will cause conflict among the stakeholders since it will infringe the right to life of others by placing them at an increased risk of getting infectious diseases.

III. Analysis

Needs and Interests of Key Stakeholders

There are five main stakeholders. First, there are the healthcare workers and public-school children. The legislation will directly affect these two stakeholders. Depending on the legislation that is passed, these stakeholders will have to balance between the need to have their freedom such that they can get vaccinated if they want and the need to live in an environment, which positively affects their healthcare outcomes. Second, there is the Evergreen Legislature. The representatives must formulate policies, which offer the greatest benefits to the people of Evergreen, the state’s healthcare outcomes, and the state’s economic wellbeing. Currently, the main legislation is supported by Pine County and objected by Fir and Cedar Counties.

Third, there are the nurses. According to Pope (2019), such individuals desire to operate in a territory that promotes preventive healthcare. More so, nurses are at the forefront of providing healthcare to the public. In Evergreen, nurses feel that the schools in the state lack the necessary finances to enforce the proposed legislation. Therefore, even though they desire to have everyone vaccinated, they feel that the new legislation should outline practical ways of implementing the proposed changes without subjecting the current healthcare facilities to the burden of shouldering the financial costs involved.

Fourth, there are the religious leaders. These individuals oppose the proposed legislation because they feel it will infringe on the citizens’ right to religion. Finally, there is the business community. Currently, the preventable outbreaks are adversely affecting tourism and the overall economy of Evergreen. Therefore, the business community supports the proposed legislation since it will result in fewer outbreaks and lead to the improvement of the economy.

Application of Current Healthcare Policies, Laws, and Financing Practices

Currently, there are various policies and laws that guide the issue of immunization across the country. First, there is the issue of the school entrance. All American states have made it mandatory got children to be subjected to specific vaccinations before being allowed to go to public schools (Barraza, Schmit, & Hoss, 2017). However, all states all some children to be exempted from this policy due to medical reasons, 18 states and 47 states exempt children from vaccination for philosophical and religious reasons respectively (Barraza, Schmit, & Hoss, 2017).

Second, there is the issue of healthcare worker vaccination. The relevant laws and policies vary from state to state. Nevertheless, there are four major classes to take note of. Class one covers the laws that make it mandatory for healthcare institutions to evaluate their workers' vaccination status. Class 2 covers the laws that push healthcare institutions to offer their workers vaccination. Class three covers the laws to either get vaccinated or possess valid religion/medical exemptions (Barraza, Schmit, & Hoss, 2017). Class four covers laws that make it mandatory for individuals that lack influenza vaccination to wear surgical masks while working.

Finally, regarding the potential financial ramifications, NCSL (2020) notes that “every $1 spent on childhood immunizations saves $10.20 in avoided costs.” Therefore, although vaccination programs are expensive, they are worthy investments since they result in lower healthcare costs in the long term. Therefore, Evergreen should consider adopting suitable legislation that will see it lower its healthcare costs and improve its economy in the long run.

Probability of Stakeholder Value Conflicts

In the current case, two potential conflicts arise. First, there is the conflict brought about by the freedom of religion. The passing of the proposed law will result in conflict because the right to religion will be blocked for the people who do not wish to be vaccinated on religious grounds. Second, there is the conflict brought about by the right to life. The passing of the second legislation will result in stakeholder conflict because people will be at a higher risk of contracting preventable diseases because fewer people will be getting immunized.

Evaluation of Malpractice Issues and Legal Risks

One major legal risk revolves around the right to religion. Currently, the constitution offers this freedom to everyone. However, the proposed legislation poses a legal risk because if passed, it will conflict with the right to religion when it forces people to be vaccinated even if their religion forbids it. This might make people sue the state for intervening with their religious rights. Malpractice is another major issue during the immunization practice. Considering that the state is not well equipped to handle the current number of immunization procedures, if the proposed legislation passes, the number of people to be immunized will be higher. An overwhelmed healthcare system might lead to malpractice because healthcare workers will be prone to mistakes.

IV. Recommendations

Course of Action for the Healthcare Executive

The course of action that should be taken is to support the proposed legislation and ignore the counter-proposals. Specifically, the legislation that allows public school children from being exempted from immunization on religious grounds should be exempted. Although this decision will cause certain conflict in the State of Evergreen, it is the one that will meet the needs of the majority of stakeholders. More so, it is the one that will lead to desirable outcomes in terms of healthcare and the economy. For starters, public school children will be safer and less likely to be exposed to various preventable diseases since all of them will be immunized. The healthcare system in the county will also spend less on treatment-related expenses since immunization is a preventable measure that prevents people from getting infected with the preventable diseases. The business community will also benefit since the economy will improve once the outbreaks stop occurring regularly. Finally, the legislature will have come up with a policy that best meets the needs of the people who elected its officials into office.

Reconciliation of Divergent Stakeholder Needs and Interests

To ensure that the proposed legislation is implemented effectively, it will be crucial to reconcile the divergent needs and interests of the stakeholders. Presently, the stakeholders that oppose the proposed legislation must be sensitized on the importance of ensuring that every child in the state is protected from various diseases through immunization. Although these stakeholders hold that their right to religion will be infringed by the proposed legislation, they must be made aware that the right to life holds more weight than the right to religion. Individuals who do not wish to immunize their children because of religious issues should be given the alternative of taking their children to private schools. This may ensure that there is a leeway for these individuals to take their children to school without having their children being immunized.

Extent to which Legal Risks and Potential Malpractice Issues Shaped the Decision

In the case presented, it is clear that regardless of the decision that is selected, there must be individuals with a dissenting opinion. Nevertheless, the option of having the proposed legislation adopted has been chosen in this case. Legal risks and potential malpractices have been considered when coming up with the decision. For starters, there is the issue of right to life. This has been the cornerstone of the selected decision. By ensuring every child going to public school is immunized, less children will be at a health risk from the various communicable diseases that are spread without immunization. There is also the issue of right to religion. To offer the dissenting individuals with an option not to immunize their children, a leeway has been given to ensure that they can take their children to private schools, which allow the enrolment of non-immunized children. Regarding the malpractice of healthcare workers making mistakes due to being overwhelmed by the large numbers of people needing immunization, there will be need for more resources to be unveiled in the state to counter this problem.

Extent to which the Recommended Course of Action Addresses Financing Practices that Impact Key Stakeholders

To effectively implement the new legislation, the legislature will have to craft a policy that releases extra funds to the primary care association in the State of Evergreen. Purchasing and supplying vaccines in the state is quite expensive. If the proposed legislation passes, there will be more individuals requiring immunization. This implies that eh cost of carrying immunization will go up. Currently, the healthcare institutions are already overstretched when it comes to facilitating immunization. Therefore, during the legislation change, the legislature will have to outline how the primary care association will receive extra funding to effectively meet the demands of immunizing people in the state.

Plan to Resolve Potential Conflicts

The plan to resolve potential conflicts will be comprised of two major conflict management strategies. First, there is compromising. This strategy will aid in settling on a solution that will be perceived to be fair for all (Habas, 2019). In this regard, the final solution will be based on a compromise to ensure that each stakeholder makes a sacrifice and does not completely get his/her way. This is why in the recommendation given, although the proposed legislation will be passed, a leeway will be created so that parents who do not wish to have their children immunized can take them to private institutions. Second, there is collaboration. This will be vital in maximizing the cooperation and assertiveness between all the stakeholders involved (Habas, 2019). Once each stakeholder reveals his/her needs, the whole group cooperates to come up with a solution that best suits all those involved.

To ensure the conflict resolution strategies work, there is a need to employ effective risk management strategies. In this case, there is the risk of being unable to raise the necessary funds to cater to the demands of the new immunization program. This risk can be mitigated by diverting funds from less important projects into this worthy cause. Also, there is the risk of facing lawsuits regarding the infringement of the right to religion. The stakeholders involved have to mitigate this risk through collaboration. This will ensure that a compromise is reached that best suits the parties involved.

Strategy for Key Stakeholders to Influence the Healthcare Executive’s Decision

The key stakeholders can influence the healthcare executive’s decision through advocacy and lobbying. Advocacy will entail the stakeholders educating the executive and creating awareness among the policy makers with regards to how they perceive the problem at hand (Williams, n.d.). The objective of advocacy is not to directly oppose or endorse the proposed legislation. Instead, it works to inform all those involved on the likely outcomes of the proposed legislation. This is vital in ensuring the executive is well informed before making its decision.

Lobbying on the other hand entails the steps taken to influence the executive to either oppose or endorse the proposed legislation (Williams, n.d.). There are two major forms of lobbying. The first one is direct lobbying. This is where the stakeholders will initiate direct communication with the legislators that will either vote for or against the proposed legislation. Second, there is grassroots lobbying where the stakeholders encourage the public to take a specific stand with regards to the proposed legislation. In turn, the public will sway the decision of the legislators. Overall, a combination of advocacy and lobbying will help the stakeholders influence the healthcare executive’s decision

How the Strategy for Key Stakeholders May Improve Population Health Outcomes

The strategy described above is quite effective in pushing a particular agenda forward. If used to push for the adoption of the proposed legislation, it will work towards the improvement of the population health outcomes in the State of Evergreen. Recently, there have been numerous outbreaks of diseases that are preventable through vaccine. In turn, this has strained the healthcare facilities in the area. The legislation will ensure that such outbreaks are eradicated or significantly minimized resulted in more people having positive outcomes because they will not be at risk of contracting such diseases. More so, the healthcare facilities will free up resources for other important problems.

Summary of the Analysis and Recommendations

From the analysis conducted, it is clear that whatever legislation is passed, it will not be fully supported by each stakeholder. Consequently, there is need to reach a compromise that will best suit all the parties involved. In this regard, the course of action that should be taken is to support the proposed legislation and ignore the counter-proposals. Specifically, the legislation that allows public school children from being exempted from immunization on religious grounds should be exempted. To ensure that the proposed legislation is implemented effectively, it will be crucial to reconcile the divergent needs and interests of the stakeholders. Individuals who do not wish to immunize their children because of religious issues should be given the alternative of taking their children to private schools. This may ensure that there is a leeway for these individuals to take their children to school without having their children being immunized.

References

Barraza, L., Schmit, C., & Hoss, A. (2017). The latest in vaccine policies: Selected issues in school vaccinations, healthcare worker vaccinations, and pharmacist vaccination authority laws. The Journal of Law, Medicine & Ethics, 45(1_suppl), 16-19.

Habas, C. (2019, December 5). 5 conflict management strategies. Chron. https://smallbusiness.chron.com/5-conflict-management-strategies-16131.html

Largeron, N., Lévy, P., Wasem, J., & Bresse, X. (2015). Role of vaccination in the sustainability of healthcare systems. Journal of Market Access & Health Policy, 3(1), 27043.

Pope, J. (2019, December 9). Importance of immunizations. Health Link BC. https://www.healthlinkbc.ca/health-topics/hw255342

NCSL. (2020, May 14). Immunization policy issues overview. National Conference of State Legislatures. https://www.ncsl.org/research/health/immunizations-policy-issues-overview.aspx

Williams, S. (n.d.). Advocacy vs. lobbying. Marion County Commission on Youth. https://mccoyouth.org/advocate/advocacy-vs-lobbying/