How Health Policy Advocates Mines FiscalNote Data to Build a Vaccine Scorecard

Health Policy Advocates is a boutique consulting firm focused on helping organizations, nonprofits, and coalitions reach their legislative priority goals at the state level. With a small team, technology is at the heart of HPA’s mission to keep the pulse of healthcare policy across the states and to be the eyes and ears keeping their clients informed and ready to take action.

“We adopted FiscalNote with the purpose of making HPA be that legislative hub for our partners, so we could monitor legislation and look at trends of health policy legislation that is moving through the states,” says Rekha Lakshmanan, managing director at Health Policy Advocates.

Lakshmanan’s background is specifically in vaccine policy so with the pandemic, she — and therefore HPA — has been uniquely positioned to advise her clients.

“We started to see significantly more pieces of legislation getting filed in the states,” she says. “Even doing a look back from the past couple of years, the volume of vaccine policies have exponentially grown.”

And that’s not an overstatement.

“To date, 2021 has seen an overall 249 percent increase in the total number of vaccine-related bills filed and specifically a 441 percent increase in the number of anti-vaccination bills filed when compared to 2018,” adds John Moore, primary consultant at Health Policy Advocates.

Scoring Vaccine Policy Across the United States

With the majority of the COVID-19 vaccine rollout coinciding with the end of the 2021 state legislative sessions, HPA decided to take FiscalNote’s data to the next level. Having the more than 900 vaccine-related bills organized in their customized issues folders in FiscalNote, they looked beyond the volume of legislation being introduced and analyzes what was getting enacted as well as the sentiment of the bills. This is how HPA’s 2021 Vaccine Policy State Legislative Scorecard was born.

“The scorecard came about as a way to look at the different kinds of bills, and then try to find how effective they were at getting through the process: actually making it to the governor's desk and getting enacted into law,” says Moore.

Data at their fingertips

Using FiscalNote, HPA is able to automatically track, tag, and sort relevant bills as they are introduced. For the scorecard, HPA sorted the bills as pro-vaccine, anti-vaccine, and neutral, then broke them out into categories based on the subject matter.

“Be it the requirements for vaccination, or the immunization information systems that states use to track records and things like that,” Moore says. “For example, especially with COVID-19, we've seen a lot of states adjust their regulations in terms of what kind of medical professionals can actually administer vaccines.”

Seamlessly building that system with FiscalNote and having everything organized, tagged, and categorized made the scorecard a possibility for such a small team.

The scoring criteria

HPA prioritized the scoring based on what had the most impact, so bills that actually passed scored higher than ones that were just introduced. Then they added the “pro, anti, and neutral” dimensions to the scoring system, giving pro-vaccine bills higher scores for helping improve the public health infrastructure or immunization coverage rates.

“If the bill ultimately helps improve immunization coverage rates and that bill gets through the process, then you get  a certain amount of positive points,” Moore says. “Now, if there's a bill that can significantly weaken the immunization infrastructure or can potentially decrease the vaccination rates and that bill is passed and enacted, then it gets more negative points because, at the end of the day, our lens is what is going to ultimately be beneficial to the overall public health.” 

Positive client reception

Using FiscalNote to capture the entire vaccine policy landscape at the state level and build this insightful and digestible scorecard aligns perfectly with HPA’s mission — and clients appreciate it.

“The way a lot of our clients are using the information is, as we go into 2022, they need to start strategizing and thinking through, ‘where do we go and deploy resources? What states do we need to think through and inject more resources into based on how they scored?’” Moore says. “Or they're also looking at it from, ‘these states have As and Bs; are there opportunities to be more proactive and think through those policy landscapes to identify what the policy needs and solutions are?’ So that's another way the data has helped support their strategy efforts.”

With these insights, HPA can use FiscalNote to go one level deeper and provide its clients with information on key stakeholders to help them build a holistic and actionable health policy strategy.

“Who is introducing these bills? Who controls those chambers or the governorship? Is this a bill that could actually get signed? Is it something that will end up being vetoed?” Moore says. “We started using the [FiscalNote] stakeholder features to not only follow lawmakers who are sponsoring these kinds of bills, but also those out there making public statements about vaccine policy.”

Regional Insights

HPA also uses FiscalNote to take a step back from looking at a vaccine policy within the individual states and glean insights at the regional level.

“What pieces of legislation are being filed on the East Coast? Are those similar to bills filed on the West Coast?” Lakshmanan says. “We're trying to identify if there is a concerted effort to try to introduce these kinds of legislation, or are they one-offs.” 

She highlights a specific example where, using FiscalNote, Moore was able to quickly run a report for all the western states and categorize bills based on the issues he’s tracking, including bill analysis and key talking points, marrying the public health aspect with political trends.

HPA shared that report with a client who, in turn, shared it with her board, other partners within the state, and even state lawmakers to call attention to the kinds of legislation they should be prepared for moving into the 2022 state legislative session.

Unlocking Success with FiscalNote

“What I appreciate about FiscalNote is that it is very user-friendly,” Moore says. “We look at it 99.5 percent of the time and the easy-to-use interface and comprehensiveness [is key].” 

He sees features such as the whipboard and outlook predictions, which give a sense of where and how bills will be moving through the process, becoming more important as the organization grows. HPA anticipates it will continue benefiting from these features as it incorporates more hands-on grassroots advocacy campaign management for clients using FiscalNote’s flagship advocacy platform VoterVoice.

“Our goal is to help our state partners position themselves and be ready to take action,” Lakshmanan adds. HPA credits having FiscalNote at its fingertips as a reason they can reach that goal.