Topic 4 DQ1: Advocacy through Legislation Assignment Solution

This article covers a discussion about Advocacy through Legislation.


Topic 4 DQ 1     Choose a legislator on the state or federal level who is also a nurse and discuss the importance of the legislator/nurse\’s role as an advocate for improving health care delivery. What specific bills have the legislator/nurse sponsored or supported that have influenced health care?    

Topic 4 DQ 2     Research legislation that has occurred within the last 5 years at the state or federal level as a result of nurse advocacy. Describe the legislation and what was accomplished. What additional steps need to be taken to continue advocacy for this issue?

Advocacy Through Legislation

Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system.

For this assignment, identify a problem or concern in your state, community, or organization that has the capacity for advocacy through legislation. Research the issue and use the \”Advocacy Through Legislation\” template to complete this assignment.

You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance


Advocacy through Legislation


The current public charge policy has made it challenging for immigrants to access health care resources in fear of being deported. On October 4, 2019, President Trump proclaimed the issuance of suspension of entry to any immigrant that would financially burden the U.S. healthcare system. This proclamation aimed to prevent the entry of uninsured individuals and those unable to pay for their healthcare costs. The Supreme Court voted in favor of the proclamation. Its implementation would deny individuals seeking admission to the United States through consular processing.  Denial of entry includes some citizen’s family members who cannot prove some form of healthcare coverage within thirty days in the U.S. or lack financial resources to take care of the foreseeable medical expenses. Some consideration for the public charge determination would also impend health care delivery among the immigrants. The determination seeks to include public health benefits like non-emergency federally-funded Medicaid, Supplemental Nutrition Assistance Program (food stamps), federal housing assistance programs, and cash benefits for income maintenance. Considering previously excluded programs for public charge determination would decrease participation, contributing to more uninsured persons, negatively affecting health care delivery and family’s financial stability. It would also affect child health growth and development.
Idea for Addressing Solution
Immigrants today make up about 13 per cent of the U.S. population, and more than 60% of them have lived in the United States for more than 15 years. The public charge means that many immigrants would not want to be documented hence not eligible for public assistance like food stamps, Medicaid and Medicare, and social security. The public charge facilitates economic and social inequality, which affects health. The advocacy seeks to convince legislators not to consider vital public health benefits in determining the public charge rule. Nurses need to address this issue by advocating for vulnerable individuals within the healthcare settings. The American Nurses Association and International Council of Nurses require nurses to advocate for social justice. Advocacy through legislation is the best solution for the problem since policymakers play a pivotal role in public charge determination. Immigrants are among the most vulnerable populations in the U.S., and nurses should address the issue by advocating on their behalf at the hospital, community, state, and federal levels. Nurses should work together and use the ethical principles in their practical application to protect, promote, and optimize immigrants’ health and abilities. Nurses should contact all systems, organizations, and institutions that work with immigrant populations to pressure the legislators not to bring the new public charge amendment to effect. Nurses can also form or join coalition buildings such as the National Network for Immigrants and Refugee Rights and take advantage of volunteer and advocacy opportunities to improve immigrants’ health conditions. These coalition buildings and organizations have lobbyists that can bring the issue to Capitol Hill.  
Research the Issue
Biggerstaff, M. E., & Skomra, T. S. (2020). Nurses as Immigrant Advocates: A Brief Overview. OJIN: The Online Journal of Issues in Nursing, 25(2). & Skomra (2020) provide a brief overview of how nurses can advocate for immigrants. The authors argue that nurses’ professional and ethical responsibility to be social justice and vulnerable population’s advocates. Nurses interact with vulnerable people at all levels of the U.S. healthcare system. The article urges nurses to advocate for immigrants at the individual, community, state, and federal levels.
Vernice, N. A., Pereira, N. M., Wang, A., Demetres, M., & Adams, L. V. (2020). The adverse health effects of punitive immigrant policies in the United States: A systematic review. PloS one, 15(12), e0244054. et al. (2020) argue that punitive policies to control immigrants’ entry reduce immigrants’ access to health care resources since they instill fear, confusion, and anxiety. Many undocumented immigrants fear deportation, and the government should preserve and expand access to health care for undocumented immigrants. Nurses should also serve to protect and promote the health of vulnerable populations. This move would improve the health outcomes of citizens and non-citizens. 
Haq, C., Hostetter, I., Zavala, L., & Mayorga, J. (2020). Immigrant health and changes to the public charge rule: Family physicians’ response. The Annals of Family Medicine, 18(5), 458-460. et a. (2020) also discusses the confusion caused by the federal’s public charge rule changes. These changes have triggered confusion and anxiety among immigrants making them more reluctant to apply for public health benefits in fear of deportation. The authors encourage healthcare practitioners to address these concerns through referrals to legal and social services.
Stakeholder SupportOrganizations and institutions working with immigrants like Families For Freedom, United We Dream, and National Immigration Law CenterThese organizations assist immigrants, enabling them to obtain work authorizations, deportation relief, and help them go to schools and develop careers and families. These organizations engage in advocacy and grassroots mobilization, and they would fully support the idea to ensure immigrant rights are human rights.  
The American Immigration Council in coordination with federal judges.The federal judges were the first to block the new changes from coming into effect. The American immigration council works closely with the court system to protect immigrant rights by holding the government accountable for unjust treatment of immigrants. They ensure immigrants can present their case and work closely with federal judges to influence policy implementation.
Stakeholder Opposition
The Supreme CourtThe Supreme court voted in favor of the public charge rule to support the government’s effort of controlling immigrants’ entry into the U.S. The ruling would also reduce the government’s health care spending on immigrants. The only way to convince the court system is to provide evidence on the adverse effect of the public charge rule on immigrants’ health status.
The Immigrant Legal Resource Center (ILRC)The ILRC offers training and technical assistance on public charges to control immigrant entry and reduce overstaying. The ILRC determines whether an individual is eligible for a green card or visa by assessing dependability on federal benefits in the future. Together with organizations assisting immigrants, we can reduce and influence the grounds of inadmissibility and considerations for the determination of the public charge.  
Financial Incentives/Costs
The government seeks to reduce spending and the financial burden associated with the immigrants’ surge in the U.S. However, the issue has negative financial implications on the U.S. economy. With the new changes, many immigrants would become inadmissible, affecting a total annual income of about $53.6 billion. The U.S. will suffer an indirect economic loss of about $37.4 billion. The total cost to the economy would be over $91 billion. Many other sectors of the economy, such as hospitality and food services, personal and general services, construction, manufacturing, and natural resource and mining industries with many immigrant workers, would also suffer (New American Economy, 2019). The public charge affects around 255,000 immigrants, hurting many businesses and the economy. The idea seeks to prevent the inclusion of specific benefits that affect immigrants’ health in the public charge rule. The idea would strengthen the financial stability of many immigrant families since they would access Supplemental Security Income, Supplemental Nutrition Assistance Programs, and Medicaid. Immigrants would have more access to healthcare resources without fear of deportation. The government would also incur a financial burden to expand access to health care resources to the immigrants.
 Legislature: Information Needed and Process for ProposalName of legislator and contact informationCongresswoman Eddie Bernice Johnson (D-TX-30) Dallas District Office 1825 Market Center Blvd. Suite 440 Dallas, TX 75207 phone: (214) 922-8885 fax: (214) 922-7028
Steps of presenting the idea to the legislatorStep 1: Writing a letter to the legislator. The letter should be factual and respectful with a water-tight argument of why removing vital public health benefits accessible to the immigrants from the public charge determination is critical. Step 2: Appealing to the legislator to consider the issue as a threat to the health and wellbeing of 13% of the U.S. population. Step 3: Making a special request to the legislator to oppose the inclusion of essential public health benefits and assistance in the public charge determination for inadmissibility. Step 4: Including personal encounters with immigrants who cannot access health care resources for being undocumented and fear deportation. Step 5: Helping the legislator recognize the impact of the public charge rule on concerned citizens and how I appreciate her work of helping improve access to healthcare resources for everyone Step 6: If necessary, arrange a personal meeting to emphasize my idea.
The process if the legislator chooses to introduce the idea as a bill to congress.Step 1: A representative will sponsor the bill. Step 2: Assigning the bill to a committee for study Step 3: The committee releases the bill Step 4: The bill is put on a calendar for voting, debating, or amending Step 5: If the bill passes majority, it moves to the senateChristian Principles and Nursing AdvocacyThe Christian worldview preaches equality for all populations, including low-income families and ethnic minorities. Proverbs 31:8-9 says, “Speak up for those who cannot speak for themselves, for the rights of all who are destitute. Speak up and judge fairly; defend the rights of the poor and needy.” Also, Deuteronomy 16:20 says, “Follow justice and justice alone, so that you may live and possess the land the LORD your God is giving you.” Biblical advocacy calls for congressmen and women to do what God called them to do, considering that 88% of them claim to be of Christian faith. There are also many instances in the Bible that show advocacy. Moses negotiates for the Israelites using his connection to the Pharaohs. Esther also risks everything to advocate for her people. Christian advocacy is without bias and considers all human beings as having an intrinsic value and should be treated with respect. The Bible teaches that everyone was created in God’s image and likeness and should be treated equally despite gender, culture, race, or religion. Christians care for the sick and the needy, offering support in aid and developing health care facilities to improve health outcomes. 

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Advocacy through Legislation
Advocacy through Legislation


Biggerstaff, M. E., & Skomra, T. S. (2020). Nurses as Immigrant Advocates: A Brief Overview. OJIN: The Online Journal of Issues in Nursing, 25(2).

Haq, C., Hostetter, I., Zavala, L., & Mayorga, J. (2020). Immigrant health and changes to the public charge rule: Family physicians’ response. The Annals of Family Medicine, 18(5), 458-460.

New American Economy. (2019). The New “Public Charge” Rule and Its Negative Impact on the U.S. Economy. Retrieved from,to%20more%20than%20%2491.0%20billion.

Vernice, N. A., Pereira, N. M., Wang, A., Demetres, M., & Adams, L. V. (2020). The adverse health effects of punitive immigrant policies in the United States: A systematic review. PloS one, 15(12), e0244054.

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