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Influenza Vaccination Of The Health Care Workforce, Alexandra M. Stewart

Health Policy and Management Faculty Posters and Presentations

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The Affordable Care Act: U.S. Vaccine Policy And Practice, Alexandra M. Stewart, Orriel L. Richardson, Marisa A. Cox, Katherine J. Hayes, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

When fully implemented, the Patient Protection and Affordable Care Act, amended by the Health and Education Reconciliation Act will extend health insurance coverage to 94 percent of Americans while establishing a comprehensive set of strategies to improve care and contain costs. The central provisions of the Act – guaranteed affordable and accessible coverage – take effect January 1, 2014. Important insurance reforms aimed at improving coverage become effective before that date, as do a series of investments aimed at improving the accessibility and quality of health care.

This report has several aims: 1) to examine how the laws address vaccine …

Mandatory Vaccination Of Health Care Workers, Alexandra M. Stewart

Health Policy and Management Faculty Publications

New York State’s regulations require health care workers who have direct contact with patients or who may expose patients to disease to be vaccinated against seasonal and H1N1 influenza. Courts must take into account Constitutional guarantees of personal autonomy, freedom of contract, and freedom of religion when reviewing the current lawsuits. These rights, however, have been constrained when they conflict with government measures that are intended to protect the community’s health and safety. Health care workers have a profound effect on patients’ health. Although they have the same rights as all private citizens, it is likely that courts will continue …

Analysis Of The Extent To Which State Insurance Laws Mandate Coverage And Payment Of Vaccines And Vaccine Administration Fees During Periods Of Declared Public Health Emergencies, Sara J. Rosenbaum, Nancy Lopez, Ross Margulies

Health Policy and Management Faculty Publications

This analysis examines whether state insurance laws require health insurers, as a condition of doing business, to pay the costs associated with the administration of immunizations during declared public health emergencies. As is the case with the current H1N1 emergency, a public health emergency triggers nationwide distribution of free vaccine. But even when vaccine is distributed free of charge, its administration poses costs to private physicians and charges can be significant. As a result, the Institute of Medicine has identified vaccine administration as a potential financial barrier to care. Most communities have limited numbers of public health workers and professional …

Use Of Revised International Health Regulations During Influenza A (H1n1) Epidemic, 2009, Rebecca L. Katz

Health Policy and Management Faculty Publications

Strong international health agreements and good planning created a structure and common procedure for nations involved in detection and evaluation of the emergence of influenza A (H1N1). This report describes a timeline of events that led to the determination of the epidemic as a public health emergency of international concern, following the agreed-upon procedures of the International Health Regulations. These events illustrate the need for sound international health agreements and should be a call to action for all nations to implement these agreements to the best of their abilities.

Vaccines And Autism: The Evidence And The Law, Alexandra M. Stewart

Health Policy and Management Faculty Publications

A potential link between the measles-mumps-rubella vaccine and autism was dismissed by a federal vaccine court in February 2009. The U.S. Department of Health and Human Services said the findings demonstrate a lack of medical evidence for any association, while Autism Speaks, a patient advocacy group, said questions remain about potential risks for certain subgroups.

Other legal actions are pending as the scientific and patient advocacy communities debate the need to conduct further research on the vaccine-autism link. Meanwhile, public health advocates worry that continuing concerns about the safety of vaccines may depress the population immunization rate. A small rise …

Hpv Vaccination: Should It Be Recommended Or Required?, Alexandra M. Stewart

Health Policy and Management Faculty Publications

Legislation introduced by two members of the District of Columbia Council on January 9, 2007 would require all girls to be vaccinated against the human papillomavirus (HPV), the primary cause of cervical cancer, by the time they enter the sixth grade, unless a parent or guardian specifically "opts out" of the mandate. A similar bill was introduced last week in Virginia, and Maryland and West Virginia are poised to consider legislation. To place the proposals in a broader context, this paper reviews some of the scientific, legal, ethical and financial issues surrounding the HPV vaccine and compulsory vaccinations.

The Epidemiology Of U.S. Immunization Law: Translating Cdc Immunization Guidelines Into Practice: State Laws Related To The Use Of Standing Orders Covering Immunization Practice, Alexandra M. Stewart, Marisa A. Cox, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

This pilot study examines how five states -- Georgia, Massachusetts, New York, Oregon, and Texas – approach the legal question of delegation of medical practice powers in an immunization practice context.

The Epidemiology Of U.S. Immunization Law: Immunization Requirements For Staff And Residents Of Long-Term Care Facilities Under State Laws/Regulations, Alexandra M. Stewart, Marisa A. Cox, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

Medically appropriate, timely immunizations are an important component of the medical plans for approximately 1.6 million individuals who reside in the nation's long-term care (LTC) facilities. Increasing the immunization rates among these persons is a recognized public health goal. LTC facility residents are often members of high risk groups and are more susceptible to infectious diseases. The elderly, many of whom reside in LTC facilities, comprise 90% of the 36,000 annual deaths from influenza. Immunizations are equally important for employees of LTC facilities. Immunizations not only improve the individual's health status, but staff who have direct contact with residents represent …

The Epidemiology Of U.S. Immunization Law: A National Study For The National Immunizations Program, Centers For Disease Control And Prevention: Medicaid Coverage Of Immunizations For Non-Institutionalized Adults, Sara J. Rosenbaum, Alexandra M. Stewart, Marisa A. Cox, Alexis Lee

Health Policy and Management Faculty Publications

As a health policy matter, coverage of immunizations and their administration for all ages at levels recommended by the Advisory Committee on Immunization Practices (ACIP) has grown in importance for several reasons: 1) the growing attention to both manmade and naturally occurring public health threats; 2) recognition of the value of immunization to society; and 3) the relatively high cost of at least certain immunization services in relation to personal income. No population stands to benefit more from immunization coverage than low income persons.

Studies suggest that adult immunization status is particularly low, and that financial barriers play a role, …

The Epidemiology Of U.S. Immunization Law: Mandated Coverage Of Immunizations Under State Health Insurance Laws, Sara J. Rosenbaum, Alexandra M. Stewart, Marisa A. Cox, Shawnte Mitchell

Health Policy and Management Faculty Publications

Immunizations represent both basic clinical care as well as an essential public health activity with population-wide health implications, and for a number of reasons, the focus on national immunization policy has intensified in recent years. Insurers and employee health plans may cover immunization services as a matter of benefit design choice. Federal and state insurance laws also may mandate coverage of one or more classes of immunization services. For approximately 100 million persons who are members of state-regulated health insurance plans, state law plays a primary role in determining coverage. Thus the extent of state immunization health insurance mandates is …