39 th National Conference on Pediatric Health Care Be the CHANGE: Steps Toward Child Health Advocacy March 19-22, 2018 CHICAGO No Disclosures Disclosures Lacey Eden, MS, NP C & Karlen E. Luthy, DNP, NP C Learning Objectives Develop a clear understanding of the political procedures for passing legislation. Obtain tools and resources needed to move forward with creating and passing legislation in their state of residence. Empower NPs across the nation to be a CHANGE agent and advocate for their patients, not only in the office, but also through political activism Idea Legislator Constituent Special Interest Group/Lobbyist State or Local Government Agency Bill Sponsor Needed in House and in Senate Bill File Office of Legislative Research and General Counsel Can be protected Can be prioritized Bill Created Bill Drafting & Approval Bill is numbered (ie HB 100 or SB 100) Goes to Legislative Fiscal Analyst for Fiscal Note First Reading Introduced on Floor and Assigned to Rules Committee Lobbying Starts Here Assigned to Standing Committee A LOT of Lobbying Work in This Stage Second Reading Introduced Again on Floor and Committee Vote Reported Lobbying Continued During This Stage Third Reading Sponsor Explains Bill and Fields Questions Vote Held Process Starts Over in Opposite House If Amendments are Made: <15 words on House floor <10 words on Senate floor Must be relevant to original bill Protected Substitution with Amended Changes Released 1
If either house amends a bill, the bill is sent back to the first house If both houses do not agree on the amendment, the bill is sent back to the house that made the amendments If houses cannot reach an agreement, the bill goes to a conference committee. Need Constitutional Majority for Bills to Pass Signatures Speaker of the House President of the Senate Governor If the governor vetoes a bill: Legislature can override the governor s veto 2/3 of the House/Senate must be in favor to assemble a veto override session (must begin within 60 days of adjournment) 2/3 vote required in both houses for override New laws become effective 60 days after adjournment, unless otherwise stated in the bill. C: Collect H: Hinge A: Associations N: Negotiate G: Gather E: Expertise Be the CHANGE Know the facts C: Collect Data 2
C: Collect Community Immunity C: Collect Background Data The data shows that roughly one out of every four schools fail to meet the "herd immunity" rate for measles (MMR) or whooping cough (DTaP). A school has to have at least 92 percent in either category to protect all students. Exemption Rates Nationwide Graphic courtesy of cdc.gov 5 4.5 4 C: Collect Data Specific to Your Geographical Area Kindergarten Exemption Rates C: Collect Data Regarding Your Specific Issue Personal Medical Religious 4% 1% 3.5 3 2.5 2 1.5 1 0.5 0 2005/2006 2008/2009 2010/2011 2013/2014 2014/2015 95% Utah Department of Health (2016) Immunization Coverage Report. Retrieved from http://www.immunizeutah.org/pdf/2016immcovrpt/2016statereports/2016coveragereport_oct2017.pdf Utah Department of Health (2016) Immunization Coverage Report. Retrieved from http://www.immunizeutah.org/pdf/2016immcovrpt/2016statereports/2016coveragereport_oct2017.pdf H: Hinge H: Hinge Right Hinge and Right Location Everything hinges on education. Without it, you can t advocate for proper health care Susan L. Taylor 3
H: Hinge Comparison With Other States H: Hinge 13 States Require Parental Education Before Obtaining an Exemption State Immunization Program Manager Survey 33% 67% Required Education No Required Education In collaboration with: Association of Immunization Managers CDC H: Hinge Of The 13 States Requiring Exemption Education Exemption Education by Type 22% 33% 45% Not Interactive Interactive Non educational H: Hinge Barriers to Education 3.5 3 2.5 2 1.5 1 0.5 0 Barriers to Exemption Education Health Department Healthcare Provider Parental Interest Refusal to Participate Time Cost A: Associations Gather recommendations, feedback, and interested parties on the language in the bill Utah School Nurses Association Local Health Departments Utah Chapter of NAPNAP Utah Chapter AAP Utah Medical Association (UMA) Legislature N: Negotiate In The Beginning Carefully Select the Senator and House Representative to sponsor bill Needs political capital Needs power to negotiate Needs to be trustworthy Draft Bill Negotiation takes place through the entire process Make sure sponsor understands what points in the bill are negotiable and which points are non negotiable 4
N: Negotiate HB 302 HB 308 Sub 2: Public Health in Schools Require completion of online education prior to receiving exemption form Increase the frequency an exemption must be obtained 21 day conditional enrollment E: Expect to be the Expert Utah Chapter of the American Academy of Pediatrics Utah Nurse Practitioners Association Utah School Nurses Association Voices for Utah Children Utah Health Department PTA Association Utah Board of Education 5
E: Expect to be the Expert Provide Expert Responses E: Expect to be the Expert Dispell Anti Vaxxer Arguments Did you know there is an national organization that actually handles all vaccine injury cases. That means the CDC knows that immunizations are dangerous Did you know that the information insert found in the box of MMR vaccine actually states that it can cause autism? Did you know there is a MTHFR gene that, when given the MMR vaccine, will cause autism? A Few Final Thoughts Legislature Statements I am all for parental rights. Let the people govern themselves. Once children start dying from these diseases, parents will start to vaccinate again A Few Final Thoughts Politics is a Process Not an Event Even after a bill passes, your work is not done A Few Final Thoughts Lessons Learned It s not personal it s politics (Ok maybe it s a little personal) Loyal lawmaker Need help A Few Final Thoughts Tips to Improve Your Experience How to talk to your legislator Tell them real life stories Know funding capabilities Show them statistics How to be heard They receive SO many emails They have interns answer their phone They are being broadcast to ALL of the time Letters actually work! Let them know who you are 6